I did a podcast once about a psychiatrist named Ike Herschkopf, who got his hooks into patients by entering their lives in ways that went way beyond therapy. One woman first started seeing him because her business was in trouble. One day, he arrived unannounced at her job. “I was so impressed,” she later told me, “that he cared enough to visit my office.”
Before too long, they were having their “therapy sessions” in some of New York’s most expensive restaurants (she paid), and she had written him into her will. It took her a decade to break loose from him.
Another patient, Marty Markowitz, first came to Ike in the early 1980s because he was in a terrible dispute with his uncle over who should take over the family business. Ike told Marty that he would handle Marty’s problems, and he did. But Marty’s vulnerability allowed Ike to rule over him for the next 30 years: He took over his patient’s house in the Hamptons, used Marty to type his unpublished mystery novels, and even became the president of Marty’s small fabric company.
In both of these cases, Ike had committed “boundary violations.” As Dr. Paul Appelbaum, an expert on psychiatric ethics, told me, “A boundary violation is something that takes place for the benefit of the therapist and with the possibility of harm to the patient.” Even when the therapist’s motives are benign, it can psychologically damage the patient.
