The following stories from the lives of three women—a patient, myself, and a colleague—describe the psychological fallout of unexpected sexual advances from former supervisors and mentors. Despite the events occurring decades apart to women ranging in age from youth to maturity, our experiences are remarkably and painfully similar. Conversations with female colleagues suggest that these are common occurrences. By describing these three stories, and providing reflections for educators, I hope to increase awareness and insight and perhaps reduce the frequency of these unfortunate events.

Joan’s Story

Last year, I evaluated a 31-year-old woman in great distress. Joan,Footnote 1 a research biologist at a local university, had been propositioned by her highly revered, 53-year-old former professor, Dr. Anderson.

Joan had been a brilliant student at a top university. Dr. Anderson was an award-winning distinguished faculty member of international renown. He had taught many of Joan’s courses, and was her academic advisor for her major. She had worked in his lab as a research assistant. They had collaborated on projects, both locally and on international field trips. She had continued to work for him as a graduate student, and had done background research for a book he was writing. She had deep respect for him, and thrived academically with his unwavering support of her intellectual pursuits. After completing graduate school and moving to another city, Joan and Dr. Anderson remained intermittently in touch for several years by email, continuing to share intellectual interests.

One day, Dr. Anderson emailed Joan that he would be in town to give a lecture and invited her to catch up over dinner. She was delighted to accept. During the meal, he unhappily shared that he and his wife of 20 years were getting a divorce, and Joan politely expressed sympathy. After dinner, Dr. Anderson drove Joan back to her apartment in his rental car. As she said goodnight and started to get out of the car, he suddenly pulled her into him, held her tightly, and French-kissed her. He told her that he had always been deeply attracted to her, and asked if he could stay the night. She was utterly blindsided and horrified. “Aren’t you attracted to me?” he asked. She blurted out “No!” and ran from the car. That was the last time she spoke to him. After the visit, he emailed and called, but she did not respond.

In therapy with me, Joan struggled to process her shock and grief. She felt violated. She wondered if Dr. Anderson’s mentoring and support throughout college and graduate school had been a sham. Did he truly think highly of her academic ability? Or, had he only been pretending to be impressed with her work because he was secretly sexually attracted to her? She began to reevaluate the validity of everything he had taught her, all their conversations, her admiration for him as a mentor. Joan’s positive impression of her overall college experience was contaminated. Her own sense of self-identity as a person with a meaningful intellectual life was now on shaky ground. We talked about her transference to Dr. Anderson as an idealized father figure. She described her sense of revulsion that an “old man” more than 20 years her senior could imagine that she would be attracted to him. In short, his sexual advances felt to her like an attempt at incest. Joan recognized that technically he was no longer her supervisor and that she was now a grown woman. Since he had refrained from sexual overtures while he was her teacher, he avoided using the inherent power imbalance for possible coercion while she was still his student. Still, years later, Joan continued to see him through the lens of their original teacher-student relationship.

Over a difficult and painful period of reevaluation, Joan was able to construct a new narrative. She was able to affirm that her intellectual pursuits in college and graduate school did indeed have worth. However, she could not fully shake the fear that the level of Dr. Anderson’s high esteem and strong support during his years of mentorship had been exaggerated due to his underlying sexual desire for her. She also had to work through her grief at losing one of the most important, indeed sacred, trusted relationships in her life, which had been irrevocably damaged by his unanticipated sexual advances. At a pragmatic level, Joan no longer felt comfortable asking him for letters of recommendation.

My Story

Joan did not know this, but her story resonated with my own experience at approximately the same age. When I completed my psychiatry residency and moved to a different institution in the same city for my child and adolescent psychiatry fellowship, I was able to take several of my adult cases with me. One of my residency supervisors offered to continue supervising me intermittently at no charge. I gratefully accepted. Over the next 18 months, we met monthly at a restaurant near his downtown office. We would share breakfast (his treat) in an isolated corner of the restaurant while talking seriously about my patients’ issues and discussing clinical practice in general. We also talked about my engagement and plans for my upcoming wedding and he would share anecdotes about his wife and three grown children.

One day, knowing my interest in art, my supervisor mentioned that he had recently purchased some paintings and asked if I would like to come to his office after our breakfast meeting to view them. I had never seen his office, which was just a few blocks away, and readily accepted. When we arrived at his office, out of the clear blue, he suddenly pushed me up against the wall, stuck his tongue in my mouth, and started grinding against me, putting his hands up my shirt.

I shoved him away, exclaiming, “What are you DOING? What are you THINKING? You’re happily married! We were just talking about my wedding plans! You’re my SUPERVISOR!”

“I’m attracted to you,” he said, “I thought we could have some fun!”

I ran out of his office and never spoke to him again.

Over the next several months, I struggled to understand what had happened. Had I been unconsciously flirting with him or in some way inviting his advances? I could honestly state that I had never been physically attracted to him, or even had a romantic fantasy about him. In retrospect, the premise of the entire mentoring relationship seemed suspect. I continued to turn the events over in my mind, trying to see what I must have missed. Had he only offered to continue to supervise me for free, and pay for breakfast, because he was sexually attracted to me? I concluded it had likely played a part. Why had I not questioned this? Because he was my mentor and teacher and colleague and, within the limits of our supervisory sessions, somewhat of a friend. Because we had been sharing details of our respective personal relationships, both of which seemed happy and fulfilling. Because, like Joan, I had developed an idealized and platonic father-daughter transference. In that context, it had seemed acceptable for a senior professional to pick up the breakfast check while mentoring a younger student who was struggling to pay off loans.

Going further, I began to question everything he had ever taught me about therapy. How could I trust his advice and insight about my patients when his own ethical and moral compass was so seriously flawed? I had looked up to him as a senior analyst, trusting his opinions and judgment. Now, I saw him predominantly as a philanderer.

Eventually, I had an insight. To cope with the boundary violation that I had experienced, I needed to move past the idealized father-daughter transference that the mentoring relationship had fostered and think of him simply as a man (with less than admirable morals) who was trying his luck with a woman. “He’s just a man.” This realization may seem obvious, but to me it was an epiphany. I felt as if I had snapped out of a trance, moving from a shaky sense of confusion and violation back into all-too-familiar territory. As a woman in her early 30s, I was reasonably experienced and comfortable dealing with male sexual advances and invitations. Although he was still acting as my supervisor, he was no longer grading me, so I did not need to fear retribution for rebuffing him.

Luckily for me, although I had enjoyed and benefited from this supervisor’s teachings, he was a relatively minor player in my overall education. I shudder to think how I would have felt if my most important mentor (a faculty member with whom there was a mutually acknowledged, decades-long, deeply positive father-daughter transference) had ever violated that trust. Like Joan, I would have had to rethink everything I had learned from him, and my sense of safety would have been shattered. Developmental theory supports that optimal learning takes place in a safe space or holding environment [1] with a secure attachment [2] and basic trust [3], in which we can share our thoughts freely and learn from our admired role models [4, 5]. A paternal transference is common in women mentored by senior male faculty members and can be very positive. It is deeply disturbing, when a woman feels she is with a safe father figure, for him to move in on her in a sexual way. This principle applies not just to father-daughter transferences, but to other parent-child transferences that arise in the creation of an educational safe space.

Reflections for Educators

Over the course of a career as a medical educator, I have witnessed (and experienced) frequent inappropriate sexual advances in our academic community by senior men approaching women who were their students, residents, or junior faculty members. Some of these were egregious; others were “serial womanizers.” Many tearful women have confided in me, and most of those incidents were not reported. One colleague who did report a harrowing case of sexual harassment by an analytic teacher summed up the experience in her comment to me, “So upsetting and so much fallout, both professionally and personally.” These days, it is pretty clear that sexual advances within the context of a teacher-student relationship are off-limits, and are understood as potential exploitation of an inherent power imbalance. One helpful psychotherapy resource website provides verbatim quotes from eight major professional organizations’ codes of ethics regarding sexual dual relationships between teacher/supervisors and current students [6]. Perhaps surprisingly, the ethical guidelines provided by the American Psychiatric Association are less definitive than those of other organizations, stating that sexual involvement between a faculty member and trainee “may be unethical” [7]. Specifically:

  1. 14.

    Sexual involvement between a faculty member or supervisor and a trainee or student, in those situations in which an abuse of power can occur, often takes advantage of inequalities in the working relationship and may be unethical because:

    1. a)

      Any treatment of a patient being supervised may be deleteriously affected.

    2. b)

      It may damage the trust relationship between teacher and student.

    3. c)

      Teachers are important professional role models for their trainees and affect their trainees’ future professional behavior.

But what is the proper code of conduct after the student-teacher relationship has officially ended? Again, although other organizations have position statements on this topic, the American Psychiatric Association does not specifically address the issue of post-supervision sexual relationships. In his discussion of challenges in the post-supervision relationship [8], Canadian psychology professor Ed Johnson states:

Because the post-supervision relationship includes an ongoing role for the supervisor in advancing the professional progress of the supervisee, as well as the ongoing residue of a close, influential relationship formed during a time of supervisee dependence, the power differential and ongoing influence, although lessened, continues. Accordingly, former supervisees remain vulnerable to subtle influence and outright coercive pressure and thus, intimate sexual relationships between former supervisors and supervisees should remain off-limits (as do intimate relations between former clients and clinicians). The post-supervision period represents a period of vulnerability for supervisors and supervisees. One reason for this may be the belief that the cessation of formal supervision means that the power differential and supervisor influence has ceased and that the participants are on an equal footing now. Research by Glaser and Thorpe (1986) suggests that such thinking is naïve or self-serving.

My purpose is not to condemn consensual workplace relationships. A female medical student in my class has been happily married for over 30 years to one of our instructors. My husband and I met at work when we were both students in our 20s. Instead, my intention is to ask educators to think twice before sexually approaching former students. By trying to address teachers, I do not in any way intend to minimize the experience of former students. Rather, I am hoping (perhaps too optimistically) that by describing these painful anecdotes, some teachers might begin to comprehend and consider the impact of their actions before they initiate sexual advances with former students. The following self-reflective questions for these educators may prove useful as a guide:

  1. 1.

    Why am I attracted to this former student? How much of my attraction could be based on this student’s adoring idealization of me?

  2. 2.

    What am I seeking? Am I looking for a heated affair or a romance and relationship? Do I want a one-time fling? An affirmation of my own attractiveness from someone who admires me?

  3. 3.

    Why now? Am I lonely, feeling bad about myself, on the rebound? Or am I genuinely seeking a full reciprocal relationship between equals? If I am in a troubled relationship, am I capitalizing on my ex-student’s positive transference, which is based on a limited, and usually idealized, view of who I am as a person?

  4. 4.

    What might be the cost of attempting to change the relationship from a teacher-student bond to a sexual relationship? If there is a strong, positive mentor-mentee relationship, and my sexual advances are not welcomed, what would both of us stand to lose?

  5. 5.

    If I decide to go ahead and risk it, is there a way for me to carefully explore the possibility of mutual attraction without destroying the pre-existing mentor-mentee relationship if I am wrong?

Due to our understanding of the enduring nature of transference, I believe that psychiatric educators especially should know better. A psychiatric supervisor helps his supervisee understand nuances of therapeutic relationships, including the concepts of transference and the importance of maintaining appropriate boundaries. It is deeply and sadly ironic, then, when that same supervisor misreads the transference and violates the residual frame of a formative mentoring relationship with his own student.

Eleanor’s Story, and Conclusion

I will close with one last anecdote. Eleanor, a colleague in her 50s, recently reconnected with one of her former psychiatry faculty mentors at a social function. After the social event, they exchanged several emails, spoke by phone, and agreed to meet for dinner. Following their meal, he made an entirely uninvited, unanticipated, aggressive sexual advance. His moves were almost identical to the behavior of my own supervisor years ago. My colleague rebuffed him, the evening ended awkwardly and precipitously, and they have had no further communication. When later describing this incident to me, she reflected that it had retrospectively tainted her previously positive memories of her residency training from over 20 years earlier.

In the murky territory of sexual overtures, there is a world of difference between assaulting a woman, versus tentatively exploring feelings of attraction towards a former student and backing down if the response is unwelcome. Even so, the common thread in the three different anecdotes described above is that all of the women were blindsided by their mentors’ sexual advances, did not invite them, and were hurt by them. The fallout from these sudden sexual moves was far-reaching and damaging. Beyond the abrupt loss of a mentor, collateral damage included disillusionment, breach of trust, questioning one’s self-worth, and a reevaluation of everything that had been taught.

These situations are not clear-cut. These individuals may not have considered the potential negative repercussions of their actions. At one point, we genuinely admired and appreciated these mentors as trusted teachers and supervisors. We looked up to them and learned so much from them. As in the context of a positive father-daughter (or parent-child) relationship, we at one time had felt safe, and were able to thrive and develop professionally and personally. Boundaries are one key component of the educational contract, because they help maintain an environment conducive to learning. As in a therapeutic relationship, creating an educational safe space can allow beautiful and precious and amazing insights to develop. The lessons learned could endure for a lifetime, long after the formal teacher-student relationship has ended. Please, think twice before trading a long-standing valuable relationship, for (as Monty Hall would say) what’s behind the curtain.