“You fuck your patients, and your patients will FUCK you,” was the generally wise counsel given to me by my mental health supervisor, a shrink (psychiatrist) when I worked as a master level counseling therapist at a Community Mental Health Center at the start of my career. I say generally wise because it wasn’t always accurate or relevant.
I had numerous relationships with former “clients” or “patients” as a counseling therapist. I’m neither proud nor ashamed of this conduct in any general way, each situation and instance was unique in terms of circumstances; both where I was in my life at the time and where the former client was in their's. The ethics of such conduct can and should be legitimately questioned and judged.
But this questioning and judgment must consider many important factors, and in American Christian society, anything dealing with sexuality is preferred to be dealt with, if at all, in the most stark, black and white, right and wrong, cut and dried manner—just like the bible tell us to do, except for those myriad places in “the good book” where it contradicts itself—you know slaves, multiple wives, concubines, and always a stern admonition against anything pleasurable and joyful if it had S-E-X attached.
A caveat: I’ll be 76 years old in less than two weeks if I live that long which I expect and hope to do. I have always been a writer, but now that’s about all I am. I am not a therapist any longer. I am not a college or any other kind of teacher. I am not a public figure, nor do I have any desire to be seen as one. My writing is now, as it has always been, meant to make the world a better place, which starts with being honest and truthful. I have no skin in this game any longer, I am past the statute of limitations for any conduct that might have once been considered criminal, such as placing my penis into any orifice other than the make-a-baby one, or for which I might have been accused of harming that someone could allege I’m civilly responsible for doing or not doing, besides I don’t have enough money to make such a suit worth it. If there are any individuals out there reading this who feel anything that I ever did was harmful to them, I sincerely apologize especially if their feelings have considered their own choices and conduct. For others, and I hope you know who you are, while age is no excuse for risking harm, life does go on and unfold in many ways we’d not have expected. I can’t help it that for many years, at least a couple of decades, I was considered handsome and charming and to some people “sexy”.
A further simple confession, while I’m at it anyway, orgasm has always been my favorite drug. The release at a sexual climax is the best feeling in the world. John Lennon is quoted as saying in the Beatles Anthology Book, that sex was the only physical activity that interested him any longer. Sex is better than the image of your gentle baby sleeping peacefully, better than the loveliest sunrise or sunset, better than a nice steak dinner, or a compliment from one of your peers and loved ones. Sexual release is the best, maybe that’s just me but if it is, how come there are over 8,000,000,000 of us walking around out here trying to get laid?
Training & Choices
Although I was trained in Psychology as a developmental psychologist, I studied counseling, clinical, and other parts of the field well enough to eventually be employed as a master’s level therapist in a variety of counseling settings.
Early in my career as a therapist, I was intrigued by Provocative Therapy (PT). This is a type of psychotherapy that employs comedy, sarcasm, and overstatement to confront the client's pessimistic views and habits. The therapist acts as a friendly opponent and agrees with the client's issues, while also being caring and understanding. The aim is to stimulate the client to stand up for themselves, affirm their value, and make positive changes. In many of my cases, this approach seemed to work well, and it always fit my personality and strengths. I always felt compassion for my clients.
Some of the benefits of PT were: - It can assist clients who are in a stalemate, reluctant to change, or too solemn. It can generate a dynamic and captivating environment that lowers the client's stress and resistance. It can spark the client's ingenuity and adaptability and help them find new insights and outcomes. It can cultivate a solid therapeutic bond based on reciprocal esteem and confidence.
Some of the minuses of PT were that It can be misunderstood or misused by inexperienced or insensitive therapists, who may offend or harm the client. It can be inappropriate or ineffective for some clients, such as those who are highly sensitive, depressed, or psychotic. It can be difficult to balance the humor and the seriousness and to know when to switch from provoking to supporting the client. It can be challenging to evaluate the outcomes and effectiveness of the therapy, as it relies on subjective and qualitative measures.
Sometimes PT was not effective or helpful to the client. Some of these difficulties in Provocative Therapy led me to a natural, similar form of counseling, set still in a client-centered approach to therapy. Carl Rogers Client-centered therapy (PCT) is a psychological approach that emphasizes the client's autonomy and capacity for self-determination in the therapeutic process. PCT differs from other types of mental health therapy in several ways, such as:
- PCT therapists are non-directive, meaning they do not pass judgment on the client's feelings or offer suggestions or solutions. Instead, they act as an equal partner and facilitate the client's self-exploration and growth.
- PCT therapists create a therapeutic environment that is comfortable, non-judgmental, and empathetic, by using three techniques: genuineness and congruence, unconditional positive regard, and empathetic understanding. These techniques help the client feel safe and free from judgment and allow them to express their true thoughts and feelings.
- PCT therapists believe that the client is the best expert on their own life and experiences and that they have a self-actualizing tendency, or a desire to fulfill their potential and become the best that they can be. PCT therapists encourage the client to determine their direction and goals and to rely on their own strengths and resources to change.
- PCT therapists use the term "client" rather than "patient", to emphasize the importance of the individual in seeking assistance, controlling their destiny, and overcoming their difficulties. PCT therapists respect the client's dignity and worth and do not view them as sick or in need of a cure.
Some examples of other types of mental health therapy that differ from PCT are:
Rational emotive behavior therapy (REBT) is a bossy type of cognitive-behavioral therapy that targets and attacks the crazy ideas and feelings that make you miserable. REBT therapists give a lot of orders, expose the flaws in your thinking, and teach you how to swap them with more sensible ones.
Psychoanalysis, is a kind of psychodynamic therapy that digs into the hidden agendas and dramas that shape your behavior and personality. Psychoanalysis therapists use tricks such as word association, dream decoding, and mind reading to reveal your buried secrets and emotions, and to help you sort out your inner mess.
Behavior modification therapy is a type of therapy that tries to change your bad habits by rewarding or punishing you like a dog. You see, according to some guy named Skinner, you are nothing but a product of your past experiences and the consequences they had. So, if you want to stop smoking, drinking, or biting your nails, all you need is a therapist who will give you a treat or a shock every time you do or don't do those things. Sounds fun, right? Who doesn't love being manipulated by someone who thinks they know better than you? Behavior modification therapy is based on the idea that you don't need to understand why you do what you do, you just need to do what you are told. Forget about your thoughts, feelings, or values, they are irrelevant. Just focus on the outcome, and don't mind the side effects. Behavior modification therapy is perfect for anyone who wants to become a mindless robot who follows orders without question.
My treatment of clients was not seeing them as needy, sick, losers who required me to save them, but instead as more or less equals to me, and our therapy was us starting off together to solve one or more of their problems. One of the founding principles of Provocative Therapy that goes along with PTO as well, is the assumption that the human experience is closer to universal than it is unique, and that we all have gone through, are going through or will go through very similar times of life; loss, love, hope, disappointment, grief, joy, all of it. We are all in this fucking mess together, and the client is wanting help through a difficult passage rather than for me to pretend to be a savior or hero.
“If you fuck your patients your patients will fuck you.”
But if you establish a relationship of human equality, treating your client as you’d want to be treated if your situations were reversed and recognizing that this could very easily be the case if a few variables were shifted around, in these circumstances of equality the chances for anyone feeling a need to fuck anyone in the pejorative sense of the expression, becomes far less likely or onerous.
My hope and belief are that I did far more good as a therapist than harm. I never lost a client to suicide despite working with some of the most suicidal people in our community, some of whom, after leaving therapy with me eventually did end their lives. I made friends, a few lovers and often both over the years I spent trying to help.
This is not a mea culpa. It is a true testimony to who I was and who I am now. I hope the world will be at least some tiny bit better for my having been here, but if not, at 76 years of age, don’t worry, I’ll be gone soon enough.