According to Ryan & Deci, “social affiliation is considered to be a basic psychological need”, and “a primary way adults fulfill this need is to form an intimate relationship with another person.” Naturally, like all other living things on this planet, an intimate relationship happen between a male and a female. Once formed, intimate relationship can be the primary source of all emotions that human beings convey: love, anger, jealousy, hatred and forgiveness. Based on the emotions, the need of supporting and the request for being supported appear. An invisible link that connects two soul-mates together also is creates through all those elements. Actually, there are different aspects that divide the intimate relationship into two directions: nonsexual or sexual relationship, depending on each situation. With the nonsexual relationship, a man and a woman can be close friends without the need of having sex. The partners support each other and receive intimate feedbacks. In fact, nonsexual relationship is very rare. Or, it can last for short time then changes into sexual relationship if there is an unexpected element that ignites the condensed explosive feelings between them. Mostly, intimate relationship starts at a sexual contact and develops fast into a strong bond between the two. Nevertheless, after a time being happy, many sexual relationship reverses to non-sexual one. The couple may silently or noisily announces the break of their intimate partner.
Intimate Relationship and Restrictions.
Due to all the strong effects that intimate relationship can cause to the lives and the professionals of persons who involve in, intimate relationships between a psychiatrist and his or her client are forbidden.
According to APA Ethical Codes, “A psychologist refrains from entering into or promising another personal, scientific, professional, financial, or other relationship with such persons if it appears likely that such a relationship reasonably might impair the psychologist's objectivity or otherwise interfere with the psychologist's effectively performing his or her functions as a psychologist, or might harm or exploit the other party.” APA also confirms: “Psychologists do not engage in sexual relationships with students or supervisees in training over whom the psychologist has evaluative or direct authority, because such relationships are so likely to impair judgment or be exploitative.
With the same notions, American Association for Marriage and Family Therapy (AAMFT) has the similar regulations: "Therapists, therefore, make every effort to avoid conditions and multiple relationships that could impair professional objectivity or increase the risk of exploitation. When the risk of impairment or exploitation exists due to conditions or multiple roles, therapists take appropriate precautions.” AAMFT explains clearly, “Marriage and family therapists do not provide therapy to current students or supervisees."
American Association of Christian Counselors (AACC) applies the same rule: “Dual relationships involve the breakdown of proper professional or ministerial boundaries. A dual relationship is where two or more roles are mixed in a manner that can harm the counseling relationship.” Nevertheless, there is a special notice that AACC wants to clarify: “Some dual relationships are not unethical—it is client exploitation that is wrong, not the dual relationship itself.” AACC “oppose the ethical-legal view that all dual relationships are per se harmful and therefore invalid on their face. Many dual relations are wrong and indefensible, but some dual relationships are worthwhile and defensible...” In fact, to prevent some harmful effects due to the intimate relationships, “Christian counselors do not provide counseling to close family or friends.”
Other organization related with counseling matters, American Counseling Association gives out more directions to help solve the problem: ”When a dual relationship cannot be avoided, counselors must take appropriate steps to ensure that judgment is not impaired and that no exploitation occurs."
Ethical Decision Making
Practically, regardless all the above restrictions, many intimate relationships have happened in many fields. People’s hearts are softer than their brains. Although being trained for several years and earn credits for being thoroughly achievements on this issue, a number of professionals had rather be their licenses provoked than forfeiting their sensitive feelings. Therefore, there are ways to help professionals to prevent the problems happen prior to the happenings. In case a professional has the feeling of being in the mid of an inevitable intimate relationship and may not make an Ethical Decision appropriately, he or she needs to follow 14 steps that are clearly stated in Chapter 9, Ethics in Psychotherapy and Counseling, A Practical Guide, 3e, wrote by Kenneth S. Pope and Melba J.T. Vasquez, 2007.
Step 1: Identity the situation that requires ethical consideration and decision making. The psychiatrist needs to clearly define the ethical question or issue. Is it an intimate relationship between a psychiatrist and a client who comes for a treatment? Is there any element that the professional forget to add? Is it a violation of APA Ethical Codes and Rules? After having an answer, mark Yes to the situation of an intimate relationship.
Step 2: Anticipate who will be affected by your decision. Of course, there are two persons and their relatives, friends, and families. Whatever decision is, all the parties related with the situation will be affected. Besides, other clients will be shocked or emotional when they know that there is professional who involves in an intimate relationship with a client.
Step 3: Figure out who, if anyone, is the client. “Is there any ambiguity, confusion, or conflict about who the client is?” The client here is one among two lovers. She or he pays the fees to the professional for a treatment.
Step 4: Access your relevant areas of competence- and of missing knowledge, skills, experience, or expertise- in regard to the relevant aspects of this situation. The psychiatrist needs to prepare to handle this situation. Will it be solved by the support of media or by other colleagues or friends? Anybody else can do the job instead of him or her?
Step 5 : Review relevant formal ethical standards. Is this situation unethical under the eyes of all others? Are there any hidden information that makes the situation worse or better? Are there any other way to solve the problem ethically?
Step 6: Review relevant legal standards. This question is very important because it related to the Law. Would I be fined or penalized by the authority if I didn’t know how to handle the situation?
Step 7: Review the relevant research and theory. The professional must seek some helpful information from other resources to respond to the situation.
Step 8: Consider how, if at all, your personal feelings, biases, or self interest might affect ethical judgment and reasoning. The psychiatrist of the therapist must consider all aspects related with his interests that may be lost in this case.
Step : Consider what effects, if any, that social , cultural, religious, or similar factors may have on the situation and an identifying ethic responses. Many issues related with a personal conflict must be thoroughly displayed for the professional to reconsider.
Step 10: Consider consultation. This means will help the professionals see things more clearly about him or herself in professional ways.
Step 11: Develop alternative courses of action. Of course, there will be some alternations that may be helpful to the case.
Step 12: Evaluate the alternative courses of action. After looking at all solutions, the professional has time to evaluate which one is the best and which one is the worst.
Step 13: Try to adopt the perspective of each person who will be affected. Thinking about the effects on the others is one way to fill out the whole picture of the case.
Step 14: Decide what to do, and then review or reconsider it. This is the most important moment for the professional to follow. His or her life may or may not be in good shape depending on the final conclusion. If the psychiatrist or the therapist accepts all the consequences of the incident, he or she will follow what his brains (not his heart) tell him to do.
Naturally, an intimate relationship starts by a dual relationship. According to American Association of Sex Educators, Counselors and Therapists, “A dual relationship occurs when a member is in a professional role with a person and (1) at the same time is in another role with the same person, and/or (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the member has the professional relationship, and/or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the consumer.”
Human beings are not the perfect creatures on the Earth. They create a great number of imperfect things since they grow up. They walk towards their destinies with or without their consciences. Sometimes, they do right things that the society asks them to do. At other times, they care nothing about rules or regulations if their hearts are not hard enough to follow all the rules and regulations that the society set up. If they accept all the consequences, they will be happy by themselves. Sadly enough, if they can not clarify what they really want, they will get stuck in the middle of somewhere and will be unhappy forever.
Kenneth S. Pope and Melba J.T. Vasquez, 2007. Ethics in Psychotherapy and Counseling, A Practical Guide, 3e. Jossey-Bass, A Wiley Imprint.
APA Codes and Ethics from: http://www.apa.org/ethics/code2002.html
Dual Relationship from: http://www.kspope.com/dual/index.php
Intimate Relationship from: http://www.apa.org/monitor/jan04/ethics.html