You were always on my mind

You're sitting opposite your shrink. Social stigma abandoned, British reserve left behind, you've begun to air your angst. But have you ever considered that as your therapist leans forward in a display of empathy and attentiveness, he (or she) may well be revealing a deep sexual attraction to you?

Well, if you haven't, perhaps you ought to. In her new book, The Intimate Hour, psychologist Susan Baur peeks through the keyhole of the therapy room and divulges a well kept secret that has the Big Apple's hundreds of thousands of shrink-goers troubled to the core: 95 per cent of therapists have experienced an erotic longing for a patient. Scientifically, it would be impossible for Baur to prove her statistical findings. Her conclusions are based on 5,000 anonymous responses to surveys and on years of revelatory conversations with fellow doctors of the mind. Brave clinicians have told her of their own inclinations towards a patient. The slightly less robust have talked of their colleagues' professional brush with love and lust and The Intimate Hour has opened up the sluice gates to a torrent of revelations about the sexual feelings that well up in those intense 50-minute hours.

"What surprised me," says Baur, "was the number of therapists who came to me after the book was finished. One of my colleagues actually said to me, 'Did I tell you about the time a fellow therapist and I fell for a set of identical twins?'"

Taboo as the subject of sex in therapy might be, according to The Intimate Hour, it's certainly no new phenomenon. Baur tells us how Sigmund Freud himself predicted that intense sexual attraction would often hover dangerously near to the couch. "In view of the matter we work with," he said, "it will never be possible to avoid little laboratory explosions."

And explosions there apparently were - and still are. Jung "made poetry", as he so delicately put it, with his patient Sabina Spielrein, as did renowned psychologist Otto Frank with his famous client Anais Nin. Though unshocked by the penetration of sexual attraction into the therapy session, Freud was adamantly opposed to its consummation. He thought it could lead to madness and delusion on the part of both the therapist and the patient.

Baur certainly doesn't condone lovemaking during therapy, but then nor does she utterly condemn it. She believes the sexual act to be deeply psychologically damaging, usually leaving the patient feeling totally abandoned, but she doesn't think that each and every therapist/patient "liaison" should end up in the court room. In short, she paints a picture of what can and does happen when sessions become inappropriately steamy and then she sits adamantly on the fence.

She presents us with much more than the stereotypical picture of the male therapist jumping on his female patients, though this "modern story of erotic exploitation" does, she admits, make up the majority of cases. But, she points out, there are some (albeit few) female therapists who seduce male clients, together with a handful of male and female patients who make amorous advances to their therapists and a plethora of possible homosexual scenarios. "Female clinicians," says Baur, "can be as predatory as any male."

The book provides ample fodder for feminist fury, not least because Baur suggests that when the male therapist touches his client we can't assume he has committed a criminal or even a morally reprehensible act before we have examined the case in detail. "One of my points," she says, "is that not all women are so anxious to blame men for their troubles that they scream abuse when a therapist hugs them. I am 100 per cent against sexual acting out in therapy. It is destructive, sometimes mildly so and sometimes in a major way. But there are levels of exploitation."

Is a therapist exploiting a patient when he hugs her? she asks. Is he exploiting her when he flatters or flirts with her? Is he exploiting her if he falls in love with her?

And though it is very much the exception, Baur does present us with several case studies of patient and therapist who have actually made it to the altar and one of a lesbian therapist/patient couple who have been together for 10 years and "tied the knot" in a Unitarian ceremony.

But what shocks the readers more than the open discussion of a subject traditionally so shrouded in secrecy is Baur's assertion that sexuality (as opposed to sexual intimacy) actually has its legitimate place in the therapy session. Disdainful of the distant detachment once deemed essential to healing, Baur thinks "love, in its most generic sense of caring and nurturing, is the sine qua non of therapy. In all long-term therapy, love is the shaping and the moulding force..." and, in her opinion, if it gives way to sexual longing, then so be it. Her belief is that romantic love between patient and therapist should remain like courtly love; pure and unfulfilled, but not unacknowledged. Acknowledgement of the fact that Baur has dared to broach a subject so fraught with ethical and psychological repercussions has come in sackloads of letters from women in love with their therapists and therapists afraid and infuriated by the book's findings. But what of Baur's own sexual longings in the intimate hour? "They are what gave rise to my book," she admits. "I was deeply attracted to one patient in particular. My fantasies took off and had a life of their own. I was appalled by what was happening to me."

Whether her love remained courtly or whether she and her patient "made poetry", is a subject on which the author of The Intimate Hour wisely remains tight-lipped.

2 'The Intimate Hour' is published in America by Houghton and Mifflin

'I knew that what I was thinking of doing was wrong'

D. Norman is a psychotherapist in her early forties. She had always kept a "proper" distance between herself and her patients."But one day - and this is still hard to spit out," she says, "I fell in love with a client. He was an attractive man my own age and I felt a kind of kinship the moment he walked in. I thought, 'Oh at last, here's a man who speaks my language.' It didn't occur to me that I'd ever act on the attraction."

She thought about him incessantly. She began to contemplate the ethical problems of having sex with a client. "On some days I'd think, 'Well, every one of my colleagues has probably gone through something like this.' But other days I felt awful. I knew what I was thinking of doing was wrong."

One day, she told her patient she was having a hard time respecting therapist/client boundaries. So, apparently was he and the two decided they wanted to pursue a physical relationship. Dr Norman is no longer Patrick's therapist but, unusually for such a situation, after five years she remains his lover. "We've had to undo some of the intimacy that therapy generated prematurely," she says. "It's been difficult." It has also been difficult for Dr Norman to accept that in 12 of the American States the liaison could put her behind bars.