The Sensuous Psychiatrists

From the June 19, 1972 issue of New York Magazine.

Are you sure you want to sleep with your psychotherapist? One New York woman, who thought she was sure, came away even more distressed after she had joined her doctor on the couch than she had been before. It simply did not work, not even as sex. For her it was the ultimate sexual failure. If she couldn’t have an orgasm with her psychoanalyst, whom could she have an orgasm with? But it may not have been her fault. At the risk of superficiality, it should be pointed out that many therapists are lousy lovers. They may not be very good doctors either.

The woman’s therapist had told her that she was blocked; that there were things she had to work out about her father; that perhaps they could solve them on a nonverbal level if she would trust him. She said that she trusted him.

The doctor stood up and dropped his trousers. He did not even take off the rest of his clothes.

The doctor told her, “Take your pants down.”

He got on top of her. He had an orgasm. She didn’t.

She said, “I’d like to get on top of you.”

The doctor told her that that was her problem: she wanted to be in control.

Affairs between male therapists and their female patients seem to be increasing, especially in New York and to a certain extent in California. William Masters and Virginia Johnson talked to many women who said that they had had sexual contact with their psychotherapists, and concluded, “If only 25 per cent of these specific reports are correct, there is still an overwhelming issue confronting professionals in this field.”

Now, for the first time, some doctors are willing to defy the taboo against even discussing the subject. A Greenwich Village psychologist says that doctors should sleep with patients, but “very rarely. If they do, they should send them to another doctor. You lose your objectivity. I know I do.” This psychologist wears an antelope-skin coat, likes to tell World War II stories, and gestures with the longest finger of his right hand. He says that he often treats other psychotherapists who sleep with their patients and who come to him for help in resolving the “guilt” and “conflict” precipitated by these relationships.

Another New York doctor said, “There may be occasions where sleeping with a patient might be catastrophic. I have known it to occur where nonetheless the therapy has proceeded pretty well.”

Dr. Martin Shepard recently published a book called The Love Treatment: Sexual Intimacy Between Patients and Psychotherapists in which he writes, “A sexual involvement can indeed be a useful part of the psychotherapeutic process.”

But it is usually harmful. A 31-year-old secretary last year filed suit in Supreme Court against New York psychiatrist Dr. Renatus Hartogs, accusing him of forcing her to have sexual relations with him “under the guise” of psychiatric treatment. Asking $1,250,000 in damages, she claimed Hartogs had caused her “irreparable emotional discomfort and harm and aggravated her psychiatric condition.” (When reached for comment, Dr. Hartogs said that the suit was dropped six months ago.)

The use of the couch for a direct attack on frigidity and other problems of female discontent might, in theory, sound like a brave new experiment. In practice, however, it often turns out to be nothing but a new variation on a very old routine: exploitative sex. The doctor who joins his patient on the couch often helps her about as much as the master who joins his maid in the linen closet. In fact, some doctors actually treat their patients as if they were maids or other such female helpers, using them as secretaries, typists, babysitters, errand runners, plant-dusters and therapy assistants. Not only do these therapists generally favor cliché social roles (with the man on top) but they also seem to prefer cliché sexual roles (with the man on top).

I interviewed eleven women—nine from New York and two from California—who had had sexual relations and/or affairs with their therapists. (Two had had affairs with the same doctor.) I located these women through talking to colleagues in the profession and simply by asking groups of women if anyone in the room had slept with her therapist. Four of the women were married, four separated or divorced, and three single. The husbands of the four married women were in treatment with the same therapists at the time of the sexual contact, which suggests the familiar use of women in the service of male competition. The doctor-patient affairs lasted from one night to eighteen months.

Nine of the ten therapists assumed a “missionary” position during sexual intercourse for the first time and in general throughout the sexual treatment. Seven of the women did not experience orgasm the first time; four women never did throughout the treatment; seven of the women eventually experienced orgasm after from one to nine months. Four of the therapists had difficulty maintaining an erection.

Many of the women described being humiliated and frustrated by their therapists’ emotional and sexual coldness.

Cindy (fictitious names are used throughout) told the following story: “He’d interpret everything I said as ‘transference love’ or sexual desire for him, but there was very little affection between us. We started having a drink after the session was over; then one night he said he wanted to see what my place looked like. We got undressed all at the same time and we went to bed together. And it was a very strange thing, there was almost no tenderness or prelove play. I remember thinking afterward when I said ‘That was great’ or ‘That was very good’ … thinking that it wasn’t, really… . Then, all of a sudden, he said, ‘Excuse me I have to make a train,’ because his wife was sitting out in the Bronx with his kid. I’d never slept with a married man before. It was probably the coldest affair I’ve had in my life.”

Joyce: “He was always on top of me. And he said things to me, too. Dirty things. And he wanted me to say them back to him. It was extremely stimulating. I was being very whorey. I was depraved and he was a beast, he grunted and groaned louder than any animal I had ever heard. He asked, ‘Does the thought of having another couple watch stimulate you?’ ‘Should I smack you on the behind?’ He said he wouldn’t hurt me, not in the face, but in the behind. I was beginning to get terrified.”

Stephanie: “It took ten minutes. He jumped up, washed in the bathroom and was back at his typewriter. I thought we’d talk till four in the morning. If anyone should know what he’s doing, a therapist should. If I don’t have an orgasm here, then it’s really my fault.”

“… Some doctors use patients as secretaries, typists, babysitters, errand runners …”

I am opposed to sex between female patients and male therapists not out of puritanism but because such affairs generally seem to do more to harm patients than to help them. One crucial problem with such affairs is that they reinforce the female tendency to be what has come to be considered as “feminine”—to love Daddy and to violate the incest taboo. In our society, little girls are taught to respect, depend upon and try to please their fathers. When they marry or have relationships later on, they are generally expected to choose men who in many ways are father-like—men who are older, wealthier, stronger, taller, and better educated than they are. Most doctor-patient sex is a psychological form of such “incest” as well as being medically unethical and legally questionable.

Most seductive therapists are father figures. The eleven women interviewed ranged in age from 22 to 45, with an average age of 31. The average age of the male doctors was 47, making them an average of sixteen years older than their patients. With the exception of one woman, the earning capacity and educational levels of these women were never more than a fraction of those of their therapists. Two were students, three secretaries, two housewives, one a waitress, one a recreational counselor, one a saleswoman, and one a sociologist. Candy, in a book by that name, was, like the women I interviewed, in search of soul-healing. Being female, she found sex, not God or herself, with the “help” of her various male spiritual teachers. But Candy finally realized, as many women never do, “Good grief, it’s Daddy!”

The patient may be in search of a father and/or happiness, but what is the doctor in search of? Dr. Charles C. Dahlberg was one of the first to break into the sometimes Victorian learned journals with an article on this hypocritically forbidden subject. In a study called “Sexual Contact Between Patient and Therapist,” published in 1970 in Contemporary Psychoanalysis, Dahlberg concluded that the seductive therapist is generally “withdrawn and introspective, studious, passive, shy … (more) intellectually (than) physically adventurous … This adds up to being unpopular with the opposite sex. None of this stops a person from having fantasies of sexual conquest. It may even encourage sexual fantasies.” Such typically “deprived” men now find themselves in a professional position where many young women may be expressing fantasies of sexual desire for them. They can’t help being flattered.

Dahlberg draws a composite portrait of the “seductive” therapist, who is usually over 40; from 10 to 25 years older than the patient; always a man; the patient is always a young female; most are married; many experience premature ejaculation with their patients; some terminate therapy or payment for therapy once sexual contact begins but others continue both therapy and payment.

Female therapists rarely if ever sleep with their male patients. I finally located one female therapist in New York who had, but this took place in an atmosphere in which her husband-therapist had all but abandoned her for sexual relations with many of his young female patients. There have also been a few reports of male therapists sleeping with male patients, but this is rare. Male patients who are propositioned generally find it easier to say no than women do.

Perhaps male therapists, like male artists in our society, are seen as, or fear themselves to be, more feminine than business executives, soldiers or politicians. It is therefore important to them to be able to “have” as many women as do their presumably more masculine counterparts.

Sexual encounters between patients and their therapists may be a relatively new phenomenon in New York, but historically they are not unprecedented. Many analysts in Freud’s time had “love affairs” with or married their female patients when the comparatively short (three to six months) treatment process common in those days was completed. Reich’s first wife, Bernfeld’s last wife, Rado’s third wife, and one of Fenichel’s wives were former patients. Freud’s disciple Tausk had a love affair with a former female patient, sixteen years his junior. Freud himself encouraged a prominent American analyst to marry a former patient. W. Bern Wolfe, a gifted psychiatrist, was forced to flee the United States in the 1930s for “impairing the morals” of a girl he was treating. Dr. James McCartney, a therapist who encourages sex between male therapists and their female patients (when “necessary”), claims that a number of well-known psychiatrists (Hadley, Sullivan, Alexander, and Reich) told him, despite their writings to the contrary, that “they allowed their patients physically to act out.”

Freud once said of a patient, “What this lady really needs is a prescription reading: Rx penis normalis, repetetur.” But the founding father has also been quoted as saying, “If you start with a kiss you risk an ultimately very lively scene.”

In New York, there have been some lively scenes. One woman refused to sleep with her therapist, then told her husband, who was also seeing the doctor, about the proposition. The wife wanted to end the treatment. But, as often happens, the doctor turned the woman’s “illness” on her in an attempt to discredit her.

“… Women over 35 insisted that they were to blame; they were the real seducers …”

Sandra: “I decided that I owed it to Mark [her husband] to go up with him and confront the group we’re all in together. So I go up and there’s Dr. X and his two assistants sitting there and I figure, well, the cards are stacked against me. Dr. X says, ‘Well, well, tell us what happened.’ So I tell the story again, and then he proceeds to tell the group how I was provocative to him, how I wore a miniskirt, which I always wear. He made it look as if I were coming up there to seduce him, not to have a session. Then he says I’m using this lie of a proposition to cop out of therapy. He reminded me that I didn’t quit a job I once had just because my boss made a pass at me. Then all of a sudden, we’re sitting there and he’s starting to say things like: ‘Sandra, you know how dishonest you are, how dishonest you are with Mark, there are things you haven’t told him …’ [He was referring to a brief affair she’d had.] And I started crying, ‘I’m getting out of here.’ I mean it was like a kangaroo court. When we left, Mark said to me, ‘What haven’t you told me, what did you do?’ He forgot all about what Dr. X did … everything got twisted.”

Joyce: “And then I had a dream about going to bed with him. And he said, ‘Ah, transference at last’—in his accent. The week before, he’d made me put my head on his lap just like I used to do with my father when I had a bad headache, and he’d stroked my hair. It was very warm. I was a little girl and he was my father. Then his hand slipped … The next session he helped me on with my coat, turned me around to him and kissed me quite passionately. And I was quite shocked. And then I burst into tears. I’m melodramatic anyway, but I was really upset. Because I didn’t know what to make of it. And I said, ‘Why did you do that?’ It was a stupid question to ask, really, and he said, ‘What? Do what? What are you talking about?’ And I said, ‘Kiss me.’ ‘I don’t know what you mean,’ he said. He was really playing into my hang-up. Because my parents would do that to me. Whenever my mother did something and I said, ‘Why did you do that?’ she’d go, ‘What? I didn’t do anything.’ “

Two New York doctors, whose patients were interviewed, were involved in creating a primal patriarchal family empire, consisting of one male guru (themselves), and many “wives” (female patients, legal wives, mistresses). Both men used their female patients to do menial chores. Both men kept odd office hours, and even odder treatment hours. “Sessions” lasted from ten minutes to four hours, and no questioning of this arbitrary “spontaneity” was brooked, even from other patients who had to wait long beyond their scheduled appointment times. Both men were married. Both described their wives as “crazy,” “hopeless,” “dependent,” and “too old.” Both men were cold and/or inadequate sexual partners and lovers. Both apparently had sex with as many of their female patients, simultaneously, as they could, often presenting it as either necessary for the “cure” or as a unique instance of “love.” (If a woman acted this way, people would call it nymphomaniacal and suggest she see a psychiatrist.)

Both these therapists prescribed drugs for everyone for anything. Both were very authoritarian in directing and ordering their patients’ lives: they told them whom to sleep with and when; what jobs to leave and what jobs to take; where to live and with whom. Both thundered at sexually reluctant female patients about how “unhealthy” their sexual “repression” was and how they’d “better start making love a lot” if they wanted to get rid of their “hang-ups.” Both therapists insisted that only they could “help” or “save” their patients, and they warned their unhappy or rebellious female patients to leave only at their own risk.

“… Candy finally realized, as many women never do, ‘Good grief, it’s Daddy!’ …”

All eleven women interviewed were superficially unambivalent about being “feminine.” They were all conventionally and frantically “attractive”; they were all economically and intellectually insecure; they were both heterosexually fearful and heterosexually compulsive; they were paralyzed by actual and feared loneliness and self-contempt; and they all blamed themselves for any “mistreatment” by men.

Those women over 35 seemed the most worldly, hiding behind sophistication and compassion. They were the most vocal advocates of “pity” and “understanding” for the therapists—and for all men. They insisted that they were to blame; they were the real seducers.

Melissa: “I think that he finally couldn’t resist me any more. I think I just put too much pressure on him. I was making moves from the very beginning …”

Donna: “I had a fantastic tan … and I was high, and I’m very attractive when I’m high. I’m irresistible. I wanted to look nice for my therapy sessions. I always took off my glasses and combed my hair before I went.”

Roslyn: “Actually, in a certain way, I was seducing him all along … unconsciously. I wasn’t aware of it until one time he came to a party at my house. I always had to seduce every man.”

Martha: “He was really attracted to me, and I was attracted to him before-hand. The night he gave me flowers, was hoping he’d make love to me. But I wasn’t conscious about those things then.”

Yet these women described as many fantasies of love and marriage about their therapists, and felt as little-girl-betrayed, as the younger, less “sophisticated” women did.

Ellen: “I wanted him to marry me but he wouldn’t. His wife and children, his reputation, and his failing health made it hard for him. I haven’t been able to shake the relationship and it’s been eight months. He won’t see me at all now.”

Martha: “I guess I really wanted another husband. I was still looking to romantic love for security.”

Roslyn: “I thought, I fantasized, that he would leave his wife and marry me, that he was going to give up his other life and start a new life with me. I was so happy that my therapist loved me.”

Stephanie: “I finally asked him if he would marry me, and he just laughed and said no. He was more interested in my typing for him.” Joyce: “I know I needed him very, very badly. It was like he was God. He was mistreating me, and I didn’t want to admit that, because I needed him badly. I loved him. Then he offered me a job as his typist but he wouldn’t sleep with me any more. I was so depressed and upset and I wanted some help and I called up, hysterical. ‘Please talk to me on the phone,’ and he said, ‘I can’t talk to you now, I’ll call you back.’ And he never called back. I felt deserted and all alone and usually when I talk about this with my shrink (now) I’m just in tears.”

Helen: “For about two months I was pleased enough. I had the man I wanted most. I would go to his office once a week for a session, pay him my twenty dollars, and have sex throughout the hour. Then I began to complain. He was on his second marriage. He admitted I was right in wanting to transfer the affair to my apartment but if I loved him enough I would ‘give him time.’ After a year I began to demand that he do something. He got a Mexican divorce, came back, and said, ‘Let’s cool it.’ Then, after a few months, he announced he was marrying someone else. I went mad with pain. He was willing to continue our relationship as it was, though.”

Even though many of the women felt that they were “mistreated” by their doctors, it was generally the therapist who ended the affairs. The women were hurt by the abandonment. Two lapsed into severe depression. One tried to kill herself. A fourth woman’s husband, who was also in treatment with the same therapist, killed himself shortly after he found out about the affair.

Two women, who were “treated”by the same prominent New York psychiatrist,describe their experiences.

He said to me, “Do anything you want here in this office. It’s not just speaking. If you want to do something, you can act it out. Any fantasy you can act out. Some women like to take their clothes off. Some women like to jump around. You can do anything.” But I didn’t feel like getting undressed … After that first passionate kiss I was really upset … I told a psychiatric resident at a hospital about it and he said, “Are you sure this really happened, are you sure you haven’t blown it up out of proportion? … All I can tell you is, work it out with your analyst.”

We would start a session and then all of a sudden I would find him lying on the couch next to me. So I finally went to bed with him. I was still paying for therapy and asked whether I should be, but very hesitantly … We never really resolved it … I know I needed him very, very badly. It was like he was God … I guess I loved him … I had orgasm after orgasm, even though he came pretty fast. He treated me like a whore, just like my fantasies, and I guess it worked—sexually. Psychologically it was tearing me apart.

I never called him except that one time he offered me a job as his secretary. Suddenly I was so depressed and upset and I wanted some help and I called him up, hysterical. “Please talk to me on the phone,” and he said, “I can’t talk to you now. I’ll call you back.” And he never called back. I went to his office, and told him I wouldn’t be a patient anymore, that he’d been mean and cruel and that it’s unhealthy. And he tried to talk me out of it. He said that he wasn’t using me and that the psychology books I read were old-fashioned. Modern-thinking people believed the way he did. When he saw I was really going to leave, he said, “I’m warning you. Nobody will ever, ever be able to help you. I am the only doctor in the world who can help you.”

The depression, the feelings, the fear got worse and worse. A fear mostly that I was losing my mind, that I was insane … The more upset I got, the more Librium he gave me. “But I’m upset about us,” I’d tell him. And then he stopped making love to me. I was hurt. I didn’t want him to make love to me and yet I was terribly hurt that he didn’t. He finally told me he thought it was too much for me, that I couldn’t handle it.

I was alone again—with two children, no husband and too many dishes. A couple of months later, I found myself on the floor, trying to cut my wrists. And I didn’t make a mark … Then I tried to cut my wrists with my father’s razor and finally made it into the hospital. I called him [the therapist] and begged him to get me out of there. “I’m here maybe because of you.” He said “Yes. I’ll get you into Creedmore.”

Once in a while, when I’ve gotten very depressed, and very angry, I’ve picked up the phone and called him and hysterically screamed at him: “Why did you do that to me? You tried to kill me. Why? Why?”

My therapist gave me lots of pills for my depression and weight, and insisted I take birth control pills even though I wasn’t sleeping with anyone. I always thought I was ugly … He always kissed me goodby after a session, but crudely, never affectionately. When I tried to tell him this, he got annoyed and said, “Try to pretend you like it.” But I’d go home and cry. I hadn’t slept with anyone for nearly three years when I started therapy. My marriage—well, my husband was the first man I ever slept with and it ended after six months. I was never sexually satisfied.

He was always after me to lie on the couch and I didn’t want to. When I finally did he would lie down next to me. I didn’t want to sleep with him—I was very depressed after it happened. He didn’t seem to notice that I was sad, that I hadn’t had an orgasm. If I didn’t have an orgasm here, then it’s my fault: he’s an analyst and should know what he’s doing … All he said was, “You don’t mind if I don’t take you home—I’ve got so much work to do.”

Once I screamed, a really anguished howl, and he pushed me away, got up, dressed, and said, “Don’t you think you owe me an explanation?” … He said, “There’s nothing wrong with our relationship, it’s a perfect doctor-patient relationship, a perfect working relationship, and a perfect relationship as lovers.” He had me typing letters for him—the same form letter for hundreds of different people.

When I got very distraught, I’d call him. He’d hang up on me a lot. Once I took a fistful of sleeping pills. He said, “Oh, it’s just your subconscious bothering you, don’t pay any attention to it.” I would wait for him to call, and then he wouldn’t. Once I waited home all weekend and when he called on Monday morning it was only to make sure I’d type his letters. I couldn’t work and I felt like I was cracking up. He started to go away for weekends in the summer, after he’d promised to take me with him. I stayed away as long as I could and then when I went back he said he didn’t want to sleep with me anymore but did want me to type a book for him.

You know, once we were alone together, naked, in his office. The door was locked. The bell started ringing and ringing and wouldn’t stop. It rang for nearly twenty minutes. He didn’t answer it. I was curious and I looked out the window. I saw it was a girl standing there crying. “That’s me next year,” I said to myself.

I couldn’t get it out of my head. So finally I called him and asked for my money back for all the “therapy.” He explained to me that when a surgeon makes a mistake the patient still pays. And I told him had he been a surgeon I would certainly be dead, but he wasn’t and I’m not, and I’d please like my money back.

Phyllis Chesler is Assistant Professor of Psychology at Richmond College, C.U.N.Y.

From the author’s forthcoming book, “Women and Madness,” to be published in October, 1972 by Doubleday & Co., Inc. © 1972 by Phyllis Chesler.

The Sensuous Psychiatrists