Jerusalem man says affair with psychiatrist damaged his mental health

A report out of Jerusalem

A 55-year-old man from Jerusalem intends to tell a Jerusalem court next month that a sexual relationship he had with his female psychiatrist in her private clinic damaged his mental health. The case is expected to set precedents concerning the psychiatrist-patient relationship.

The case, pertaining to 114 therapy sessions between October 2000 and November 2001, had been under a gag order since deliberations began in the Jerusalem District Court in January 2004. The psychiatrist, Tamar Kafri-Deutsch, denies ever sleeping with the man.

In March this year, Judge Zvi Zylbertal granted the complainant's request to make the details of the case public, except for the complainant's identity. "There is a distinct public interest in putting this issue on the agenda, to demonstrate the dangers of what could occur during psychological therapy," Zylbertal wrote in his ruling.

"The special relationship that is formed between patient and psychiatrist and the dependence that could grow from it - which could result in abuse - merit examination."

By making the case public, Zylbertal said he hoped to "increase awareness and prompt victims to come forward and complain to the authorities or seek compensation," as well as to "deter other therapists from crossing lines and boundaries, thereby sparing other patients future transgressions."

Zylbertal also chose to hear the complainant's case after becoming convinced that patient and psychiatrist indeed engaged in a romantic relationship - a fact that Kafri has consistently denied.

Although the court has yet to determine whether a sexual relationship between doctor and patient damaged the complainant's mental health, the court's ruling means that Kafri seriously violated the medical ethics code. The code states that "sexual and erotic contact between a therapist and a patient seeking psychological therapy is strictly forbidden and constitutes a grave ethical transgression and patient abuse, which could irrevocably damage the patient's mental health."

Israeli law had hitherto viewed sexual contact between psychiatrist and patient as a criminal offense carrying a sentence of up to seven years in prison. But the law has been made less stringent because of the case in question.

Kafri, according to the ruling, first met the complainant at a Health Ministry mental-health clinic in Jerusalem's Talpiot neighborhood, where the complainant's family doctor had referred him.

The psychiatrist then suggested that he come to her own clinics, one in Bnei Brak and the other in Jerusalem, for private treatment to prevent him from "falling between the cracks," as she put it. She repeatedly told the complainant not to mention this to other employees at the ministry's clinic, according to the ruling.

Kafri, also 55 years old, graduated in 1984 from Tel Aviv University as a medical doctor. She then specialized in psychiatry, serving at several public mental health facilities including Be'er Yaakov, Talbieh, Kfar Shaul and Hadassah University Hospital, Ein Karem. She also specialized in psychoanalysis. She described herself in court as an "accomplished and renowned psychiatrist privately treating many patients.

She added that she has stopped practicing psychiatry in recent years since she moved to the United States with her husband. Kafri cited this in requesting that the court squelch the story. "Those who were treated by Dr. Kafri in the past are entitled to know about this case," Zylbertal ruled.

Another issue in the indictment is payment that Kafri received from the complainant. He claimed that he paid the psychiatrist not only with money, but with gardening and minor construction work at her Jerusalem home.

Kafri explained that this was in the framework of "rehabilitative work." The Israel Psychiatric Association's ethics code from 1997 states that a psychiatrist can only receive monetary payment, which should be agreed on in advance, and must not receive anything else. The court calls the payment procedures "bizarre," adding that the complainant claims that this arrangement set the scene for a sexual affair.

The central piece of evidence in the case is a 70-minute telephone conversation, which was recorded, transcribed and submitted to the court in a 33-page document. In the document, Kafri replies to the complainant's observations about an "affair that was ignited" between them.

"I shouldn't have let it happen," Kafri said in the conversation. "We managed to viciously hurt one another - we were both very frivolous. We tried to ignore it, and then it hit us when we weren't expecting it. I had to put an end to it at some point because I saw what huge damage it was causing both of us."