Many experts have likened sex abuse by a therapist to rape and incest. This illegal and unethical behavior destroys the very lives of the people who are already hurting and seeking help, those that trusted their therapist and believed they would not harm or abuse them. 

Many women, my wife included, do not know if they will ever get over the abuse. But the patient/client is not the only person that is harmed. Most women report that marriages and relationships are also destroyed and that children’s lives are forever altered after such a horrible trauma.

Numerous studies have also shown that the extreme stress and trauma wreak havoc on the body and cause significant health problems. Many women, my wife included, report;

  • Sadness
  • Depression
  • Anger
  • Rage
  • Grief
  • Loneliness
  • Shame
  • Guilt
  • Confusion
  • Despair
  • Bewilderment
  • Ambivalence
  • Anxiety

According to one study victims of therapist abuse;

  • 14% of victims became suicidal after therapist abuse
  • 11% were hospitalized as a direct result of therapist abuse
  • 1 % died from suicide after therapist abuse
  • 26% of victims were suicidal, hospitalized or dead because of therapist abuse.

Another study suggests that;

  • 92% of victims have severe PTSD after a therapist abuse

I can say that PTSD is very common, as are nightmares, anxiety, panic attacks, severe depression, giltu, shame and self-loathing. 

Acccording to Kenneth S. Pope, PhD, ABPP, a graduate of both Harvard and Yale, a diplomate in clinical psychology,  a charter fellow of the American Psychological Society and a fellow of American Psychological Association who has authored or coauthored more than 100 articles and chapters in peer-reviewed scientific and professional journals and books and is in the forefront of research on therapist-patient sex; he states that "sex between therapists and clients has emerged as a significant problem...", in his book "Sex Between Therapists and Clients” Pope states that "When people are hurting, unhappy, frightened, or confused, they may seek help from a therapist. They may be depressed, perhaps thinking of killing themselves. They may be unhappy in their work or relationships, and not know how to bring about change. They may be suffering trauma from rape, incest, or domestic violence. They may be bingeing and purging, abusing drugs and alcohol, or engaging in other behaviors that can destroy health and sometimes be fatal....the therapeutic relationship is a special one, characterized by exceptional vulnerability and trust. People may talk to their therapists about thoughts, feelings, events, and behaviors that they would never disclose to anyone else." 

But "a relatively small minority of therapists take advantage of the client's trust and vulnerability and of the power inherent in the therapist's role by sexually exploiting the client." and "each state has prohibited this abuse of trust, vulnerability, and power through licensing regulations. Therapist-patient sex is also subject to civil law as a tort (i.e., offenders may be sued for malpractice), and some states have criminalized the offense. The ethics codes of all major mental health professionals prohibit the offense."

He further stated that the "harmful consequences associated with therapist-patient sex that, regardless of whether the seduction was initiated by the patient or the therapist, the therapist should be sued for rape rather than malpractice, i.e., the legal process should be criminal rather than civil."

Pope and another researcher Vetter published a national study of 958 patients who had been sexually involved with a therapist. The findings suggest that about 90% of patients are harmed by sex with a therapist; 80% are harmed when the sexual involvement begins only after termination of therapy. About 11% required hospitalization; 14% attempted suicide; and 1% committed suicide. About 10% had experienced rape prior to sexual involvement with the therapist, and about a third had experienced incest or other child sex abuse. About 5% of these patients were minors at the time of the sexual involvement with the therapist. Of those harmed, only 17% recovered fully.

He has further listed the following effects as being catastrophic

A. Ambivalence
Extreme ambivalence can be one of the most debilitating consequences of sexual involvement with a therapist. Caught between two sets of conflicting impulses, those suffering this consequence may find themselves psychologically paralyzed, unable to make much progress in either direction. On one hand, they may want to escape from the abusive therapist, from the destructive relationship, and from the continuing effects of the abuse. But on the other hand, they may believe that they need to protect the abusive therapist at all costs. Abusive therapists are often exceptionally adept at creating and nurturing these dynamics. Exploited patients may learn from the therapist that the most important thing is to keep the sexual relationship secret so as not to harm the therapist's career. They may have been led to believe that the sexual relationship was an act of great self-sacrifice on the part of the therapist, a moral and ethical act that was the only way that the therapist could "cure" whatever was wrong with the patient.

B. Cognitive Dysfunction
Many people who have been sexually involved with a therapist, whether the sex started before or after termination, will experience intense forms of cognitive dysfunction. There may be interference with attention, memory, and concentration. The flow of experience will often been interrupted by unbidden thoughts, intrusive images, flashbacks, memory fragments, or nightmares. These cognitive impairments may interfere significantly with the person's ability to work, to participate in social activities, and sometimes even to carry out the most routine aspects of self-care. Sometimes the pattern of consequences may fit the model of post-traumatic stress disorder.

C. Emotional Lability
Emotional lability reflects the severe disruption of the person's characteristic ways of feeling in a way that is similar to cognitive dysfunction reflecting the severe disruption of the person's characteristic ways of thinking. Intense emotions may erupt suddenly and without seeming cause, as if they were completely unrelated to the current situation. The emotional disconnect can be profound: a person can describe a wrenchingly sad event and burst out laughing, or talk about something funny or wonderful and begin sobbing.

D. Emptiness and Isolation
People who have been sexually involved with a therapist may experience a subsequent sense of emptiness, as if their sense of self had been hollowed out, permanently taken away from them. The sense of emptiness is often accompanied by a sense of isolation, as if they were no longer members of society, cut off forever from feeling a social bond with other people.

E. Guilt
People who become sexually involved with a therapist may become flooded with persistent, irrational guilt. The guilt is irrational because it is in all instances the therapist's responsibility to avoid sexually abusing a patient. It is the therapist who has been taught, from the earliest days of training, that engaging in sex with patients is prohibited, no matter what the rationale. It is the therapist whose ethics code clearly classifies sexual involvement with patients as a violation of ethical behavior. It is the therapist who is licensed by the state in recognition of the need to protect patients from unethical, unscrupulous, and harmful practices, and it is the licensing boards and regulations that clearly charge therapists with refraining from this form of behavior that can place patients at risk for pervasive harm.

Women victims often experience considerable guilt, risk loss of love and self-esteem, and often feel that they may have done something to "cause" the seduction. As with rape victims, women patients can expect to be blamed for the event and will have difficulty finding a sympathetic audience for their complaint. Added to these difficulties is the reality that each woman has consulted a therapist, thereby giving some evidence of psychological disequilibrium prior to the seduction. How the therapist may use this information after the woman decides to discuss the situation with someone else can surely dissuade many women from revealing these experiences.

F. Impaired Ability to Trust
When therapists intentionally and knowingly violate their patients' trust, as they do when they decide to become sexually involved with them, the effects on the patients' ability to trust can be profound and lasting. Therapy may rest on a foundation of exceptional trust.

G. Increased Suicidal Risk
As a group, patients who have been sexually involved with a therapist have significantly increased risk of both suicide attempts and completed suicides when compared with the general population and other groups of patients. The research published in peer-reviewed journals suggests that about 14% will make at least one attempt at suicide and that about one in every hundred patients who have been sexually involved with a therapist commit suicide.

H. Role Reversal and Boundary Confusion
Therapists who sexually exploit their patients tend to violate both roles and boundaries in therapy. The focus of sessions shifts from the clinical needs of the patient to the personal desires of the therapist. The therapist brings about a reversal of roles: the sessions and the relationship are no longer about the therapist being of use to the patient in service of the patient's welfare but rather the patient being of use to the therapist in service of the therapist's sexual gratification. The fundamental clinical, ethical, and legal boundary that would prevent a therapist from turning patients into sources for the therapist of sexual pleasure, experimentation, relief, variety, or control is violated.

In a legitimate therapy, the therapeutic process, effectiveness, and improvements that therapist and patient work on during each sessions is expected to continue between sessions and, ultimately, after termination.  Unfortunately, the harm as well as the benefits that therapy brings about can be long-term. The negative effects of the therapist's violation of boundaries and reversal of roles can generalize beyond the therapy and persist long after the termination of the therapy and the sexual relationship. The roles and boundaries that people use to define, mediate, and protect the self may become not only useless for the patient but also self-defeating and self-destructive.

I. Sexual Confusion
It is perhaps not surprising that many patients who have been sexually exploited by a therapist wind up deeply confused about their own sexuality. Psychologist Janet Sonne served as one of the group therapists in 1982 and 1983 for some of the patients who participated in the UCLA Post Therapy Support Program, the first university-based program offering services to patients who had been sexually involved with their therapists, conducting research in this area, and providing training to graduate students. She wrote that female patients who had been sexually involved with a prior therapist "expressed a cautiousness or even disgust with their sexual impulses and behavior as a result of sexual involvement with their previous therapists. For some female clients who identified themselves as heterosexual before they were involved sexually with female therapists, there tended to be significant confusion over their 'true' sexual orientation."

The experience of sex with a therapist leaves some patients believing that their only worth as human beings is to provide sexual gratification to others. Some engage in sex with others on an almost obsessional basis as re-enactment of the sexual relationship with the therapist.

Especially when the patient is experiencing feelings of emptiness and isolation, the specific sexual activities previously experienced with the exploitive therapist--often re-enacted in the midst of flashbacks--may represent an attempt to fill up the self and break through the isolation. For still other patients, sex becomes associated with feelings of irrational guilt. They may engage in demeaning, degrading, joyless, painful, harmful, or dangerous sexual activities that seem to express the conviction: "I am guilty, worthless, and deserve this." Some may become so confused about sexuality that they begin labeling a variety of feelings and impulses as "sexual." They may, for example, say that they are sexually aroused whenever they are feeling intensely angry, depressed, anxious, or afraid.

J. Suppressed Anger
Many patients who have been sexually abused by a therapist are justifiably angry, but it may be difficult for them to experience the anger directly. Some may feel only numbness in situations that, according to them, would have previously evoked anger. Some may turn the anger inward, becoming enraged at themselves. The anger directed inward may lead to self-loathing, self-punishment, and self-destructive behaviors including suicide.

Offending therapists are often skilled at manipulating patients into suppressing their anger. Some may use intimidation, coercion, or even force and violence to ensure that a patient will suppress anger rather than feel and express it directly. One therapist would yell at a patient, who had a history of having been sexually abused, whenever she started to become angry at him for touching her sexually during the sessions. She became terrified of her own anger, and of the possibility that anyone else might become angry at her. During her subsequent therapy she would sit in silence for long periods of time, terrified to say anything, finally whispering something along the lines of, "You're angry at me, aren't you." Psychologist Janet Sonne, describing the findings of the UCLA Post Therapy Support Group, wrote: "Although the patient may occasionally acknowledge her intense rage, she will more often suppress her anger for fear of being overwhelmed by it, or of harming its object (the therapist) or others."


Pope, concludes that sex between a patient and client is recognized as more than a violation of professional or clinical ethics, of licensing laws, and of the civil laws (i.e., patients can sue offending therapists for malpractice in the civil courts), he states that "an increasing number of states have criminalized therapist-client sex, some classifying it as a felony."  As one court held in reviewing the constitutionality of criminalizing therapist-client sex the court concluded:

"the state has a legitimate interest not only in protecting persons undergoing psychotherapy from being sexually exploited by the treating therapist but also in regulating and maintaining the integrity of the mental health profession. It is equally obvious to us that the legislative decision to criminally proscribe a psychotherapist's knowing infliction of sexual penetration on a psychotherapy client is reasonably related to these legitimate governmental interests. . . . [It] therefore comports with due process of law.

Citations: National Study of Psychologists' Sexual Attraction to Clients, National Study of Social Workers' Sexual Attraction to Clients: Results, Implications, and Comparison to Psychologists, Therapists' Anger, Hate, Fear, and Sexual Feelings: National Survey of Therapist Responses, Client Characteristics, Critical Events, Formal Complaints, and Training, National Study of Patients Who Have Been Sexually Involved with a Therapist, Therapists' Sexual Feelings and Behaviors:Research, Trends, & Quandaries, National study of sex between psychology students and faculty, Licensing Disciplinary Actions for Psychologists Who Have Been Sexually Involved with a Client, National study of of the ethics of psychologists as educators Ethics in Psychotherapy and Counseling (2nd ed.), Sexual Involvement with Therapists: Patient Assessment, Subsequent Therapy, Forensics, Sexual Feelings in Psychotherapy, Therapist-Patient Sex As Sex Abuse: 6 Scientific, Professional, and Practical Issues in Addressing Victimization and Rehabilitation, Sex Between Therapists and Clients by Ken Pope,  Women and Gender: Sex Similarities and Differences and the Impact of Society on Gender edited by Judith Worell and published by Academic Press, October, 2001, 1264 pages, ISBN 0122272455.