Playing with the doctor

Q: I have been a conscientious mental health practitioner for more than 30 years. Taboo of all taboos, lately I have been receiving oral sex from a patient. This is how it happened: My patient told me she's been in and out of therapy her whole life because "I am a cocksucker and I must suck cock regularly." She's married to a very religious man who used to allow her to do so, but now says that activity is a sin for a Christian wife. She offered to suck mine and, while I was aroused, I refused. I offered to refer her to a female therapist but she began to cry and apologize. I then agreed to treat her once a week, with a goal of better control. Next session she told me she was engaging in risky behavior — getting drunk and randomly phoning numbers until she found a man to talk with. She said she offered to suck this guy's cock at a nearby bus stop, but she passed out and didn't go. She began to beg me again, saying if she couldn’t suck my cock she would have to start asking men on the street. When I didn't say no, she looked at me, smiled, and began to remove her clothes. Now every session she happily sucks my cock and she tells me her marriage is great. She is now pleased with her husband's twice-a-month missionary routine and he tells her "your new therapist has answered my prayers." Ironically, my own marriage has also improved. My wife has been joking about my new libido and thinks it's due to Viagra. The biggest news is that my patient is now pregnant and thrilled to be starting a family, but she wants to keep this arrangement indefinitely. I don't want to jeopardize my profession, yet it seems this arrangement has made four people's lives much happier. Is it rationalizing to think that I may have saved this fragile woman from divorce, disease, arrest and maybe even rape?

A: What a humanitarian! I bet you even reduced her fees for your weekly sessions. Of course, it's rationalizing, you devious son of a bitch! You deserve to lose your license and your patient deserves a principled therapist who won't give in to emotional blackmail and keeps it in his pants.

Q: I seriously think I hate my vagina. To me it just seems like more trouble than it is worth, causing PMS and cramps and having periods. It's becoming intolerable and sex is starting to become that way too. I think I am sick of being a receptacle and I have been having some serious penis envy. A penis is just so simple; insert one into a warm, wet place and have orgasms almost every time. My G-spot has become so sensitive that I can't even stand to have it touched. Just the thought of penetration is a big turn-off. I know I am not gay, though I've considered it. I've had my boyfriend for more than 3 years and I have tried to explain how I feel. He gets all worried and thinks it's his fault. Honestly, he has satisfied me. We are very open with communication and close physically as well as mentally. I am almost positive this is psychological and not physical. I don't want to hate sex. It's almost like I've developed a phobia about it. I feel satisfied with just petting and smelling. I don't even think I like kissing any more and it is really freaking me out. I've already hated anal sex for a while, which is a big disappointment to my boyfriend, but he accepts it. I don't want to have to take this away from him too. Please, please help.

A: I'm afraid there's much more here than I can deal with briefly in a column, or even briefly in therapy, if you were consulting me in my office. Much as you may love your boyfriend, the feelings you described, unfortunately shared by a certain percentage of women, are not those of a woman satisfied by her loving boyfriend. Were sex satisfying, all this revulsion, pain and envy would not be associated with it. Of course "it's psychological," and while there may be some physical components, I strongly suggest you get yourself to a reputable therapist (avoid the above letter writer) and start doing some work on your feelings about your body, your gender and, yes, your relationship. Isadora Alman is a board-certified sexologist and a California-licensed marriage-and-family therapist. Contact her via this paper or askisadora@aol.com. Her Sexuality Forum is at