I put this request onto my Facebook page:

Another request for help with some research…

There’s a paragraph in Scott Peck’s The Road Less Traveled about adultery: something to the effect that if an affair with someone else was not abusive, was mutual/consensual – even a therapist  with a client – and he could be persuaded that the affair might be of therapeutic value, he would consider pursuing it (all my words, from recollection). I remember speaking at a conference of counselors in the Pacific Northwest of the U.S. and this paragraph was the #1 discussion-topic around the coffee-urn…

Does someone have the reference? And, if you have a bit of time, the actual wording?

One profound response:   ‘Like I always say, psycho babble’

(Remember, it’s Facebook 🙂

A Christian psychologist:    If he did say it from a professional perspective it would ALWAYS be unethical. It can never be truly consensual in. Therapeutic relationship as there is always a power imbalance.

Another:    There is a good reason why you get struck off for a therapist/client relationship, because a heart on fire (or just the loins) is so good at justifying the way to what it wants that only a blanket rule is safe.

~~~

Now here are the offending paragraphs (from the chapter titled Love and Psychotherapy,  Arrow Books Ltd, London, 1991, pp. 188-189:

If the psychotherapist  cannot genuinely love a patient, genuine healing will not  occur. No matter how well credentialled and trained  psychotherapists may be, if they cannot extend themselves  through love to their patients, the results of their psychotherapeutic  practice will be generally unsuccessful. Conversely,  a totally uncredentialled and minimally trained lay  therapist who exercises a great capacity to love will achieve  psychotherapeutic results that equal those of the very best  psychiatrists.

Since love and sex are so closely related and interconnected,  it is appropriate to mention here briefly the issue of  sexual relationships between psychotherapists and their  patients, an issue that is currently receiving a good deal of  attention in the press. Because of the necessarily loving and  intimate nature of the   psychotherapeutic relationship, it is  inevitable that both patients and therapists routinely  develop strong or extremely strong sexual attractions to each  other. The pressures to sexually consummate such attractions  may be enormous. I suspect that some of those in the  profession of psychotherapy who cast stones at a therapist  who has related sexually with a patient may not themselves  be loving therapists and may not therefore have any real  understanding of the enormity of the pressures involved.

Moreover, were I ever to have a case in which I concluded  after careful and judicious consideration that my patient’s  spiritual growth would be substantially furthered by our  having sexual relations, I would proceed to have them. In  fifteen years of practice, however, I have not yet had such a  case, and I find it difficult to imagine that such a case could  really exist. First of all, as I have mentioned, the role of the  good therapist is primarily that of the good parent, and good  parents do not consummate sexual relationships with their  children for several very compelling reasons. The job of a  parent is to be of use to a child and not to use the child for  personal satisfaction. The job of a therapist is to be of use to  a patient and not to use the patient to serve the therapist’s  own needs. The job of a parent is to encourage a child along  the path toward independence, and the job of therapist with  a patient is the same. It is difficult to see how a therapist who  related sexually with a patient would not be using the patient  to satisfy his or her own needs or how the therapist would be  encouraging the patient’s independence thereby.

Many patients, particularly those likely to be most  ‘seductive, have sexualised attachments to their parents  which clearly impede their freedom and growth. Both  theory and the scant bit of evidence available strongly  suggest that a sexual relationship between a therapist and  such a patient is far more likely to cement the patient’s  immature attachments than to loosen them. Even if the  relationship is not sexually consummated, it is detrimental  for the therapist to ‘fall in love’ with the patient, since, as we  have seen, falling in love involves a collapse of ego  boundaries and a diminution of the normal sense of   separation that exists between individuals.

The therapist who falls in love with a patient cannot  possibly be objective about the patient’s needs or separate  those needs from his or her own. It is out of love for their  patients that therapists do not allow themselves the indulgence of falling in love with them. Since genuine love  demands respect for the separate identity of the beloved, the  genuinely loving therapist will recognise and accept that the  [patient’s path in life is and should be separate from that of  the therapist. For some therapists this means that their own  bind the patient’s paths should never cross outside of the therapeutic hour. While I respect this position, for myself I  find it unnecessarily rigid. Although I have had one experience in which my relating to an ex-patient seemed to be definitely detrimental to her, I have had several other  experiences in which social relationships with ex-patients deemed clearly beneficial to them as well as to myself. I have  been fortunate enough to successfully analyse several very close friends…

~~

To which a friend not on Facebook responded italics his):

Hi Rowland,

Thankyou for forwarding this passage from Peck. It’s a long time since I’ve read the book and I’d forgotten this passage. Bit of a brain teaser.

What perhaps strikes me most is his apparent internal inconsistency. On the one hand, he says “it is inevitable that both patients and therapists routinely develop strong or extremely strong sexual attractions to eachother”, with “enormous” pressures “to sexually consummate such attractions”. He says this arises from “the necessarily loving and intimate nature of the psychotherapeutic relationship”. And he appears to defend therapists who have sex with their patients by denigrating their critics as unloving stone-casters who don’t “have any real understanding of the enormity of the pressures involved.”

This is almost tantamount to saying therapists who have sex with patients are poor misunderstood innocents who very understandably and very excusably succumb to irresistible pressures.

Having said all that, he then turns around and says “I find it difficult to imagine that a case [for sex with a patient] could really exist.” I take his word for it that in 15 years he hasn’t had such a case himself, but “difficult to imagine” is a bit of a stretch, given what’s gone before.

But perhaps I’m missing the point. Perhaps he’s making a distinction between an understandable, even inevitable, and genuinely loving — but improper and invalid — sexual involvement with a patient on the one hand; and on the other hand, a proper, valid, therapeutically beneficial, life-enhancing and affirming sexual involvement with a patient. And in relation to these two kinds, perhaps he’s arguing that there’s no such thing as the latter — ie, it’s never proper or valid.

In which case, why put forward a purely hypothetical case in which “I would proceed to have [sexual relations with a patient]” if “my patient’s spiritual growth would be substantially furthered [thereby]”? To put it another way, why raise a hypothetical only to dismiss it out of hand in the very next sentence, by saying he can’t imagine such a hypothetical case “could really exist”? Surely the whole point of a hypothetical is to put forward something that can be imagined, not something that can’t.

His claim that he would have sex with a patient if it was for the patient’s own good (by “furthering [his or her] spititual growth”) is disingenuous and misleading when immediately followed by two declarations, (a) that it’s never happened in 15 years, and (b) that it’s [virtually certainly] not going to in the future.

Why not come straight out and say, I’ve never had sex with a patient, and I never would, because I believe it would be wrong for the reasons outlined below. Why does he outline these (quite valid) reasons if he’s still open to the possibility that “I would proceed to have them (ie sexual relations)”?

One other borderline inconsistency. He needs to be more careful with the use of the word “love”. On the one hand he says, “If the therapist cannot genuinely love a patient, genuine healing will not occur”, and therepists “who exercise a great capacity for love will achieve [the best] results.” He then immediately links this love to sex as being “so closely related and interconnected”, so he’s hardly talking about filia or agape.

He later says, “therapists do not allow themselves the indulgence of falling in love with [their patients]”.

This is probably nit-picking, but I just think the distiction between “genuinely loving” and “having a great capacity for love” on the one hand, and “falling in love” on the other, should have been more unambiguously drawn.

Here endeth my 2 cents’ worth.

(Rowland: worth more than 2c my friend!).