Sex, Lies, and Psychotherapy

Author: Majken Lorelei Matzau

Irvin D. Yalom's novel Lying on the Couch contains a scene that has stayed with me for years. A therapist, caught in an affair with a client, defends himself with the conviction that his intentions were pure – that he was acting from care, from intimacy, from a genuine desire to help.

The novel is fiction. The dynamic it describes is not.

The Danger of Unexamined Need

When a coach or therapist enters a helping relationship carrying unexamined needs – the need to be admired, to be desired, to be indispensable, to feel powerful – those needs do not disappear simply because the practitioner has good intentions. They find expression through the relationship. The client feels something pull at them that they cannot name. The power dynamic shifts in subtle, invisible ways.

The coach believes they are serving. And in a sense they may be – but they are also being served. The relationship has become, at least in part, about the coach's own satisfaction rather than the client's growth.

What Self-Work Prevents

This is why the most important ethical commitment a coach or therapist can make is not to a code of conduct, but to their own inner work. The practitioner who has examined their own wounds, their own need for admiration, their own unresolved dynamics with authority and intimacy, is far less likely to act them out in the professional relationship.

Not because self-knowledge makes one immune to being human – but because it creates enough awareness to pause. To notice. To choose.

The Transformation That Protects

I have trained coaches who arrived carrying a great deal of unexamined history. Through sustained self-examination – not simply cognitive insight but emotional metabolising – something fundamental shifted. The desperate need to be needed began to dissolve. They became less interesting to themselves and more genuinely curious about their clients.

When that shift happens, the helping relationship becomes what it was always meant to be: a space in which another person can grow freely, without the invisible weight of the helper's own needs pressing down upon them.

Ethics, in the end, is not a rule. It is a practice – and it begins with the willingness to look honestly at yourself.

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