Toronto psychiatrist loses licence over relationship with former patient

A Toronto psychiatrist has lost his licence to practise after becoming romantically involved with a former patient less than a month after their professional relationship ended.

The College of Physicians and Surgeons of Ontario says Dr. Nagi Ghabbour failed to respond to the woman’s escalating feelings for him while she was his patient and “clearly did not recognize his own part in it.”

The regulatory body says Ghabbour, 55, should have known how to manage the situation but instead chose to “pursue his own romantic needs.”

An agreed statement of facts shows the woman, who was married and had young children, sought treatment from him for anxiety and depression stemming from her work and marital difficulties.

The document says the woman announced she no longer wanted to be his patient about a year later amid concerns from her family over her relationship with — and her own romantic feelings for — the psychiatrist.

It says they started to date within a few weeks and began a sexual relationship the following month. They now live together and plan to marry once her divorce is finalized, the document says.

While licence revocation is a more severe penalty than typically imposed for this type of case, Ghabbour’s misconduct was egregious and a lengthy suspension would not address the public’s or the college’s concerns, the disciplinary committee wrote in its decision.

“While Dr. Ghabbour’s case is not a case of sexual abuse of a patient, rather, professional misconduct in that he started a sexual relationship too soon after termination, the very nature of the relationship, the profound vulnerability of this specific patient and Dr. Ghabbour’s lack of insight into the egregiousness of the misconduct, led the committee to decide that revocation is the only suitable penalty to fully protect the public,” it said.

Ghabbour can apply for reinstatement in a year, which the committee said should give him an opportunity to show that he has learned how to prevent the same issues from arising again.

He also faces a reprimand and has been ordered to pay $11,000 to cover the costs of the two-day hearing.

The college’s current guidelines say that when treatment involves significant psychotherapy, sexual involvement is likely inappropriate any time after the end of the patient-doctor relationship.

The agreed statement of facts says the woman, whose identity is protected by a publication ban, began to see Ghabbour at the suggestion of her uncle. It says Ghabbour, who worked in the Child and Adolescent Mental Health Program at St. Joseph’s Health Centre in Toronto, agreed to take her on as a patient.

He initially diagnosed her with adjustment disorder, with depressed mood and anxiety, and a high likelihood of depressive disorder, the document says. He later noted that she discussed suicidal ideation.

After roughly five months of treatment, the woman “began experiencing and expressing strong romantic feelings” towards Ghabbour, which was reflected in his notes, the document says.

Ghabbour documented that on separate occasions, she kissed him on the cheek, hugged him and mentioned that she wanted a physical bond with him, it says. Another note mentioned “transference,” a term that describes the unconscious redirection of feelings from one person to another, often a therapist.

Meanwhile, the woman’s marriage was deteriorating and she told Ghabbour she wanted a separation while she considered filing for divorce, the statement of facts says.

The woman’s mother voiced concerns about their growing closeness and threatened to lodge a complaint with the college, the document says. Ghabbour’s notes suggest he was not worried about possible repercussions, it says.

“He testified, and had charted, that he did not feel he had anything to worry about should her family members complain about him as he was doing nothing wrong,” it reads.

Almost a year into treatment, the woman told Ghabbour she no longer wanted to be his patient due to her romantic feelings for him, the document says. His last note on her case was dated about a month later, saying the file should be closed.

The disciplinary committee found that note to be “self-serving and disingenuous,” saying it did not believe a psychotherapeutic relationship could be adequately severed in this fashion.

“When there is a deep intimate one-sided exchange of personal information as occurs in ongoing psychotherapy, this inherently sets up a deep trust in the doctor by the patient,” the committee wrote.

“This trust causes a great vulnerability in the patient and an exceptional power imbalance of lasting and enduring impact.”