Dissociation among Psychoanalysts about Sexual Boundary Violations

Abstract

The official condemnation of all sexual contact between psychotherapists and patients can be called the “absolutist position.” Some therapists harbor private views that differ from the absolutist position, such as the view that such relations may be more acceptable if they lead to a happy marriage, the “relativist position” or the “empathic-sentimental” position. A few clinicians have condoned such relationships, claiming that they are helpful to patients at least half the time, which is not supported by research. Mending the disconnection among public, private, and unconscious views may lead to more consistent and fair handling of sexual boundary violations.

Keywords:

• boundary violations
• sex with patients
• psychoanalysis
• psychotherapy
• erotic transference
• Fromm-Reichmann

Notes

¹ It is hard to believe that the husbands or families of female patients gave consent to such treatment and agreed to pay for it.

² This is quite close to the finding of Dahlberg (1970). In his relatively informal survey, in one case out of nine (11%), the sexual interaction between psychoanalyst and patient had no apparent harmful effect.

Additional information

Notes on contributors

Mark J. Blechner

Mark J. Blechner, Ph.D., is editor emeritus of Contemporary Psychoanalysis. He has published three books: Hope and Mortality (1997), The Dream Frontier (2001), and Sex Changes: Transformations in Society and Psychoanalysis (2009). At the William Alanson White Institute, he is training and supervising psychoanalyst. As founder and director of the White Institute's HIV Clinical Service (1991–2001), Dr. Blechner led the first psychoanalytic clinic devoted to working with people with AIDS, their relatives, and caregivers.