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DISSOLUTION OF THE DYAD IN PSYCHIATRY: IMPLICATIONS FOR THE UNDERSTANDING OF PATIENT-THERAPIST SEXUAL MISCONDUCT

NCJ Number
143411
Journal
American Journal of Psychotherapy Volume: 46 Issue: 4 Dated: (October 1992) Pages: 506-514
Author(s)
R A Schultz-Ross; M J Goldman; T F Gutheil
Date Published
1992
Length
9 pages
Annotation
Changes in the conceptualizations of psychiatric illnesses and the doctor-patient relationship appear to be linked to the current hesitancy to examine explanations of sexual misconduct between both members of the therapeutic dyad.
Abstract
The trend in conceptualizing illness has moved away from seeing the patient's presenting symptoms as a defensive shield to a perspective based on symptomatic diagnosis, in which treatment focuses on reducing the identified symptoms. The medicalization of mental disorders encourages the therapist to align the patient with the sick role and to minimize the impact of the patient's thoughts, feelings, or family relationships on his condition. In this psychodynamic model, the doctor and patient transfer and countertransfer their feelings for each other in a dyadic relationship involving inescapable mutual influence. There has also been a parallel change in the psychiatric understanding of human motivation, with a decrease in emphasis on sexuality, but increased interest in sexual abuse, particularly in childhood. This context of psychiatry has perhaps resulted in weakened sexual boundaries between doctor and patient, and a rise in sexual misconduct between the parties. 33 references

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