What Happens When You Want to Fuck Your Patient and Other Confessions of a Therapist

The resident Gawker therapist, Anonymous, is a licensed therapist who treats many different patients, but specializes in teens and couples therapy. After many years in the field, Anonymous has lots of stories and insight to share. We'll be publishing some of them here. Today: the tricky sexual tensions that sometimes develop between therapists and patients.

If you have any questions you'd like to ask our therapist, send them to gawkertherapist@gmail.com with the subject line "Therapist." We'll use the most relevant ones for publication.

So what happens when you become attracted to a patient you're treating? Does that complicate the process?

I have been sexually attracted to a patient, and moreover, been incredibly emotionally and psychologically attracted to a patient. During the therapeutic process you get to know a patient so deeply that many connections arise. It is undeniable that as much as you try to be professional, you develop a genuine caring for specific patients. Sexual attraction at first appearance is superficial, but once you get to know someone's personality, the more or less attractive they become.

In a twisted sense, perception of attractiveness in a therapeutic setting is no different than in any other social venue, except I have the advantage of inherent trust and knowing them at a deeper level in a facilitated time frame. Plus, it is a game of probability. I have seen thousands of patients in my career, which increases the chances of attraction and connectedness.

But yes, it is difficult to deal with feelings of attraction towards a patient, especially when you are trying so hard to fight and deny them and remain professional. It compounds the difficulty when there is a connection with the patient, they are mutually attracted to and seducing you, or even in extreme cases when they idolize you, your work, or how you have helped them and they are fulfilling natural human ego needs in me. You have to remind yourself of your role, that their attraction/seduction may be part of a destructive or manipulative pattern of their behavior, and try to remain as benign and bland as possible to allow the therapeutic process to take effect. Another great motivator in dealing with those feelings is the knowledge that if I act on the feelings I may lose my credibility, my family, my practice, and my license to pactice psychology. Fear is always a great motivator.

But when it does happen, how do you adjust the treatment?

With that being said, attraction does not play a major role in how I treat a patient. First and foremost, I have slept with my fair share of attractive partners, so human aesthetics do not blow me away. In addition as I stated earlier, attractiveness tends to fade or increase based upon the discovery of their personality. Being aware of your issues is key to combating this. I neither want to be physically attractive or overly charming in the eyes of my patients. I would rather be viewed as competent and someone who is a vehicle to them leading a better quality of existence. I also don't want to portray myself as attainable and intentionally deceive my patients. Part of my effectiveness is in the mystery of who I am and what I am really about, that the less-indepth knowledge they have the less the have to connect or attach to.

Even with this level of insight, certain feelings are unavoidable. One time in my career, upon termination of the therapeutic relationship, did a patient and I acknowledge a connection and an attraction, almost in the presentation that we could exist together in another lifetime. It was as strong as a connection as I have ever felt for someone, but unacted upon. Where it had its lasting effects was in my own marriage and my own questioning of my choices and the reality of my feelings for my partner. I would idealize my relationship with my patient and become confused about the feelings with my partner, when in reality I was ignoring circumstantial elements in my marriage that did not exist with my patient that may have lead to some issues of detachment in my own relationship. Hence, issues in marriage and child-rearing that often breed stress and contempt did exist with my one time per week patient.

What about former patients? I've heard of many people having affairs with their therapist after the fact.

Yes. It has. One former patient and I kept in correspondence a few times a month and when they came home on break from college or, after that, when they would visit their family we would go out to lunch and catch up. There was certainly an emotional and physical connection between us that was rather intense and acknowledged yet unacted upon. I can honestly say that our connection was one of the top three interpersonal connections I have ever experienced in my life. I have acknowledged that the roles our relationship began under—therapist and patient—did play a role in our perceptions of each other and allowed us to easily identify the needs we could fulfill in each other.

That's intense. So I presume it was consummated?

In the early winter of what would be the sixth year since our therapeutic relationship had ended, my spouse and I were invited to a wedding. My spouse was friends with the bride, and unbeknownst to me at the time, my patient was related on the groom's side and was also in attendance at the wedding. My patient had since moved away and our telephone and personal encounters had diminished due to schedule and proximity. Nothing was lost in our feelings between each other and after they had a few drinks we found our way to her room in the hotel, sneaking off of course, to engage in 10 minutes of the most intense, long-awaited, built up make-out session of my life that had indicated an unparralled chemistry and compatability.

Ethically, I feel like some may call my behavior into question. And they could probably question my choice to proceed given the fact I was married with children. But there was something so right about this. I had known this person since they were a teenager and had guided them through an incredible developmental process that yielded them happiness and success. They admired me. And they represented all in the world that was good and pure. They gave me hope and allowed me to believe again. We knew each other as who we were, who we are, and who we wanted to be while simultaneously having the utmost respect for each other and the utmost trust that we had each others best interest in our hearts.

As luck would have it my spouse was going away for a weekend with friends and my patient was in town for another week. We had made plans for them to come to my house after I put my kids to bed when my spouse was away. My patient was gorgeous, tatooed all over with a perfect body. For the next two nights, after my kids were asleep, we fucked and sucked and kissed and held until they had to go before sunrise. It was the ultimate physical and emotional expression and outlet.

I will always remember those two nights as the most intense and intertwined sexual experience of my life, not just on a physical level but on an emotional and psychological level as well. It will be the "rosebud" on my death bed. I still to this day cannot decipher if the complexity or taboo of our therapeutic relationship had made our experience what it was, or maybe it was as simple as two people with the right connection just happened to be a therapist and a patient.

And do you still keep in touch with this person after that? Do you regret it?

Though I still keep in contact with them, they have moved far away and are now married with a child of their own. I have never had a physical encounter with another past or present patient. We have discussed our fond memories of our past together and that taking our relationship to a physical level has helped increase our feelings of connectedness to each other even though we have both moved on in our lives. So I have absolutely no regrets.
