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Gray, S.H. (1992). Bulletin of the Menninger Clinic. LIV, 1990: The Exploitation Index: An Early Warning Indicator of Boundary Violations in Psychotherapy. Richard S. Epstein and Robert I. Simon. Pp. 451-465.. Psychoanal Q., 61:680.

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Psychoanalytic Electronic Publishing: Bulletin of the Menninger Clinic. LIV, 1990: The Exploitation Index: An Early Warning Indicator of Boundary Violations in Psychotherapy. Richard S. Epstein and Robert I. Simon. Pp. 451-465.

(1992). Psychoanalytic Quarterly, 61:680

Bulletin of the Menninger Clinic. LIV, 1990: The Exploitation Index: An Early Warning Indicator of Boundary Violations in Psychotherapy. Richard S. Epstein and Robert I. Simon. Pp. 451-465.

Shiela Hafter Gray

The authors believe that psychotherapists' exploitative behavior stems primarily from subclinical narcissistic mechanisms. They propose a thirty-two item self-assessment that therapists may use to identify their latent tendencies toward violation of the boundary between professional and personal relationships. These include erotic attitudes toward or emotional dependency on a patient, exhibitionism, seeking power over a patient, financial greed, and "enabling" a patient's pathological behavior. The process of determining one's Exploitation Index alone or in the context of a support group helps psychotherapists gain insight into their unprofessional attitudes before these are expressed in the psychotherapeutic situation.

The authors caution that people in whom denial is a major defense mechanism are likely to distort their responses. The Exploitation Index may not elicit certain less prevalent but more malignant causes of patient abuse, including overt narcissistic issues, mania, dementia, substance abuse and frontal lobe disorder. It is thus unsuitable as a screening technique to identify serious psychopathology in another person.


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Article Citation

Gray, S.H. (1992). Bulletin of the Menninger Clinic. LIV, 1990. Psychoanal. Q., 61:680

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WARNING! This text is printed for the personal use of the subscriber to PEP Web and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever.