From Charmed to Harmed: The Aftermath of Sexual Exploitation – Maria’s Story

By Maria Zitkalasa

“Apparently she had no problem with whatever happened that night” is what the finding of my police report stated. I was devastated. It didn’t bode well, because it took four weeks for the police department to even arrange for time to take my statement. They probably figured because there was a delay of ten weeks before I reported that four more weeks would not matter. Besides, I was told there was a homicide and the small department was focused on that crime, not mine.

From the beginning I was worried about not being believed. He is affluent, a doctor, and a doctor who has a nationally recognized name. I met the perpetrator five years ago after experiencing the loss of a really close friend and when I was experiencing a few other difficult situations in my life. I was depressed and feeling very vulnerable. I thought a psychiatrist could help me through the suffering I was experiencing.

I have seen mental health professionals most of my adult life. As a child I grew up in a very violent and chaotic home where sexual abuse, alcohol abuse, and domestic violence were at times a daily experience. I had grown up “acting as if.” I had to go to school after witnessing my mother being battered. I had to “act as if” nothing happened. I had to “act as if” the camping trips we took as a family were fabulous, fun trips instead of the drunken and argumentative events they often were. I had to survive, so I compartmentalized my pain from my pleasure, even though they were confusing events that were intertwined as one experience.

I had worked on many of these issues by the time I met the perpetrating psychiatrist. I had also experienced a domestic relationship that was abusive. The abuser in that situation turned my spirituality into a “symptom” of mental illness. From that time onward, I suppressed my spirituality lest anyone use that against me again in the future. On my first visit to the perpetrator psychiatrist, I told him that part of my recovery plan would include me going back to a spiritual community. He asked me, “What spiritual community will you be going to?” I informed him the name of the community I was planning on attending in my hometown. He said, “But that’s my community!”

He assured me that if he saw me at the community he would maybe say “hi” but that was all. He assured me that he would not cross any boundaries or reveal our therapeutic relationship. When I finally had the courage to go to the fellowship a couple months later, sure enough there he was. He did say “hi” and that was it. For a few Sundays after that, he would say “hi” and nothing more. I felt this could work. I was enjoying learning about all the offerings of the community and started attended more events besides weekly service attendance.

He seemed to be present at every event that I was at. He began to talk to me more and more at the community. He would ask me how I was doing and even suggest medication changes while attending events! He often called me from work asking how I was doing. In treatment he requested that I call him several times between appointments to give him updates on how I was doing. One Sunday everyone was exchanging hugs and he came up to me and hugged me. From then on out he was hugging me both at the spiritual community and at the office when I saw him. He seemed so very interested in my ideas and my life. He was a good listener. I thought, well he is psychiatrist after all. He is trained to be a good listener.

Almost a year after I met him, he had a change in his employment situation. He would not be available to see me where I had been going. However, he began to call me at home from his personal cell phone, and he invited me to outside events not related to church activities. For the last four months before he moved, he took me to outside events. He invited me to lunch, dinners, and to his home. His hugs had become more intimate in that I could feel his “junk” sometimes and he would linger, holding me.

By December of that year, he was visiting me in my home. At my last appointment at the clinic that was closing, he asked me if it would be all right for him to follow me as a patient. I could call him anytime, since I now had his cell number and knew where he lived. He would continue to be my doctor and he would not charge me for “following me.” I readily agreed to that as I couldn’t imagine trying to find another psychiatrist. Later, when I told him I had seen another psychiatrist who didn’t feel like a good fit, he became enraged with me. “I told you I would be here for you! Do you really want to put all those toxic drugs in your system?” So, I never saw another psychiatrist the whole time he was in my life. I didn’t want to lose the good doctor, healer, and friend.

For two years I wondered what this relationship I had with him was. He was living apart from his wife, but often spent weekends and sometimes a week with her. Yet, when I stayed with him, we exchanged massages in which he would sexually touch me. He kept trying to get me to stay the night with him at his home. I was confused and tried to talk to him about what his intentions were. He always dodged these questions or simply stated, “This awesome relationship we have.” Then, one night, while we were intoxicated and lying on the couch in his home, he began to sexually touch me in a way that I knew I was being sexually exploited, but I just lay there limp. I thought to myself, if I just lie here he will stop if he thinks I am asleep. He did stop and I fell back to sleep.

He was so giddy the next morning. He couldn’t keep his hands or lips off me. I was trapped there with him as I was still very intoxicated. Later, the state investigator asked if he had slipped me anything in my drink. I did not have a vehicle. He took me home eventually, after stopping for a few hours at his parents’ and then his wife’s house! He texted me the next morning, thanking me for the wonderful evening, and I texted back, “You are welcome and likewise.”

I had to see him later that day at the spiritual community. I was trying to maintain control over what was happening to me. I saw him at the fellowship and he followed me around like a lost puppy. I finally told him he had to go home because I had to meet a friend for lunch that day. After lunch, he called me and told me he watched me at the restaurant where I had met my friend for lunch. I had no idea he was there. He was stalking me!

A little over a week later, I agreed to meet with him for breakfast. Four days after he had dropped me off at home, I had texted him “I am not OK.” He wanted to talk and invited me to breakfast. I was blindsided by what happened next. What happened next was a four-hour marathon of the oddest conversation I ever had in my life. He stated that I had eroticized the relationship. He denied any romantic interest in me. He said it was my entire fault. He stated that I wanted him as a boyfriend. I told him I did not want him as a boyfriend. I told him he heard me all wrong and misunderstood my behavior (compliance). I told him frankly I did not want his penis! He then told me he could place his penis in any orifice of my body if he wanted to! I looked at him and said, “You are crazy-making.” He said, “What?”

I told him of all the sexualized touch, comments, and the future planning he had expressed to me. He said, “I never said that.” Or, “I never did that.” I then said, “Now you are gaslighting me and it isn’t working. You are pissing me off.” He then burst into tears. He said, “You are going to out me. If you out me, I will just give up my license and then do myself in.” He begged me not to report him. He threatened suicide if I said anything. As I left his home that day, he stood on the stoop of his house, saying “I love you” over and over as I walked to my car to leave. Until the time I reported him, he continued to harass me by saying how much he loved me, or how special I was to him, or how we had this great connection. He kept calling me and saying he had to connect with me. “Let’s connect soon.”

 

Reporting What Happened to Me

It did not occur to me to label what had happened as sexual assault until later, after telling my story to a sexual assault advocate. I know I felt humiliated and violated by what he did. I was simply telling her about therapist sexual exploitation. It had taken me ten weeks after the event to make an appointment to tell her what had happened because I was worried about what reporting would do to him and his career. I cared about him and I didn’t want to lose his friendship. I told her I had just lain there because I didn’t want to be raped. She said, “I think you were raped.”

I made an appointment to report this to law enforcement, since there is a therapist sexual exploitation law in my state. Since the exploitation took place in two counties, I got the runaround of “You need to report this in the other county since the worst part of the exploitation took place in the other county.” The report was passed to an officer in the city where the perpetrator lived. It took them four weeks, even with my repeated calls as to where things were, to set up an appointment to get a statement from me. When that county did not charge him, they sent me back to the other county as they thought that county should be able to charge him. In the end, neither county charged him with the crime.

It took another three weeks for the one county to interview the perpetrator. I waited for another two weeks to hear anything from the district attorney in that county. I was told that they typically write up a letter that explains the charging decision. I insisted on meeting with them. It was a good thing I insisted on the meeting because I never received a letter stating why they did not charge my case. The county they sent it back to, to my knowledge it went straight to the district attorney, and the police in this county never investigated the case.

 

Why He Was Not Charged With A Crime

Too many survivors of therapist sexual exploitation and abuse are not believed. Too many of the perpetrators are not held accountable. Very few states have a criminal code that recognizes this abuse as a type of sexual assault. Survivors state that the words “boundary violations” or “misconduct” or “malpractice” fail to capture the violence involved in the process of being sexually abused and exploited. Very few law enforcement officers or sexual assault advocates are informed regarding the dynamics of transference and countertransference within the context of helping relationships. They do not understand how the dynamics of treatment are manipulated in order for sexual exploitation to occur.

Further, district attorneys and judges may not have the information they need to understand survivors’ behavior after the assault or after they realize the harm that has been done to them. The second part of the last sentence is important in order to understand why so many sexual assaults by therapists go unrecognized as assault. Most often these cases are understood as professional conduct violations and that the participants are consenting adults. Victims, law enforcement, and judicial professionals simply do not have the information they need to understand the neurobiology of trauma. Therefore, not having this scientific information, these helping professionals have no way to understand a victim’s counterintuitive behavior in the aftermath of sexual assault and exploitation.

In addition to the lack of understanding regarding the neurobiology of trauma, the added suspicion toward someone who is in mental health treatment complicates the ability to determine the credibility of the victim. Common myths regarding both what a “real” rape victim looks like and myths surrounding mental illness prevent those working in the legal system from comprehending what actual victims behave like during and after the assault.

Because law enforcement could not comprehend why I kept in contact with him after the assault they failed to see the violence I had experienced and the crime that was committed. My behavior was seen as discrediting as well as confounding. I was informed no jury would believe me and that it did not meet the “beyond a reasonable doubt” standard.

I continued to have contact with the perpetrator for six weeks. There were times I chatted with him via texting as if there was nothing wrong. There were other texts that told the story of suffering, being afraid, and of being perplexed by “the event.” This “split” reaction I had was interpreted as unreliable. Yet, this very behavior demonstrates the traumatic blow my brain and body had experienced from the years of sexual exploitation I had experienced.

The survivor of therapist sexual exploitation faces a multi-fold myth: what sexual assault is “supposed to” look like, what a “good victim” looks like, and what the perpetrator looks like. The myths of rape culture are many: A “real” victim resists her attacker and fights back with all her might. She reports to the police right away. She agrees to a sexual assault nurse exam. She doesn’t have any further contact with the rapist. She is able to describe in coherent, chronological detail what happened. She didn’t use alcohol or other drugs with the rapist. She isn’t a prostitute or mentally ill. She does not know her rapist.

The rapist in this myth is a vague, violent offender lurking in corners of the darkness who attacks a victim who is not known to him. He brandishes a weapon. He threatens her life. He leaves bruises and cuts on her. He vanishes back into the murky darkness and has no further contact with her. He certainly isn’t a highly respected doctor who has been practicing psychiatry for 26 years and a very gentle man on the surface.

My case was closed after the district attorney reviewed the case. The police officer had written that I had no problem what happened that night. I was flummoxed. If I didn’t have a problem with what had happened that night, why in the world would I have reported it?

 

Case Attrition

There is an 86% attrition rate for sexual assault cases. That means 86% of sexual assault cases never get charged. Sometimes the cases close before they reach the district attorney or are never investigated in the first place. Kenneth Pope in his research states that 4-8% of therapist sexual abuse/assault cases are ever reported to authorities or to licensing boards.[1] The likelihood of having a sexual assault case charged under these circumstances is extremely low.

It is hard to move forward with recovery when the sense of fairness has been robbed from the survivor. The criminal justice system cannot be accessed any further to help with obtaining that sense of fairness, justice, and a predictable world where wrongs are righted. Perhaps a survivor has been told, “You kept going back.” Or, “You had a consensual relationship.” “Going back” from the survivor’s point of view was compliance, not consent. Survivors of therapist sexual abuse are not the only ones who are told these cruel words. Many sexual assault survivors have had their credibility questioned because they tried to “fix” what happened to them by going back. Yet, compliance is seen as consent. Cases are not investigated or they are closed after the police investigation stage because “going back” was interpreted as consent.

However, when the survivor was seeking help for an emotional or mental health concern, the trauma of being disbelieved or dismissed only further increases the feeling that one is going crazy. The system takes the place of the abuser in crazy-making for the survivor. For the survivor, it is crazy-making on steroids!

Where other survivors may confidently turn to the mental health system to find solace and comfort from working with a therapist, this avenue may be cut off for the survivor of therapist sexual abuse. Further treatment in therapy may trigger the trauma experienced in previous “therapy” or “treatment.” It becomes a very, very difficult process to trust another therapist. Trust often cannot be established with a new therapist to develop a healing therapeutic relationship.

In my experience with the perpetrating psychiatrist, we did share many interests; at least he led me to believe that we did. We attended meditation together, drumming circles, and other alternative healing conferences. We read books on healing and discussed them with each other. It was in many ways like a long therapy session together, except I was caring emotionally for him most of the time. And, of course, there was the sexual abuse.

The mixing of the therapeutic relationship with an outside social relationship, sexual or not, confounded me. What he was doing was mixing pain with pleasure. This is a formula for traumatic bonding or Stockholm Syndrome. The avenues I used for healing other traumas in my life had now become painful. If I meditated, I thought of him. If I drummed, I thought of him. If I tried to read an interesting book, I thought of him. In my massage therapy work I was reminded of his sexual touching during the massages he gave me. My avenues of healing were avenues of pain. It has been a slow process of regaining the pleasure I once associated with these activities.

It is in this sense that this type of assault is compared with incest. The very person I trusted to heal old trauma wounds, whom I trusted to help me and to protect me from further trauma by creating a therapeutic sanctuary, violated me in the worst ways possible. I gave my sacred, secret information to a predator. I was a gazelle trusting a lion! He used this information to further control and isolate me.

The worst of the trauma wasn’t from the sexual exploitation or sexual acts themselves. The exploitive psychiatrist actually did very little sexual touching. He seemed to enjoy trying to triangulate me and his partner. He took pleasure in just seeing if he could “get” me or “woo” me. As traumatizing and bewildering as his unwanted sexual touch was, it was the grooming, coercion, and deception that left the deepest wounds. He pretended to be interested in and concerned with me. He made himself look like an overall swell guy showing care for me around his family, wife, and spiritual community. He was grooming them, too. I later found out that there was a patient connection with many individuals in his personal life, including other romantic interests. I learned that other members of the spiritual community were also patients or former patients of his. One member told me that I wasn’t the first or the last woman he had seduced. It was a nice little cult following.

In short, he committed soul murder. The criminal justice system and the civil legal system focus on the sexual acts. But how do you measure soul loss? How can compensation be derived from how slight or deep the penetration was? There is no measuring compensation for soul loss even if he would rot in prison or pay a large settlement. That is banal for victims of sexual assault. There is simply no money or prison time that can replace taking responsibility and offering a sincere apology. There is no compensation for not being able to trust another human again. So far, this psychiatrist has not admitted to any wrongdoing. He has denied all of the sexual contact. The justice system just isn’t designed, even with victim-witness oriented systems, to be supportive of the victim’s experience of trauma. At best they mitigate the retraumatization, but they cannot fully prevent it.

 

The Cumulative Effect of Therapist Sexual Exploitation

During the experience of the trauma, the survivor’s brain and body take over for them. Survival has designed the brain to shut down the prefrontal cortex so that we can respond quickly and effectively to a threat. However, if the traumas are repeated, the brain and the body respond with hyperarousal. If one is always in a state where the prefrontal cortex, which is the locus of much of our rational mind, is not working right, then we are not thinking clearly to make well thought out decisions. There does not need to be one violent act that a victim can point to for the brain to shut down its rational thought capacity. Many micro-aggressive acts have the same effect of a compromised brain “on trauma” as one large traumatizing event. In fact, recovery rates are significantly better with only one traumatizing event. When trauma is insidious it is only later, or sometimes much later, that the victim reflects on their experience and thinks: “I should have done this” or “I could have done that.” “Should of/could of/would of” rational thoughts are not accessible while in a traumatizing situation.

Because the perpetrating therapist is loved and respected by the survivor, she is unlikely to report what happened to her right away. It is hard for her to sort through what happened. She may blame herself. This is because very powerful neurochemicals are coursing through her body that prevent her brain from processing effectively the higher functions of rational thought, due to the very skillful grooming process by the predatory therapist.

She looks back and wonders why she didn’t see this or that or do this or that to protect herself from the exploitation. A district attorney, a victim-witness coordinator, a judge, or jury—they all may wonder the same thing. The behaviors of continued contact, protecting the offender, and extreme ambivalence toward the offender are often called “counterintuitive” behavior. These behaviors, when properly understood, should be seen as evidence of trauma. However, they are more often understood as incongruent to the victim’s account of what happened. These behaviors, when not properly understood, become reasons to not charge a case, because it is difficult to prove “beyond reasonable doubt” a crime was committed.

Survivors may find it helpful to understand common myths regarding sexual assault, the impact of assault on survivors, and how trauma causes a cascade of neurochemicals to flood the brain. These neurochemicals impair her ability to understand what happened to her. It is imperative that law enforcement and legal professionals understand the impact of trauma on survivors. Having a trauma-informed system would help decrease the attrition of cases.

A survivor of therapist sexual assault runs up against these common rape myths because the context of the sexual exploitation as rape is lost on the general public. Because of misperception, it is also lost on the victim. The myths regarding what a “real” sexual assault look like work against her not only in obtaining justice, they work against her in her self-understanding of what happened. Often she is very isolated because of these myths. Friends, family, and other helping professionals simply do not understand what happened to her because of the same myths.

Her neurobiology changed over time precisely because she was groomed to accept sexualized behavior in the context of therapy. Once she has become comfortable with the sexualized behavior of the therapist through the grooming process, the therapist will then move the contact into other spheres of her life. It begins to look like a regular relationship to her. The perpetrator no longer sees her “patienthood” and the patient loses her sense of being a patient or the sense that the psychiatrist is a helping professional with ethical boundaries. This lack of the sense of “patient sanctuary” creates a false bond of specialness or uniqueness that feels very good to the survivor and to the treating professional.

The perpetrator’s grooming does not stop with grooming the victim. He grooms others around him to accept this new person in his life and to hide his behavior in plain sight of other colleagues. He may offer to work longer hours or appear very dedicated to his patients in front of other staff. He may offer staff small favors. In my case, at the spiritual community where we socialized, there were colleagues who also attended the community, so it appeared to them we were friends. He hid in plain sight. This is the power of grooming.

Grooming is a slow process, especially for adults. You can’t simply give candy to an adult and get them to go along with you easily. Yet, like candy, he gave me many, many gifts, which started with simple tokens, like a gemstone rock, and increased to include things like expensive jewelry. It took a year of this gift giving, going to dinner, calling me socially, and hugging to break down my natural defenses. I did ask questions about what the gifts meant. I questioned him on what our “friendship” meant. Each time I questioned him on something, he would say something to the effect that he thought I was “special” and “underappreciated.” He expressed his appreciation through gift giving. Each time after questioning him like I did, he would go silent and not call. Sometimes it was weeks on end that I would not hear from him. The silent treatment served to create anxiety and to keep me off balance. It also taught me not to ask too many questions lest I would lose his friendship, which I had come to value.

When he first asked me personal questions outside the symptoms of my mental health condition while in treatment, I noticed this behavior. I said something to him. He told me that it was hard for him to know if my “symptoms” were really “symptoms” or if it was something situational I was experiencing. However, I wasn’t sure how him asking me if I liked going to an event with him or not related to my illness! He did, however, ask questions no other psychiatrist had asked me. At first I thought he was just a really good doctor for having curiosity about my life. It made me feel human and not like I was a “walking illness,” like I had in so many other encounters I’d had with psychiatrists over the years.

I was suspicious when he began extending our sessions to an hour. I was never billed for this extra time. Typically a medication check appointment with a psychiatrist is anywhere from 15 to 20 minutes. When I asked him about the extra time he replied, “No one was scheduled after you so I thought I would spend it with you.” Again, this was intended to make me feel attended to and “special.” Eventually he would tell me I was “very dear to him.”

Perpetrators target people they perceive to be vulnerable, believe will not tell, or whom they consider unreliable reporters. Grooming is a process they not only use to “normalize” unprofessional sexual conduct, but it is also a way to control and gauge where they are at in their power over the victim.

Possible grooming behaviors include, but are not limited to:

• Taking unusual interest in the person
• Buying them gifts
• Offering to do favors
• Excessive compliments, such as on appearance
• Acting like a boyfriend
• Hugging
• Touch
• Massages
• Meeting with the person outside the therapeutic setting

Eventually, the grooming is less covert and becomes overt without raising the alarm of the individual being manipulated. They begin to use threats to keep the person compliant. I felt particularly honored when he began telling me of his struggles, fears, and other anxieties. He would couple telling me about his struggle with addiction with, “Maria, please don’t tell on me.” I thought that if he could trust me with his feelings and struggles, I must not be so “sick.” He used my natural caretaking ways as a vehicle to gain further trust. Of course I wasn’t going to tell! Look at how much he trusts me!

Grooming includes “love bombing.” Love bombing is not love. It is meant to overwhelm and confuse the victim. The barrage of constant attention and affection overwhelms the senses and the natural defenses. It does take the victim off guard and can cause confusion between intimacy and intensity. Ultimately, she may feel like she has never been loved like this before and she thinks she has found her soul mate or ideal friend or lover.

Intense grooming such as love bombing is coupled with intermittent withdrawal by the perpetrator. This communicates to her that he can discard her at any time. That prospect is frightening, as she has now grown accustomed to the favored “special” status. Out of all his patients, he chose her. Being favored by the perpetrating psychiatrist may feel good to anyone, but especially to a person with a serious mental illness. He may be one of the few persons in her life who is giving her any attention that feels good. More than likely she is unaware of the impact that childhood trauma or previous sexual abuse has had on her and how the perpetrating psychiatrist is taking advantage of the information she has shared in treatment in order to manipulate her.

The victim will now do anything or everything she can not to lose the “special” status and fall out of graces with the perpetrating therapist. I eventually took an intoxicating substance with him. The idea of taking this substance was his idea. He wanted to have some sort of spiritual breakthrough. He told me that he was so desperate and had so little hope. He asked me to do this in order to help him. He pleaded, “I am so lonely.” I found myself complying and making poor decisions in order to support and please him. He had made it clear with his silent treatments that he could easily discard me.

So, even after uncomfortable sexual touching, I kept going back. He would never say anything when he touched me in this way. He just did it and never said anything about it. It was as if this touching occurred outside of space and time. Afterwards, he would not contact me for long periods of time. I wondered what I had done wrong. It was very confusing. When I did try to talk to him about these things, he would change the subject as if what I was asking or saying had not been spoken or the actions never happened. Then suddenly, he would be really sweet toward me again. It was at these times he would gift give and play at emotional intimacy. I later came to realize these were the tactics he used to control me and to keep me silent.

The fact that I kept returning to him and stayed in contact with him was used against me by the legal system. I was told, “You kept going back!” What those in the legal system failed to understand was that the grooming behavior had brought me to where I would comply with what he wanted. I wasn’t in love, but I found myself not wanting to upset this man. I found myself wanting to please him in ways I did not understand myself. The district attorney and the investigating officer confused my compliance with consent. Those working in the justice system do not understand that adults can be groomed and that grooming is traumatic on the victim. It is traumatic because it is violence. They miss that the “going back” does not constitute consent. It is compliance, not consent. Therefore, they could not conceive that I was responding from a traumatized, vulnerable condition.

Those who were supposed to help me simply did not understand the neurobiology of trauma. They saw behavior they could not explain without having the appropriate educational background about the neurobiology of trauma. Prolonged grooming is in itself an assault that takes place slowly and deliberately. For women who are already vulnerable emotionally and psychologically, they may not be able to detect that anything is going amiss with their therapy at first. They have learned to comply with authority as part of treatment. They have learned to stuff down their objections precisely due to previous grooming by previous predators. A large percent of therapist sexual exploitation survivors have histories of childhood sexual abuse or have experienced other interpersonal violence. Victims may also have learned compliance as part of the expectation in treatment by previous treating professionals.

Mental health consumers learn pretty quickly not to question mental health providers without there being consequences. Mental health consumers may be under the threat of forced treatment such as outpatient commitments or emergency detentions in psychiatric hospitals. Mental health professionals in many states can begin the process of forced treatment, which is another tool for control and coercion that some of these predatory psychiatrists and therapists use against victims. Although I am not focusing on the role of compliance in treatment that makes people vulnerable to exploitive therapists, compliance is never the goal of treatment. Unfortunately, compliance is often expected in mental health treatment. It is this compliance that creates further vulnerability in the therapeutic setting and is exploited by the professional.

For women who have lived through therapist sexual abuse, they may blame themselves or believe they had a consensual relationship. Until they are “discarded” by the narcissistic therapist, they may not even realize all the harm they have experienced. However, this doesn’t mean they felt good before they were discarded, either. The confusion is overwhelming while the person is in the relationship. It creates extreme ambivalence. There was never a time in which it felt “right.” Usually the predatory therapist’s goal is to keep the person off kilter in order to control the patient and keep her compliant and silent. This repetitive, intermittent reward and punishment cycle creates a very strong trauma bond, which explains why it is so difficult to leave the abusing therapist. Many victims report that they called it off or tried to not go back, but were mystified by their own behavior when they kept going back.

The district attorney in my case referred to the cycle of abuse as domestic violence. Referring to the sexual exploitation as domestic violence was offensive to me. I was certainly not in a domestic relationship with my doctor. I did not perceive my relationship as a domestic partnership. I did not even want a romantic relationship with him.

I was perplexed by how the justice system failed me. These individuals were trained in recognizing counterintuitive behavior as part of having received training to be a sexual assault response team provider county. Yet, the rape myths prevailed even where there was training. These individuals who were involved in my case should have known that most women will comply and freeze when facing a sexual assault. Many delay reporting because of what is labeled “intimate partner abuse.” That term means one knew the perpetrator. They should have also known that about 75 percent of sexual assaults involve alcohol or other drugs. In my case, these facts certainly were true as well. Because I had extensive background in domestic violence and sexual assault services, I was extremely humiliated that this had happened to me. I acted “as if” for several days after: I acted as if it never happened. Acting “as if” is also a trauma response and a strategy used by survivors in order to try to take back the power stolen from them as a result of the violence committed against them.

The police officer, the state investigator, and the district attorney all made reference to me being a “professional” woman. It implied I should have known better. Most vulnerable adult laws would exclude women like me because they focus on the ability to intellectually understand the implications of a sexual act, including societal responses. Trauma responses are not about the intellectual ability to comprehend. Many women who experience therapist sexual assault have in their histories childhood sexual abuse[2] and one third have experienced previous sexual assaults.[3] The vulnerability isn’t intellectual; it is developmental in her inability to access the “felt sense” of the body. Submitting and complying allowed her to survive in the past. When under threat, she falls back on what worked in the past. How she survived any previous threat will determine what her brain will do in response to a current threat.

She doesn’t consciously choose her response to trauma. Under threat, people will go into a fight, flight, or freeze response. Of the three, the most utilized survival skill is not fight or even flight, it is freeze. Freezing and submitting are the most conditioned responses people have. Otherwise we would all be bloodied and bruised much more than we are in society. So, when under threat, the brain goes to what it knows to do. Unless this is trained out of the person, her brain will go with the old standby solution. She doesn’t have to be floridly psychotic or out of touch with reality to be extremely vulnerable to sexual exploitation and to comply with the perpetrator.

In fact, trauma responses are not symptoms of mental illnesses. Previous experience with what one has learned when under potential threat or harm determines how the person will automatically respond to a current threatening situation. Bessel Van der Kolk calls this “the brain on trauma.”[4] It is a human response that arises out of what previously happened to a person. If that response allowed the person to survive, it will be tucked away as a ready survival response for the next time something happens that poses a threat.

Rape myths, however, say that a victim will fight or flee the situation. “Real” rape victims do not easily submit. “Real” rape victims don’t love their rapists or try to make peace in the relationship after the assault. “Real” rape victims are not educated professional women working the domestic violence and sexual assault field. “Real” rapists aren’t doctors. The reality is, the more a rape looks like the mythical “real” rape, those cases should be scrutinized closely. This is not to say that real rapes do not happen as they do in Hollywood, but the statistics bear out that the more they resemble what is portrayed on television, the more likely that rape may be confabulated in some way.

If 86 percent of all rape cases are never charged, more than likely the other 14 percent of rapes resemble the “real rape” myth perpetuated in the media. A violent sexual assault committed against a victim is more likely to be charged if the assault resembles what judges and juries expect. Police officers may not send a case that does not resemble the mythical rape to the district attorney. If law enforcement and the judicial system form conclusions “about victims’ credibility or entitlement to legal protections and rights are based on rape myths, these victims are denied fair adjudication.”[5]

 

Moving Forward After Justice Denied

 He denied everything, of course. He never had to produce any evidence to counteract all the evidence I had provided to the police. There was enough corroboration in the police report that could have been used, but I never got my day in court. I simply was not the “good victim.”

Accessing justice is correlated with better mental health outcomes for sexual assault survivors. If 86 percent of sexual assault cases are closed or found baseless, then 86 percent of survivors struggle to recover fully. That number is unacceptable to me. If only 4-8 percent of sexual assaults committed by psychiatrists and therapists are ever reported, how many more survivors struggle with recovery because justice was denied? In fact, many states simply do not recognize this form of sexual abuse as sexual assault. It is not addressed in most state criminal codes. Licensing boards do not have the authority to incarcerate or even put these offenders on the national sex offender list if therapist sexual exploitation is not recognized as sexual assault in the criminal code. Far too many of these perpetrators receive nothing more than a slap on the hand, such as an administrative warning, for “erring” in their professional conduct. Further, if they are not even licensed, then licensing boards cannot hold those individuals accountable. Unless the state’s criminal codes include unlicensed individuals, then criminal prosecution is unlikely.

An attorney friend of mine is bit more cynical regarding the “reasonable doubt” standard. She believes they just won’t charge these crimes, not that they can’t charge these crimes. She believes the “beyond reasonable doubt” standard that district attorneys are told they have to use in order to evaluate a case before they charge the case is used as an excuse to not charge them, not because the case meets the actual reasonable doubt standard. She believes this is because many district attorneys do not believe that therapist sexual exploitation should be a crime. I, too, wonder if this is the case in states that have criminalized therapist sexual exploitation but fail to charge perpetrators with the crime.

In those states that have criminalized this conduct, it is almost virtually impossible to prosecute because of many of the so-called “counterintuitive” behaviors or what appears to be “consensual” behavior to law enforcement. They may be treated as “he said, she said” cases. Unless he says “I did it,” there will be difficulty in overcoming the “reasonable doubt” standard. Many states do not allow expert testimony to explain “counterintuitive” behavior to the jury.

My story, like those of so many other women who have survived this form of rape, does not have a happy ending. The bad guy did get away with it. I have to live with rebuilding my life without justice. The road is indeed much more difficult because I was denied justice. My words of advice for the readers of this story are this: Do not judge yourself harshly. You could not have known better. There is nothing you did wrong. It is always the doctor or the therapist who has the responsibility of upholding their ethics. It is always the professional’s responsibility to “first, do no harm.”

The legal system is fraught with people judging the victim and focusing on her behavior. Instead, focus on the perpetrator. Look at his behavior. Get appalled. Point out how counterintuitive it is for a doctor to exploit his patient who trusts him to heal and not harm. Point out how he coerced and cajoled. Point out that he asked you to lie for him to cover his ass. Point out how he threatened you or threatened suicide if you told anyone. Your behavior during and afterward is nothing to be ashamed of because it was not predatory. You acted as a human being. He acted like a sociopath. It is his behavior that should be seen as shocking, incongruent, and counterintuitive as a human being.

 

More of My Story

 I remember being grateful and thankful he cared so much for me that he risked his license for me. Of course I wanted to protect him. He was such a caring person for taking a personal interest in my life. Looking back I can clearly see he did not have my best interests at stake. He NEVER had my best interest at stake. Never.

I suspected something was not right with the relationship. I suspected he wanted something sexual from me. However, I did not trust myself. I wrote in my journals at this time the things he did, how he touched me, and what he said to me. I couldn’t believe he would want something sexual from me, though I had the suspicion he did. I could not believe that this was his intention when he crossed the boundaries and asked me to a social event with him. I remember thanking him for helping me and for being part of my transformation. He said that he stood amazed at how much I had “progressed” in the past two years he had been in my personal life. He stated, “See, healing does happen in relationship.”

It kept coming back to me that this psychiatrist-friend relationship was odd. He wanted something more. I kept wondering what it was. Most of the time I was attending to his psychological needs and emotional needs. What was going on? What was this relationship?

What my mind kept telling me was that perhaps my psychiatrist “friend” wasn’t such a benevolent friend after all. I was having more and more misgivings. Empowered by the insight I had gained, I did confront him with what I knew. I knew he had feelings for me that ran deeper than friendship. I knew he wanted a sexual relationship with me. He told me he wasn’t going to deny that he wanted that and that he didn’t want to get in trouble from the medical board. He told me he loved me and how dear I was to him.

I knew I loved him, but it was not romantic love. I did not fully realize how narcissistic or dangerous he truly was. I failed to realize he was a vulnerable, malignant narcissist to his core. His mask hadn’t fully slipped yet. He did tell me that “the relationship” was good for me and I was having a “corrective” experience and that he liked how our relationship was progressing.

He then spent the next four weeks love bombing me. When that didn’t work, he showed up at my house upset. He said he felt like a failure and asked if I would do some intense spiritual work with him. He seemed very distraught. I agreed to help him. I went to his house to help him sort out what he was feeling. It was a night that changed me forever. I knew this “relationship” had to end.

Once I was away from him after that weekend, it all hit me like a ton of bricks. I saw him less than a week later and I physically got sick when I was around him. I left the event we were at early. He walked me to my car. He grabbed me and was trying to passionately kiss me. I was able to get in my car and drive away. About ten miles down the road I pulled over and was sick to my stomach. It was then I began to communicate to him how I really felt about what had transpired. I told him, “I am not okay.”

I communicated with him for a little over a month before I decided I just couldn’t be around him anymore. It took me another month to gather all my information and write my complaint to the medical board. I was encouraged by a friend to seek the services of a sexual assault advocacy program. I was encouraged by an advocate there to report to the police the therapist sexual exploitation. So I did.

 

A Not So Happy Ending

Do I regret reporting? Yes and no. As with the sexually exploitive abuse, I have very ambivalent feelings about reporting. I was re-traumatized by the legal system. I never got any satisfactory feelings out of reporting. I did not report for revenge, but I never felt relief for reporting either. I reported out of a sense of obligation for fellow patients who should not ever have to go through what I did. I was naïve that I somehow thought my case might be different from the all too many stories like mine I have heard about over the years. The last thing I needed was to feel more disempowered by the system that was supposed to be there to help.

I know that if he does this again or if other victims come forward and report, it will not bode well for him. I do not know if my reporting will deter him. It is my hope it does. More than likely, if he gets away with very little consequences, he will likely get even better at what he does. I truly understand why victims may stay, keep going back, or never report. When the legal system victimizes, blames, and discards the victim, how is that any better than staying with the perpetrator or just moving on in silence? That isn’t empowering either. However, I would say that I do not regret reporting. I regret how I was treated by the system.

On a personal level, I still struggle with the fact I promised him I would not tell. It isn’t because of the outcome for him or even that he felt betrayed by the fact I told his secret. I am conflicted by my value system. I usually keep my word. But in this case, it was insidious that he even asked me to not “out” him. He was first and foremost my healer. He was supposed to be my friend. He was a mentor. Yet he was none of those things from the moment he targeted me and groomed me in order to meet his needs. I even think he took pleasure in duping me. Yet, by telling I did break his power over me. If I had not told the secret, I would have continued to be a victim. Because of the value I place on community, I felt a duty to warn the public in order that the public be kept safe from this man. He is nothing like he publically portrays himself to be. This was a higher road than keeping his secret. Although telling the secret has cost me, silence equals rape and I am silent no more.

 

[1] Kenneth Pope. “Sexual Involvement with Therapists: Patient Assessment, Subsequent Therapy, Forensics,” 1994.

[2] Richard Kluft. “Incest Related Syndromes in Adults,” 1990.

[3] Pope, 1994.

[4] Bessel van der Kolk. “The Body Keeps the Score,” 2014.

[5] “Victims’ Rights Compel Action to Counteract Judges’ and Juries’ Misperceptions About Sexual Assault Victims’ Behaviors.” NVCLI Legal Publication; p. 4, June 2014.