Analyst-Patient Sexual Involvement: Clinical Experiences and Institutional Responses

This symposium represents a major step forward in our profession's growing awareness of the role of sexual trauma in the lives of patients. A quarter of a country of increasing interest on the part of the public and scientific community has led to an outpouring of scientific reports and a major change in the way we listen for sexual trauma in our patients, as well as a change in the way we educate students entering the mental health professions to be sensitive to the presence of such events. This is hardly the case when we consider the phenomenon of sexual boundary violations by psychotherapists and psychoanalysts, a particularly egregious form of sexual trauma. Unfortunately, in this area there is still a curtain of silence drawn around the sexual exploitation of patients by psychoanalysts; as a consequence, there are very few publications in this area. Psychoanalytic clinical data is data is virtually absent in this literature.1

Why has there been such silence about this issue? I would like to suggest that our silence has been due to the same forces within us that