In re Sprague

564 A.2d 829, 132 N.H. 250, 1989 N.H. LEXIS 102
CourtSupreme Court of New Hampshire
DecidedOctober 6, 1989
DocketNo. 88-143
StatusPublished
Cited by9 cases

This text of 564 A.2d 829 (In re Sprague) is published on Counsel Stack Legal Research, covering Supreme Court of New Hampshire primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re Sprague, 564 A.2d 829, 132 N.H. 250, 1989 N.H. LEXIS 102 (N.H. 1989).

Opinions

Johnson, J.

Petitioner Betty Sprague petitions this court pursuant to Supreme Court Rule 11 to vacate a decision of the State Board of Registration in Medicine (the board), which denied the imposition of sanctions against Dr. David C. Whitenack for the treatment he rendered her, and to impose sanctions against Dr. Whitenack. In a cross-petition, Dr. Whitenack argues that the correct evidentiary standard to be applied by the board in a disciplinary proceeding is “clear and convincing evidence” rather than the “preponderance of evidence,” and that the board erred in applying the lesser standard. For the reasons which follow, we vacate the decision of the board and remand. We do not at this time instruct the board to use any standard other than the “preponderance of the evidence” standard.

In April 1986, Betty Sprague began to see Dr. Whitenack, a psychiatrist licensed to practice medicine in New Hampshire, for counselling. Ms. Sprague initially saw Dr. Whitenack, who diagnosed her as suffering from an adjustment disorder with anxiety features, once a week. Soon, however, she began to visit him twice a week, until August 1986, when she voluntarily terminated the therapy. Soon after terminating therapy with Dr. Whitenack, [254]*254Ms. Sprague sought the advice of a number of other mental health professionals as to whether the treatment she had received from Dr. Whitenack had been appropriate.

In October 1986, Ms. Sprague sent a complaint to the board in which she alleged that a number of incidents had occurred during the course of her therapy with Dr. Whitenack which she characterized as “questionable” and “inappropriate.” These included Dr. Whitenack’s hugging her, kissing her, using erotic language, telling her intimate details of his life, and about drinking with patients, joking about a gun he kept in the office, displaying a lack of awareness of the drug Xanax (a charge that was later withdrawn), and revealing to her the name of another patient. Ms. Sprague sent an almost identical complaint to the Ethics Committee of the New Hampshire Psychiatric Association.

After conducting a preliminary investigation, which included interviews with both Ms. Sprague and Dr. Whitenack, the board decided that it would hold hearings to determine whether Dr. Whitenack had acted inappropriately and whether it would impose sanctions against Dr. Whitenack, which could include the revocation of Dr. Whitenack’s license to practice medicine. See RSA 329:17, VII. Prehearing conferences, intended to narrow the factual issues, were held in the summer and fall of 1987. On November 13, 1987, a one-day, twelve-hour evidentiary hearing was held before the board.

An examination of the record reveals agreement by the parties as to a number of important facts. No party disputes that Dr. Whitenack hugged Ms. Sprague at the close of a number of treatment sessions. Dr. Whitenack asserts that the hugs, which he described as the kind he would give his children, were intended to convey support for the patient’s “tentatively offered inner emotions.” Ms. Sprague recognized that the hugs were part of Dr. Whitenack’s style in practicing psychiatry. With regard to the kisses, the board concluded that Dr. Whitenack had kissed Ms. Sprague on the top of her head on three occasions, as Ms. Sprague alleged. Although Dr. Whitenack could not recall kissing Ms. Sprague, he did not dispute that the incidents may have occurred, and he asserted that a nonerotic kiss could show support for a patient, and thus be beneficial to the patient. Ms. Sprague agreed that the kisses were not erotic in nature. The record makes it clear that the claim of misconduct was not based primarily on the mere occurrence of the physical acts themselves. Rather, Ms. Sprague’s counsel argued that Dr. Whitenack had been negligent, immoral, [255]*255and unprofessional in his actions, given the probable perception of these acts by Ms. Sprague and his intent in performing them.

Ms. Sprague’s perception was influenced, her counsel argued, by an intense “transference” directed towards Dr. Whitenack. Transference is a term used to denote a patient’s emotional reaction to a therapist and is “generally applied to the projection of feelings, thoughts and wishes onto the analyst, who has come to represent some person from the patient’s past.” Stedman’s Medical Dictionary 1470 (4th Lawyers’ ed. 1976). Experts have viewed transference as crucial for a successful therapeutic process because “[i]t is through the creation, experiencing and resolution of ... feelings [which the patient may have repressed towards the past figure] that [the patient] becomes well.” See L.L. v. Medical Protective Co., 122 Wis. 2d 455, 461, 362 N.W.2d 174, 177 (Wis. App. 1984) (quoting D. Dawidoff, The Malpractice of Psychiatrists 6 (1973)). Both parties agree that Ms. Sprague developed feelings of transference during her therapy with Dr. Whitenack.

Ms. Sprague’s counsel characterized the transference as “eroticized.” Eroticized transference has been defined as “... an intense, vivid, irrational, erotic preoccupation with the analyst, characterized by overt, seemingly ego-syntonic demands for love and sexual fulfillment from the analyst.” H. Blum, The Concept of Eroticized Transference, 21 Journal of American Psychoanalytic Association 63 (1973). Thus, although according to Dr. Whitenack, the hugs and any kisses that may have been given were intended to convey support and acceptance of Ms. Sprague, according to Ms. Sprague, she perceived them as sexual in nature, thus fueling her intense emotional and physical attraction to the doctor.

It is also undisputed that the doctor used commonplace “street language” to describe sexual acts during at least one therapy session with Ms. Sprague. Ms. Sprague testified that the use of such language served to intensify her feelings for the doctor. Dr. Whitenack testified that he had made a particular statement containing such language following Ms. Sprague’s description of a sexual fantasy that she had had involving considerable force and violence. Dr. Whitenack testified that he believed that Ms. Sprague, by revealing the fantasy, was asking him to accept her and be supportive. His use of this “street language,” he suggested, had to be understood in this context.

It is also undisputed that Dr. Whitenack told Ms. Sprague that he owned a gun. Ms. Sprague testified that Dr. Whitenack offered her the use of his gun. Dr. Whitenack denied he had offered her use of the gun. Rather, he testified that he had told her that [256]*256“sometimes when people are so control oriented ... they’re safer ... if they have some means to take control,” and that his “shorthand way ... of asking people of ... how suicidal they might be was to ask them if they needed a gun.”

It is undisputed as well that Dr. Whitenack revealed to Ms. Sprague a number of facts about his personal life. Ms. Sprague testified that she had found these revelations “tantalizing.” Dr. Whitenack testified that he had supplied these facts in answering direct questions asked by Ms. Sprague, and that doing so was consistent with his general therapeutic approach.

It is also undisputed that Dr. Whitenack drank with a few patients during therapy sessions and revealed this fact to Ms. Sprague. Dr. Whitenack testified that there were three or four patients with whom he had a beer at each session and that he scheduled them as the last session of the day. He testified that he was certain that he had mentioned this fact to Ms.

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Cite This Page — Counsel Stack

Bluebook (online)
564 A.2d 829, 132 N.H. 250, 1989 N.H. LEXIS 102, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-sprague-nh-1989.