Early in June, The Boston Globe ran a piece about a psychologist in Boston who had sex with one of his patients. Reading the online comments after that story, it’s clear to me that most people do not understand the dynamics underlying this type of serious, evil professional misconduct.

No mental health profession allows therapists to have sex with their patients. It is in each profession’s ethical code of conduct. And it is against the law in most states (though not, in fact, in Massachusetts).

The lay public does not understand the underlying dynamics that make patients vulnerable to this kind of sexual betrayal.

Patients enter psychotherapy because they feel out of control, depressed, or vulnerable in some way. In many cases, patients came from families in which they did not get the kind of love and support they should have received from parents.

The therapist’s role is to be a concerned helper in the patient’s life. The therapist turns loving attention to what the patient says in each session, not asking for emotional attention in return.

When the psychotherapist is skilled and ethical, particularly over time, psychotherapy is a deeply healing experience. For many patients, the experience with the psychotherapist is the most loved and listened to they have ever felt in their life.

However, the patient can develop idealized, somewhat irrational feelings of adoration and love for the therapist, because the therapist seems so selfless and devoted.

In their training, psychotherapists are taught how to deal with the patient’s idealized and often sexualized feelings toward them. These feelings are very flattering, of course. The cardinal rule is to allow the patient to explore those feelings verbally, to normalize them as what is called “transference”— and never to act them out in the session or outside of the session.

Keeping this boundary is the therapist’s responsibility. The therapist has all the power, all the knowledge, and all the responsibility.

Being sexually exploited by one’s therapist is experienced by most people as so shameful that it is kept a deep, dark secret, even from friends and families.

The recent Boston Globe story is exceptionally distressing because the whistleblower brought the case to the state licensing board two years ago, and no action has yet been taken.

If you have been sexually victimized by your therapist there is an excellent resource: the Therapist Exploitation Link Line (TELL).

TELL is an online organization with volunteers from all over the U.S., Canada, and Australia that offers a place for survivors of sexual and emotional abuse by psychotherapists or other medical personnel. All of the volunteers who speak with victims are people who themselves have experienced and survived this kind of sexual victimization.

TELL volunteers give advice on how to navigate your way through this terrible experience, and the website offers excellent readings on the topic.

Sometimes, TELL helps victims of medical and psychotherapeutic exploitation contact each other (only with their permission) to network. Otherwise, TELL keeps everyone’s information confidential.

If you feel that your therapist is acting “creepy” and blurring boundaries, TELL will be a great resource. If you have already been sexually violated by a helping professional, contact them.