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Typology of Sexually Abusive Mental Health Professionals
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Chesler, in her book "Women and Madness," indicates victims report that
the professionals who abused them were going through life crises or changes. If
you recall Russ, the therapist that treated Mary, indicated he was unhappy with
Chesler indicated one victim, who felt that her psychiatrist was
too familiar during her first session with him, reported that "he kissed
me, and asked if he could visit me on his way home." She cancelled any follow-up
sessions and later discovered "the psychiatrist was in the process of a divorce."
Josephine, whose female psychologist had recently gone through a marriage breakdown,
confided, "She kept telling me that I was uptight about my body. So she suggested
that we go to the nude swimming session at the YWCA together. Afterwards, she
asked me back to her apartment."
sex was a common experience with abusive professionals, as described by the
nine women abused by therapists in the Chesler study. The professional appeared
to be interested only in his or her own sexual needs, and had no interest in the
emotional or sexual gratification of their patients or clients.
♦ Incest Victims
states there is a tendency for professionals to abuse incest victims shortly after
they disclose their abuse. This could be linked to a perception of the incest
victim as having been "publicly deflowered" and therefore no longer
deserving of protection or respect. Thus the mental health professional may view
the incest victim as "fair game," and may excuse his or her seduction
of the client by telling themselves that they cannot do the client any further
The abused child, trained as to please men, may engage in a kind of ritualized seductive behavior that arouses the professional and permits him to believe that
she has an adult desire for sex with him. Because the victim has low self-esteem
and may believe that no man will care for her without a sexual relationship, she
may feel that sexual involvement with the professional is a necessary price to
pay for his attention.
♦ Stone's 6 Types of Sexually Abusive Mental Health Professionals
on his clinical experience, Alan Stone proposed a typology of sexually abusive
mental health professionals. Interestingly, Stone makes no mention of female
therapists. We'll discuss his focus on male therapists later. The six types of
therapists are as follows:
1. The therapist who is middle-aged,
depressed, and has problems in his own marriage. He usually gets involved with
a younger female client, to whom he tells his troubles. Sometimes the client is
led to believe that the therapist is contemplating divorcing his wife and marrying
2. The manipulative and sociopathic therapist is exploiting
his position and its opportunities with a goal of self-gratification.
3. The therapist who uses patients to satisfy perverse instincts. This group includes
therapists who drug their patients into unconsciousness and then have sex with
them. Unlike the other examples, this does not involve an exploitation of transference,
of the patient's view of the therapist as a parent- like figure.
4. The charming, expansive, grandiose therapist who wants to be loved by his female
patients, particularly if they are young and attractive. He initiates hugging
and kissing early in the therapy, and goes on from there.
therapist who sees himself as "progressive" and believes that this includes
sexual contact with his patients.
6. The introverted and withdrawn therapist who is very uncomfortable with interpersonal intimacy. If a patient
appears to be intensely sexually attracted to him, he succumbs. He may contend
that the patient seduced him, but is likely to feel guilty and will probably confess.
♦ Schoener's 6 Types of Sexually Exploitative Therapists
typology of sexually exploitative therapists, again with six categories, has
been developed by Schoener and his associates at the Minnesota Walk-In Counseling
Center. The clusters are as follows:
1. Naive and uninformed: This
group includes trainees and poorly trained therapists who may lack knowledge of
professional standards and the importance of boundaries.
or mildly neurotic: Minimal sexual contact or comprises in a single episode
leading to remorse and requests for help are common.
Severely neurotic: This group has severe, long-standing emotional problems
and focus on getting their personal needs met in the work setting. As intimacy
grows in a therapeutic relationship, these therapists play seductive games, talk
about themselves, use touch excessively, and arrange business or social involvements
4. Character disorders with impulse control problems: These therapists have a variety of problems which may include legal difficulties;
they have little or no appreciation of the effect of their impulsive and inappropriate
behavior on others, and tend to deny or minimize any harm they have caused.
Sociopathic or narcissistic character disorders: These therapists are adept
in manipulating clients and professional colleagues; they are cool and calculating,
able to cunningly seduce a variety of clients and cover their tracks.
Psychotic or borderline personality disorders: These therapists are more obviously
mentally ill, with poor judgment and a tenuous grasp on reality.
do you feel after hearing this list of Stone's typology of sexually abusive mental
health professionals? Do you feel a knot in your stomach right now? Is this material
difficult for you to hear? I know for me it is because the thought of this existing
in our profession is unthinkable. However, as stated at the beginning of this
CD, it is hoped that by bringing these "uncomfortable" professional
imbalances to light, the veil of secrecy will be somewhat lifted from this emotionally
charged area, which most have felt is not an actual issue to be considered for
- Schoener, GR, PhD Boundaries
in Group Therapy: Ethical and Practice Issues. Women and Group Psychotherapy,
New York, Builford Press, 2001.
Peer-Reviewed Journal Article References:
Farkas, M. (2011). Review of Personal recovery and mental illness: A guide for mental health professionals [Review of the book Personal recovery and mental illness: A guide for mental health professionals, by M. Slade]. Psychiatric Rehabilitation Journal, 35(2), 158–159.
Pathé, M. (2014). Guiding mental health professionals through murky waters. Journal of Threat Assessment and Management, 1(1), 25–26.
Spaulding, W. (2016). Introduction to the special section: Mental health professionals with mental illness. American Journal of Orthopsychiatry, 86(6), 603.
What are the six categories listed in Schoener's typology of abuse?
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