Professional-Patient Relations

Publication Title: 
Bulletin of the Menninger Clinic

The causes of therapist-patient sex are complex and multidetermined. Efforts to understand why psychotherapists transgress sexual boundaries are hampered by the lure of reductionism and oversimplification. Most of those who examine this issue would prefer to categorize all such therapists as "bad" and "corrupt" as a way of distancing themselves and disavowing any similarities between these therapists and themselves.

Author(s): 
Gabbard, G. O.
Publication Title: 
Professional Psychology, Research and Practice

This article invites reconsideration of the American Psychological Association's policy permitting sexual involvement between therapists and their former patients under certain conditions. The article (a) restates 5 major concerns about sex after termination that have not been adequately addressed; (b) examines 9 major arguments set forth in support of allowing posttermination sexual relationships, all of which appear ill-founded, fallacious, or misleading; and (c) describes 6 obstacles that seem to hinder attempts to create sound legal and professional policies in this area.

Author(s): 
Gabbard, G. O.
Publication Title: 
The International Journal of Psycho-Analysis

The author argues that seduction is not primarily a fantasy but a 'real' situation, which lies at the heart of the other two allegedly primal major scenarios: castration and the primal scene. This statement is not to be confused with an event-based realism, as, for this to be achieved, a third category of reality must be postulated. This reality, constantly misconstrued by authors as corresponding to material and psychological reality, is that of the message conveyed and, more specifically in the case of analysis, the enigmatic message.

Author(s): 
Laplanche, J.
Publication Title: 
Intensive & Critical Care Nursing

The ambulance service should offer good care signified by humane and individual treatment of the patients, based on love to our fellow man. The aim of this study was to find out how loving care was practised in one ambulance service. The method for the study was the critical incident technique. Twelve paramedics, the majority of whom are qualified nurses, took part in the study; they were asked to describe, in writing, critical incidents in which they had acted with loving care.

Author(s): 
Wahlin, U.
Wieslander, I.
Fridlund, B.
Publication Title: 
American Journal of Psychotherapy

To avoid the passions of love and hate between them, therapists and patients construct and preserve negative barriers of angry criticism, dissatisfaction, and sadomasochism. This review aims to help therapists tolerate and work with loving feelings between patient and therapist for the benefit of the patient.

Author(s): 
Coen, S. J.
Publication Title: 
American Journal of Psychotherapy

The study of sexual boundary violations, through the actual evaluation and treatment of therapists who have engaged in sexual misconduct, reveals that all of us are potentially vulnerable to violations of this nature. A number of lessons can be learned from the detailed examination of these cases. These lessons include the following: (1) There is a difference between the conscious and unconscious intent of the therapist.

Author(s): 
Gabbard, G. O.
Publication Title: 
The Journal of Analytical Psychology

The literature on erotic transference and countertransference between female analyst and male patient is reviewed and discussed. It is known that female analysts are less likely than their male colleagues to act out sexually with their patients. It has been claimed that a) male patients do not experience sustained erotic transferences, and b) female analysts do not experience erotic countertransferences with female or male patients.

Author(s): 
Schaverien, J.
Publication Title: 
The Journal of Psychotherapy Practice and Research

The intimate nature of the psychodynamic psychotherapy process requires that trainees be educated to deal competently with sexual and loving feelings that arise during psychotherapy. The absence of substantive teaching on these complex treatment issues places a responsibility on the psychotherapy supervisor to educate trainees about the erotic aspects of transference/countertransference. A model of supervision addressing sexual feelings in treatment relationships is proposed and discussed with reference to clinical vignettes.

Author(s): 
Bridges, N. A.
Publication Title: 
Journal of the American Psychoanalytic Association

Even though Freud said that "the secret of therapy is to cure through love," the "unobjectionable" positive countertransference has remained a neglected topic in clinical and theoretical writings. This paper explores a number of personal and historical reasons to account for this avoidance. A case vignette is presented to highlight the facilitating and therapeutic role of the positive countertransference. It also demonstrates the analyst's struggles with his loving feelings and some of the reasons behind this conflict.

Author(s): 
Fox, R. P.
Publication Title: 
The International Journal of Psycho-Analysis

In this paper the author explores the relationship, first formulated by Freud, between depression and the experience of losing one's feeling of being able to love. She emphasises the narcissistic organisation underlying depression and depressive anxieties, and argues that the defences used to protect against such anxieties frequently produce the very states of mind they are supposed to be defending against.

Author(s): 
Roth, P.

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