Dual Relationships the Relationship Between a Service

Dual Relationships

The relationship between a service provider and their client is particularly sensitive because the circumstances that bring the two individuals into contact are usually necessitated by a state of mental unrest in the client. Accordingly, the issue of whether or not to engage in a dual relationship (when the doctor has a relationship with their patient distinct from the clinical context) with the client must be treated in a very sensitive manner; the therapist has a responsibility to not only operate in their own best interest but also that of the patient they are hired to assist. This paper examines the relationship between a therapist and an unhappily married Latin American female client, determining whether or not the therapist should advocate divorce and pursue a romantic relationship with his client. Although the therapist has decided that they will pursue the relationship and advocate divorce, this is not recommended.

The patient and therapist have been in treatment for three months. In this period, the client, a thirty-five-year-old Latina woman, has grown increasingly unhappy with her marriage. The impetus for the counseling was that her husband was verbally abusive with her, never giving her any respect and ordering her to restrict herself to a steady diet of housekeeping and satisfying his desires. As the relationship progressed, the patient has grown more effusive in complimenting the doctor on his attire, physical appearance, and intellectual acumen. The doctor is forty years of age and recently divorced. There are a number of factors that must be considered by the doctor in deciding whether to pursue the relationship with his patient, including the patient's vulnerability, whether or not it is in her best interest to get a divorce, and whether the two individuals would be compatible in a romantic context, and finally, if it is possible to continue with the therapeutic relationship.

The first matter that must be addressed is whether the patient should file for divorce. Because she comes from a strict Catholic family, divorce is frowned upon by her family. A further complication is that her husband does not see the need for a divorce and she was raised in a patriarchal culture in which the women are subordinate to the men. Accordingly, the patient feels an inherent duty not only to her husband but also to her culture. To divorce would transgress the values with which she was raised, and this is a burden she may not want to assume.

The client is also Catholic, which would result in her excommunication from the church. However, over the course of the therapy sessions, it has become increasingly clear that the patient feels deep-rooted resentment toward the church, and one of the reasons that she married her abusive husband was out of a religious responsibility to get married and start a family. Ultimately, she and her husband refrained from starting a family because they did not possess the requisite funds to care for a child, but nevertheless she has felt pressured by the church her entire life.

Ultimately, the therapist finds the patient physically attractive and intellectually perceptive, and her personality to be effusive and compelling. She is very emotive and has a creative, enquiring mind. The two have an enthusiastic rapport with one another and the doctor finds the patient's enthusiasm to be a welcome alternative following a highly distressful divorce. Given that the therapist's former marriage resulted in divorce, he has no moral obligation to divorce, but is concerned that the patient's attraction to him is merely a reaction to her unhappiness with her current marriage. Moreover, because the therapist is deeply committed to gender equality, there would be no possibility for the patient becoming involved in another patriarchal relationship. However, considering his client's resentment toward the Catholic Church, he decides that it is prudent to advocate for her to pursue a divorce. It is possible that her overtures toward him constitute an act of sublimation and that the therapy sessions are a return of the repressed compensating for years of subordination.

The therapist is very introspective and after much rumination, he has decided to go through with the relationship, but with the stipulation that either he or his patient be allowed to terminate the relationship should either of them feel uncomfortable. He does not want the patient to feel as though she is subservient to him, but after months of therapy, enough of a foundation has been established to determine that the two may well be compatible in a romantic context. Although the professional relationship will continue, he has decided to offer a reduced rate for the therapy sessions, in order to ensure that his patient can afford the sessions and that he is not financially exploited.

In conclusion, the dual relationship is certainly avoidable, and there is also cultural sensitivity relating to the patient's religious upbringing. However, the doctor's decision is predicated on a belief that he and his client have a deep romantic attraction toward one another. Indeed, this case study is a salient example of absolutism vs. relativism with regard to ethical decision-making (Dewane, 2010). While it could be argued that the therapist is morally obligated to not proceed with the relationship no matter the circumstances (absolutism), the doctor's sensitivity to the woman's history and his attraction to her permit the pursuit of the relationship (relativism) (Freud, Kreug, 2002). Although critics of dual relationships contend that boundaries are necessary in order to ensure that neither party is exploited, the dynamics of the relationship will shift to a more cooperative dynamic, thereby ensuring that neither party takes advantage of the other. After taking all of these factors into consideration, it is determined that the service provider and client pursue the dual relationship.

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