Sex in the forbidden zone

Sexual exploitation, by design or accident, in professional relationships is becoming increasingly a source of concern. A psychiatrist looks at the issues and calls for maintaining the sacred frontiers in personal relationships.

Peter Rutter, M.D., is a psychiatrist, practicing in San Francisco.

Twenty years ago I began my psychiatric practice with the be lief that sex with patients was out of the question. I assumed that everyone in my professional community also observed this prohibition. The only doctors and therapists who had violated it were, I was sure, confined to the criminal or lunatic fringe.

It took me nearly a decade to stop believing in the myth of the beneficent doctor. I was forced to acknowledge that a yearning for just such a forbidden episode existed within myself, and was shocked to discover that a psychiatrist who had been my mentor had for years engaged in sex with women patients. I have since discovered that sexual exploitation by men of women under their care or tutelage is actually quite common, and that a remarkably similar pattern of sexual contact is perpetrated not only by male doctors and therapists, but by male clergy, lawyers, teachers, and workplace mentors.

What I have come to call sex in the forbidden zone sexual behavior between a man and a woman under his care of mentorship in a professional relation ship can occur any time a woman entrusts important aspects of her physical, spiritual, psychological, or material welfare to a man who has power over her. (Women in power can exploit men too, but the balance of power is all too often in the other direction and such situations represent a small percentage of cases of sexual abuse.) Because these relation ships invite both men and women to put into them their strongest hopes, wishes, fantasies, and passions, they are especially vulnerable to abuse and can be severely damaging to both people.

My encounter with Mia

I lost my professional innocence during an incident that came upon me suddenly, dangerously, in the closed chamber of my first psychiatric office, when I felt the psychological barriers protecting me from forbidden sexuality come tumbling down.

It happened on a dark, rainy evening when a patient I will call Mia came to her appointment with the unspoken, unplanned, but extremely compelling agenda to offer herself sexually.

Mia was a tall, dark-haired woman of 25 whose bright clothes and quick pace masked her severe chronic depression. Life had dealt her nothing but deprivation and loss she had dim memories of possible sexual molestation by an older brother and had for a time drifted into street life and drug abuse. In the five months she had been my patient we had identified her pattern of becoming sexually intimate with men rather quickly because she felt she had no other way to keep them interested.

Nevertheless, Mia had never been seductive with me. But that night, without warning, I felt her sexuality directed to ward me from the moment she stepped into the room with an intensity beyond anything I had yet experienced.

Mia made her way to the patient's chair, but did not stay there. As she spoke, tearfully recounting a humiliating rejection from a man she'd been dating, she slid off the chair and sat cross-legged in front of me. The sexual posturing grew more intense as she looked up at me, wondering through her tears whether men would always use her and throw her away. In her desperate need for comfort, Mia began to edge toward me, brushing her breasts against my legs, beginning to bury her head in my lap. As she reenacted her role as victim, all she needed was my participation.

Nothing in my training had prepared me for this moment. I sat frozen, neither encouraging nor stopping her. I was overcome by an intoxicating mixture of the timeless freedom, and the timeless danger, that men feel when a forbidden woman's sexuality becomes available to them. I also sensed that if I went ahead with this sexual encounter, I would be able to count on Mia, as a well-trained victim, to keep our illicit secret.

Another part of me. however, remained separate from this sexual intrigue. This part was trying to understand what was going on inside Mia and searched for a way I could help her.

I made a choice in that moment: I asked Mia to return to her chair. In our respective seats, we began a therapeutic exploration of the way she was bringing me her illness, her self-destructive pat tern, in the only way she knew how by repeating it with me.

I realized that at the critical moment the path taken depended not on her but on me. To steer her toward the healthy side, I had to fight off some typically masculine components of my sexuality that were all too ready to accept Mia's self-destructive offering.

How the boundaries erode

From this experience I discovered just how passionate and dissolving the erotic atmosphere can become in relationships in which the man holds the power and the woman places trust and hope in him. Having sex with patients was not out of the question at all, I realized. In fact, it was both more readily available and powerfully alluring than I had ever admitted.

Day after day we men sit in inviolable privacy with women who trust, admire, and rely upon us. There is a constant pull toward greater intimacy. Businessmen travel with their female protegees, sharing adjacent lodging in faraway cities. Women who see lawyers, especially in divorce or custody cases, usually disclose to them the most intimate details of their lives. A male teacher or professor can invite a woman's trust through his ability to foster her intellectual or professional development. A doctor has instantaneous access to a woman's unclothed body and thus to the sense of self she experiences through her body. Therapists and clergy invite the women under their care to share secrets, sexual and otherwise, that they would never disclose to anyone else.

If we have been working together for some time, a familiarity and trust develop that start to erode the boundaries of impersonal professional relationships. Openly or not, these women often convey their feeling that we are treating them better than they believed a man could. As a result, we find ourselves experiencing a closeness, a completeness, with these women; and many of them begin to feel the same way about being with us.

But while women have the ability to hold intensely passionate feelings that remain distinct from being sexual, under these same conditions men are flooded with images of sexual union. The rule forbidding sexual contact with these women can seem hazy and distant, no longer applicable. In the moment it feels so easy, so magical, so relieving for us to cross the invisible boundary and merge with the woman in shared passion.

Yet every time I have found myself having sexual fantasies about a patient, I have discovered, as I did with Mia, that something holds me back not just a rule against sexual contact, but a feeling that something of great value will be destroyed if I cross the line. I still shudder to think how close I came that night to harming the two of us.

The destructiveness of sexual betrayal

For harm it is. Although conservative estimates suggest that several million women in this country have been sexually victimized in relationships of trust, no numbers can possibly convey the full human cost of sex in the forbidden zone. Because men so often control a woman's future and her physical, psychological, spiritual, economic, or intellectual well-being the mere presence of sexual innuendo from a man who has power over her can determine whether she experiences her femininity as a force to be valued and respected or as a commodity to be exploited.

When trust turns into a sexual opportunity for the man in authority, the damage can be even more critical. He binds her to him, and when he relinquishes her she is often too injured to find happiness in another relationship. She is likely to adapt to the victim role, repeating it in other relationships, each time losing more of her self-respect and enthusiasm for life.

A woman also suffers serious injury when she resists a man's sexual incursion: He makes it impossible for her to continue their relationship, so she loses a teacher, healer, guide, or mentor. This loss can doom a woman to years or a lifetime of hopelessness about expressing her potential in a relationship or in work.

The damage a man causes himself is often elusive, because in the moment of forbidden sex he may be able to convince himself that he is satisfying a deeply felt need. Yet by exploiting the woman in order to feel more fully alive, he abandons the search for aliveness within him self. When a man's brief moment of forbidden sexual release is over, he is further still from the access to resources within himself that his sexual fantasy represents.

Why do men, many of them professionals who have taken oaths not to partake of such behavior, attempt to realize the fantasy of forbidden sex? Why do women, many of whom have no interest in beginning a sexual relationship, allow their positions to be compromised? To understand, and ultimately alter, these behaviors we must take into account the feelings buried in all of us that make forbidden expressions of sexuality so difficult to resist.

Why women comply

Every woman I've spoken to who engaged in forbidden-zone sex described the immeasurable nonsexual value she felt the relationship had attained before any sexual behavior took place. All felt they acceded to sex as a way of maintaining a relationship that had extraordinary importance in their lives.

A male therapist, pastor, or teacher may be the first man in a woman's life who listens to her, encourages her, and teaches her to develop her own strength. When a woman feels from a man this recognition for who she really is, the relationship becomes vitally important to her.

Most of these women, in trying to account for the reasons they participated in sex with a therapist, pastor, or mentor, also cited cultural factors in their upbringing that steered them toward complying with the sexual desires of these powerful men. They felt that the force of this preexisting message that encourages compliance, when combined with their inner need to hold on to the extraordinary promise offered in the relationship, set up a psychological trap they were powerless to resist.

The dark side of the masculine

The power of the forbidden zone has as much impact on a man's psyche as it does on a woman's. The allure of the forbidden is a central theme of male sexual psychology. When he holds a position of trust, the ordinary man with an inclination to cross forbidden boundaries emerges from beneath the professional role.

Another central component of sex in the forbidden zone is what I call the "masculine myth of the feminine" attitudes that shape the way women are perceived by men and, because of cultural influences, how women see themselves.

In masculine mythology, a woman, above all, should show deference to a man. Even mixed with love and respect, its presence as a value internalized by women sets the stage for exploitation.

Another part of the masculine myth of the feminine involves the tremendous healing, nurturing, and sexual powers that men attribute to women. Attributing these abilities to women drives men toward near-desperation in their attempts to get close to or inside the soul or body of a woman, allowing them to ignore what ever violation may be involved. If he is a male professional and she is under his care, he can permit himself to believe that her erotic powers are so strong as to overwhelm his ability to refrain from having a sexual relationship with her.

The woman, meanwhile, may or may not actually behave seductively. If she is seductive, it's often because she's blindly playing out the masculine myth that wants her to be. For instance, Mia offered herself to me because she had been taught that she had nothing of value to offer a man other than her sexuality.

Men's mutual conspiracy

The masculine myth of the feminine sheds light on why even ethical men so often look the other way when they hear about a colleague's sexually exploitative behavior. When so many men share an inner wish, it shapes their private behavior as well as the way they deal with each other in public.

Although most men holding positions of trust behave ethically, they nevertheless hold on to the hope that one day it may actually happen. When they hear about a colleague who has had sexual relations with a woman in the forbidden zone, it encourages this hope. It is as though men who violate the forbidden zone are surrogates for the rest. Because of this, we secretly do not wish to prevent them from having sexual relationships with women under their care. But since many men can barely resist the forbidden temptation, each episode of sexual contact generates an infectious atmosphere that lowers their resistance.

For all of us men and women, professional and laypeople dealing with the darker side of sexual issues is a difficult challenge. Our rational minds may try to go in one direction, trying to adapt reality to preexisting models, while our less rational sides have highly permeable barriers to sexuality. What matters in the forbidden zone, however, is not keeping sexual thoughts away, but maintaining a boundary against sexual contact so that the unique potential of these relationships can be realized.

Healing moments

Because so many women have been injured by the uncontained sexuality of men who have had power over them, the potential healing power of restraint is enormous. Not only is the woman made safe from being exploited, but the moment kindles the promise that she can be valued entirely apart from her sexuality. In these moments life takes a new turn, and the wounds from past injury as well as hopelessness about the future can be healed.

And when a man in power relinquishes his protegee as a potential sexual partner, he sees he can recover vast inner re sources of his own. These stores of masculine strength are the ones that have been denied to him by the myth that only women, through their sexuality, can provide him with renewal and aliveness.

Elaine, 34, and George, 46, now law partners in San Francisco, first met six years ago when she was assigned as an intern in his firm during her final year of law school. He was impressed with her work, and she with his intellect and caring attitude. Feeling validated by their working relationship, she no longer harbored doubts about her intellect and competence, and became excited as never before about work and life.

Their admiration and affection for one another, along with the late evenings they spent together preparing cases, presented many opportunities for flirtation, yet for nearly a year neither of them referred to the possibility of sexuality between them.

A crisis occurred before Elaine's graduation. George had to decide whether to offer her a position in his firm. But things were no longer so simple. Both by this time sensed powerful sexual tension between them. Elaine felt that the price of a job would be for her to have an affair with George, and felt that she would lose whether she consented or not: If she didn't get the job, she would lose her vital connection to him; if she did get it, it would inevitably become tarnished by a sexual relationship.

George's feelings for Elaine also placed him in a bind: It was clear to him that, on the merits, she deserved to be hired. So he found himself hoping she would leave, just to protect himself. On the other hand, he very much wanted to hire her, but felt his motivation was com promised by his sexual feelings.

This seemingly unresolvable crisis was worked out through a nearly silent, almost imperceptible healing moment one night a week before George had to make his decision.

"We were working late together," Elaine says, "and I asked George what he thought he would do about hiring me. He just said that he hadn't made up his mind yet. We were both silent, and our eyes met. For the first time, I thought I could see the pain he was feeling. In that moment I would have done anything for him. I almost wished he would embrace me just so we could get on with the sexual relationship that seemed so inevitable.

"I was shocked, but relieved, when George directed us back to our work. I didn't think it was possible for a man to turn away from that kind of sexual energy. I felt from then on that if I were offered the job, I would not be compromised by having any sexual obligation. It was as if a spell had been broken."

George remembers the same moment: "I was going crazy with tension that night," he says. "I was ready to just take her in my arms. But when I saw how unprotected she was, I suddenly realized that Elaine was my spiritual daughter. This meant I would have to give up the idea that we would ever have a sexual liaison."

George hired Elaine and they have continued to work together productively. Their relationship does not extend outside of the office. But in their day-to-day collaboration they are both aware that their special connection has yielded gifts neither expected.

Since giving up on his fantasies, George says, "I have access to a strength and inner satisfaction that I had never known before."

Says Elaine, "About a year after it happened, I asked George what he had been going through at the time. And he told me. Just the fact that we could talk about it without risking the danger of reengaging the sexual feelings showed that our relationship had acquired a whole new dimension, one of depth and honesty."

Healing moments are available to all of us in our daily lives, in or out of the forbidden zone. We have only to look around us each day for an opportunity to take a barely discernible turn in the different direction. When we are ready to call on them, the intact, untapped resources inside all of us are ready to respond.

Copyright ® 1989 by Peter Rutter. From the book Sex in the Forbidden Zone and reprinted through special arrangement with Jeremy P. Tarcher, Inc., Los Angeles.

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Peter Rutter, M.D., is a psychiatrist, practicing in San Francisco.

January 1992

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