SAN DIEGO — Ann's marriage was on the rocks. Her father was dying of cancer. One of her two small children had received a diagnosis of attention deficit disorder.
Only one person stood by Ann as she tumbled through these crises: psychologist Charles Hansen. Call any time, he told her. His staff was instructed to interrupt if he was in session and she needed him, he told her.
He would soothe her jagged nerves, reassure her that everything would work out. When her husband made her feel unattractive and stupid, Chuck Hansen would flirt and tell her she was a beautiful, intelligent woman. When her father was close to death, Chuck Hansen started smoking a pipe--just like her dad--and the wafting tobacco smoke was comforting.
Ann, then 30, saw Hansen in individual sessions as well as with her husband for marital counseling. The psychologist began telling her about his own life in a way that made her feel they were friends. He would tell her about his wife, also a San Diego therapist; the weekly appearances on a radio talk show; courses he was teaching, and his experiences as an ordained Presbyterian minister. They had sessions at his office and at his La Jolla house. Her husband had little time for her, but the 6-foot-2, blond, blue-eyed therapist was always available.
"I trusted Hansen at a point where he was the only person I trusted--he was a lifeline," she said. "I probably would have done just about anything this man asked me to do."
And over the six years that Ann saw Hansen for therapy, the sexual tension between them mounted. It was a protracted campaign. First, it was just little hints. Then he started telling her she was sexy and that he was aroused by her. Later, he described in graphic detail the sexual acts he longed to do with her.
"It made me feel desirable, that I wasn't just a schleppy old housewife, that I hadn't died yet--that I was attractive," she said.
Later, there was occasional touching and kissing. After five years of therapy, the psychotherapist and his patient started having sex--unbeknown to her husband, who still accompanied his wife to see Hansen for counseling.
"This man . . . would take whatever information you gave and he would use it," she said. "He'd weave a web like a spider and try to get you into it. . . . Chuck would say anything to get you where he wanted you."
Sex between a therapist and his patient is condemned by every major medical and psychological organization, all of which say it can be emotionally devastating for patients. In eight states--including, since 1990, California--it is illegal for therapists to have sex with patients.
Still, some experts say patient-therapist sex occurs far more often than the profession cares to acknowledge. It is, some patients say, psychiatry's dirty little secret.
Although no one can quantify the frequency of patient-therapist sex with any precision, 65% of therapists in one nationwide study said they had treated patients who had sex with previous therapists. In another nationwide survey, cited by the American Psychiatric Assn., psychiatrist Nanette Gartrell found that 7% of male therapists and 3% of female therapists had sexual contact with their patients.
Across California, more than half of all complaints to the state's Medical Board against psychologists involve claims that they had sex with their patients, said Janie Cordray, Medical Board spokeswoman. The Medical Board receives about 200 such complaints each year. In many cases, the therapist has targeted the most vulnerable, Cordray said.
"The doctor preys upon those people who are easy marks, choosing someone who isn't going to talk, someone who is needy, has low self-esteem and is looking for approval," Cordray said. "Most women don't come forward because they think it's love; they think they are the only one."
In psychotherapy, patients often come to regard their therapist as a loving, trustworthy parent. It's a phenomenon called "transference," said Ken Pope, former chairman of the American Psychological Assn.'s Ethics Committee.
"This has to do with the power of a therapist and the way therapy works: Clients tell therapists their deepest secrets, they let themselves become completely vulnerable and begin experiencing the therapist as a parent, for whom they'd do anything to gain approval," Pope said. "Therapists are trained to recognize and respect transference, vulnerability, dependency and other factors of power inherent in the role of a therapist--not to exploit them."
This is the story of one therapist, Chuck Hansen, who seduced his patients. It is based on in-depth interviews with a number of former patients, colleagues, and volumes of court documents. Because of the sensitive nature of this case, the women's real names are not used at their request.