When the frame breaks: Ripple effects of sexual boundary violations.

Abstract

Sexual boundary violations (SBVs) are devastating events within a psychoanalytic institute. SBVs are harmful not only to the patient/candidate upon whom the violation was committed but also to other patients of the violating analyst, and to the psychoanalytic community as a whole. This article considers the interpersonal and intrapsychic processes that lead to SBVs and their ripple effects. The author argues that SBVs signal a collapse of the third in the analytic dyad and in an institute as a whole. The author uses a case example to illustrate the utility of viewing ripple effects from SBVs as a consequence of a collapse of the third.

Treating clients who have been sexually abused by a therapist.

“…Working with clients who have been sexually abused by a previous therapist creates a unique set of challenges to any subsequent therapeutic relationship. Therapists must contend with their own feelings and be especially mindful of their clients' ambivalent emotions toward the previous therapist and the relationship within which the sexual contact occurred, particularly when the perpetrator is personally known or well respected (Demos, 2017;Nicholson, 2010;Slochower, 2017). Therapists must be open to hearing how the client understands the relationship, what prompted it, whether it is ongoing, or whether sexual or other types of contact occur episodically, and, if not, how it ended and what has transpired since them.…”

“…This process becomes even more fraught when the harm was perpetuated by a therapist whose role is to heal and protect and not exploit. When sexual contact takes place, the entire relationship component of psychotherapy and the field as a whole are tainted (Demos, 2017;Pope, 2001;. When the therapist is redefined as "the rapist," reentering treatment for any reason, much less to discuss what happened with a previous therapist, who may still be (paradoxically it seems) loved and grieved for, may seem impossible.…”

“…They also tend to minimize the level of damage caused by this particular betrayal trauma (Freyd, 1997), with effects similar to those of rape and incest (Luepker, 1990b;Pope, 1990; see also Chapter 13). The therapist who sexually abuses and exploits clients "obliterates the special space that defines [therapy]" (Summers, 2017, p. 178), using therapy in a way that is self-serving and harmful and that perpetrates a serious betrayal of trust that goes well beyond the individual victim (Demos, 2017). In some states, TSA is a form of criminal sexual assault that can result in jail time and requirement to register as a sex offender (for a listing of these states, see Chapter 3).…”

Epilogue: Prevention and intervention.

“…Secondary betrayals (the "second injury" as discussed in texts on victimology) are often described by victim-survivors as worse that the original violation. The harmful role of bystanders has been considered by several authors (e.g., Demos, 2017;Dimen, 2016;Slochower, 2017) who have grappled with the recurrent and significant issue of the collective bystander silence or inaction. Case studies and reports describe the impact of both the sexual misconduct and a community's silence, avoidance, and failure to act (Honig & Barron, 2013).…”