Patient-therapist sexual contact. I. Psychodynamic perspectives on the causes and results

The problem of patient-therapist sexual contact is a substantial one, perhaps involving 5-10% of male therapists, and we suggest that the structure of psychotherapy and abundance of rescue fantasies make it inevitable. While skeptical of claims that there are any positive effects, we catalogue many negative effects: ambivalence and mistrust of subsequent therapists; patients doubting their own sense of reality; childhood trauma repeated and fixated instead of being interpreted; bondage to the offending therapist; original complaints of sexual dysfunction and problems in intimacy with men are exacerbated; burdens of guilt and shame carried by the patient; fantasy aspects of sexuality difficult to discuss in subsequent therapy, and the abrupt ending of the relationship leaving patient stranded and/or disorganized.