By Andrea Celenza. New York: Jason Aronson, 2007. 296 pp. $49.95.
This thoughtful book addresses sexual boundary violations in the helping professions and clergy. The material is based on the author's extensive consultative and treatment experience, and reflections thereon. Unlike many such discussions, the book contains extended explorations of the psychology of the perpetrators, not only of the victims. Offenders, as the author notes, have suffered from avoidance on the basis of political correctness: “only victims have a psychology, not perpetrators.”
The book is divided into four sections plus a foreword by Gary Schoener, MEq, an introduction, appendices, and a short index. Part One describes the nature and scope of the problem; Part Two examines reporting, fallout, and recovery; Part Three addresses rehabilitation; and Part Four reviews prevention. As a group, the appendices are labeled Empirical Research: Appendix A is titled “Personal and Interpersonal Characteristics of Transgressors”; and Appendix B describes “A Rorschach Investigation,” involving testing of sexual boundary transgressors.
At the outset, the author identifies several goals for this work: to dispel myths, to acknowledge the potential universality of loving gone awry, to move away from the excessively punitive view toward perpetrators on the basis of “this couldn't happen to me,” to explore the possibilities for rehabilitation of the largest group of perpetrators (nonpsychopathic male therapists in crisis), and to limn the steps needed to promote openness and safety in the therapeutic arena.
The primarily empirical chapters in Part One provide a sweeping and detailed review of the relevant literature on the topic from a variety of viewpoints. This review coalesces in a composite case study of a typical violation by a middle-aged male therapist in a state of personal isolation who becomes involved with a female patient. An extensive description of his treatment is detailed in a later chapter. Other content includes a highly useful discussion of the precursors to misconduct and the facilitating conditions and personality dynamics in the therapist and patient. Subsequent chapters provide sophisticated analyses of the multiple factors in the patient and therapist that lead to misconduct, including a discussion of supervisor-supervisee relationships and misconduct by clergy. These later chapters are the most valuable in providing clinical insights.
Part Two addresses conflicts about reporting offenses, including institutional responses and collateral damage to the families of perpetrators, victims, and the professional groups to which abusers belong. Here, as elsewhere, the central strength of Celenza's approach is her persistent (and very welcome) refusal to adopt a simplistic view of what is inescapably a complex subject, with multiple intersecting dynamics, as well as internal and external forces acting on the perpetrators and victims.
Part Three addresses what is arguably the essence of this book: the rehabilitation (when possible) of perpetrators. The author explores several topics, including therapy and monitoring or supervision of the transgressor (the latter with sample reports), prevention, reasonable therapeutic responsivity, countertransference factors, and the “Boundary Violations Vulnerability Index.” The index is an assessment instrument (at present, not a validated questionnaire) designed by the author for practitioners to use to determine their own vulnerability.
This is a very valuable book for therapists of all disciplines, as well as forensic mental health professionals. Its greatest strength is the author's extremely refreshing and unusual openness to multiple viewpoints about the significance of the diverse attitudes and actions, motivations, dynamic forces, and proclivities of all players in the drama. Moreover, few works in this field pay as close attention to the psychology of perpetrators in the service of identifying the rehabilitatable ones and returning them to safe practice. This book is highly recommended.
Footnotes
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Disclosures of financial or other potential conflicts of interest: None.
- American Academy of Psychiatry and the Law