"I fell in love with my psychiatrist" - but did he do anything unethical?

Hi guys. Today we're going to be addressing the whole I'm in love with my psychiatrist saga that's been going on over on TikTok from a woman named Kendra. There are a lot of people speculating that she might be having a mental health episode, whether mania or psychosis, or that she might have a personality disorder like borderline or histrionic. I'm not going to be doing that in this video. I'm not going to be speculating what she may or may not have. I think those are all good theories, but you really would need to assess her to actually confirm what she has. Or maybe it's nothing. Maybe it's all a marketing strategy. Who knows?

Instead, I want to talk about this from the perspective of ethics. I'd like to share why her psychiatrist might have done some of the things that he did, why a mental health professional might do something like that in this situation to sort of give you guys a bit of an inside scoop on what might be going on on the other side of this equation from an ethical point of view. And I am also going to touch a little bit on some of my observations from Kendra's testimony and some things that stood out to me in sort of like the way she was making sense of her story. But again, not going to be speculating on a diagnosis. So with that in mind, I'm just going to give you kind of a summary of everything she talked about. So let's get started.

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So, let's start with sort of Kendra's accusation. Her accusation towards her psychiatrist is that he knew she was in love with him and he kept her as a client anyway. She calls him emotionally dead inside and says that's why he went into the mental health field to feed off the vulnerability of his female patients. She says that he loved the attention he was getting from her and he had every ethical duty to end the relationship after he found out about her feelings and claims he got his emotional needs met from his patients fantasies. Um, so right off the bat, I'm going to go a lot deeper into this, but no, we are not taught to get rid of patients the moment there are romantic feelings. She also calls him a predator, but she admits he never did anything worth filing a complaint on. She says he groomed her into talking about her sexual fantasies, made her feel crazy for naming the dynamic and raged at her, and she also calls it exploitation.

So, what is the story? What actually went down? So, the story is that Kendra wanted to go on ADHD medications. She had a previous diagnosis and she went to the psychiatrist. She stayed with him for 4 years until she got a new insurance plan that wouldn't cover sessions and she didn't want to pay out of pocket.

So, their first session was a 90-minute intake, which is pretty standard. Right away, she noted she thought her psychiatrist was attractive. if he was around her age. She says she told him about her past attachment traumas and she felt seen by him, which is again pretty typical of what a mental health provider would do. You know, gather background information about everything including uh childhood, including past relationships and ideally make a client feel seen and heard.

Then she mentions he let her see him every month even though she only needed to see him every 3 months. So why might he have done this? It's possible that the psychiatrist typically would see clients every three months, but may have determined that in this specific case, she needed more frequent than that for whatever reason, whether uh the acuity of what she was bringing in or something else. It's also possible that maybe she requested to see him more than every 3 months and he may have given into her persistence. If a client is very very persistent about like, no, I need to see you more than that. I really don't feel like this is enough. there is sort of an ethical duty there to accommodate that within reason. Uh once a month I would say is within reason.

She asked him if he feels okay with her calling him by his first name and he said yes. And she says that she interpreted his reaction as smug in that moment and that she knows that was because that was his first sign that pretending we're friends was working. Allowing a client to call you by your first name when you're a doctor is not pretending to be friends. It's not unethical. It's not a boundary violation. Actually, we are trained to allow clients to call us whatever they feel most comfortable with and to even out the power imbalance as much as possible. So, certainly, if a client requests, hey, can I call you by your first name? Um, that is not something that a mental health provider would typically feel a lot of resistance towards, if they were to feel resistant towards that. I would actually be a little bit more skeptical about the ethics of that because it shows it's kind of more about their ego rather than making the client feel comfortable and making them feel like there's not this huge power imbalance there. I personally call my therapist by her first name even though she is also a doctor of psychology. Um just because we are you know around the same age. She was just one year ahead of me in my training. She was a postoc when I was an intern and I don't feel that there is anything strange about that. I think it would be more strange if I were to call her by doctor last name. And this is also a really good example of why we shouldn't read into body language because it's very unreliable, right? Uh so Kendra says her psychiatrist looked smug in that moment. It may have been just him trying to politely smile. It may have been him um feeling happy that she felt comfortable enough to make such a request. I would certainly hope that there wasn't any smuggness about it. As you'll see, this is kind of a pattern throughout Kendra's story that she reads intentions into his body language and into neutral things that he says in ways that don't quite make a lot of sense to me.

She says that then her psychiatrist started turning up the volume on us being friendly. And her evidence of this is that he said it's a special interest of mine when he checked in with her about thoughts of harm. Um, it sounds like maybe what he was trying to communicate in that moment, was that it's a particularly important part of his job to make sure that there are no thoughts of harm, which is absolutely the case for all mental health providers, something that they should be checking in about, especially when they are giving someone a new medication. Or possibly it's a nice way that he was trying to make it seem like it's more about him to ask about this rather than um, you know, making it seem like it's something about her that he's asking. you know, like if a client says like, "Hey, why do you keep asking about this?" Instead of, you know, putting them on the spot and saying, you know, I need to make sure that you're not going to hurt someone. Sort of taking responsibility for it and saying like, "Oh, you know, it's just a special interest of mine." I certainly wouldn't call it evidence that he was being friendly. Uh, some more evidence of his friendliness, she says, is he would tell her about his professional successes, such as paying off his student loans, uh, being on podcasts as a professional. And to me, this sounds just like sort of building rapport, making small talk, all in the professional sphere. It doesn't sound like there's anything really personal about it that may have crossed a boundary.

Kendra says that this all made me fall for him. And here it seems like, you know, she feels an emotion towards the psychiatrist, but there's a sort of lack of ability to take responsibility for that emotion. And instead, she's kind of blaming him as the source of her emotion. She called it breadcrumbs and intermittent reinforcement that he was sometimes warm and sometimes kept her at bay. Why might he have done this? Um, he may have been trying to maintain rapport while also feeling uncomfortable with her sexual advances towards him. He may have been trying to balance doing his job with at times feeling not completely safe in the relationship.

Kendra says she went to an appointment with him when she might have been internally bleeding due to a car accident, which in the end it turns out she wasn't. She says that she told her psychiatrist this and that he should have cut it short. Um, and I think this is fair. You know, if a client comes in and says like, "Hey, I might be having a medical emergency, but I chose to see you instead." It probably is a good idea to pause and say, "Hey, you need to go to the ER right now." Why might he have done this? if there was a history of him noticing that Kendra was exaggerating things or if he suspected that maybe she was saying this because she wanted to see some sort of like personal care out of him. He may have deemed that telling her to do that would have been sort of feeding into the fantasy a little bit after that.

She says he started turning up the intimacy. For example, commenting on her appearance without complimenting it. For example, noting you curled your hair or you're wearing glasses today. I would not call this turning up the intimacy. My own therapist does this. Um, it's not a sign that she has feelings for me. It's just trying to note things that are different about a client that could reveal clinical information or simply just make a client feel seen. So, for example, some days I come into therapy wearing a bandana over my head when I'm having a really bad hair day. And sometimes she'll note that and she'll say, "Oh, you put a bandana over your hair. It looks cute." But I know that what she's really getting at is like, "Why are you wearing a bandana?" And I know that when I answer that question, the answer is, well, I haven't had time to do anything with my hair because I'm really tired because I had a really long night with a baby. So, there is clinical information that comes as a result of her commenting on things that might be different. Or another example, I usually um take my therapy sessions in my office, but one time I took it from bed because I wasn't feeling well, and she commented like, "Oh, you're in a different place." And that revealed that yeah, I wasn't feeling well. I had food poisoning. I was actually going through a really hard week. So, what might Kendra curling her hair one day mean? And why might her psychiatrist comment on that? It could mean she put extra effort into her appearance that day. Maybe her psychiatrist suspects is because of him, or maybe he's just trying to make small talk uh to see if she has something special going on later that day, something that could be of clinical interest. Apparently, as a result of their discussion on glasses, he revealed, "I prefer turtle shell glasses," which again could just be him making small talk, trying to build rapport with her. Yeah. So, unfortunately, because Kendra did sort of dox her psychiatrist, I was able to see that he actually wears turtle tortois shell. God, why can't I say this right? Tortoise shell glasses. Um, so I'm guessing he said, "I prefer tortoise shell glasses not as a way of telling her to wear it, but rather referring to himself." But Kendra then says she's wearing tortois shell glasses in these videos in case her psychiatrist ever sees them. And to me that really begged the question, is this entire series a way of getting attention from her psychiatrist now that the relationship is over now that there's no other way of reaching him?

So Kendra later tells her psychiatrist that her doctor friend thinks he's going to stop treating her to be with her. And she says her psychiatrist doesn't respond. Why might he have done this? Uh Kendra calls it weaponized neutrality, but it's possible that he was trying to spare her feelings cuz you know, if he says like, "Yo, there's no way that's going to happen." That could impact the rapport. He could have been trying to not feed her attention because sometimes some types of people, they respond to either positive or negative attention. So, the only way to sort of not feed that behavior is to not react at all when they say something a little bit outlandish. He might have also been frozen again due to not feeling safe in the moment. Personally, you know, I wasn't there. I can't say exactly why he did what he did, but like I personally do think he probably should have said something in the moment because that feels like something really important to unpack. I probably would have said something along the lines of like exploring how she feels about what her friend said, examining why this cannot actually happen, explaining the ethical guidelines, and getting her to sort of brainstorm on her own why they exist and why that would actually be a terrible idea. But it sounds like that's not the route that the psychiatrist chose to take. And in general, it sounds like the psychiatrist was a little bit non-reactive to her advances. And I do think, you know, from the outside looking in on Kendra's story, that's probably something that he could have done a little bit better. But I wouldn't say it's necessarily unethical. It's just something that maybe he needed a little extra consultation around or maybe froze in the moment.

So Kendra at one point asks her psychiatrist what her diagnoses are and he says ADHD and also other stressor and trauma related disorder and she says that he was withholding this information from her and using that information to manipulate her and she asks the question why would he keep that from me? Well I have quite a few theories. Often that diagnosis is sort of a catch all for either CPTTSD or just complex trauma history in general. So, if she told him, you know, hey, I have all these past traumas. Him diagnosing her with this doesn't really provide any new information. He already knows she's been traumatized. Um, this is just kind of putting a name to it, but it doesn't really change the situation at all. She already knows she's experienced complex trauma. He's just putting that into writing. This is a diagnosis that makes it clear that trauma is at play in a person's presentation. It could also be a diagnosis where you feel like maybe someone's presentation doesn't fit perfectly neatly into one category or it's sometimes a placeholder diagnosis if a provider is still trying to assess what is this person's best diagnosis that they're not quite sure yet. All they know is this person has trauma history that is impacting their presentation. Sometimes they'll use this as a placeholder for, you know, trying to assess if there's personality disorder at play or something along those lines.

So, Kendra also touches on her relationship with her therapist, who she says is a 75-year-old woman with the PhD. And she says she would tell her therapist about her feelings towards her psychiatrist, and she didn't do anything about it. Probably because it doesn't sound based on what Kendra is saying, like her psychiatrist really did anything wrong. Um, and probably because she wouldn't be allowed to do anything about it. She wouldn't be allowed to tell Kendra, "Oh my god, you need to stop seeing him." or reporting him based on, you know, confidential information that she has from her client. Kenra's perspective on this is that she was getting supply from me in her own way. I'm getting a little bit confused at this point what she means by supply because an exchange of respect, kindness, admiration is not necessarily a pathological supply. It's not necessarily indicative of an abuse of power. Sometimes if you're feeding someone respect and admiration, it's perfectly fine. It's okay that they feel good about that. It's not that they're necessarily doing anything wrong.

So then around a year and a half in, Kendra says she got a boyfriend and she claims that she they were having some problems in their intimate life and both her psychiatrist and her therapist told her, "You have to stay with him. There's nothing wrong with your boyfriend not meeting your needs." This does not sound like something a mental health professional, let alone two mental health professionals, would say. Of course, I wasn't there, but I do wonder if this was a misunderstanding or misinterpretation of what they actually said. She says that her therapist encouraged her to discuss her intimate problems with her psychiatrist. Her therapist might have done this if sexual issues can be a side effect of whatever medication Kendra was prescribed. possibly she's wanting like an informal second opinion on Kendra's presentation and she wants to hear, you know, what the psychiatrist says about it.

During this time, Kendra says she was sending her psychiatrist lots of emails with lots of heart emojis and saying how much she likes him. And she said at one point she admitted her crush on him and he smiled so big. So, I would hope that her psychiatrist was just bashful or uncomfortable or maybe fawning in that moment. Um, again, I wasn't there, so I really can't say. And she says that then she gave him 30 minutes of non-stop content about her intimate life at her therapist's request. And she also says she recorded the whole thing, which is kind of messed up. Like, yes, it is her medical session. Um, but medical providers also have an expectation of privacy. However, given that she has this recording, I would actually be really curious um to hear what her psychiatrist actually said. Um I think it would be completely unethical of her to release it, but I think it would sort of give her story more weight if he actually said something inappropriate.

So Kendra says, "Any ethical psychiatrist would have stopped me from sharing about her intimate life at this point." And this is not necessarily true. again, especially if there are clinical considerations related to, you know, side effects that pertain to intimate life or if she's somehow providing insight into her clinical condition in the way that she's discussing the topic with him. She claims that it was his grooming that got her to talk to him about sexual things with him. But based on everything she said at this point, I really don't see any evidence of that. And she admitted that it was her therapist who suggested she bring this up. It doesn't sound like her psychiatrist ever coerced her into talking about sexual things. It was her choice to do so. So, again, this seems like a little bit of a projection of her own intentions.

So, Kendra and her boyfriend eventually broke up and she started dating somebody else who was a therapist. And this guy, she said, on their first date started telling her he has a crush on one of his clients and that he knows where she works and all this stuff. This uh would be incredibly unethical behavior on so many levels. But at this point, I'm noticing a pattern that pretty much every mental health professional in Kendra's life is unprofessional or a boundary violator or is described as unethical in some way. And this is certainly not impossible, but I just want to mark that it is statistically unlikely for every single therapist and psychiatrist that someone comes in contact with to be so unethical. And Kendra says she told her psychiatrist about the date and he looked uncomfortable. And she assumes this is because she was holding a mirror to him. And this is again one of those examples of when she's sort of reading intentions into his body language when it's very possible that he was uncomfortable because what she was describing was incredibly unethical behavior.

Kendra then says she notices that her psychiatrist is working from an office and she asks him about it and he sort of acts like he only does teleaalth with people. He also stops replying to her emails. He only brings them up in session, which is very much standard of what a therapist or psychiatrist should do if their client repeatedly messages them out of office hours. This is to stop sort of reinforcing the behavior and to make it clear that they discuss clinical matters during their clinical time and that they do not have an out of office relationship. They do not have a personal relationship. They're not going to be teheing and hahaing texting at 8:00 p.m. on a Friday. Now, why the change? Why did he stop replying to her emails? He may have felt that she took it too far. Um, you know, he may have felt that, you know, wait, this is veering into like really personal territory rather than clinical. It's also possible that he was consulting with his peers during this time and that they told him like, hey, you should definitely stop responding to her cuz that seems to be feeding this behavior. This is very much what the psychiatrist should have done. If he were to respond and make it clear that like, yeah, I'm available around the clock, then that could bring up a liability for him because what if she messages him during the weekend, let's say, saying, I'm going to hurt myself if you don't respond to me. If he makes his boundary very clear, then that softens the liability a little bit.

So, Kendra eventually calls the office and she's shocked to find out that he does in-person sessions and she tells her therapist about it and her therapist says it's probably because there would be a lot of sexual tension. Kendra takes this to mean that like, oh, the psychiatrist probably feels sexually towards her as well. But I don't necessarily read this as being birectional. Um, Kendra having sexual feelings for her psychiatrist is kind of enough for there to be sexual tension in the room if they see each other in person. She then goes to the psychiatrist and relays all this information to him and says, "You lied to me." And again, she says, "He doesn't respond anything." Now again, he could have been freezing from discomfort, maybe trying not to feed the pattern with further attention. Um, but you know, he eventually does see her in person. And at that point, she says she gives him the biggest hug while he barely pats her on the back. And this sounds super professional to me. Kendra also mentions in a live that that she's physically larger than her psychiatrist, that she's taller than him. And typically, this is in the direction of man to woman because men are typically larger than women. Well, when you have someone who's made sexual advances towards you, tried to violate your boundaries, meeting you for the first time, and suddenly running towards you to hug you, and they're even physically larger than you. That can be kind of scary for people. So, I would not be surprised whatsoever if her therapist was frozen in discomfort. I also wonder about like cultural and religious factors into how he feels about touch. My friend Amira, who I've made a couple videos on this channel with in the past, she pointed out that if he's Pakistani, like she revealed, he's likely Muslim and likely there is a lot of taboo around touching people of the opposite sex. And Kendra admits that his reaction, how cold it was, made her never touch him again, which is precisely the point. It sounds like he did exactly what he was supposed to do in that moment. He didn't, you know, push her off of him cuz that would definitely impact rapport. But it sounds like he gave her the bear necessary to send the message, "Don't ever touch me again."

Now, in the meantime, she says her therapist started texting her in between sessions to ask for help on her other clients. And she starts telling her psychiatrist about this, and he says it's a huge boundary violation, and she shouldn't have done that. And I completely agree. Um, you know, if her therapist did that, that it's super unethical. Around this time, Kendra says she started to spiral. She started leaning on her AI chat, who she named Henry, asking for advice. And I noticed that she was sort of blushing while she was talking about Henry. A lot of people have sort of raised concerns about possible AI psychosis here. Or even like I'm just wondering like what are the implications of people with attachment issues using AI sort of personifying them as a proxy for connection? That seems to be a little bit complicated. And it does seem from what I've seen of Henry and her subsequent AI named Claude um that AI tends to be overvalidating of people's clinical issues. And to be clear, that happens sometimes with real life therapists, too. Like there are definitely therapists out there who will just tell a client what they want to hear. But most therapists are also equipped to notice when something unusual is going on or to clock when a client is being an unreliable narrator. and to sort of push back and challenge some of those narratives a little bit. So, I definitely think this does show some of the pitfalls of using AI for therapy.

At one point, Kendra says she tells her psychiatrist, "You and I have a really special patient doctor relationship." And she says that he glares at her with venom in his eyes and says, "You and I have a professional patient doctor relationship." She calls this a nasty boundary, but I think it's more than fair, especially given her continued sexual advances, which she admits seemed to make him uncomfortable. Again, this is exactly what he should have responded, in my opinion, in order to maintain ethical boundaries. She says she immediately went to Henry about this and told him she wants to be with her psychiatrist after they're no longer patient doctor. And Henry told her about something called transference, which we'll get to more in depth in a second. And she tells her psychiatrist about this and she says at this point her psychiatrist got a really scared look on his face and he asked her did Henry tell you about counter transference. She interpreted this as his fear that he was outed as having feelings for her. Counter transference does not mean you have feelings for your client. Again, I'm going to go into this in a lot more depth, but that is not what it means necessarily. And I wonder if his fear about her bringing up transference was more about the fact that again she was bringing her feelings for him in the room and maybe he was uncomfortable with it. Why might he have brought up counter transference? Possibly he was trying to indirectly communicate to her that he was feeling uncomfortable in that situation. Possibly he was trying to explain to her why he was so firm during his previous boundary setting. Or like he later said, maybe he had concerns about her own counter transference towards her clients. because again, as we're going to talk about later, she is an unlicensed ADHD coach and there are some serious ethical issues with that as well.

Then Kendra says she had a dream that they hooked up in his office and she decided to stop going to therapy because otherwise she was doing very well in life, which is kind of strange because she just mentioned she was spiraling. So, I'm not quite sure like how much time has passed since the spiraling. So she and her therapist debriefed during their last session and that night her therapist emailed her asking for an extra session to wrap up saying she was, you know, caught a little bit off guard that Kendra decided to stop sessions and she wanted to offer some clinical closure. Why might her therapist have done this? Possibly she still had lingering concerns. Possibly she felt like Kendra did not meet her goals on their treatment plan that she was maybe unready to terminate. and possibly she was just unprepared to share all of that in in the moment when Kendra first announced she was ending therapy.

Now, the next day, Kendra says she has an appointment with her psychiatrist and she asks him what she thought about uh an email that she sent him and he said he's still thinking about it and he used a metaphor to sort of describe how he's feeling. He said he's feeling a salad of emotions right now and she for some reason really really loves that metaphor and she says that he knew exactly how to make me happy. This is kind of confusing to me because to me it just sounds like a provider trying to sort of model emotional expression and admitting that he maybe feels some counter transference that he feels a little bit conflicted or you know a lot of intensity around the topic. It's not really clear to me why Kendra interpreted this as him trying to make her happy. So, he helps her draft an email response to her former therapist and then Kendra tells him about her sex dream and she says all of a sudden he looked so uncomfortable. Of course, he would. Um, as Kendra admits, sure, he could have just been uncomfortable. But then she sort of immediately pivots into you want to know why he was uncomfortable because he had played out that fantasy many times. So, again, we're hearing this reading into intentions and sort of running with the theory. what in CBT is called a mind readading distortion. When somebody pretends that they know what somebody else is thinking when really that person is offered zero evidence that that's what they're thinking. And that's especially interesting because Kendra admits she thinks she can read other people's minds more like spiritually speaking, which again does raise some concerns about psychosis, but is also basically just an admission that a lot of the ethical violations she perceives her psychiatrist as having done are really just her interpretation of his intentions. It's not anything that he's actually done to her.

So she asks him why he stopped emailing her back. And he admitted he wonders why she does it. And she replies, "It's because I want attention from you." And that response precisely explains why he stopped. And it precisely explains why he asked her that, why he wonders why she does it. By him saying, "I wonder why you email me so much." It's opening the door for her to sort of answer her own question and to say like, "Oh, I email you cuz I want attention from you." and then to sort of connect the dots. Oh, so you stopped emailing me because you don't want to give me attention. It's unlikely that a psychiatrist would flat out just say, "It's because I don't want to feed you attention." Because that would be bad for rapport. It's much more likely that he would try to sort of gently guide her to realize that on her own.

So, at the end of that session, her psychiatrist walks her out the door, which she says he doesn't usually do, and he physically watches her exit. And she finds it very weird. She says that he says, "See you next month." I have to be honest. I have no idea why Kendra finds this to be evidence of his feelings. It seems like a completely normal thing for a psychiatrist to say at the end of a session with someone. See you next month. It's probably one of like the top three things that a psychiatrist would say at the end of a session. And then Kendra says she realizes that they've gone 15 minutes over session. Why might the psychiatrist have done this? If a client is presenting in acute distress or in crisis or seems to be going through something really serious like they just left their therapist, they just revealed sexual feelings towards you. Maybe they just have a lot to process that day. It wouldn't be ethical for him to just bluntly, you know, cut the session short and send her on her way without assessing is she going to be okay. So, he actually did the ethical thing by keeping her a little bit over if he determined. We have a lot to unpack today. It's not evidence that, you know, he was giving her special treatment. It's evidence that she was needing a little bit extra than the standard session.

Kendra says that he forgot her refill that month, which she says is kind of like some huge tell that he was frazzled by their last session. He could have just made a mistake. You know, she says he never made mistakes, but even people who never make mistakes sometimes make mistakes. Or yeah, maybe he was frazzled by their last session and maybe on some level he didn't want to think about her.

So, at this point, Kendra's former therapist replies to her and tells her that she's offering one last session just for her own clinical integrity. And Kendra says this is her wanting to put her needs above my own. Personally, that's not really how I'm reading it. I'm just reading it as a therapist, you know, wanting to make sure that the client has closure. if it was a relationship that ended suddenly, if it was a relationship where the treatment goals were not met. But then she says her therapist sends her a friend request on Facebook not even a month later. And that is indeed inappropriate and unethical and a boundary violation. And Kendra tells her psychiatrist about this. He seems disturbed, which I echo.

So, like I mentioned, Kendra switches insuranceances and and she decides to not pay out of pocket for psychiatry anymore. And so during her last session, she's showing her psychiatrist her post that went viral on Instagram. And she's sort of like asking him to check out a podcast that she was on. And it seems based on the responses she says the psychiatrist is giving that he's sort of trying to avoid saying that he's going to look her up on social media. And this is again him trying to be ethical because for example, look at what I do for work. I am a content creator. And my own therapist told me when I told her about what I do for work that she's not going to be looking me up on social media that that would be a boundary violation. That if there's something I posted on social media that's of clinical concern, I should bring that into session itself. It's not ethical for therapists to be sort of digging into a client's personal life using social media. Think about, you know, before social media. How would it be if they were trying to dig into a person's social life by like showing up at their work, showing up at their school, trying to befriend their loved ones? Like, that would be inappropriate. And it's equally inappropriate to try to figure out stuff about your clients using social media.

So, Kendra then reads to her psychiatrist how Henry said she likes to rattle him, and she says her psychiatrist didn't have anything to say to that. Again, it sounds like she's making him uncomfortable, and I find it a bit concerning that she's kind of admitting she does like to rattle him. That sounds, based on what she's saying, honestly, it sounds like sexual harassment. Then she tells him she needs to stop her appointments due to insurance. And in her monologue, she said that he let her in even deeper after he set his boundaries with her. And at this point, she says her psychiatrist interrupts her to ask, "Tell me the ways in which I let you in." Why would he do that? if he felt like she was, you know, reading into things, things that he did not communicate, it makes perfect sense that he would interrupt her in that moment and try to redirect her to the facts of the situation. So, she sort of replies, "I'll tell you at the end, but please don't play stupid." She tells him to stop interrupting her and to stop asking questions. And she says he doesn't ask any other questions all session long. Just sort of nods along. And she interprets his nodding as him agreeing that there's chemistry between her when that's what she's saying. I think it just sounds like he's actively listening. Uh, you know, when someone's talking, you just you kind of nod along to get them to continue talking. And if he feels like he's not allowed to ask questions, that might be the only course of action really available to him.

So, she says this was 5 months ago, and I don't know if by the time I'm finished editing this, there will be more to the saga. It sounds like she was kind of nearing the end. It seems to me like she's kind of drawing this out, and I have to wonder if there's some sort of financial incentive for doing so. But as of today, this is the last thing we know about the situation. So, I'm going to share some things that I noted in the story and then I'll comment on like the ethics of the situation. There's a lot of what's called the mind readading cognitive distortion and a lot of making assumptions about people's intentions and then using confirmation bias to sort of run with that theory. The things that she says are evidence of his feelings towards her are things like saying, "See you next month." him nodding along when she told him to stop interrupting. Him looking uncomfortable when she brings up her sexual feelings towards him. These, I would say, are pretty typical reactions of somebody who feels uncomfortable. Not necessarily an indication that this person reciprocates their feelings. And when people act like they can read other people's minds, there is an element of projection very often embedded in there, right? Like she admits to trying to rattle him intentionally. She admits to violating his boundaries and yet she's the one accusing him of being inappropriate even though she admits he never crossed a line. He never did anything illegal. He never did anything that she could report him for. As a content creator, I deal with people trying to read assumptions into what I say all the time. Kind people tend to give people the benefit of the doubt, whereas other times people will say, "I can't believe you didn't talk about this thing that's really important to me. you must have malicious intentions for not doing that. And in those situations, I often have to wonder, is this a projection of that person's own malicious intentions? Because I had absolutely no malice in not discussing the thing that they thought was most important for me to discuss. So, it's interesting that that's sort of the assumption that they would make. There's a lot of projection embedded in mind readading distortions. And I think this also brings up the question of at what point does something veer from a cognitive distortion into a delusion. And this is somewhat subjective and complex to assess. I'm not saying she necessarily has a personality disorder, but I have known people with personality disorders who when they're experiencing extremely high stress, they do sort of veer a little bit into delusional in their distortions. For example, I knew someone who had a personality disorder that's characterized by extreme volatility and very high conflict who when they were sort of like backed into a corner, who were sort of confronted with their actions was claiming I'm a lowconlict person. And this is historically where the term borderline comes from. These days, the term borderline refers to borderline personality disorder. But historically speaking, psychonamically, the original definition of borderline was someone being on the border between neurosis and psychosis. Neurosis being like your run-of-the-mill mental health issues like depression and anxiety. Psychosis being when somebody's actually detached from reality. And so, originally, the term borderline sort of encompassed all personality disorders because they were sort of straggling the two, straggling neurosis and psychosis. Again, I'm not saying she has a personality disorder. I'm telling you this because I want you to understand that where cognitive distortion meets delusion is not that clear-cut. It's a little bit messy. And also, I think it's interesting the internet's reaction to this. Obviously, there has been so much attention on the saga. And I think this reveals a lot about the complex nature of intersectional identities because Kendra has more power in this situation in that she is white and that she can publicly speak about what happened to her on the internet without breaking any laws and that she's physically larger than her psychiatrist. And yes, physical size does matter. It's about proportionality. You know, my niece was just here and she was, you know, excitedly running towards my cats. My niece is 2 years old, but because my cat is 1 foot tall, that's scary for them. They ran away. So like physical size does play a role in power dynamics. But on the other hand, her psychiatrist has more power in that he is a man and in that he is her mental health provider. The internet loves to misuse intersectionality theory, but this is essentially what intersectionality is about. We all have multiple intersecting identities and life is often a lot more complicated than just this person is the victim. This person holds all power. But I do find it interesting that at the end of the day, the internet's most mainstream reaction is to ridicule a woman who they perceive as having a mental health episode. Because I think at the end of the day, what wins in this situation is people love to hate a woman they deem unstable. And I'm not saying that Kendra is not causing harm with what she's doing. Two things can exist at once. Kendra can be causing harm with what she's doing. And also, this reveals that once again, people really hate women.

So, let's get into the ethical components of all this. Let's talk for a second about transference and counter transference. Starting with transference. So, Kendra defines transference as when a patient has a crush on a health care provider. And that is very clearly not what it is. Transference is when relational patterns that take place outside the therapy room make their way into the therapeutic relationship in the direction of client to therapist. For example, you feel abandoned by your core attachment figures. So your fear of abandonment gets triggered when your therapist needs to cancel next week because they're going on vacation. You have issues with respecting your children. So, when you're assigned a young therapist, you have trouble respecting their clinical judgment.

Counter transference is the opposite side of that coin. Kendra defines it as the provider developing feelings for the patient, but again, that's not what it is. That reveals her misunderstanding of what transference is. She claims that the psychiatrist's admission of counter transference is a big slip for him, him revealing that he has a crush on her. But again, that's not what it is. Counter transference usually refers to two things. Number one, the client's transference produces a reaction in the therapist. So, for example, if the client views their therapist as a mother figure, the therapist might because of some of the client's behaviors also start to see themselves as a sort of mother figure. And they may start to be, let's say, critical or controlling in the same way that the client's mother was. Second thing that counter transference could refer to is the therapist's own relational patterns outside of therapy making their way into the room. So, for example, if a therapist has a history of being sexually harassed, they might freeze up as a trauma response when a client starts making sexual advances towards them. And it's really important when a provider starts to feel counter transference for them to seek consultation in order to maintain good quality of care. But counter transference absolutely does not mean that the therapist has done anything inappropriate. And it absolutely does not mean that you have to refer that client out. you only have to refer that client out if you feel like you can't handle the counter transference ethically. And Kendra initially in her videos says, you know, he should have immediately transferred me out the moment he found out I had feelings for him. But then when people point out, no, that's actually not true, she sort of switches up her tune and says, well, he should have discussed it with me. And I do agree that he should have discussed it with her. I do think that was maybe something he could have done better, but I'm not completely convinced that again she understands what counter transference is or what you're supposed to do with it because she still continues to operate under this assumption that counter transference means he has feelings for me and he should have let me go. The best proof that counter transference does not mean the therapist has developed feelings for the client is that in every presentation and every essay in grad school where we were like working on a case report, there was a section on counter transference, right? Like our professors were not asking us did you catch feelings for your client. No, they were asking tell us about the counter transference patterns and how they play out as they do in pretty much every therapeutic relationship. And the reason it's so obvious that Kendra feels transference rather than real love for her psychiatrist is that it doesn't sound like she knows very much about him. What he shared about himself was professional. She sees this person for 30 minutes every month. She doesn't actually know anything about him as a person, anything about his personal life. That's not love. That's infatuation. And oftent times in a clinical setting, infatuation is some form of transference. Now again, I do agree with Kendra when she says he should have discussed this with her. He should have based on her own version of events. This is one clinical mistake that the psychiatrist made was not helping her work through it. I wouldn't call it unprofessional or ethical. Um, but I think he should have helped her work through her feelings. However, he was her psychiatrist, not her therapist. She was working with a therapist in conjunction for a lot of their time together. And although as somebody said, you know, it seems like he

was psychonamically trained. Psychiatrists' training doesn't focus as much on doing therapy with clients because that's not their job. Their job is to focus on the medications. They see the client for a very limited time period. They are, at the end of the day, medical providers, not psychologists. So, it's very possible that the psychiatrist was just kind of out of his element, and that a therapist would have been able to process this with her, but this wasn't entirely his job to do.

However, Kendra is completely mistaken that he should have terminated the relationship due to abandonment laws, particularly if somebody seems to be in some sort of acute episode. You don't just drop them, even if they are saying they have feelings towards you, especially if they just dropped their own therapist. He was actually doing the ethical thing if he decided that it was against her best interests to drop her as a client. Now, the psychiatrist did need to balance caring for the client with protecting himself. And, you know, it sounds like he was uncomfortable with a lot of things that happened. Like my friend Amamira pointed out, it could have been because of his Muslim religion, or it could have just been she was making him uncomfortable. There were a lot of points throughout Kendra's story where I wondered if the psychiatrist froze as sort of like a fear response, or was sort of like trying to maintain rapport so as to not anger her. And, you know, as a rule of thumb, I believe women's stories when they share exploitation that they've experienced. And that's exactly the issue is that I believe what Kendra is saying based on what she herself is saying. Her psychiatrist did not do anything unethical or predatory.

Now, a lot of people online are speculating, is the psychiatrist going to take legal action? Is he going to like get a restraining order against her? Is he going to sue her for defamation? I think that's pretty unlikely. And the reason for this is that mental health providers need to balance the ethical guideline of maintaining confidentiality with their own right to safety. So unless things escalate to a point where people are like showing up to his house, endangering him, egging him, you know, it's impacting his livelihood, he's probably not going to break confidentiality to take legal action. This is probably going to blow over in a week or two, and he's going to be perfectly fine, legally speaking. Yes, he would be able to break confidentiality if necessary, but he probably wouldn't do that unless things get very bad. And a lot of people are saying the fact that he hasn't spoken out about this means that, you know, basically like, yeah, she is his client. That's not necessarily true. Uh, I remember in grad school, there was this one ethical dilemma that was presented to us that was saying, like, if you're seeing a client and their husband calls you and asks, "Hey, are you seeing Amanda Jennifer?" I don't know, can't think of a name right now. Whether or not you are seeing Amanda Jennifer, your duty in that moment is to say, "I can neither confirm nor deny that this person is my client." Because if you say no, then you're basically also admitting confidential information, which is that that person is not seeing you as a therapist. So, the psychiatrist is really between a rock and a hard place. He can't confirm and he can't deny.

Despite this, he's probably going to be completely fine, especially if he documented everything extensively. If he consulted about this case with his team. If he's currently consulting with his liability insurance lawyers. By Kendra's own testimony, it doesn't sound like he did anything illegal or unethical that would jeopardize his license. And even if she were to file a complaint, based on the fact she presented, I'm highly doubtful that a team of fellow psychiatrists wouldn't side with him. But unfortunately, he can't protect himself from the reputational damage or the harassment that unstable internet trolls are sending his way because of the fact that, intentionally or unintentionally, Kendra doxed him.

Another ethical concern here is Kendra's ADHD coaching business. So Kendra starts marketing her coaching business in part of this story when her story is starting to gain traction. You guys know how I feel about the unregulated field of coaching. It's extremely dangerous, and this case is the perfect example of why. Unregulated coaching means they can do and say whatever they want. They can do pseudoscience on you. They can do things that are not evidence-based. They can discuss what you discussed with them in what you thought were confidential sessions with no consequences because there is no governing body to slap them on the wrist. And actually, it sounds like that is what happened in this situation because one of Kendra's former clients spoke out, and she said that she was kind of coerced into giving Kendra a lot of money, and that a lot of what they were doing was pseudoscientific. And Kendra admitted publicly that she did treat the former client. She shared, you know, intimate things that they discussed in those sessions. A licensed provider would have never been allowed to do that. It is extremely dangerous to go to these coaches who are operating on vulnerable populations because Kendra's specialty is supposedly ADHDers who have also substance abuse issues. So, unethical to be practicing outside her scope of practice. And also the fact that her client and her admitted that they were also friends in addition to professionals working together. That's another sign of a boundary violation. A sign that, you know, Kendra, in her coaching business, was not acting professionally or ethically, was violating boundaries, was in all likelihood experiencing countertransference. And I think we also have to talk about how Kendra, as a result of her unregulated coaching business, has an incentive to portray mental health professionals as predatory. I'm typically skeptical of people who make 50-part series because it's pretty clear to me that they're doing that so that people will click on their account and then, you know, see what's in their bio and, oh, what do you know? It's a coaching business that I can sign up for. But like I said, it's also very atypical that every single licensed mental health professional in Kendra's life was behaving so unprofessionally, according to her. And it sounds like she was also behaving unprofessionally in the yoga studio that she was working at. Uh, apparently she was sort of trauma dumping on her students about this series that she's making. And apparently a lot of people also reached out to the yoga studio to make them aware of her series. And, um, they ended up firing her. I don't think it's okay that people reached out to her yoga studio. I think that is equally as boundary violating and inappropriate as what Kendra did. And it sort of makes me think, you know, that the people who did that probably saw themselves mirrored in her behavior, and that's why they were reacting so disproportionately, right? Like when somebody does something like really aggressive and like over the top like that, it's usually because what they saw in the other person that angered them was a reflection of themselves.

So those were some of the ethical considerations about this whole thing. This video was a lot longer than I expected it to be. So, if you enjoyed it, give it a like, share your thoughts in the comments. This is a really complex topic, a lot of nuances, but I just wanted to share, sort of from a former therapist perspective, what some of the ethical guidelines are and why the psychiatrist might have done some of the things that he did. At the end of the day, of course, we'll never know why he did what he did, what he did exactly. We weren't there. I'm just going based off of Kendra's story. Take care.

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