Read Part 1 Here
Although the sexual relationship between a client and therapist is the topic of multiple books and movies, it is actually a fairly rare phenomenon in real life. Up until this moment of truth with Dr. John my few experiences with this type of infraction occurred within the first two years of graduate school. During my first week of training, my Ethics professor gave all of the students a list of psychologists who had recently lost or had their licenses to practice suspended. The modal reason listed was having a sexual relationship with a client but the number of professionals on the list was actually quite small.
This suggested to me that this behavior was at least somewhat rare or that licensing boards didn’t often find out about it. The professor stared admonishingly at me, the only male in the class, as he read through the list of mostly male names. This implied that these sorts of relationships occur with primarily male therapists. Or maybe patients don’t turn in female therapists because they are so thankful to be getting some. Later on in my training, a clinician at the local mental health center was fired for having a “dual relationship” with a client. I wasn’t given any specifics on the matter, but the rumor was that the relationship was sexual in nature. I heard that they got married one year later. And divorced one year after that.
Why is it such a big deal? Two consenting adults, right? A sexy therapist like you, Rob, it’s okay if clients want a “truly therapeutic experience,” right? Wrong. Once a client is in my care, there is a clear and inherent power differential: I know things about him or her, extremely personal and painful things, while very little and generally superficial information is known about me. Once more, if you are doing your job correctly, a client could see you in a skewed manner, as an ideal in many ways: a great listener, always in a positive mood, constantly trying to be helpful, etc. A vulnerable client who sees her therapist only in “therapist mode” can become easy sexual prey, and you simply do not take advantage. I’m flawed in many, many ways as a therapist (and as a person), but getting personally involved with clients is not one of those ways. Many in the field see providers who engage in dual relationships as either predators or as having their own, deep-seated psychological issues that they are trying to resolve. Is John a neurotic? A sociopath? Wait, a neurotic sociopath?!
ULTIMATE THERAPIST RULE #1: No dual relationships with clients, whether it be sexual, business, or social in nature.
ULTIMATE THERAPIST RULE #2: When a moronic colleague (John) is breaking rule #1, you are ethically required to confront him and resolve it, so that higher powers (e.g., licensing boards) do not need to be involved. If you cannot resolve the situation, your ethical obligation is to report the heinous violator.
Working on a piece of tiramisu, John doesn’t seem disturbed by my look of “What the fuck is wrong with you?”
“You know how when people’s cell phone reception cuts out,” he bitches, “and they start shouting instead of just hanging up? It’s like they think that they can improve the connection by yelling or something. Man I fucking hate that.”
“John, you’re not addressing the issue.”
“Or those people who walk around with those things on their ear? The Bluetooth-thing? They look like they’re talking to themselves! I want to inject them with an anti-psychotic or something.”
John puts down his fork and starts snapping his fingers around the room, probably assuming that he can make a cup of coffee appear by doing so. “I haven’t done anything,” he confesses. “Yet. There’s just a mom or two that have hinted that they’d like a piece of the John Love. And who can blame them? Just look at me! And for the record, they aren’t clients, they’re mothers of clients. And this one that I have my eye on is a true MILF.”
“But it’s still a dual relationship with the kid, John.”
“How the hell do you figure that? That makes no sense.”
“Of course it does. If you start spreading around your John Love to your client’s mom or, even worse, moms, you’re no longer the kid’s therapist, you’re his therapist and his mom’s boyfriend. That’s the definition of a dual relationship, stupid.”
“No you’re stupid!”
“No, you’re stupid!” I look around, and people are starting to stare. “Is this how Ph.D.’s are supposed to talk?”
“Probably not,” John chuckles, “but having a degree doesn’t mean you’re not just a regular guy, right?”
“I understand you’re a man, a man with needs. Some people who are not me might even say that you’re a good therapist. But think about the client. I’m sure you talk with the mother as part of his treatment, yes?”
“Yeah.” John frowns.
“Isn’t child therapy essentially parent-child therapy. You don’t see the kid in a vacuum, you work with the parents as well. How could it stay professional if you’ve slept with her, or even had dinner with her? You won’t be able to do your job properly, and the kid’s going to suffer because of it. And have you thought about your license, for Christ’s sake? You worked for six years after college to get that thing!”
“Alright, fine! Jesus, you’re a buzzkill. Do you want some coffee, or does the caffeine make you lamer than you already are?”
“Sure, let’s live dangerously tonight.”
“Would you have reported me if I had gone through with it?”
“Fuck, don’t ask me that.”
“What if I stopped seeing the kid? You know, refer him to someone else?”
ULTIMATE THERAPIST RULE #3: From the moment the client comes through the door, you have a professional relationship with him or her, and that status should be permanent. Once a client, always a client.
“Jesus Christ. Assuming you hit it off with the MILF, not only are you likely to spend time with him socially, but what if he wants to come back to therapy at some point with you. You’re taking away a relationship that he might really love and need, and you’re simply replacing it with someone else.”
“True, I am a superior product, no doubt.”
“Yes, I’m sure you are.”
“They do want me, you know,” John points out.
“No, they want what they see, which is a therapist and, although highly unlikely, a good one. They don’t really know you and if they did, they’d realize they can do better.”
“Pay closer attention to your clients, you’ll see the Stare of Lust in their eyes. Trust me.”
I recalled previous sessions with clients, trying to note any Stare of Lust, but I drew a blank. I’ve had clients ask me if I was single or what my plans were for the weekend, but that was completely innocent, right? The idea that Psychologists might be highly desirable stuck with me for the next couple of days, and I must have taken John’s words to heart to at least some degree, as evidenced by my interaction with a late 20’s woman outside a local bar.
“Hi, I’m Rob. It’s nice to meet you. What’s your name?”
“Bonsoir, Rob. I’m Suzie.”
Hmmm, the accent is British, but she’s using a French salutation. Should I respond in kind with French? Oh it doesn’t matter, I’m a Psychologist, and therefore highly desirable.
“So Suzie, what brings you to town? The ‘Gorgeous Women of Europe’ Convention?” I try to wink at this feeble come-on, but because of the smoke the she is gently blowing in my face, I end up blinking at her, slowly and dry-eyed.
“Oh Rob, you are the charmer indeed. I’m actually here for support. My friend who lives in New York is pretty shook up about losing her brother.”
“I see. That sounds really hard. That’s really nice of you to come all this way to help her. How long are you here for?”
“About a week, it’s so depressing not to be here for fun. What do you do, Rob?”
She’s on the hook! Just tell her what you do and prepare for the Stare of Lust.
“I’m a Psychologist,” I say proudly. And therefore you want me.
“Really?” she says, with eyes widening. “That is so cool. I’ll bet you love your job, you know, helping people?”
I look closely, but I can’t really see a Stare of Lust. A Stare of Admiration maybe? That might work.
“I do enjoy my job,” I say, mentally flexing my biceps.
“So Rob, maybe I could take your card?”
Damn, John was actually right about something. “Of course, feel free to call me anytime. Being in the field I am, I love good ‘conversation.'” I’m quite pleased with this sexual innuendo, which is sad.
“No, it’s for my grief-stricken friend, you wanker,” she says, looking disgusted. “For an appointment.”
I give her my card, which she sticks in her purse with one hand as she flicks away her cigarette with the other. She then goes into the bar, leaving me on the street. As if on cue, it starts to rain.
“Stupid John and his Stares of Lust theories,” I grumble as I walk down the wet street. Maybe I’m a just very poor judge of who is interested in me. Or – God no! – what if I’m not as attractive and charming as I think I am?