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Balancing the Power Dynamic in the Therapeutic Relationship

Section 2
Therapist Self-Awareness

Question 2 | Test | Table of Contents

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If you are uncomfortable with the topic of physical contact boundaries and the balance of power with the mental health professional, take a second to do some honest soul-searching to see if your self-talk falls into one of the following categories.

5 Categories of Therapist Self-Talk

♦ Category #1. The "Bad Apple" Theory
This first one is what I call the "Bad Apple Theory." It goes something like this: therapists who abuse clients are "Bad Apples" that bear no relation to the rest of the mental health profession.
If you feel this way... I feel your belief may be fueled by the few cases of repeated sexual abuse by a professional whose cruel and bizarre behavior seems far removed from that of a caring and compassionate mental health professional.

It's easy to write these people off as sociopaths and take an "us-them" attitude, but, in fact, problems with the "balance of power in the therapeutic relationship" are a perpetual difficulty for therapists. Sometimes the line dividing abuse, impropriety, and unethical professional behavior is blurred. This blur is indicated in the articles found in this course.

♦ Category #2. Do You Want to Blame the Victim?
Secondly, regarding your self-talk and this attitude assessment exercise, at a certain level, do you want to blame the victim? Even when the sexual violation is recognized, we may find ourselves looking at the victim's emotional problems or personality traits. After all, haven't we all counseled clients who are on the borderline of reality that could misconstrue even the most innocent remark or gesture as a sexual violation?

As you may know, focusing on client characteristics is a common strategy used by lawyers who defend sexually abusive mental health professionals. We would like to pathologize the client to such an extent that they appear to exonerate or partially exonerate the professional. I have found, in my practice, a typical description of female clients who were sexually involved with their therapists was often depicted by the opposing council as "hysterical" and promiscuous.

♦ Category #3. Sexism
Thirdly, regarding your self-talk, ask yourself, is sexism involved in your thinking? The old saying, "Hell hath no fury like a woman scorned" seems to underlie feelings of some judges in our court system today. One of my clients, I'll call Mary, was found by the court to be making "false allegations." The court felt these allegations were vindictive acts against her male therapists, whom the court felt Mary perceived as being disinterested and rejecting.

♦ Category #4. Therapists Never Feel Attracted to Clients!
Fourthly, for whatever reason, you may feel that therapists never feel attracted to their female clients. I'm surprised, when I talk with other mental health professionals, because they see therapists as benign, compassionate eunuchs, so to speak, far removed from the trials and tribulations of ordinary people. Some view all therapists as dedicated and nurturing parental figures. Think about it... this belief is carried over into college and university training programs, where there is little or no instruction pertaining to sexual attraction to clients.

♦ Category #5. What is Your Professional Code of Ethics?
Fifth, in this attitude assessment is: what is your professional code of ethics? Do you feel we are totally able to police ourselves, so to speak? Do you feel mental health professionals are able to stand apart from their biases, like the ones just mentioned?

Peer-Reviewed Journal Article References:
Conlin, W. E., & Boness, C. L. (2019). Ethical considerations for addressing distorted beliefs in psychotherapy. Psychotherapy, 56(4), 449–458.

Cox, J. R., Martinez, R. G., & Southam-Gerow, M. A. (2019). Treatment integrity in psychotherapy research and implications for the delivery of quality mental health services. Journal of Consulting and Clinical Psychology, 87(3), 221–233. 

Goldner, L. (2016). Therapists’ self-perception, attachment, and relationship: The role of selfobject needs. Psychoanalytic Psychology, 33(4), 535–553. 

Kim, S., & Rutherford, A. (2015). From seduction to sexism: Feminists challenge the ethics of therapist–client sexual relations in 1970s america. History of Psychology, 18(3), 283–296.

Knapp, S., Gottlieb, M. C., & Handelsman, M. M. (2017). Self-awareness questions for effective psychotherapists: Helping good psychotherapists become even better. Practice Innovations, 2(4), 163–172.

Rubel, J. A., Bar-Kalifa, E., Atzil-Slonim, D., Schmidt, S., & Lutz, W. (2018). Congruence of therapeutic bond perceptions and its relation to treatment outcome: Within- and between-dyad effects. Journal of Consulting and Clinical Psychology, 86(4), 341–353.

What are some biases against the validity of the topic of the Sexual Abuse of Power by therapists toward their clients? To select and enter your answer go to Test.

Section 3
Table of Contents