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Doctor used hypnotherapy with shocking sexual imagery to treat smokers despite nearly 20 years of complaints

The young patient had only recently sought counselling for a harrowing episode of sexual abuse when his psychiatrist referred him to another doctor for help to quit smoking.

The sessions that followed sent the 28-year-old into a spiral of depression and re-traumatization, he said Tuesday, while raising questions about Canada's medical-discipline process and the sometimes-dubious treatments marketed to tobacco addicts.

The second physician asked the Toronto man about his sexual orientation, told him to unbutton his pants and then encouraged him to picture graphic, sexual images while under hypnosis.

As it turns out, patients had been complaining about Dr. Jacques Dubins unusual smoking-cessation methods for almost 20 years, causing regulators deep concern, a just-released appeal ruling reveals.

The family physician, however, has never received more than a caution for his transgressions, according to the Health Professions Appeal and Review Board decision.

In a rare rebuke, the board ordered Ontario's College of Physicians and Surgeons to re-examine the latest case, saying it had failed to properly investigate an almost two-decade history of complaints.

The hypnotherapy techniques are unnecessary and unacceptable and would be shocking and even disturbing for some patients

The [College] found that the hypnotherapy techniques are unnecessary and unacceptable and would be shocking and even disturbing for some patients, said the decision. Yet is appears [Dr. Dubins] has continued with his unacceptable hypnotherapy techniques. This suggests the prior disposition did not carry out its intended purpose.

Meanwhile, as stipulated by regulation, no information about the cases has ever been posted on the physician's public College profile.

In response to the latest allegations, the agencys complaints committee had again ordered Dr. Dubins to appear for a verbal caution, as well as write a short essay on hypnotherapy.

The penalty was a joke, said the patient, who asked not to be named. My understanding is the College is supposed to be protecting the patients, but it seems that it protects the doctors.

Dr. Dubins will not comment on the matter, his lawyer, Meredith Jones, said Tuesday. The review board decision, however, indicates that he has already made unspecified changes to his hypnotherapy techniques.

The patient said the first question Dr. Dubins asked during their initial meeting a year ago was whether he was gay, straight or bisexual. He felt uneasy, but his psychiatrist encouraged him to go back.

The College is supposed to be protecting the patients, but it seems that it protects the doctors

At the start of the ensuing treatment, Dr. Dubins asked the patient to unbutton his pants. During hypnosis, he told the man he may have an erection and may decide to have sex afterward. Then he sent the patient into the washroom, and told him to imagine the toilet bowl was full of bloody vaginal discharge, and to take up and smoke a cigarette that was in the midst of the liquid, the patient said.

It completely re-traumatized me, said the man, now studying to be an addictions counsellor himself. It paralyzed me. Depression came up, the PTSD.

He filed a complaint with the College, then appealed its ruling. The appeal board said the committee could not adequately assess the case because it examined only brief summaries of the earlier complaints.

The allegations included one in 1996 that the physician used inappropriate imagery and offensive comments during stop-smoking treatments. He was cautioned at that time.

There was another complaint about his offices unsanitary conditions in 2005, and a third in 2010 regarding inappropriate comments, graphic imagery and lack of cleanliness. Neither of those cases produced any kind of penalty.

The complaints committee takes the appeal boards recommendations seriously and will carefully consider them as it works on a new ruling, said Kathryn Clarke, a spokeswoman for the College. Meanwhile, it has already begun perusing the full texts of previous decisions about doctors who are under scrutiny, she said.smok

Aside from questions of physician regulation, the case shines a light on a thriving industry that offers desperate smokers treatments of frequently questionable merit, said one addictions expert.

It's a huge market, because most people who use tobacco want to quit, said Rosa Dragonetti, director of the nicotine-dependence clinic at Ontarios Centre for Addiction and Mental Health. They'll try and try with several methods to find something that works. They're vulnerable and people can take advantage of that.

Ms. Dragonetti said invoking sexual imagery in treating addiction is a dangerous practice, given the possibility of aggravating past trauma. She also suggested there is little scientific evidence that hypnotherapy of any kind is effective in smoking-cessation.

Jay Pandhi, the Edmonton-based president-elect of the Canadian Federation of Clinical Hypnosis, said effectiveness depends on the skill of individual therapists, and some have produced great results.

Via - news.nationalpost.com