Psychologist seeks return of license

In SJC case, psychologist admits having sex with patient, but says there were mitigating circumstances

A female psychologist is asking the state’s Supreme Judicial Court for her license back even though she violated one of the cardinal rules of her profession by having sex with a former patient.

The standard punishment for someone in the medical and related professions who has sex with a patient or former patient is permanent revocation of his or her license. Officials at several of the boards that oversee health professionals said they couldn’t recall an instance where a practitioner who had sex with a patient failed to lose his or her license.

But Brookline psychologist Mary O’Neill says she deserves another chance. She acknowledges beginning a sexual relationship with her patient, Eric MacLeish, just weeks after his therapy sessions ended, yet says her license shouldn’t be permanently revoked because her lapse in judgment was caused by a marriage that had collapsed.

O’Neill petitioned a single justice of the Supreme Judicial Court to review her license revocation by the Board of Registration in Psychology.  Subsequently, she and the board jointly asked the full court to hear the case, which it agreed to do. Oral arguments are scheduled for this fall.

O’Neill is arguing that the psychology board “arbitrarily and capriciously” refused to consider the mitigating evidence she presented. Rather than revoking her license, she says the board should have suspended her license for a year and then allowed her to resume work on a probationary basis for a year. She says she would continue to receive personal psychotherapy and have her work supervised by a peer. O’Neill also says she would do 100 hours of community service.

The psychology board’s regulations adopt the code of conduct of the American Psychology Association. The code states that “psychologists do not engage in sexual intimacies with current therapy clients/patients” nor with “former clients for at least two years after cessation of therapy.” Beyond two years, sex between a psychologist and patient is permitted only if the therapist can prove there has been no exploitation. The regulations also say it is not a defense to say the patient consented. The regulations were crafted to prevent psychologists from exploiting the tremendous power they often have over their patients and former patients.

In its April 2010 decision, the psychology board held that O’Neill’s marriage crisis “no doubt exacted a significant emotional toll” on her and that her “marriage crisis can be understood to have ‘clouded’ her judgment.” But the board nonetheless revoked her license, saying her care was the “antithesis of treatment” and her “conduct abrogates a basic tenet of the psychology profession: trust.”

O’Neill’s former patient, Eric MacLeish, is an attorney who is no stranger to sexual abuse. He represented many clients who sued the Catholic Archdiocese of Boston, alleging priests had sexually abused them. He helped pry loose thousands of pages of secret documents on abusive priests from the archdiocese. His lengthy deposition of Cardinal Bernard Law was instrumental in sending the prelate packing. And when the archdiocese settled for $85 million, MacLeish became a wealthy man.

But then his life began to unravel. According to a complaint MacLeish filed with the psychology board and an interview he gave to the Boston Globe in April 2010, all the horrific details he had sat and listened to from his clients triggered a strong emotional reaction in him. He came to realize that he himself had been sexually abused as a child at the hands of a teacher at a boarding school in England and by a scoutmaster associated with the school.

In 2004, MacLeish turned to O’Neill for help.  She diagnosed him with having post-traumatic stress disorder and treated him for 10 sessions between August and September 2004. Shortly after treatment ended, they were sleeping together.

Psychology board records contain passionate emails that MacLeish and O’Neill sent to each other after the treatment sessions ended. “You know how incredibly hard it is for me to resist you in every way,” O’Neill wrote in September 2006. “I love you so deeply.”  In December 2006, MacLeish emailed O’Neill: “I know this is right, at least for me. . . . I want to be absorbed in your life and with you.  It will be very, very healthy.  I am just totally in love with you.” 

Another email from MacLeish in November 2006 indicates he and O’Neill were discussing the possibility of disciplinary action against O’Neill. “You are exactly right about the prospect of some sort of board inquiry,” he wrote. “You did nothing wrong and you never exploited me,” he wrote.

But MacLeish’s attitude would change when the relationship went sour a year-and-a half later. In October 2007, he sent O’Neill an 11-page letter demanding a written apology from her that “should be sincere and reflect your enormous lapse in judgment as well as your acknowledgment of the damage which you have done.” He also demanded that she receive professional supervision and pay him compensation for the damage she had caused. When he didn’t get what he wanted from her, he filed a lawsuit against O’Neill at the end of 2007, only to withdraw it a year-and-a-half later.

In 2009, MacLeish filed a complaint against O’Neill with the Massachusetts Board of Registration in Psychology, detailing their relationship and his strong feelings for her – feelings that didn’t last. “In retrospect, it was a disaster, filled with pain and manipulation by Dr. O’Neill,” he wrote. “Dr. O’Neill did incredible damage to me, my former wife, and my two kids.”

O’Neill readily admitted that she had become sexually involved with MacLeish within weeks after his therapy sessions with her ended.  “It was clearly an extreme violation of ethical code,” according to a transcript of her testimony at the board. “I am really ashamed of my behavior.  I am more disappointed in myself than anyone else could be disappointed in me.”

But O’Neill argued that there were mitigating circumstances that the psychology board should consider. She noted that eight months prior to her beginning treatment of MacLeish, her life had also fallen apart. She said her 23-year marriage to another psychologist had ended badly.

O’Neill also said she had no history of discipline and had pursued psychotherapy therapy for herself as well as peer supervision and continuing education on the issue of maintaining proper boundaries with patients.

Dr. Daniel Brown, a forensic psychologist retained by O’Neill, submitted a report to the psychology board in which he said her behavior most likely resulted from “situational factors,” primarily the collapse of her long-term marriage. He said O’Neill could be rehabilitated and there was a very low probability of recidivism.

Brown also was critical in his report of Dr. Stuart Grassian of Newton. Brown said Grassian was the psychiatrist to both O’Neill and MacLeish and a friend of MacLeish. Brown claimed Grassian referred MacLeish to O’Neill and did not discourage her from developing a relationship with MacLeish. “When Dr. O’Neill discussed in advance with Dr. Grassian the possibility of a sexual intimate relationship with MacLeish, she seemed to get ‘permission’ to go ahead with it,” Brown said in his report.

Grassian says he did refer MacLeish to O’Neill but never served as MacLeish’s psychiatrist. He denies saying anything to O’Neill indicating approval of a sexual relationship with MacLeish. “It’s all nonsense,” he said in a telephone interview.

Neither MacLeish nor O’Neill’s attorney responded to requests for comment.

Attorneys familiar with case law on license revocations said it was unlikely the Supreme Judicial Court would return O’Neill’s license to her. “I have empathy for Dr. O’Neill,” said Linda Jorgenson, a Massachusetts attorney who has represented hundreds of people who have claimed their therapists abused them sexually. “But her first obligation is to her patients. What she did to Mr. MacLeish was, plain and simple, wrong, and the revocation of her license was an appropriate sanction.”

Thomas Gutheil, professor of psychiatry at Harvard Medical School and co-author of Preventing Boundary Violations in Clinical Practice, said there are always mitigating factors helping to explain why therapists have sex with their patients. “But they are never a justification for behavior clearly recognized as wrong,” he said.

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Clinical psychologist Gary Schoener, who has written extensively about the sexual misconduct of therapists, said courts rarely overrule licensing boards in such cases. “The reason for this is that they are supposed to have more expertise in the issue of how to protect the public, and these cases involve a lot of professional opinion in a given field,” he said.

Janet Wohlberg, a victim advocate and herself a victim of sexual abuse by a psychiatrist, has a suggestion for the SJC justices. “They should ask themselves whether they would send a member of their family to Dr. O’Neill – their child, their spouse, their parents.”