||Breakdown: Sex, Suicide, and the Harvard Psychiatrist
1230 Avenue of the Americas
New York, NY 10020
This account of sexual impropriety and the psychiatrist's assumption
that her client had repressed childhood sexual abuse was written by a
reporter for the Boston
Globe Magazine. The book is mainly
historical and well prepared, and describes a black page in the history of
psychoanalysis. The book provides a detailed account of Dr. Margaret
Bean-Bayag masturbating in front of her client, having sexual intercourse
twice with her client, and prematurely diagnosing child sexual abuse by
the client's mother while he was in his crib. McNamara describes her
book as a "cautionary tale about the fragility of the human mind, the
imprecision of psychiatry, the cavalier diagnosis of childhood abuse and
use of unorthodox therapeutic techniques" (p.273). Dr. Bean-Bayag
took, as gospel truth, the literature she had read on childhood sexual
abuse, recycling myths as if they were facts. The book closes with a
good set of references, no index, and an informal guide to the book's
The client committed suicide and his family sued Dr. Bean-Bayag for $1
million and won. Bean-Bayag resigned from the Harvard Medical School
and surrendered her medical license.
Among the malpractice issues were:
||She did not report her suspicions of sexual abuse to the
Welfare Department as required by Massachusetts law.
||She never attempted to validate her suspicions of sexual
abuse by talking to the mother even though she had the chance to do so.
||She did not truly comprehend Mexican culture and
||She ordered her client not to talk to his family.
||She did not manage erotic transference well and ended up
having intercourse with her client in her home along with taking
||She used a new unorthodox form of treatment called
The client stole Bean-Bayag's written account of her sexual fantasies
(55 handwritten pages) from an unlocked desk. After his 4th
hospitalization for depression, she terminated him from therapy. The
client spoke to a hospital social worker who contacted the Massachusetts Board
of Medicine. The social worker got no more referrals from the
establishment as she was identified as a whistle blower. She was later
accused of violating the client's confidentiality by the local chapter of the
National Association of Social Workers.
Bean-Bayag's treatment records were criticized for their lack of empirical
supporting data. The author also raises interesting but unanswered
questions about her sexual abuse claim and inappropriate (reparenting)
treatment. Bean-Bayag maintained that her sexual activity with the client
was part of the transference process and was scientifically supported.
The Social Service Department of Wyandot County, Ohio (where the client was
raised) claimed they had no record of child abuse and felt Bean-Bayag's theory
of sex abuse was "ludicrous" (p. 215). The family received grief therapy
after the suicide and eventually returned to Mexico, claiming that American life
was hazardous to Mexican children. Bean-Bayag, without a license, opened a
private practice in her home with a big caseload of women well-wishers.
Reviewed by LeRoy G. Schultz, Professor Emeritus of Social
Work, West Virginia University,
Morganstown, West Virginia.