Having Sex With My
Client
Steve Reedy
Professional Issues
and Ethics
W. Dubnov, Ph.D.
November 28, 2006
Abstract
This is an ethical scenario where
I am given the opportunity to consider the possibility of having sex with one
of my clients. Through writing this I hope to gain a better understanding of
what might possibly go through my mind if such an event occurs.
Having Sex With My Client
It
appears that the field of psychology has changed a great deal over the past few
decades. What was once a playground for philosophical thought and
experimentation has been reshaped into a profession that seems more suitable
for a medical doctor than an artist of the mind. This change seems to have been
brought about by those who wished to create a profession using an ethics code
that would serve to protect not only the client, but also the therapist from
harm. While I understand that some deem it necessary to place restrictions on
those who enter the psychological profession, I begin to wonder, as I do when
any kind of restriction is placed on me, why am I being restricted and who is
doing the restricting. Due to my rather religious upbringing, and the insanity
it ultimately caused, I am very weary and cautious of being constrained to the
rules and regulations that serve to inhibit my thoughts and behavior based on
someone else's perception of what is right and what is wrong. Right and wrong
are subjective in nature, and therefore questionable. Unfortunately, the plasticity
of subjective reasoning could ultimately make it difficult for me to understand
exactly what to do in certain ethical situations if the motivations for my
actions are based only on the unaccommodated suggestions of others. Even though
these suggestions may be enforced by various forms of consequence and
punishment, if I do not find a way to accommodate them into my own ideology, I
am only abiding by the rules of others to avoid punishment, which does not
necessarily make me an ethical therapist.
An
ethical therapist appears to be more of an achievement created by the
transformation of thought through a greater understanding of cause and effect.
An ethical therapist is not someone forced into being by the use of
consequences. Consequences only serve to create an obedient therapist. The
problem with obedience is that it often feels like submission, which can
ultimately lead toward a form of unconscious rebellion to regain dominance.
Those who have not taken the time to understand the logic behind the ethics
they incorporate into their practice may find themselves unable to make
appropriate decisions when met with experiences that go against their ethical
standards.
The question I
find myself asking is, should I blindly follow the restrictions placed on me by
my profession? Should I do something simply because someone tells me to? No,
because if I do then my decision to act is not my own and therefore has no
strength behind it. This makes my decision impersonal, weak, and therefore
unstable against opposition. Because of this I intend to use this essay to
question my thoughts on what I would do in a certain therapeutic situation that
could be considered unethical according to those who govern our profession. In
researching this particular ethical dilemma, it appears to be almost epidemic,
and therefore quite possibly something I will have to contend with at some
point in my career. I'm talking about sex, and the possibility of having it
with one of my clients. As of right now, I can honestly say that I will not
have sex with any of my clients. I can also say that I will not create a
romantic relationship with any of my clients. Now, what I say and what
ultimately happens in the future depend largely on the strength behind my word.
It is my hope that, by looking more closely at my thoughts on sex within the
client/therapist relationship, I will better prepare myself for dealing with
such a situation rather than simply relying on the echo of someone's voice
saying, "it's wrong."
We begin
with the scenario. A client has become sexually attracted to me. She is
beautiful, intelligent, and has been coming to therapy every other week for the
past six months to work through some problems she is having with her mother,
who has moved in with her until they are able to find her an assisted living
program that her mother agrees upon. My client has been divorced for over ten
years and doesn't have time to date due to the pressure of her job and the
extra time she spends taking care of her mother. Our sessions have dealt mostly
with the frustration she was experienced in making the right decisions for the
care of her mother. The guilt she felt for placing her mother into an assisted
living program instead of allowing her to continue living at her home caused
her a great deal of stress and was affecting her job and her life. During our
sessions together she was able to work though her guilt and decided that the
assisted living program would be the best choice since it would be able to
provide care at all hours of the day and night. Last week she told me that she
felt her next session would be her last. She felt as if a tremendous burden had
been lifted off her shoulders and was eternally grateful for the time we spent
together. She also said that she found me very attractive and was wondering if
we could get together sometime. She told me she wasn't looking to date anyone,
but thought it might be nice to hang out. Before I knew what was happening, she
gave me a long passionate kiss and walked out the door. A week has passed and
she is about to arrive for her last appointment. I'm single, alone, and
extremely attracted to her. What do I do?
Well, I
know what the American Psychological Association says; by absolutely no means
am I to have any kind of sexual contact with my client (APA, 2002). Of course,
I could wait until after the last session is over except, according to the APA,
"psychologists do not engage in sexual intimacies with former clients /
patients for at least two years after cessation or termination of therapy" (APA,
2002, 10.08). Even after two years it is frowned upon, especially if there was
any mention of having a sexual relationship before termination. At first
glance, there doesn't appear to be any problem with her offer except it seems
to go against APA standards. Her therapy had nothing to do with any kind of
relationship problems, codependency, childhood trauma, or any personality
disorders. She instigated the kiss. She invited me out. Normally I would not
consider dating a client, but now that she is terminating her sessions, I do
not see any problem with accepting her offer. It seems harmless. Because of
this I might decide to forgo the standards of the APA and go out with her.
Sex, to
me, is one of the most amazing experiences you can share with another human
being. Mitchell (2002) said that, "the very physical intensity of human sexual
physiology requires a juxtaposition of persons, their excitements, their
pleasures, their fantasies, their fears, their longings, their hopes - the
entire range of mental life can come into play" (p. 59). He goes on to say
that, "because it provides such powerful material for emotional experience,
sexual desire in humans has become our most intimate arena for personal and
interpersonal expression" (Mitchell, 2002, p. 60). Why wouldn't I want to share
this with a beautiful woman who is no longer going to be my client and is
obviously interested in me?
The very
fact that I am questioning this shows that the APA standard of Ethics, and the
consequences for not following them, are not powerful enough alone to deter me
from trying to validate why it may be appropriate to have sex in this
particular example. The possibility of being the target of a lawsuit, convicted
of a felony, having my license revoked, loosing my insurance coverage, loosing
my job, and facing possible incarceration where I could wind up being someone's
prison bitch should be enough to convince me to say no. But, again, those are
just punishments designed to keep me from doing something I obviously want to
do. So, there is a possibility that these threats may not be enough to convince
me not to act because they were created by someone else, and are therefore
subjective.
The
fundemntal problem is that I have spent a greater part of my life blindly
subservient to the rules and regulations of a confused and corrupt government
and misguided religious leaders. Over the past six years I have gone to great
lengths to create my own perception of reality. Because of this I question all
authority and law, weighing them against experience and personal belief.
Therefore, restrictions, threats, and punishment do very little to change my
perception. In fact, they often provoke curiosity in the very thing they are
trying to dissway me from experiencing.
When a
law or restriction is created to protect us against a worse case scenario, it
tends to use generalizations which undermine the reality that the circumstances
behind each situation are different and may prove harmless to those involved
depending on their state of mind. For example, the rules and consequences I am
questioning appear to be designed for the soul purpose of protecting my client
against possible harm and manipulation. I am intending to do neither, so why
should they apply to me? In fact, looking over this particular ethical
scenario, it seems as if it would be a playful and innocent sexual encounter
between two consenting adults. In this case, it would appear that the rules and
punishments should not apply and therefore serve only as an obstacle, and
obstacles can be overcome.
By
transforming the ethical guidelines created by the APA and our lawgivers into
an obstacle, I find myself becoming more focused on the sexual act than the
possible emotional repercussions that could arise from the experience. I am not
thinking of the possibility that the experience could ultimately give her a
"distrust for therapists and the therapeutic process, guilt, depression, anger,
feelings of rejection, suicidal ideation, and low self-esteem" (Corey, Corey, and Callanan, 2007, p. 299).
I have given no thought to the fact that I have created a perception of her
based on our limited experience together and, "perceptions of the world around
us, including other people, are influenced by both the way things really are
and by our imaginative elaborations of the way things are and our fantasies of
how we would like things to be" (Mitchell, 2002, p. 105). Am I seeing things as
they are, or as I would like them to be?
I know I
have been attracted to my client since the moment we met. Is it possible that I
have created a fantasy of her that is clouding my better judgment? Is it
possible that I somehow lead her on, hoping that she would make the first move?
Is it possible that she is ending her therapy sessions so that we can have a
sexual relationship? After all, I didn't suggest she continue seeing me, and
she may still have some unresolved issues with the guilt she was feeling toward
her mother. Could this be a way for her to avoid dealing with some form of deep
emotional issue? Could she have a problem with sexual intimacy or use sex to
avoid dealing with bad situations? There appear to be more questions than
answers, which usually indicates that the action is not worth the possible
outcome.
By
thinking as a therapist instead of a single and sexually aroused male, I begin
to wonder how much of what I thought was going on really was taking place. I
realize that, though I may see nothing wrong with having sex with a client
under certain circumstances, there may be something I am not seeing. There is a
great quote by Stephen Mitchell referring to the expression of love, "If 'I'
give my love to you, what exactly am I giving and who is the 'I' making the
offering, and who, by the way, are you?" (Mitchell, 2002, p. 183). In
any relationship, sexual otherwise, we begin with a perception of the other
based on our limited understanding of them. Over time, we hopefully move
forward in a way that dismantles our initial perception so that we may see the
other as their true self. Often in a sexual relationship we place an identity,
a fantasy, into our partner, which is played out in the heat of passion.
Because of this, we may never truly know the person we are with, and therefore
can never know what may be the result of our actions. Suddenly something that seemed
harmless now seems extremely complicated.
Complicating
the situation further is the idea that to maintain a positive relationship with
my client I must create a loving and empathetic caring for her, "a caring which
demands no personal gratification" (Cochran
and Cochran, 2006, p. 82). Plus, there is the belief that any form of
sexual contact with a client or even ex-client, no matter how innocent it may
seem, ultimately "represents an abuse of trust and power and is always
self-indulgent and antitherapeutic"(Kottler, 2003, p. 91).
Upon
further study, the ethics standards proposed by the APA appear to be more of a
guideline than an obstacle fraught with limitation and punishment. It would
appear that to avoid the possibility of making a mistake in judgment, it would
be wise to incorporate the APA ethical codes of conduct into my own ethical
standard to give me a stronger foundation for dealing with ethical questions
than merely relying on the fear of punishment.
Applying
this to the scenario I presented, I would begin our final session by explaining
my concern with what occurred at the end of our previous session. I would talk
about the kiss hopefully in a way that would not leave her feeling guilty or
disimpowered. Depending on how she reacts, I may also ask her to consider
continuing our sessions, thereby giving her at least the opportunity to use the
relationship we created to explore herself further. In doing so I uphold the
professionalism of my position and possibly prevent unperceived repercussions
that could prove disastrous to the health of my client, myself, and my
profession.
References
- Kottler, J. (2003). On being a
therapist. 3rd ed. San Francisco: Jossey-Bass.
- Mitchell, Stephen (2002). Can
love last. New York, NY: W. W. Norton & Company, Inc.
- Corey, G, Corey, M, & Callanan,
P (2007). Issues and ethics in the helping professions.Belmont: CA:
Thomson Brooks/Cole.
- Cochran, J, & Cochran, N
(2006). The heart of counseling. Totonto, Ontario: Thomas Nelson.
- American Psychological Association.
(2002). Ethical principals of psychologists and code of conduct. American
Psychologist, 57,(12), 1060-1073.
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