Dr. Martin Williams has twenty years experience as an expert witness on the standard of care in therapist-patient sex and other ethics matters involving psychologists, clinical social workers, marriage and family therapists, and psychiatrists. In Therapist-Patient Sex Twenty Years Later: A View From the Courtroom, the psychology expert witness writes:
Despite the current ethics and enforcement climate-a climate that can best be described as zero tolerance for sex with patients-cases of therapist patient sex still occur. But while the cases continue to arise, they are different in certain regards from the earlier cases that came to light in the 1970’s and 1980’s. What follows is a description of some differences I have observed in my own consulting practice between therapist-patient sex as it occurred in the earlier, more naive era (let’s say, before 1980) and the current era (let’s say after 1995). One caveat is that numerous types of sampling error and bias are built into any such first-person account. I hope to provide illustrative examples that might lead to further discussion, and I acknowledge this is by no means a scientific survey.
In the earlier era, the therapist could convince himself-the male pronoun is used intentionally because most of the offenders were men-that the sexual behavior might be a helpful part of treatment. I believe that some, if not most of the offenders, who pitched this line to their female patients, actually believed it themselves. They told their patients that the patients needed to open up to intimacy, needed to overcome their fears regarding their sexuality, needed to break out of their shells, needed to learn body-acceptance, trust and so on.
While these arguments in support of sex with the therapist may have been cynical manipulations created by the therapist merely to seduce the patient, they also may have been sincerely stated-however false such arguments may be viewed by the rest of the professional community. Because in the former era there had been so little discussion of therapist-patient sex, the therapist could convince himself, as he convinces his patient, that this particular intervention had not been studied, could result in benefits to the patient, and had been rejected out of hand due to an anti-sexual, puritanical bias. Note that many of the known cases of therapist-patient sex occurred during the so-called “sexual revolution,” a time in our society when sexual experimentation of all kinds was seen as more acceptable. Indeed, during the 1970’s, Masters and Johnson and other sex therapists incorporated “sex surrogates” into their treatment. Perhaps, at the time, it was seen as only a short leap for the therapist himself to offer to serve as a male sex surrogate as a way to directly resolve the patient’s sexual issues. The therapist may have told himself that he was forward-thinking, if not cutting edge, and that lowering the barriers to sexual expression would benefit both therapist and patient. Like much else that went on in the name of the sexual revolution, today these ideas seem dated, wrongheaded and destructive.
Excerpted from National Psychologist, March 2008, with the author’s permission.