Am J Psychiatry 1989; 146:597-602
Copyright © 1989 by American Psychiatric Association
Borderline personality disorder, boundary violations, and patient- therapist sex: medicolegal pitfalls
TG Gutheil
Program in Psychiatry and the Law, Massachusetts Mental Health Center, Boston 02115.
The author addresses the issue of sexual relations between therapist and
patient and the related boundary violations that are involved in such
relations. He points out that patients with borderline personality disorder
are particularly likely to evoke boundary violations, including sexual
acting out. These patients apparently constitute the majority of patients
who falsely accuse therapists of sexual involvement. Therapists who are
aware of patterns of errors in therapy and countertransference--through
education, anticipation, and forewarning--can avert the serious outcomes
that result from these errors.