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A patient may well have a closer, more dependent relationship with her auto mechanic than with the dermatologist she once visited to have a plantar wart removed.

Similarly, a patient may not even remember the anesthesiologist who presided over his gallbladder surgery or the emergency department doctor who once stitched his finger.

To the doctor -- if the would-be paramour is a patient -- it's also unethical.

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To the besotted poet, love is intoxicating, exasperating, invigorating.

Thus, essential features of the psychoanalytic process include the therapist's characteristics and competencies, the working alliance, transference and countertransference, submission, and the nature of the therapist's authority.

Factors that may lead to unethical practice include a God-like complex the therapist may derive from unrealistic feelings of superiority and power, and a strong narcissistic tendency that may be expressed through a need to control.

The patient has only hope and faith, which provide the groundwork for therapeutic influence.