Paul Schnabel: A dangerous method

Paul Schnabel thinks addiction guru Keith Bakker broke the rules.

Maximum involvement paired to keeping the required minimum distance. It’s an awkward sentence but this is the rule psychotherapists have to abide by. If they don’t they are harming their patients and, ultimately, themselves.
Keith Bakker, the therapist who is in court because he had sexual contact with a number of girls in his care, is a case in point.
Bakker is not a psychotherapist nor does he call himself one. He did behave like one, however. In a television programme called ‘Family Matters’, for instance, in which he tried to get dysfunctional families back on track. What you saw was an extremely overbearing man who showed very little patience. He was certainly charismatic, what with his American accent, his impressive physique, his threatening mouth and his wild head of hair.
Bakker is not a registered psychotherapist. His expertise is based on experience. His personal story is one of early neglect and an addiction to injecting hard drugs which led to a HIV infection. This is no secret nor did he hide the fact that he is addicted to sex and porn. Openness about his frailties, especially in such a charismatic personality, became an appealing trademark. When society had given up on him as one of life’s ‘losers’ he turned himself into a ‘winner’. He made a perfect role model for all the other losers looking for help.
That is now a thing of the past. Bakker failed to keep the required distance to his patients. He invited them to his house, watched porn with them and slept with them. It is not important whether they wanted to or not, it just should not have happened in a patient-therapist relationship. Therapists who get caught out often say sexual contact is a wholesome and liberating part of the therapy. Of course not all patients get the benefit of this liberating effect, only the attractive ones. Very early on in the history of psychoanalysis and psychotherapy it became apparent that physical contact with patients, let alone sexual contact, causes more problems than it solves. Sigmund Freud certainly thought so and even went so far as to avoid eye contact by sitting behind his patients. Some of his students were less scrupulous. It is the subject of the film ‘A dangerous method’, about the relationship between Carl Jung and Sabina Spielrein.
Apart from all the other complications that sexual contact may bring, we now also know that it makes the processes of transference and counter-transference during psychotherapy almost impossible to handle. A therapist should be alert for signs of projection of feelings and fantasies on the part of his patients, even outside a typical psychoanalytical setting. During transference the emotional history and the behavioural patterns of a patient become visible. At the same time the therapist needs to be aware of his own feelings and longings towards the patient. That is the counter-transference and it can be pretty difficult and confusing. These feelings are usually discussed during a supervision talk with another therapist but they can never be acted upon. The moment the therapist allows the thought that sexual contact might be the way forward, every alarm bell in his head should start ringing. Psychotherapy is ‘a dangerous method’ and it takes a professional to apply it well.
Paul Schnabel is head of the government social policy unit SCP

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