"The Caregiver"

"The Caregiver" - Sample Chapter.

By: JJ Kusnell - Protected by U.S. Copyright July 2006
Copy on file with the US Copyright office November 03,2006

In the mid-1950's, Doctor Richard Masters met Virginia Johnson and formed the now famous "Masters & Johnson, Institute For The Study Of Human Sexual Behavior". Their stated goal was the study of the 'Human Sexual Response'.

To accomplish their purpose, Doctor Masters installed one-way glass inside the Institute behind which he and Virginia were able to watch volunteer couples engaging in sexual activity. When news of this new ‘therapy’ leaked out, the medical community greeted it with shock, dismay and disapproval and the two researchers became virtual outcasts in society; yet, they didn't let public opinion deter them.

Sometime after the introduction of this practice - and some say because of it - Doctor Masters divorced his wife of many years and married his co-researcher (and co-voyeur), Virginia Johnson. This news too was greeted with derision and disapproval but it was their collaboration that helped launch the field of sex therapy.

"The Caregiver" - explores the dichotomy present in sex therapy. Doctor Phillip D'Anese, a Harvard-trained psychiatrist specializes in the treatment of sexually dysfunctional woman. In his practice, he is expected to share the deepest sexual experiences and fantasies of these vulnerable women while maintaining a professional detachment from them.

This is the story of one man’s failure to maintain that delicate balance.

The Author
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Chapter 1

The office door flung open and the young woman, obviously upset, rushed out of the room. She hurried across the office to the clothes rack and gulping air as if she were hyperventilating, reached up for her coat. Tears were streaming down her face.
In the doorway of the office she had just left, a bearded man stood quietly, watching the frenetic actions of the young woman. Then, turning his head, he caught the eye of an auburn-haired nurse sitting at her desk and at his nod, the nurse stood up and moved quickly to intercept the departing woman.
“Is something wrong, Miss Miller?” she said softly as the woman fussed with her coat.
“No, nothing, everything’s fine. I just have to get out of here! I’m sorry!”
The nurse put her hand lightly on the woman’s shoulder. “Please, Miss Miller,” she said, “don’t leave. You came here for help and we want to help you. Won’t you please reconsider?”
The distraught woman was Carol Miller, a stunning twenty-eight year old that had come here for treatment of a long-standing emotional problem. Carol was extraordinarily beautiful and that beauty had brought her attention – wanted and unwanted – from both men and women for years. But Carol had a secret. Carol was sexually dysfunctional. Twice she had been involved in serious relationships and twice she had seen them fail as a result of the fear of intimacy that had accompanied her since childhood. Finally coming to grips with her problem, Carol had decided to seek treatment. She had treated with two sex therapists without success before making today’s appointment with the
Well publicized but non-traditional Dr. D’Anese.
Phillip D’Anese was a Philadelphia-born, Harvard trained, psychiatrist, a sex therapist who had been practicing in Philadelphia for ten years. Generally acceded to be one of the city’s finest doctors, his methods were nevertheless considered highly unusual and attracted a good deal of attention and comment not all of it favorable.
Carol became aware of Dr. D’Anese’s reputation through conversations with her other therapists. Out of desperation, and despite misgivings, she finally decided to consult with him, hoping fervently that he might succeed where others had failed. Today’s appointment was in the nature of an initial consultation but Carol was so thoroughly upset and confused by the nature of Dr. D’Anese’s comments, that in complete bewilderment and embarrassment she had fled the room
There was a noticeable hesitancy, as Carol seemed unsure of what to do. She stood there holding her coat, the tears still shining in her eyes. The nurse couldn’t help notice how lovely she was and she felt sorry for her. She put her hand gently on the young woman’s shoulder.
“Miss Miller, I am Marsha Perryman, Dr. D’Anese’s assistant. Won’t you please reconsider? I am sure we can work this out.” She reached to take the coat but the other woman would not release it.
“I can’t go back in there,” she said, “I can’t! I can’t believe what he told me. I have to go! I’m sorry!”
Again she began to put on her coat and again Marsha Perryman intercepted her.
“But Miss Miller – “
“Carol,” the other woman said catching her breath. “Just call me Carol, okay? Now I have to go!”
The nurse took her hand away. “Okay, Carol, if you feel you must go, I won’t try to stop you. But look, you came here for help. Why not go back in the office and talk about it before you just give up. If it makes you feel better, I will be more than happy to sit in with you. But you came here for help and I don’t want you to throw away that chance before you really understand what the Doctor is saying. Dr. D’Anese is really very good. I’m sure that’s why you came to him. So why not just come back in and listen to him for a moment. Then, if you still want to go, you can go. What do you say?”
Marsha Perryman was a registered nurse and had a lot of experience dealing with distraught females. She has certainly seen enough of them. She was tall, almost statuesque in appearance, with a model’s face and figure – which was what she had been before she became a nurse – but her job here had nothing to do with her stunning beauty and everything to do with her professional capabilities. Marsha knew her job and she did it well. Right now, her job was to convince the reluctant Miss Miller to come back into the treatment room and resume the consultation.
Carol Miller had calmed down. Her mind was clearer now. She knew the nurse was right, she had come to this office for help and running away wasn’t going to help her resolve her problem. Still she was upset at what she had heard and though she was wavering, she still wasn’t sure what she wanted to do.
Marsha Perryman, seeing the indecision, tried again to reassure her. “Whatever it is, Carol, we can work on it together. This is not uncommon in this type counseling. It is highly personal and because of that, it takes some getting used to. But you came here for help and we do want to help you. What do you say we give it another chance? As I said, I will be happy to come in with you and sit in for the session. Maybe that will make it easier for you. I am certain De. D’Anese will do everything in his power to help you relax. Dr. D’Anese is really a very good doctor and if you let him, I am sure he can help you. But the decision is up to you. What do you say?”
Carol was obviously weakening. She had brushed the tears aside and now stood holding the coat she had not yet put on. Gently, Marsha Perryman reached for the coat and this time, Carol let it go. Marsha hung up the coat and turned Carol back to toward the treatment room. Carol had stopped protesting. As the two women moved across the room, Marsha kept talking to help the young woman relax. “Carol,” she said confidentially, “Dr. D”Anese is really nice. I am sure whatever it was that upset you, it was just a misunderstanding. Let’s go back in and start over, okay? I think you’ll be glad you did.”
Carol Miller swallowed and tried to smile. It was a half-hearted effort but she felt better. “Okay, I’ll try. But, Marsha, it was so upsetting – what he told me. I couldn’t believe it. I didn’t know what else to do so I just ran out. I feel a little dumb now –“ And again, that half hearted endearing smile.
“Nonsense,” Marsha said, noticing once again the uncommon beauty of the woman. “You aren’t the first woman to cry in this office. We treat women with this same problem all the time and it is often emotional. They come to see Dr. D’Anese because of his reputation for succeeding where others have failed. And it’s true that his therapy is unconventional but I assume the conventional therapies haven’t worked for you, right? Isn’t that why you came here?”
Carol nodded as they moved back toward the office. “Yes,” she said quietly, “you’re right. I did hear that his therapy was unusual but I never expected this. This took me by complete surprise. I guess that’s why I reacted the way I did. I still feel pretty dumb.”
“Forget it. It’s perfectly understandable.”
They reached the office. The door was still open but Dr. D’Anese had retreated back into the room and was now seated behind his desk. As they took their seats, he nodded to Marsha then turned his full attention to the patient.
“Carol,” he said kindly, “I understand why you reacted the way you did. Our therapy can be something of a shock. And of course it’s hard for anyone to open up about his or her most intimate thoughts. Most of us have spent a lifetime concealing them and so it’s hard to let go. But, if therapy is to succeed, we must talk about them and you must share them with your therapist. There simply is no other way. I am hopeful that the presence of Miss Perryman will make that easier for you.”
He smiled at Marsha. “Miss Perryman - Marsha - is my first assistant,” he said. “She often sits in on therapy sessions but not always. As you know, we deal with sexual dysfunction here and that is deeply personal to many women and sometimes they prefer the sessions to be one-on-one. If they do, that’s what we do. Our treatment program is what we call Regression Therapy. Here’s how it works.
It is my belief that the cause of most sexual dysfunction in women is found in their earliest childhood experiences – generally some form of sexual abuse. The only way to correct this problem is to regress back in time and re-visit those experiences but this time, without the trauma - overlaying bad memories with good ones, as it were. We aren’t always successful, of course, but we have been fortunate enough to help some of the women who have come to us with this problem.”
At his words, the color again rose in Carol’s face and once more she was uncomfortable. Phillip D’Anese stared at her then sat back patiently and waited. He knew this was difficult for her. Regression Therapy while very successful was also highly invasive and had attracted a good deal of notoriety. Recently, his controversial treatment program had brought him to the attention of the Pennsylvania State Medical Board. Christy Cassleman, an attractive forty-year old former patient had charged him with violations of professional ethics and demanded that his license be revoked. When called upon to defend himself, Doctor D’Anese was equal to the task. He explained that his treatment program was restricted to patients with the most severe and debilitating sexual disorders; patients who had failed elsewhere and had sought him out specifically for this experimental program. He went on to explain that Regression Therapy was designed to allow a patient to go back to her childhood as an adult and to confront those unhappy experiences that were now preventing her from enjoying a normal and fruitful sexual existence. By revisiting those traumatic experiences and seeing them for what they were, the patient was able to overcome those early traumas and go on with her life. Patients were fully informed of the procedures before beginning treatment.
After listening to his explanations and examining his case records including the records of Christy Cassleman, the Board voted to dismiss the charges. Despite this action, a few members felt his Regression Therapy treatments were unorthodox, unnecessary, and personally intrusive. As a result, the Board issued a written reproof to Doctor D’Anese cautioning him about involving himself on a personal level with his patients in the future but admitted this was an occupational hazard for all sex therapists. They dismissed the charges.
Following his vindication, Doctor D’Anese returned to his practice busier than ever. He was the only medical doctor in the office. Assisting him was Marsha Perryman, three RN’s, two administrative persons and a bookkeeper that rounded out the staff.
Following the hearing, there was a change in office procedure. Doctor D’Anese announced that Marsha would, with the patient’s permission, be present at all future treatment sessions both to reassure the patients as well as protect the office from future charges. Although there was no comment by members of the staff, it was obvious that the new policy met with their approval.
The plaques on the wall in the reception area indicated Phillip had attended both the University of Pennsylvania and the Harvard School of Medicine, where he earned his medical degree. Following that, he had interned for three years at the prestigious Harvard Longwood Psychiatry Residency Training Program in Massachusetts, after which he returned to his native Philadelphia to set up practice. He was forty years old and single.
Seeing his young patient’s continued embarrassment, Doctor D’Anese changed tact. “Carol,” he said patiently, “let’s go over your situation again. You have seen other doctors for this problem, have you not?”
“Yes, Doctor, I have.”
“Have any of them helped you?”
“No, not really.”
“You have never experienced a sexual climax.”
The woman’s eyes fleetingly went toward the nurse, then returned to the man in front of her. She appeared uncomfortable but she answered. “No - ”
“No, what? Is that true or not?”
“Yes, that’s true…”
“Okay. So I would be correct in stating that the standard types of treatment were generally not successful, is that right?” She nodded silently.
He turned away from her. “Just a moment, please,” he said as he reached back and picked up a folder. Putting it on his desk, he opened it and read:

Name: Carol Anita Miller Age: 28
Address: 40345 East 2nd Avenue, Apt. 203, Ardmore, PA
Marital Status: Single
Ht: 5’7” Wt: 118 Eyes: Brown, Hair: Brown
Psychosis: Sexually dysfunctional
Comments: Possible sexual abuse history.
Referred from Doctor Thomas Warner

He put the folder down and turned back to the patient. “Carol, I see you were seeing Doctor Warner. How long were you in treatment with him?”
The woman thought for a moment. “Less than a year…about eight months, I think.”
“Did Doctor Warner ever discuss your personal history with you?”
She nodded. “He tried to but it made me so uncomfortable that he didn’t pursue it.” She crossed and re-crossed her long legs nervously and the movement was so sensual it caught and held Phillip’s attention. She had beautiful legs. He shifted his eyes to her face and tried to concentrate on what she was saying. This wasn’t the first time he had experienced difficulty keeping his mind on his business when treating an attractive female patient; Phillip’s medical specialty created a constant dichotomy for him. On the one hand, in order to help his patients he had to share with them the most intimate details of their sexual lives; on the other, he was expected to remain aloof and detached from any normal male reaction to what was being said. It wasn’t always an easy thing to do.
He turned his attention back to his patient and nodded toward a couch. “Carol, would you please move to the couch? I think you will be much more comfortable there.”
At first she hesitated but then she did as she was asked. Once she was comfortable, he went on. “Good. Now I want you to just lie back and try to relax, okay?” He leaned back in his chair. “Now Carol,” he asked quietly, “why exactly did you come to see me?”
Tears showed at the corners of her eyes and she shook her head side to side as if to say ‘I don’t know’. But she didn’t speak. Doctor D’Anese sat silently, waiting for her to get control of herself. The treatment room was dark. The blinds were drawn and only a small lamp lit the area. He could see she was nervous. She had come to him in desperation, as a last resort, but his bedside manner was making her very nervous. He got up from his chair and came around his desk to stand next to her. She closed her eyes tightly as she felt him lean down toward her. She heard his voice, soft and sympathetic but strong in its authority.
“Carol, I know how you feel, but if I am to help you, you must learn to trust me. You do want me to help you, don’t you, Carol?”
She opened her eyes. He was very close to her. She pushed her head back into the pillow looking up at him. “Yes,” she said, her voice a whisper, “but it’s so hard…”
He saw that she was struggling to get control of her emotions and he straightened up. Reaching back he took a straight-backed chair and put it next to the couch then sat back down. He stared at her for a long moment then spoke.
“Of course it is, Carol, you’ve had this problem for a long time. But it is necessary that we communicate with total honesty if I am to help you. Nothing must be held back. Carol, have you ever truly enjoyed sex? Ever?”
The color rushed to her face as she found herself again struggling with his direct manner. “Doctor,” she stammered, “I don’t know…if I can talk about – “
He sat up suddenly and looked away from her. When he turned back, his tone was cool and impersonal.
“Carol,” he said, “we need to have an understanding. I am a busy man and I really don’t have a lot of time to waste. Before we can proceed one step further, I need to know if you want me to treat you or not. Yes or no. It’s up to you of course, but we have to start somewhere and this seems a proper place. So the question is do you want me to treat you or not, yes or no? It’s entirely up to you.”
She was intimidated by his sudden shift in mannerism, and for a moment, she hesitated uncertain of how she felt. When she did speak, her voice was hushed, barely audible.
“Yes,” she whispered, “I do.”
At that, he sat back up and grinned. “Good,” he said. “That’s one obstacle cleared. I can’t say it will be the last one and maybe it won’t even be the biggest, but at least it’s a start.” And he smiled again.
Then he became serious. “Okay then, we agree that I am the doctor and you are the patient. Whatever I tell you will always be in your best interests and you must trust me. I am not going to keep repeating this, but for all of your adult life, you have suffered from severe sexual repression. I am going to try to correct that so that you can enjoy a normal sex life but you have to help me. I know that’s what you want and that’s what I want for you, so we have a common goal. But it won’t be easy for either of us. Do you understand?”
She couldn’t speak but she nodded that she understood.
Once again, he leaned over her and again she pressed back into the pillow. But this time, his voice was softer, almost seductive, coaxing her to relax, to confide in him.
“Now Carol,” he began, “I am your friend. You can confide in me. I am going to ask you a very personal question but I must have an answer so just relax. Carol have you ever experienced a sexual climax? Ever in your life?”
She didn’t speak but her head moved ever so slightly side to side.
He sat up and shook his head vigorously. “No, that won’t do Carol. Shaking your head in response allows you to isolate yourself from the therapy and we can’t have that. When I ask a question, you must articulate your answers. It’s absolutely necessary. So, let me repeat the question. Have you ever experienced a sexual climax?”
A hesitation and then softly…”no, I haven’t, not with anyone else anyway...”
“You mean you have masturbated yourself to a sexual climax?”
Her face turned crimson at his words and she became agitated. He didn’t back off. He leaned back over her and his voice was persistent, controlling.
“Carol,” he said forcibly, “listen to me. We have to break through this barrier if I am to treat you with any hope of success. Please answer my question. Have you ever masturbated yourself to a sexual climax?”
Her eyes were pressed closed but she could feel him leaning over her, demanding an answer. She swallowed once; twice…then spoke. He could barely hear the words. “Yes I have - ”
“Yes, you have what, Carol? Say it. It is very important that you articulate your answers to me. Shall I repeat the question?”
She shook her head no. She opened her eyes to find his face inches from her own. She was horizontal; he seemed nearly the same.
Suddenly, to her shock and amazement, she felt a tinge of sexual excitement. She closed her eyes and swallowed hard, then with great difficulty, she answered him.
“Yes, Doctor,” she said, “I have masturbated myself to a climax.”
Her eyes remained tightly shut and she was trembling. He noticed this but ignored it. He sat back.
“Carol,” he said, “from now on, when we are in session, I want you to call me Phillip. I want this to become personal between us. Now say it again and this time, say it to me. And open your eyes, please.” And he leaned over her once more.
She swallowed hard and opened her eyes. He was very close to her. She fought a feeling of panic and closed her eyes again.
“No, Carol,” he said gently, “that won’t do. Open your eyes and look at me.”
And again she felt that undeniable tinge of sexual excitement, something that was totally foreign to her. She forced herself to look directly into his eyes, then did as he had instructed her.
“Yes, Phillip,” she said, her voice low and husky, “I have…masturbated …myself to a climax.”
She fell back, exhausted. Her emotions were spent, her libido newly awakened, was running amuck. This was truly a defining moment in her life. She looked away from him her faced flushed, her breathing labored.
Philip appeared not to notice her discomfort. He was obviously pleased.
“Good. See, that wasn’t so hard, was it?” And he smiled.
She stared back at him. She was not smiling. “Yes it was, Phillip,” she said softly, “it was very hard. In fact, it was the hardest thing I have ever had to do in my life.”
He sat back and crossed his legs, drumming his fingers on his knee. “Yes, yes of course it was. I’m sorry, I do understand. That was insensitive of me. But you did well. So tell me Carol, how often do you masturbate?” She was still nervous and it showed but her answer came more readily now. “I don’t know, I don’t keep count...”
He nodded. “But you do find it pleasurable?”
She hesitated then she nodded yes.
“Good. Well, the first thing we have to do is we need you to sign a consent form. This form says that we are agreed to try whatever method we think may work in restoring you to sexual normalcy. That means whatever I want you to do, you do. You place yourself totally in my hands. Is that agreeable?”
She nodded again. He shook his head no. “Yes,” she said aloud but softly.
“Fine,” he said, “We will give you the form to sign. As you might imagine, there are those who attack my work as being too personally intrusive, too sensual. They prefer the more traditional methods of treatment. But I only accept as patients, those women who have been unable to find help elsewhere. My approach is certainly different but I have succeeded where others have failed. Still, if you join the program, you must know that I am the one who decides what is to be done in your best interests. Do you understand all that?”
She nodded again.
“Is that a yes? Remember what I told you about using my name and articulating your answers.”
“Yes, Phillip, I understand.”
“Good. Now Carol, have you ever experienced a sexual climax with a man at all? Ever?”
She looked at him. He could see she was a very private person and this wasn’t easy for her. Her answer was almost inaudible. “Not as an adult, no...”
Her answer caught his attention. He leaned toward her. “Not as an adult? What does that mean, Carol?”
She closed her eyes. “As a child, I think I did…”
“As a child? Does that mean you were sexually abused?”
She nodded. “Yes…”
He had heard it many times before. His heart went out to her. “Who abused you as a child, Carol? Was it a member of your family?”
She looked across the room at the nurse who had not yet said a word. She seemed to hesitate, then…“it was my stepfather.”
“Your stepfather? What happened to your birth father?”
“I don’t know…I never knew him.”
“I see. And how old were you when your mother got married again?”
“It wasn’t ’again’. It was her first marriage. She never married my father.”
“Oh, I am sorry to hear that. How old were you when your mother got married?”
“I was three years old.”
“And did you like your stepfather?”
“At first yes, he was very nice to me and my brother.”
“What is your brother’s name?”
“Anthony, we called him Tony.”
“Is he older or younger?”
“He is four years older.”
“So he was seven when your mother got married?”
“Yes.”
“And you liked your stepfather?”
“Yes, at first.”
“Tell me what happened.”
She opened her eyes. “I don’t know if I can. I never spoke about it to anyone before.”
“Not to your other therapists?”
She shook her head.
“Well, tell me, Carol.”
She blushed deeply, which he noted but ignored. He knew she was embarrassed sharing this with him but it was something he felt she had to do. He tried again.
“Carol, what was your stepfather’s name?”
This time she looked directly at him. He could see the pain in her eyes as she forced herself to speak of it. It was obviously something she had kept hidden from the world for years. It was like opening a door and letting something out, something ugly and frightening. “Tommy,” she said, “his name was Tommy”.
“Do you still see him?”
“No. I moved away. He still lives with my mother though.’
“Where?”
“In Butte. That’s in Montana.”
“Is that your home?”
“It was. Now my home is here.”
“And you are alone here?”
“Yes.”
“I see. Tell me about Tommy. Tell me about the abuse. When did it start?”
Her voice was so low he had to strain to hear her. Nurse Perryman moved her chair just a little closer.
“It started when I was about three. Right after they were married. My mother always gave me a bath, every night. One night she was cleaning up the dishes and I remember she asked him to run the bath water for me. He was in there and he asked her if she wanted him to get me ready. She said okay and he picked me up….” Her voice trailed off.
Phillip stood up and walked to the water cooler, returning with two cups of water. She sat up as he handed one to her and drank the other. Then she lay back. He took his seat again. “You okay?”
She nodded. “Yes.”
“I know this is hard for you but just try, okay? We don’t have to go into it very deeply but I want you to articulate your pain. It’s important to your treatment.”
She nodded. “He carried me into the bedroom and he was singing to me. The song was “Old Macdonald”. I heard that song a lot in those days. I guess he liked it because he always sang it to me when he bathed me…”
“When he bathed you. You mean he did that a lot?”
She nodded. “Yes, after the first time, it seemed my mother was always too busy and he did it…”
“I see. Tell me about the first time.”
She became agitated. “I don’t know if I want to…”
“Carol, if you are going to be my patient, you have to do as I ask. It is all for a very important reason. You want to get well, don’t you…?”
She nodded.
“Don’t you? Say it, Carol.”
“Yes, Phillip, I want to get well - ”
“Good. Now tell me…all of it.”
Again she looked across the room at the nurse. Again, there was no reaction from her and Carol returned her eyes to the man in front of her. Then she dropped them to the floor and continued.
“He took me into the bedroom and undressed me. Then he wrapped a towel around me and carried me into the bathroom. He closed the door…”
“And did he give you the bath?”
“Yes…”
“Was it different than it was supposed to be?”
She leaned back into the pillow and closed her eyes hard. “I didn’t know it then, but now I do.”
“Was it, Carol?”
“Yes, it was.”
“How was it different?”
“He washed me. He washed me first with a cloth and then with his hands. He soaped up his hands and washed me for a long time…”
“Do you remember that?”
“Yes, I remember it. I remember all of it.”
“When you say he washed you, and he used his hands, you mean he put his hands on your body?”
“Yes, all over my body. For a long time…”
“How did that make you feel, Carol, do you remember?”
“Yes. It made me feel good. I liked it. I didn’t know any better then.”
He leaned forward. “That’s right, Carol, you didn’t know any better then. How long did he continue to give you these baths?”
She opened her eyes and looked at him. “For years. Until I was almost nine years old.’
“Nine? Didn’t you mother ever bathe you again?”
“It was mostly Tommy.”
“But why? Did you ask her not to?” Carol looked up at him. Her eyes again reflected her deep pain and for just a minute, he felt her pain himself.
“I remember one night after he had done it a few times, she did come in and she said she would do it now. They had a terrible fight.”
“Wait a moment. Let me go back. He had bathed you a couple of times and then your mother came in and said she would do it? Is that right?”
“Yes, and they had a big fight.”
“Do you know what they were fighting about?”
“I’m not sure but I think he was yelling that she didn’t trust him and maybe he should just move out…something like that.”
“And what happened?”
“He won. My mother went out of the room and Tommy bathed me.”
“And after that time, did your mother ever bathe you again?”
“Yes, a few times, but only when Tommy wasn’t home. When he was home, he did it.”
“Carol, did it upset you when Tommy bathed you?”
She hesitated. It was obvious that she was embarrassed. He repeated the question. She dropped her head and her voice could scarcely be heard.
“No, I liked it,” she muttered, “I didn’t…but I was so young…I didn’t know…”
He shook his head and raised the palm of his hand toward her. “Of course you didn’t. This isn’t about you, Carol. You were just a child. This is about him. He is the reason you cannot now enjoy physical contact with a man, cannot enjoy love or sex. Talking about this is opening up the door for your eventual healing. At least, I hope that is what will happen. But we have to talk about it…”
She nodded. “All that I remember was that it felt good.”
“Do you think, looking back at it now, do you think it was a sexual response you were feeling?”
“No, not right away. At least, I don’t think so….”
He got up and checked the tape in the recorder, then returned to his seat. She looked off to the side, staring at the small table lamp that was the only light in the room. Then her eyes looked down. She seemed lost in her thoughts so he prompted her.
“Did the nature of the bath change in time?”
She nodded. “Yes,” she said softly, “at first he would wash me like I said and then put a towel around me and carry me back to the room…then he would put my pajama’s on and kiss me goodnight…”
“And that was the end of it?”
“Yes. It was like that for a long time. When he was done, my mother would tuck me in.”
“Did she ever say anything to him again about the bath?”
She shook her head side to side. “No, not to him. But she used to tell me he was a good father and I should be a good girl…she actually made me think it was all right so I thought it was…for a long time…”
The doctor had picked up a note pad and was writing in it. There was a delay while he finished and then, “was it all right, Carol? Looking back, do you think it was all right?”
“No, it was not all right. He took advantage of me! But I didn’t know that at the time. I remember he would tell me this is what daddy’s did with their little girls…and it made me feel good so I liked it when he did it.”
“Did you love him then?”
“I thought I did. I thought he was a wonderful daddy…”
“And your mother did nothing to stop this?”
“No. I can remember that first argument but then every time she mentioned it, he would get upset and shout at her that he was going to leave…then the fight would stop and…” Her voice trailed off.
“Carol, can you continue? If you cannot, we can stop and continue at another time.” She began to cry. “I don’t know…it is so painful to remember…”
“I know. This is a big part of your problem. If we are to help you, this all has to come out. We have to get rid of these feelings of guilt before you can feel normal again.”
“Guilt? Do you think I feel guilty?”
“Yes, I’m sure you do. You understand intellectually that you weren’t to blame but you feel guilty anyway…and you have a deep hurt inside you because your mother let this happen to you…”
Moments passed and she continued crying. He reached over and held her hand and they stayed that way for a long time. Then Phillip spoke again. “Let’s go on, Carol. At some point, did the nature of the baths change?”
She nodded.
His voice showed his impatience. “Carol remember, you have to articulate your answers. That’s important to your healing process. I’ve told you that. Now, did the nature of the baths change with time?”
“Yes, they did.”
“Tell me about that.”
“I guess I was about six or maybe seven. Tommy had been bathing me for a long time, over three years; he was the only one who did it now. And I loved my bath time. He made me feel good every time he did it.”
“So it wasn’t a bad experience?”
“It was bad…I just didn’t know it then. To me, it felt nice. And it felt loving…”
“And did you love Tommy then?”
“Yes, I thought he was wonderful.”
“How did he treat you the rest of the day, you and Tony? Was he a good stepfather? I believe you indicated he was?” She nodded her head, slowly, deliberately. “Yes…he was very good to us. He took us places and he bought us things…he and my mother were very happy. The only time I ever saw them fight was about me….”
“You mean about the baths?”
“Yes, but it didn’t happen much after the first few times. It just became normal for him to bathe me.”
“So when did the nature of the baths change?”
“It was when I was about seven years old…perhaps a little younger. Tommy used to bathe me and wash me all over. When he was finished, he would wrap me in a towel and bring me into the bedroom and dress me and then the door would be open and my mother would come in and kiss me goodnight and tuck me in.
One night, he carried me in and I was laughing because he was singing that Old Macdonald song…and he laid me down on the bed but he didn’t dress me right away…”
“What did he do?’
“He said he noticed that I was getting a rash and he had to put some lotion on it.”
“Did you have a rash?”
“I don’t know.”
“Go on. What did he do then?“
“He took some lotion and began to rub me with it. Oh yes…I forgot, before he did, he closed the door…”
“Did he lock it do you remember?”
“No I don’t think he did, but he closed it. That night, my mother didn’t come in.”
“I see. So he rubbed your body with the lotion. What happened then?”
She looked at him and her face turned a deep crimson. He knew she was embarrassed about sharing the next moment with him but he needed her to talk about her past if he was going to help her, so he prompted her to continue. “Go on Carol….”
She didn’t respond and so he prompted her again.
“Carol, is that the first night you reached a climax?”
She sat up straight. “I don’t want to talk about this any more!”
He stood up. His manner changed abruptly. His voice became harsher. “Carol, we can not go over this time and time again. You either want my help or you don’t. It’s entirely up to you. But you do have to make a decision.”
His changed demeanor intimidated her, which was his intention. She cowered, and she spoke in a whisper…”Yes, but - ”
He interrupted. “No, no buts. If I am to help you, it means that you and I must share your deepest sexual secrets. If you cannot or do not wish to share them with me, we can agree to go our separate ways. There are many psychiatrists in Philadelphia and I am certain you can find one that will treat you on your terms. But I am not one of them.”
He sat back and watched her reaction carefully. Once more she nervously crossed and uncrossed her legs. Once more, the sensual movement caught his attention and held it as he felt the sexual tension mount within him. He struggled to repress it, as she looked at him unaware of his own internal conflict. Finally, she sighed in apparent resignation. “I’m sorry, I’ll try to do better.”
She began speaking again, this time without his urging. “He laid me down and began rubbing me and I felt better than I ever felt before. I didn’t know it then, but he was deliberately trying to stimulate me…to bring me to a climax. I don’t know if I did… I don’t know if a seven-year old girl can even have a climax…”
He nodded. “Yes, she can.” His voice showed the emotional strain he was feeling. “So he brought you to a climax…?”
At that precise moment, Marsha Perryman who had been paying careful attention rose to her feet. She spoke quietly but with surprising authority.
“Doctor D’Anese, may I see you for a moment in the outer office, please?” She nodded to the woman on the couch and walked out the door.
He turned to Carol. “I’ll be right back. Why don’t you try to relax,” and he left the room. He joined Marsha outside the room. She looked at him and without a word, turned and walked toward a private anteroom.
When they were inside, she closed and locked the door, then turned toward him and opened her arms. He moved close to her and she held him.
“Are you all right, Phillip?”
She began to stroke his back and his neck and held him close. She could feel him trembling and she soothed him. “It’s all right, just breathe deeply…I can feel that you are excited. I knew you had to get out of there…we don’t need that problem again…not so soon after that last one.”
For another long minute, she continued to hold him and neither of them spoke. Then he straightened up and kissed her again and it was all they could do to keep from going further. She reached her hand down and stroked him. He was erect and she understood that it came from this beautiful girl’s vulnerability but it still created a big problem. He couldn’t go back in that room looking like that. And there was no time to take care of it any other way. With a sudden motion, she took the edge of her hand and struck it hard! The erection disappeared immediately. “Oh My God!” he said vehemently, “must you always do that!”
She grinned. “Apparently I do. But I will make it up to you later, I promise. But right now, we don’t need that. Remember what happened with Mrs. Cassleman and that investigator. We don’t need to go through that again. Not so soon anyway. Do you think you can go back now?” He looked at her, feeling chagrined. Then he grinned. “Yes, thank you for that. But next time, try not to be so rough, okay?”
She laughed. “Well it worked didn’t it?” He laughed with her and they prepared to leave the room.
This wasn’t the first time such an encounter had taken place and it wouldn’t be the last. When it did happen, Marsha Perryman was quick to step in.
They started out the room when Marsha stopped and looked at him. “Is it really that hard, Phillip? Is it really that difficult to control yourself?”
He looked at her for a moment then put his hand on her arm. “Marsha,” he said, “let me tell you a story. A few years ago, two noted sex researchers—a male and a female—decided to open an institute for the study of human sexual performance. They invited a number of couples to come into their building and engage in various sexual practices before a one-way mirror, the doctors on one side, and the test couples on the other.
The research went on for some time. During the course of this study, one of the two divorced his spouse of many years, and married the other. Although they never discussed it, rumors persisted that it was the stimulation involved in the work they were doing that contributed to the marital breakup. Today, that Institute is in the forefront of sexual research. It wasn’t easy for those two then, and it isn’t easy for any of us now. In order to help our patients, we are forced to share their most intimate sexual secrets and fantasies, oftentimes over and over. That can be very difficult and it’s easy to become emotionally involved no matter how hard we try to avoid it.” He grinned. “Let’s call it an occupational hazard.”
With that, he let her go and she reached for the door. Before she opened it, she turned back and kissed him. “I understand, Phillip, I really do. But even so, it wouldn’t make a very good defense if the Board were to call you up again so let’s try to be a bit more careful, okay?” He nodded in agreement.
Marsha Perryman had learned about Phillip’s weakness shortly after she joined his staff almost ten years ago. She had been trying to protect him against it ever since. Sometimes she was successful, other times she was not. But she never stopped trying.
Or worrying.
She took a deep breath as they left the room. She was always concerned that they had made a scene but none of the other employees paid them any attention. It was an open secret in the office that the doctor and his nurse were having an affair and everyone had long since accepted it. They walked across the office and entered the treatment room.
Phillip returned to his patient and Marsha took her seat. He smiled. “Sorry we took so long,” he said, “we had an emergency…”
She nodded. “I understand…”
“Are you feeling any better?”
She nodded. “Yes”.
“Have you had an opportunity to think about this while we were gone, do you still want to through with the therapy?”
Tears again formed in the corner of her eyes but she didn’t cry. “Doctor, I hate being the way I am, I will do anything…anything…to overcome this. I have nowhere to turn, if you can’t help me, nobody can.”
He moved very close to her. She was sitting up and before she knew what had happened, he had leaned over and kissed her. She was shocked but she didn’t move.
He pulled back and they exchanged stares. Marsha half rose in her seat. Carol looked at him quizzically and it was a few minutes before she could speak.
“Why did you do that?”
“I wanted to see how you react to physical closeness.”
“Oh? Did I respond the way you anticipated?”
“You didn’t seem to respond at all.”
“I know. The only thing that does is frighten me.”
“Frighten you? Why would a kiss frighten you? I mean assuming it wasn’t from your therapist…?
She looked away. Once more, her eyes found the eyes of Nurse Perryman but there was no interaction between them. She turned back. “It frightens me because a kiss is never just a kiss unless it is from a child.”
“What about adults like friends and family?”
He recognized what he had said before the words were out of his mouth, but he couldn’t take them back. She didn’t respond. In her case, kisses from family had caused her great pain. He tried to repair the damage. “I’m sorry, Carol, that was careless of me. So it’s because of where the kiss might lead that you hold yourself aloof from it, is that it?”
She nodded once…twice…but she didn’t say anything. He pulled his chair close to her and put his hands on her shoulders pushing her gently back down on the couch. This was the preferred position for therapy but even though he was doing it for the right reasons, he could feel the power of his libido as he forced her down on her back. He leaned over her and it was all he could do to keep from kissing her again. He heard the slight cough from the other side of the room and immediately sat back up; Carol Miller remained lying on the couch staring at him, an unusual look on her face. Had he not known better, he would have sworn he saw a sexual response in her eyes. His voice was soft and intimate as he resumed speaking.
“Carol,” he said, touching her hand, “our therapy sessions are going to get very personal. What I need you to do is trust me and go along with whatever I suggest. Do you think you can do that?” There was only the slightest hesitation.
She nodded. “Yes,” she said quietly.
“Then you do want to continue the therapy with me?”
She nodded again.
“Please, Carol, you must answer. And I want you to use my name.”
Again she hesitated…then, “yes, Phillip, I want to continue therapy with you.”
He smiled. “Good,” he said, “now I am going to describe this program to you in more detail. Please remember, it is a very unique program. In fact, I believe I am one of the very few who practices it and that’s because it is personally intrusive and many doctors are afraid of it. But, nothing else has worked for you so it may be your best chance for recovery. But it won’t be easy.”
She looked directly at him. “I will do anything you say.”
He nodded in approval. “Good. Then here is how we will proceed.”
He turned and beckoned to Marsha who got up and came to join them. She didn’t speak but sat down beside him. He spoke to Carol quietly, his voice adopting a monotonous tone making what he was saying very ordinary.
But it wasn’t ordinary and Carol’s eyes opened wide as he spoke. He could see her swallowing frequently but kept on, his voice hypnotizing in its monotone.
“Carol, what happened to you as a little girl has made such an impression on you that you can not free yourself of the memory. It rests in your subconscious mind. Someone you trust violated you and now you can’t trust anyone. Do you agree with that?”
She nodded. Her voice was so faint that it was almost inaudible and he had to lean close to hear her. “Yes, that is right. I know that’s right.”
“At a later time, we will go into all that happened to you. For now, this is what I want to do. I want to take you back and give you a chance to live your childhood again. I want to go through those same experiences that existed in childhood, this time without the trauma. I hope what will happen is that the new experience will overlay the old, and all the hurt will be erased for all time.”
The room was still. Carol looked at him quizzically. “I don’t think I understand, Doctor, what do you mean? I mean what do you mean exactly?”
He didn’t flinch. He took her by the hand and looked into her beautiful eyes even as he felt his knees go weak. But he struggled to control himself and when he spoke to her, it was in a professional voice.
“I want you to come into this treatment room, and when you enter the room the next time, I want you to think that you are a child again. We, Nurse Perryman and I, will be here and we will take care of you. We will act the part of your parents. I will act the part of your stepfather. I want you to go through that difficult stage of your childhood again, this time with none of the unhappiness that you experienced the first time. I want to make new childhood memories that will overlay the old; new memories that will support you as an adult.”
The color rushed to her face as she realized the implications of what he was saying. She looked at him, then the nurse, then back at him again. “Doctor, what will happen if I come in and act as a child again? What will I do? What will you do?”
He didn’t hesitate. “We will treat you as a child…cuddle you and love you…”
Suddenly she understood. “…And bathe me?” she asked incredulous.
He nodded. “Yes, Carol, and bathe you in order to remove the trauma.”
She leaned back, stunned by his words. She started to speak, then stopped, then started again. Her head shook side to side as if in denial. She swallowed once…twice…then looked at the two of them, first at him then at her, then at him again. Finally she spoke and her voice was barely audible.
“You intend to bathe me, Doctor D’Anese?”
The thought of her in that situation gave him a rush he had to fight off. He honestly believed this was good therapy and that it would help her where other therapies had failed; but he knew it was a catch-22 and he had never learned quite how to deal with it.
“Yes,” he said not trusting himself to say more.
For a long moment, no one spoke. Then Doctor D’Anese recovered. “Carol,” he said, “it is important that you re-live that stage of your childhood as you lived it but without the trauma. That is what I intend to do.”
“But doctor, some of that period I don’t want to relive…”
“I know. But you must. In reliving that time, we hope to eliminate the bad memories and replace them with good.”
“And you believe this is the way to do that?”
“Yes. It has worked with others and I can see no reason it wouldn’t work with you. It is a final attempt to bring you back to a normal life. I know the therapy is considered unusual…perhaps even bazaar…but it has worked and I think it will work for you.”
“But bathe me, Doctor? Is that necessary?”
He nodded. “Yes, it is the central experience of your childhood which you have brought forward as an adult. We need to go back and erase that bad experience. This is the only way to accomplish that. It’s either this, or you go on as you are, forever.”
She stared at him, obviously shocked at what he was suggesting. He in turn was having an equally difficult time with the thought. But despite his personal reaction, he was absolutely convinced that this was good therapy and would help her. He had done it before with great success. His last patient, Christy Cassleman, a forty-year old sexually dysfunctional woman, had experienced those results. When she began the treatment, she couldn’t engage in any type of sex; after the treatments, she found she enjoyed sex for the first time in her adult life. Unfortunately, someone had persuaded Christy that this treatment was sexual harassment and almost unwillingly, she had filed a complaint against him with the Pennsylvania State Medical Board. Following a review of the evidence and of Doctor D’Anese’s records, the Board had dismissed her complaint but the experience left Phillip shaken and from that point on, he went out of his way to ensure that patients fully understood the therapy before electing to accept treatment. He crossed his legs and sat back.
“Carol,” he said pointedly, “perhaps you don’t want to do this, if you don’t, that’s fine. It’s entirely up to you.”
Now it was she who was flustered. She had failed in therapy for years and she had heard a lot about him. She desperately wanted to be cured. She took a deep breath.
“No, doctor, if you think it will help, I will do it.” She pointed at Marsha Perryman. “Will she be part of this?”
Marsha Perryman was tall and slim and very attractive in her own right. She was possessed of all the attributes of face and form that most women covet. She didn’t respond but she did smile. Doctor D’Anese took Carol’s hand as he spoke to her. “Yes, she will. It will be the two of us. That is the essence of going back and starting over. You will be the child, we will be the parents.”
She was still showing signs of nervousness. She pulled her hand away. “Doctor,” she asked very quietly, “what about what came after?”
“We will talk about that later, Carol, and hopefully in the telling, you will be relieved of some of that pain. But not today.”
She hesitated and for a long moment, no one spoke. It was obvious she was weighing the alternatives. Then she looked at him and came to her decision.
“Very well, Doctor, if you think it will work, I will do it.”
At that, they all relaxed. Doctor D’Anese stood up. “Carol,” he said, “in therapy you will continue to call me Phillip and Miss Perryman will be Marsha, okay? It’s necessary to personalized the experience for the best results.”
She nodded imperceptibly. She still wasn’t sure she could do this, but she had made up her mind to try. His voice brought her back from her thoughts.
“One more thing I want to explain, Carol,” he said, “when the treatment sessions begin, please remember that our goal is to restore your ability to be stimulated sexually. That’s what this is all about. If that weren’t our goal, then what we do here would be totally unprofessional; but it is, and so it is not. Do you understand that?”
She nodded her head hesitantly. “I guess. But it’s so hard to think like that, Doctor – Phillip - ” she stumbled over his name…“to think my doctor is deliberately trying to arouse me sexually…and that it’s all right...”
He smiled. “I understand. But that is why you are here, to become a sexual human being. At some point, you can worry about controlling your libido but first you have to re-energize it and that’s what we’re going to try to do.”
“And it will be completely confidential…?”
He nodded. “Absolutely. This is between a doctor and his patient. It is protected and private. What goes on in this room will stay in this room.“
There was a long moment’s silence, and then she let out a slow, deep breath. “Okay, I’ll try. I’ll really try.”
He nodded. “Good enough. We will schedule you for next week. Each session will last about an hour.” He stood up and the two women rose too. He put out his hand. “Carol, if we can make you sexually receptive, we will be delighted. But there’s one other thing I think you should know. There is no way I can do this with a woman as beautiful as you are, without the possibility of a physical response within myself. It’s just not possible. I just want you to know that before we start.”
At first, she didn’t seem to understand. Then her eyes opened wide.
“Doctor…” she asked incredulous at the thought…”are you telling me you might be sexually aroused by trying to teach me how to become sexually aroused?” She seemed genuinely amazed. “I thought as a professional, this would be the same as treating someone with a cold.”
He shook his head and smiled wryly. No,” he said carefully, “I’m afraid it’s not the same as treating someone with a cold. Not anything like that. This is about sex. You are a beautiful woman and we are going to share long intimate personal conversations and experiences that are intended to stimulate you. In doing so, I just want you to understand a response may exist both ways. Not that it will interfere with the therapy, but I don’t want you to go into this with your eyes shut.”
Carol looked at him. It was obvious this was something she hadn’t considered and she was upset.
“Then perhaps I’d better not do it, Doctor,” she said, “it sounds more like sex than sexual therapy to me.”
Doctor D’Anese sat down on the edge of his desk. He was tired and he was exasperated. “Look Carol,” he said pointedly, “that’s up to you. The whole point of this therapy is to teach you to enjoy sex and sexual arousal. By any definition, that’s sex…”
“But doctor, we aren’t talking about me now, we are talking about you…”
“No, we are not talking about me. This is all about you. You can’t do this without my help and I don’t happen to have the same problem you do; therefore, there is the distinct possibility that I will be aroused as well. But you are the patient and none of this will alter that fact. I assure you, I can handle it.”
She sat back down and looked at him for a long moment. She was confused and uncertain. “Does this happen to all sexual therapists, doctor?”
He nodded. “Probably with some patients, but not all. After all, sex is sex and despite the fact that we are in a controlled professional setting, if we are talking about sex, it is likely to become stimulating. That is after all the purpose of the therapy isn’t it?”
There was a pause. When she spoke, her voice seemed more caustic. “So are you saying the goal is for all of us to get turned on together?”
The way she said it made it sound like it was a bad thing. But that’s not the way he took it.
He smiled. “Yes,” he said pleasantly, “I guess you could say that.”
“And if we get turned on…together - what then, Doctor?”
He became cautious and chose his words carefully. “If you get turned on Carol, that would define success for me. You can act on those impulses somewhere else.”
“But what about you – both of you?”
He and Marsha both rose and he walked toward the door. Standing there, he looked back at her. “That will be our problem, Carol. You have a few days to think this over. If you want this therapy, call for an appointment. I believe you have all the information you need to make your decision. If not, no hard feelings.”
She rose and joined him at the door. Putting her hand on the handle, she turned back to him.
“I don’t need any more time, Doctor. You are my last hope. I will call for the first appointment and see you both next week. Thank you.”
And she was gone.


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