A Therapist Can't Say That EP 2.7 - Let's Talk About Sex: A Humane Approach to Sexual Boundary Violations with Dr. Andrea Celenza
Sex with clients.
It’s an interesting topic because it’s both very taboo and not at all polarizing. Many taboo topics are just that because discussion of them invites conflict. Sexual boundary transgressions aren’t like that. We can pretty much all agree that they’re wrong and bad.
So then why is it so hard to talk about?
I would argue that in this case, it’s because of fear of being in any way associated with a transgression of that magnitude, and the vicarious shame of being part of a group whose members sometimes commit these transgressions.
But we have to talk about it and here’s why: a 2017 paper reviewed multiple studies and found that as many as 7 to 12% of therapists surveyed in those studies admitted to having sexual contact with a client. And that’s in self-reported surveys. The consensus among people who study and write about this topic is that the actual numbers are probably much higher.
Obviously, just agreeing that we shouldn't do that and then moving on isn't working.
We need to be having conversations that go beyond, “it’s wrong,” and “here’s some tips for holding boundaries,” especially if you are a supervisor or therapist of therapists. At some point, you will have a supervisee or client who comes to you about sexual attraction to a client and how you respond can make or break whether they go on to act on it.
To guide us in wrestling with this very fraught subject in a deeper, broader, and more generative way, I am so excited to bring you my conversation with psychologist and author Dr. Andrea Celenza.
Andrea Celenza, Ph.D. is a Training and Supervising Analyst at the Boston Psychoanalytic Society and Institute and Assistant Clinical Professor at Harvard Medical School. She is also Adjunct Faculty at the NYU Post-Doctoral Program in Psychoanalysis and The Florida Psychoanalytic Center. She has written numerous papers on love, sexuality and psychoanalysis. Her third book, entitled, Transference, Love, and Being: Essential Essays from the Field, was published in 2022 by Routledge. Dr. Celenza is in private practice in Lexington, Massachusetts, USA.
Content note: This episode contains brief, non-graphic mentions of sexual assault, incest, and suicidality
Listen to the full episode to hear:
- Why we need to reframe sexual boundary violations as something we are all potentially vulnerable to
- Risk factors and precursors for boundary transgressors and how they overlap with non-transgressors
- How the therapeutic relationship can mimic common problematic childhood dynamics for therapists
- The impact of negative transference on the potential for boundary transgressions
- Why we have to be aware of and positively leverage the power imbalances inherent in the therapist-client relationship
- Why we have to learn to capture and tolerate multiplicity in ourselves and our patients
Learn more about Dr. Andrea Celenza:
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