Having blogged about therapy abuse for several years, I recently made the decision to start work on a book on the topic. For that reason I’ve begun reading through the published literature, which isn’t as large as one might think. I have to thank Amanda Williamson (who has personal experience of therapy abuse) for pointing me in the direction of one of the seminal texts – Sex in the Forbidden Zone: When Men in Power – Therapists, Doctors, Clergy, Teachers and Others – Betray Women’s Trust, by Peter Rutter. As well as this review, you can also read Amanda’s own review here.
The ‘Forbidden Zone’ of the title refers to the zone in which a relationship of power exists of a man over a woman – be it therapist and client, doctor and patient, priest and congregant or manager and employee – and in which a breach of sexual boundaries is likely to cause enormous harm. Isn’t a long book, but it’s packed with detail. There are candid accounts not only by women who have had their boundaries breaches, but also by men who breached them. I found the latter somewhat surprising, given that in most such cases I’ve covered on the blog, I’ve been struck by the sheer lack of insight on the part of the men involved.
Rutter analyses these cases from a Jungian perspective – something else I found interesting, because I’ve seen more cases of therapy abuse involving Jungians than pretty much all the other psychotherapy modalities put together. He argues that in sexual boundary breaches, both the man and the woman are playing out wounds in their psyches – from culture and from parent figures – against their respective masculine and feminine identities. Given that the book is somewhat dated (published in 1989) it’s perhaps unsurprising that his descriptions of male and female fantasies and interpersonal dynamics come across as rather heteronormative (women who have had their boundaries breached in childhood may be less able to distinguish between relationships with men where sexuality is appropriate and where it is not; men may have difficulty distinguishing between their fantasies of women and the actual woman sitting in front of him; women are encultured to be sexually deferent to men; men are encultured to hide their wounds and seek healing from them in sex). Which is not to say that such dynamics don’t exist, or have been extinguished in our supposedly more progressive times. Indeed, one only has to go on Twitter and browse through the many recent discussions about Ched Evans to find them been played out repeatedly.
Rutter makes it clear that sexual encounters in the forbidden zone are almost always extremely damaging to both parties. Indeed, he suggests that these are psychologically analagous to incest. One eye-opening observation by Rutter is that of all the women he interviewed for the book, not one of them had given birth to a child since the abuse took place. He also states categorically that the responsibility is entirely with the man to prevent such boundary breaches occurring.
As well as analysis, Rutter also offers practical advice, including a chapter each for women or men about how to recognise when a breach may occur, and what to do about it. Although the chapter for women is considerably longer, I actually found the chapter for men more engrossing. Probably because, as a heterosexual male, it challenged the nature of male fantasies about women.
The book ends on a somewhat hopeful note. Rutter argues when there is a risk of sex in the forbidden zone, there is an opportunity for healing rather than damage. He provides the respective accounts of a male manager and female employee who had both been contemplating a sexual encounter. By not allowing fantasy to play out in reality, they both healed wounds in their respective masculinities and femininities, becoming more able to see the opposite gender in ways unrelated to sex.
Overall, the book might be considered dated in parts, but not as many as one might think. Definitely essential reading for anyone interested in this topic.
Peter Rutter MD (1989) Sex in the Forbidden Zone: When Therapists, Doctors, Clergy, Teachers and Other Men in Power Betray Women’s Trust. New York: Fawcett Crest.
Unsafe Spaces 
This is good and necessary work. However, I do wish the focus wasn’t always entirely on sexual exploitation of female clients by male therapists. There are many kinds of abuses perpetrated by therapists of both sexes and they don’t always involve sex. However, they ALWAYS involve the misuse of power. Read my story here: https://therapygonebad.wordpress.com/the-aftermath-of-a-narcissistic-friendship/
I have also read this book and agree that it is important reading, especially for learning to keep boundaries in place – and it is an excellent review of the abuse of trust.
However, a book which also is worth looking at is “Sexual Abuse by Health Professionals” by P. Susan Penfold (ISBN 0-8020-8106-1).
The author of this book is a psychiatrist, and the survivor of sexual and emotional abuse by the psychiatrist who was her therapist. She employs two voices in the writing of her book: the first part of each chapter is a narration of her own experiences as a victim of abuse; the second part, an account of her journey as a psychiatrist towards understanding the meaning of the abuse and how to heal from it.
Her journey includes having a second, very different, experience of therapy; listening to the stories of other survivors of abuse by health professionals; reading published accounts of such abuses; making her story public to professional and general audiences; being a member of a group dedicated to combating sexual abuse by therapists; talking to colleagues who have treated victims of abuse by health professionals; culling ideas from the literature on trauma and abuse; and treating patients who are themselves survivors of abuse by health professionals.