Transcending My Psychiatrist’s Sexual Abuse
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Seduced into Darkness: Transcending My Psychiatrist’s Sexual Abuse is a vivid and captivating story of hope for survivors of abuse as well as a case study in a skilled manipulator’s tragic exploitation of his professional power. This poignant memoir chronicles the traumatic psychological abduction and sexual exploitation of depressed college student Carrie Tansey at the hands of her psychiatrist, Dr. Anthony Romano–thirty-one years her senior. For three years, their secret “affair” was carefully calculated and controlled by Romano, as Carrie’s mental and emotional health continued to deteriorate, bringing her closer and closer to the edge. Their dual-relationship finally came to light when Carrie’s suicide attempts landed her in a world-renowned psychiatric hospital. Gradually, she began to reclaim her power, reported Romano to the state licensing board, successfully sued him for malpractice, and testified before the state legislature to bring awareness to such abuses. As Carrie tells her tale, it is a journey paralleling that of the mythical archetype Persephone, the naive innocent who was abducted into darkness, reemerged and regenerated herself, then fearlessly returned to the prison she had fled, this time to help free others.
Today, Carrie Ishee is a widely respected art therapist and life coach as well as a teacher specializing in the issues of ethics, self-care, and boundaries for mental health professionals.
–This image poured out of me in a matter of minutes and spoke more clearly than words could ever convey. It not only broke through my denial, it began my healing journey, and was the impetus for me to eventually become an art therapist. I now help others access their creativity and the healing power of images.
In Seduced into Darkness: Transcending My Psychiatrist's Sexual Abuse, Carrie Ishee gives us a moving and powerful account of sexual abuse by her “healer," as well as a psychologically astute description of her own process of fighting back and recovering. In her willingness to speak out, she offers a gift of compassion and hope to all who suffer from authority abuse.—Peter Rutter, MD Psychiatrist, and Author of "Sex in the Forbidden Zone"
A beautiful and evocative account of how a client feels on the other end of the so-called slippery slope, the receiving end of egregious sexual exploitation. In this book, Carrie Ishee makes the path intelligible and sympathetic without recourse to angry polemics or victimology. You will hand your heart over to her and thank her for your deepened understanding of this terrain and for the knowledge that there but for the grace ….—Andrea Celenza, Ph.D. Assistant Professor, Harvard Medical School, Author, Sexual Boundary Violations: Therapeutic, Supervisory, & Academic Contexts
As Earle Plumhoff and I walked out of our initial meeting with Carrie, I voiced what we were both thinking: How are we ever going to get her through the rigors of litigation? She seemed so fragile, and a lawsuit would involve divulging the most intimate secrets of her life in a public setting. Carrie had suffered a terrible wrong that deserved to be rectified so she could live the life she deserved. Getting through the litigation would allow her to triumph in taking back the power that had been taken from her. Carrie persevered, and through her strength, justice was done.—Robert Hanley Attorney at Nolan, Plumhoff, & Williams Representing Carrie in litigation against her psychiatrist
Kudos to Carrie Ishee for writing this book to help others realize that victimhood is not the end-all but can be the beginning of the Hero’s Journey to become a Survivor, and—as Carrie demonstrates—a Thriver!—Charles L Whitfield, M.D., Author of "Healing the Wounded Child"
Carrie Ishee has shared a physical, emotional, and psychological journey showing us how in her words, “Trauma recovery is a spirit path toward wholeness and wisdom.” Her courage to speak truth to power shines a bright light on abuse, and we are better for it. Her book should be required reading for any Ethics classes for health professionals.—Ann Filemyr, Ph.D. President, Southwestern College, Santa Fe, N.M.
I was stunned when Carrie—one of the most positive, optimistic, and creative people I’ve known—shared this dark and twisted story of her past with me. It is a testament to her intelligence and resilience that she not only pursued justice but also used this searing life experience for her own and others’ positive growth.—Valerie Plame, Author of "Fair Game"
Carrie Ishee’s compelling true story of her psychotherapist’s exploitation, betrayal, and abuse follows her journey from depression and attempted suicide through survival to strength and a fulfilling life of meaning and value. The story resonates in today's environment, documenting the real-life impact of the betrayal and exploitation of patients.—Gerald S. Smith Former Counsel to the Pennsylvania State Board of Medicine
Carrie beautifully shares the moment of deep healing through art therapy when her image revealed with painful honesty what words hadn’t been able to. What began as a lighthearted abstract led to the opening within her psyche of the harshest painful truth about what had actually happened to her. It is no surprise that she became the gifted professional art therapist that she is, now offering important healing opportunities to others.—Deborah Schroder, ATR-BC, LPAT Chairperson, Art Therapy/Counseling Southwestern College, Santa Fe, N.M.
In Seduced into Darkness, Carrie Tansey Ishee shares her harrowing experiences sinking into the depths of despair and suicidal depression as a result of emotional and sexual exploitation by her psychiatrist. The book also documents Carrie’s inspiring healing and transformation: Carrie not only recovers from such a life-altering trauma, but allows it to become an initiation into a greater level of consciousness and self-compassion. Carrie’s personal narrative demonstrates her amazing resilience – not only to survive, but to live beyond the trauma and tap into deep healing through the arts--especially music, visual art and writing. Her masterful weaving of her story on many levels—psychodynamic, interpersonal, sociocultural and archetypal—makes this a standout among personal narratives and memoirs. Seduced into Darkness provides a compelling and instructive read, and a helpful model for others on a healing journey.Catherine D. Nugent, LCPC, TEP
Executive Director & Principal Trainer
Laurel Psychodrama Training Institute
Former Chair, Committee to Implement the Recommendations of the Maryland Sexual Exploitation Task Force
Former Vice-Chair, Maryland Task Force to Study Health Professional-Patient Sexual Exploitation
This book is a wonderful contribution and will be useful not only to helping professionals who are interested in learning more about professional-client boundaries, but to all helping professionals. All of us are susceptible to being seduced into a serious boundary crossing, not so much by our patients, but by our own neediness, isolation, and life stresses that may lead us to deny the reality of what we are doing.S. Michael Plaut. Ph.D.
Former Chair, Maryland Task Force to Study Health Professional-Client Sexual Exploitation
Psychologist, teacher, consultant, and author of numerous papers about professional-client boundaries
Former Associate Professor, University of Maryland School of Medicine
Carrie T. Ishee Seduced into Darkness: Transcending My Psychiatrist’s Sexual Abuse (2020). Terra Nova Books: Santa Fe, New Mexico. 307pp $23.95 (PB).
This reviewer is a psychiatrist who has been involved in the evaluation of dozens of men and fewer women who have been identified by their medical, psychological, social work, or nursing boards as having had sex with their patients. In these evaluations, I usually read short victim statements. The only time I have an opportunity to interview the complainant is when I serve as an expert witness hired by a victim’s attorney. Seduced into Darkness provided me with an enriching view of the offending process and its subjective and objective consequences - in this case, terrible ones. It is uncomfortable to read Ms. Ishee’s well-presented story. Thankfully, the pain is somewhat mitigated by the positive 35-year follow-up. Such valuable follow-up is a rare luxury for any mental health professional.
Ms. Ishee, a college senior in 1980, was not well prior to meeting her psychiatrist. He suggested thrice weekly therapy without medications. She seemed to slowly benefit during the first year of therapy, during which the therapist instructed this 31-year younger patient to call him by his first name. She thought all was well until she revealed that she thought she was falling in love with him. His incompetent self-serving boundary-less response to her erotic transference constituted malpractice. As Ms. Ishee describes her naive compliance with his egregious requests, readers witness the effects on her emotional, intrafamilial, sexual, educational, and economic health. These consequences culminated in a suicide attempt, a six-month inpatient stay, and years of therapy.
One cannot expect even a highly intelligent patient such as Ms. Ishee to know how her intensifying bond to her therapist should have been handled. She knew that what was happening should not have occurred. Nonetheless, she was drawn into the doctor’s betrayal of her therapeutic potential in order to satisfy his emotional needs. Her participation added to her self-criticism and hopelessness. This case-of-one report beautifully demonstrates why sex with patients has been prohibited for over 2500 years. While there is a known range of patient responses to romance with a therapist, from abrupt termination of the therapy to suicide, this case report will remain in professional memory and hopefully help prevent such disasters. It would seem that writing Seduced into Darkness enabled Ms. Ishee to return to her mind numbing traumatic process with a mature perspective that further stabilized her mental health. One can only admire the courage, strength and insight this work reflects. It reminds readers that prolonged misery need not be permanent. Upon finishing this book, I predict that each professional reader will mentally thank the author.
Ms. Ishee, who had taken notes on her life experiences, employs the Greek myth of Persephone throughout her fast moving 42-chaptered account. The analogy works quite well as it helps readers to understand that Ms. Ishee and her errant psychiatrist are merely one example of a recurrent human story. State boards liken professional-patient sex to incest. The interweaving of the Persephone myth adds to our understanding of literal incest as risking recurring descents into Hades.
Seduced in Darkness is bookended by a Forward from a Santa Fe psychotherapist, Jason Holley, who provided her with an astrological consultation, and an Afterward by Michael Plaut, a psychologist who enabled her to testify before the Maryland General Assembly. Dr. Plaut has made important contributions to the understanding and regulation of sexual boundary violations by therapists and educators (Plaut, 2010). Each recognizes that despite the tradition of sexual avoidance between healers and the distressed such behavior continues to occur.
It is likely that most sexual boundary violations do not come to a state board’s attention. Boards attempt to protect the safety of the public from harm-inducing licensees while ensuring the professionals’ due process rights. Their investigative processes do not always succeed. Ms. Ishee won a civil settlement, but the psychiatrist, who was not removed from practice, had a sexual relationship with a subsequent patient. Remanded mental health treatment for the professional, license suspension or permanent revocation may not occur because patients may not think they are victims, may be too ashamed to report, may love the doctor and not want to cause harm, or may feel guilty because of their participation. Despite protection of the identity of complainants, boards may have to close an investigation because the victim will not cooperate. Like the intense stress of courtroom trial, reporting to a board can recreate the emotions and memories of the original trauma.
Concepts about professional boundaries apply regardless of a clinician’s degree, theoretical orientation, or years of experience. Boundaries are the guidelines for what is acceptable, what is risky, and what is unacceptable in therapeutic relationships. Good boundaries enable, but do not guarantee, effective outcomes. They represent a suit of armor that clinicians put on each day to protect themselves and the patient. Patients believe that the guidelines exist to protect them, but they generally don’t conceptualize that the rules simultaneously exist to protect therapists’ from their sexual impulses toward their patients, from their lack of understanding what these attractions have to do with the professionals’ and the patients’ circumstances, and from the rare patient’s deliberate manipulation of the doctor for opioids or money.
The processes of psychotherapy and those of love relationships are integrally related (Levine, 2014). The professional provides interest, acceptance, understanding, caring, and optimism about the future. The difference is the absence of the expectation for sexual behavior. Professionals are understandably stressed by a patient’s expressed love and the strong accompanying erotic stirrings. Ideally this is handled with a calm acceptance and curiosity about the meaning of the love to the patient. The therapist recognizes the patient’s frustrated longing to love and be loved and knows that its intensity serves as a resistance to discussing some emerging painful memory, situation, or personal concern. When well handled, patients benefit in awareness and self-confidence. The fact that the skillful handling of an expressed erotic transference was not discussed in the professional’s training program provides no excuse for the sexual violation of a patient. Classroom discussions are not absolutely required to internalize and grasp professional values.
Journal of Sex & Marital Therapy
Volume 46, 2020 - Issue 6
Reviewed by Stephen B. Levine, MD
Clinical Professor of Psychiatry
Case Western Reserve University
Plaut, SM. (2010). Understanding and Managing Professional-Client Boundaries in S.B.
Levine, C.B. Risen, and S.E. Althof (eds.) Handbook of Clinical Sexuality for Mental Health Professionals 2nd edition. New York: Routledge, pp. 21-38. Levine SB, (2014). Love and Therapy in Barriers to Loving: A Clinician’s Perspective, New York: Routledge. pp109-123.