Sexual Abuse in the Mental Health System is Pervasive, Watchdog Reports

LOS ANGELES, Dec. 12, 2017 /PRNewswire/ -- Citizens Commission on Human Rights (CCHR), a mental health industry watchdog, says that amidst the growing reports of sexual abuse and intimidation coming out of the entertainment industry, the systemic sexual abuse of patients within the mental health industry must be brought to the public's attention. According to CCHR, since allegations of sexual abuse by a prominent Hollywood film producer broke, more than 15 psychiatrists and psychologists that committed sexual violations of patients were convicted and jailed or had their licenses to practice suspended or revoked or had civil charges brought against them for sexual violations. CCHR urges all victims of sexual assault committed by mental health professionals to speak out.

The group says its database of therapist abuse shows that about a third of the mental health professional convictions reported are for sexual abuse. In 2016, an Atlanta Journal-Constitution investigation culminated in an article headlined, "Licensed to Betray," which pointed to the fact that while society condemns sexual misconduct by citizens and demands punishment, when a physician is the perpetrator the nation often looks the other way. It further stated that "layer upon layer of secrecy makes it nearly impossible for the public" to know the extent of the abuse.[1]

According to a study published in the Bulletin of the American Academy of Psychiatry Law, "While estimates vary across studies, it is widely held that 7 to 10 percent of male and 1 to 3 percent of female therapists report having had sexual intercourse with one or more patients. Those therapists who report having sex with their patients are often repeat offenders with some surveys noting over 50 percent of male therapists reporting sexual involvement with more than one patient."[2]  

Kenneth S. Pope, Ph.D., reported in his book, Sexual Involvement with Therapists: Patient Assessment, Subsequent Therapy, Forensics, that research studies also suggest that at least 50 percent of all therapists will encounter a least one patient who has been sexually abused by a previous therapist.[3]

Until the passage of state laws in the United States — many of which CCHR worked to obtain — making it a criminal offense for psychiatrists and psychologists to have sexual relationships with their patients, mental health professionals could abuse patients entrusted to their care with impunity or claim it was "consensual."

There are now 26 U.S. states that have criminalized various aspects of psychiatrist, psychologist and psychotherapist sexual contact with patients. Consent is not a valid excuse. Out of a sample of 120 mental health practitioners who were convicted for sexual crimes in the U.S. (that CCHR documented in recent years), more than two-thirds of the offenders were in states that have enacted such statutes.  

Several of the sexual assaults in the sample were against children, one as young as nine years old while one was only four years old. Dr. Pope said that according to a national survey of therapist-client sex involving minors, one out of 20 clients who had been sexually abused by their therapist was a minor, with girls as young as three and boys as young as seven.[4]

Psychiatric Diagnostic Manual Excuses Pedophilia

The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders or DSM5, published in May 2013, defines the sexual abuse of children as potentially "pedophilic disorder" (insurance billing code number 303.2). However, according to the APA, should the perpetrators not feel guilt or shame about their pedophilic impulses, then this ceases to be a "disorder" and becomes a pedophilic "sexual orientation."[5] After public outcry about pedophilia being designated as a sexual orientation, the APA released a statement that the phrase "sexual orientation" was used in error and that the correct terminology was "sexual interest."[6] The DSM defines pedophilic disorder as having a "recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children (generally age 13 years or younger)" for at least six months and "the individual has acted on these sexual urges" or the "sexual urges or fantasies cause marked distress or interpersonal difficulty." But were such individuals to "report an absence of feelings of guilt, shame, or anxiety about these impulses and are not functionally limited by their paraphilic impulses … then these individuals have a pedophilic sexual orientation but not a pedophilic disorder," according to the APA's DSM5.[7]

Shameless in its candor, but chilling in its content, in its section on "Other Conditions That May Be a Focus of Clinical Attention," the DSM includes: "Child Physical Abuse" (Code No: 995.54); "Child Sexual Abuse" (Code 995.53) that involves any sexual act involving a child that is intended to provide sexual gratification for the perpetrator, including incest, sodomy and rape and "Child Psychological Abuse" (Code No: 995.51).[8] 

The late Richard Gardner, a clinical professor of child psychiatry, drew criticism when he said, "Society's excessively moralistic and punitive reactions toward pedophiles ... go far beyond what I consider to be the gravity of the crime." He suggested that pedophilia serves "procreative purposes."[9] 

Such views were in stark contrast to a Michigan Circuit Court judge Alice Gilbert who sentenced an Oakland psychologist to 6-15 years in jail for molesting a teenage boy. Judge Gilbert stated: "There is no civilization if we don't protect our children."[10]

This is further exacerbated, CCHR says, because often psychiatric-psychologist abuse of patients is referred to licensing boards, not courts. Public Citizen, a U.S. advocacy group, conducted a study of physician sexual misconduct in the National Practitioner Data Bank over a period of 10 years, ending in 2013. Published in 2016, it concluded that a full two-thirds of those doctors with strong evidence of sexual misconduct against them had not been disciplined by medical boards. This is evidence, CCHR adds, of the continued secrecy and complicity shrouding such abuse. The national repository is where state medical boards, peer review committees and malpractice insurers report physician wrongdoing. The data bank was established by Congress but is meant to be used by hospitals and other health care organizations before hiring a doctor.[11]

"Sex Addiction" is not an Excuse for Abuse

Therapists often excuse their misconduct in much the same way as some perpetrators in Hollywood use "sex addiction" to excuse their behavior. In a U.S. survey of psychiatrist-patient sex, 73 percent of psychiatrists who admitted they had sexual contact with their patients claimed it was committed in the name of "love" or "pleasure"; 19 percent said it was, for example, to "enhance the patient's self-esteem" or provide a "restitutive [compensatory] emotional experience for the patient," while others said it was merely a "judgment lapse."[12]

Current Psychiatry also referred to psychiatrist-patient sexual contact as "crossing boundaries" or "boundary violations," while acknowledging that such contact with patients is "inherently harmful to patients, always unethical, and usually illegal."[13]

CCHR advises that perpetrators of patient sexual abuse should not have their behavior excused as "misconduct" or the result of a "sex addiction." David J. Ley, Ph.D., writing in Psychology Today, said that "sex addiction" is a "pseudo-scientific pop psychology phenomenon." Explaining further, he wrote: "Using the sex addiction label with offenders puts the blame and responsibility for these sexual crimes on the perpetrator's supposed addiction and on the effects of a disease process rather than placing responsibility on the individuals themselves." Furthermore, "I'm a sex addict, it's not my fault" should not be a "get out of jail free card."[14]

The Atlanta Journal-Constitution reported, "Sexual contact between a doctor and a patient, even if ostensibly consensual, is strictly forbidden. In ethical terms, it's a never event. In a legal sense, it can be a crime. Physicians know it's a line that can't be crossed — it's a prohibition as old as the Hippocratic Oath."

Laura S. Brown, a clinical professor of psychology at the University of Washington, said any sex between therapist and patient "is an abuse of a vulnerable person by a person that should know by virtue of their training that this is harmful." Further, "This is not just an affair."[15] In other words, there are no excuses, CCHR says.

Blaming the Victim

Some psychiatrists claim that the patient is at fault because of their mental illness, described as "masochistic personality disorder," that purportedly drives their therapist to abuse them. Dr. Richard Simons contended to The New York Times in 1985 that it was important to identify "masochistic personality disorder" in women, which can take the form, for example, of her repeatedly choosing boyfriends who beat her up.[16] Simons further described the example of "patients who unconsciously provoke therapists either to give up on them, or sadistically abuse them..."  Whatever the "unconscious motives may be in an individual case the final behavioral outcome is the achievement of … 'victory through defeat,' and often the defeat is failed psychiatric treatment," Simons stated.[17]

CCHR's co-founder, the late Dr. Thomas Szasz, professor of psychiatry emeritus summed up psychiatric-therapist sexual abuse of patients as: "This is intellectual bankruptcy compounded by moral paralysis. The assertion that sexual contact … may be therapeutic for the patient is self-serving and stupid. Using it to justify such sexual contacts is illogical and immoral." Sexual abuse of anyone is self-serving, immoral and wrong, adds CCHR. It offers its Report Abuse hotline should anyone wish to confidentially report any act of sexual abuse by a mental health therapist: Call 1-800-869-2247 or click here to file a report online.

CCHR is a mental health industry watchdog organization that works for patient protections and encourages the public to take action against mental health coercion and abuse. In the course of its 48 years, it has helped get more than 180 laws enacted, including protections against psychiatric-therapist patient abuse in the U.S., Australia, Israel and Germany. As a nonprofit, CCHR relies on memberships and donations to carry out its mission and actions. Click here to support the cause. 

Contact: Amber Rauscher, [email protected] or (323) 467-4242.

References:

[1] Carrie Teegardin, Danny Robbins, Jeff Ernsthausen and Ariel Hart, "License to Betray," Atlanta Journal-Constitution, http://doctors.ajc.com/doctors_sex_abuse/?ecmp=doctorssexabuse_microsite_nav

[2] Gary C. Hankins et al, "Patient-Therapist Sexual Involvement: A Review of Clinical and Research Data," Bulletin of the American Academy of Psychiatry Law, Vol. 22, No.1, 1994, http://jaapl.org/content/jaapl/22/1/109.full.pdf

[3] http://www.apa.org/pubs/books/4317430.aspx

[4] Kenneth Pope, "Sex Between Therapists and Clients," Encyclopedia of Women and Gender: Sex Similarities and Differences and the Impact of Society on Gender, (Academic Press, Oct. 2001)

[5] Diagnostic and Statistical Manual of Mental Disorders (DSM5), American Psychiatric Assoc., May 2013, pp. 697-698

[6] Deborah Brauser, "DSM-5 Typo: Pedophilia Described as 'Sexual Orientation,'" Medscape, 1 Nov 2013, https://www.medscape.com/viewarticle/813669; Cheryl Wetzstein, "APA to correct manual: Pedophilia is not a 'sexual orientation,'" The Washington Times, 31 Oct 2013, https://www.washingtontimes.com/news/2013/oct/31/apa-correct-manual-clarification-pedophilia-not-se/

[7] Diagnostic and Statistical Manual of Mental Disorders (DSM5), American Psychiatric Assoc., May 2013, pp. 697-698

[8] DSM5, pp. 717-719

[9] Kelly Patricia O'Meara, "Has Psychiatry Gone Psycho?" Insight Magazine, 26 Apr. 1999, p. 17

[10] Ilene Wolff, "'I'm no monster,' molester tells judge," Oakland Press, 12 Dec 1997

[11] Susan Cutti, "Report on physician sexual abuse stirs alarm," CNN, 12 July 2016, http://www.cnn.com/2016/07/11/health/doctor-sexual-abuse/index.html

[12] Nanette Gartrell, M.D., Judith Herman, M.D., et al., "Psychiatrist-Patient Sexual Contact: Results of a National Survey, I: Prevalence," American Journal of Psychiatry, Vol. 143 No. 9, Sept. 1986, p. 1128

[13] "Psychiatrist/patient boundaries: When it's OK to stretch the line," Current Psychiatry, 2008 August;7(8):53-62, http://www.mdedge.com/currentpsychiatry/article/63241/psychiatrist/patient-boundaries-when-its-ok-stretch-line

[14] David J. Ley Ph.D, "Sex Addiction Should Not Be a 'Get out of jail free' Card," Psychology Today, 16 Aug. 2012,https://www.psychologytoday.com/blog/women-who-stray/201208/sex-addiction-should-not-be-get-out-jail-free-card

[15] Nancy Bartley, "Abusing The Trust — Ruined Careers, Damaged Lives: Sex Between Therapist And Patient Can Be Devastating," Seattle Times, 4 April 1993, http://community.seattletimes.nwsource.com/archive/?date=19930404&slug=1694111

[16] "New Psychiatric Symptoms Spur Protest," The New York Times, 19 Nov. 1985, http://www.nytimes.com/1985/11/19/science/new-psychiatric-syndromes-spur-protest.html

[17] Herb Kutchins & Stuart A. Kirk, Making Us Crazy: The Psychiatric Bible and the Creation of Mental Disorders," (The Free Press, New York, 1997), pp. 129-130

SOURCE Citizens Commission on Human Rights International