Late in 2009, a 28-year-old woman not long out of graduate school found herself in a stressful job at a Bronx hospital and decided it would be useful to talk to someone. Searching online, she came across the name of a psychiatrist, Keith Ablow.

Dr. Ablow was familiar to her from his writing, both his journalism and the best-selling thrillers he turned out — “Denial,’’ “Projection,” “Compulsion,’’ “Murder Suicide.’’ She had read all of those, as well as “Psychopath,’’ a book about a psychiatrist who prods the interior lives of strangers only to kill them, baroquely obscuring the distinction between patient and victim.

The woman — who has asked to be identified only by her confirmation name, Monique — found Dr. Ablow just as his media star was rising. That year, Roger Ailes had hired him as a regular contributor on Fox News, where he would remain until 2017, speculating about the mental states of political figures and presiding over viewer segments like “Normal or Nuts?”

Dr. Ablow offered counseling in the conventional sense, but he also conducted life-coaching via email. Monique engaged with him this way at first, but after she answered various questions about her past, mentioning adolescent bouts of depression, she agreed to see Dr. Ablow in person. His busy schedule meant that she would have to go to his primary office, in Newburyport, Mass. He was impressive to her, and so Monique made the five-hour trip for her first visit.

Over the next year and a half, Monique saw Dr. Ablow two or three times a week, at the reduced rate of $350 an hour. During this time she found herself coming unwound.

Her anxiety about work did not recede. On the contrary, she felt increasingly addled and insecure, and problems that had been latent for a long time resurfaced. She began cutting herself, something she hadn’t done in years.

Monique came to believe that Dr. Ablow had not only failed to help her; he left her more damaged than she already was. For his part, Dr. Ablow would maintain that whatever boundaries she thought he violated — the frequent texts and emails, the intimate revelations about his own life — were in the service of her treatment, well within the standard of sound psychiatric care.

As Monique would discover, it would take years — and several other patients coming forward with their own stories of manipulation — for Dr. Ablow’s transgressions to be taken seriously.

The case represents a core challenge of psychological treatment. At a cultural moment in which all kinds of relationships are policed for abuses of power imbalance, psychotherapy takes place in seclusion: two people, alone in a room, with one holding extraordinary influence over the other, just as it has been since Freud. It remains a world with murky oversight, and if you are harmed, it is not obvious what can be done.

By the time Monique left his care, her new marriage had fallen apart and she had developed a dependency on Valium, Xanax and Adderall. She also said she had drained her savings of $30,000 to pay for the treatment.

Most alarming, she had become obsessively, insidiously reliant on Dr. Ablow’s affirmation, a circumstance she and her lawyer would later suspect he engineered.

On an unusually hot late-summer morning, in a coffee shop just north of the city, Monique recounted how she had come under Dr. Ablow’s thrall. When she finally disentangled, she filed a complaint with the disciplinary board in New York that oversees psychiatrists — a body that works secretly and can take years to respond to charges. In this case, when it finally completed its initial review of Dr. Ablow, it found no reason to sanction him.

As we spoke over several hours, Monique’s caution gave way to a fluid and emotional narrative. It was easy to imagine her on the other side of conversations that played out this way hundreds of times. She was, in fact, a therapist herself.

That she had this training compounded the embarrassment anyone in her situation would surely feel. Monique was reflexively skeptical about human motivation. As a child she had resisted authority. How had she landed here?

From the beginning, Dr. Ablow presented himself as an idealized caretaker more than a guide. “As if he said, ‘Let down your guard, let go of everything and completely fall on me, because I will give you everything you ever needed. And you need nothing but to trust me,’” she reflected.

This was intoxicating to Monique. Her childhood had been marked by her father’s volatility, her mother’s emotional absence, a difficult relationship with her brother. With Dr. Ablow, she found herself in the strange state of feeling both further weakened by her past and protected from it.

If therapy is the project of overcoming, Monique belatedly came to believe that Dr. Ablow urged her neither toward strength nor self-reliance. “He did make me feel beautiful and precious and special,’’ she said. “But very broken.’’

On May 15, Dr. Ablow’s license was suspended in Massachusetts after an investigation determined that his continued practice was a threat to the “health, safety and welfare” of the public. He is appealing the ruling.

This article is based on interviews with Monique and others, including her current therapist as well as legal and medical documents obtained by The Times. Dr. Ablow did not respond to attempts to speak with him directly, but his lawyer, Paul Cirel, issued a statement on his behalf, writing in an email that his client would not “breach the ethical/confidentiality standards of his profession” and comment further.

Earlier this year, Dr. Ablow referred to the claims Monique made in her legal complaint to the health department in New York as “groundless.” He has categorically denied all allegations of sexual misconduct against him that have come up in subsequent cases. And he has said, as he did with Monique, that to whatever extent he revealed personal information with patients, he did so in the effort to help them work through issues of psychological importance.

On Feb. 5 next year, a hearing will take place in Massachusetts that will ultimately determine the future status of Dr. Ablow’s medical license.

From the outset, Monique had inklings of doubt about Dr. Ablow, but she easily suppressed them. Her first meeting with him ended with a prescription for an antidepressant. Although she found it curious that he would administer drugs so quickly, she deferred to his approach.

The boundary between patient and doctor was permeable from the start. Dr. Ablow took Monique to a taping at Fox; he connected her with a literary agent when she wanted to write. On one occasion, she mentioned she was near his office with her dog. This was in Newburyport, where she still went for treatment on occasion, running up bills in local inns, in addition to seeing him in New York. She knew Dr. Ablow had expressed an interest in meeting her dog, and he briefly left a session with another patient to come outside and play with him, she said.

Their sessions had an improvisational, transgressive tone. According to her official complaint, Dr. Ablow twice wondered, for no apparent therapeutic purpose, whether Monique had genital piercings. At one point, when she was describing a conflict with her father, Dr. Ablow responded: “Why don’t you tell your father to come stick a gun in my face and see what happens.”

Money was an ongoing problem for Monique, and she eventually questioned why so much of her costly time in therapy was spent listening to Dr. Ablow talk about issues he confronted in his own life — that his sister was drawn to broken men, that his son did a lot of pacing.

These confidences nonetheless made Monique feel as though she held outsize status with Dr. Ablow. Which made it all the more painful for Monique when she felt dismissed by him — when he would arrive late for their sessions, she said, or text and email during them.

Any of these incidents might have given her pause, but it took what she regarded as an explicit act of cruelty to compel her to leave. Early on, Monique had told Dr. Ablow that she feared, above all, being physically trapped — imprisoned, taken somewhere and locked up.

Many months later, during a disagreement about something relatively minor, she said, Dr. Ablow suggested that he might have to hospitalize her. Hospitalizing a distraught psychiatric patient is not an unreasonable course in certain circumstances, but Monique was certain he was preying on her vulnerabilities.

“I couldn’t trust him after that,” Monique said.

When Keith Ablow was in medical school at Johns Hopkins University in the 1980s, after graduating from Brown, he hoped to become an ophthalmologist. It was a mentor at Hopkins who suggested psychiatry, recognizing someone profoundly curious about other people’s lives.

His ambition was evident early on. He wrote the first of his 16 books, “Medical School: Getting In, Staying In, Staying Human,’’ while he was still a student. A paperback edition featured a blurb from The New England Journal of Medicine.

In the mid-1990s, Dr. Ablow was interviewed for a book, “In Session: The Bond Between Women and Their Therapists.’’ The author, Deborah Lott, had met him at a gathering of clinicians and found him to be insightful on the subject of boundaries and transference. Ms. Lott thought of him “as one of the good guys,’’ she said recently, “an advocate for women.”

Before his emergence at Fox, Dr. Ablow was a familiar presence on daytime talk shows, where he delivered advice with a brash compassion. Ms. Lott had lost track of him until his television appearances. As a Fox commentator, she said, his persona was radically different from the one she remembered. (A spokeswoman for Fox confirmed that Dr. Ablow’s contract was not renewed in 2017 and had no further comment.)

On TV, Dr. Ablow’s habit of diagnosing political leaders, particularly President Obama, who he believed suffered from abandonment issues that made him a weak leader, sparked criticism from a profession that maintains a fierce distaste for this sort of conjecture.

In 2014, Jeffrey Lieberman, chair of the psychiatry department at Columbia University, publicly denounced Dr. Ablow, who in turn responded with a clever press statement: “I am apparently joined by my nemesis Dr. Jeffrey Lieberman in rejecting the position that psychiatrists ought not comment on public figures. Lieberman condemned me as a ‘narcissistic self-promoter’ — yet he has never interviewed me.”

In November of that same year, Ms. Lott received a circumspect email from a young woman who had read her book and had questions about Dr. Ablow’s involvement. It was Monique. She was wondering what Dr. Ablow was doing in a book about boundaries. “She had no ax to grind,” Ms. Lott recalled, “other than trying to make sense out of what had happened.’’

Two years earlier, in 2012, Monique had outlined all of her allegations against Dr. Ablow in a lengthy complaint she made with New York State’s Office of Professional Medical Conduct, the agency empowered to suspend and revoke psychiatric licenses.

In these documents, she claimed that Dr. Ablow had crossed multiple boundaries, overwhelming her with details about himself — that he had been attracted to his children’s babysitters, for instance, and that his marriage was unfulfilling.

He asked her to coffee frequently. He encouraged her to move in with a female friend of his in Manhattan when Monique separated from her husband, only to later tell her that the roommate he recommended was “nuts.” He mentioned to Monique that he wanted to send a former all-star running back for the New York Giants to her as a patient. He also suggested that she date him.

At one point, while she was still seeing Dr. Ablow for regular therapy, he offered her a job with his life-coaching business. She took it, counseling people remotely. For a few months, she was both his patient and his employee.

In the course of her efforts to establish her own practice, Dr. Ablow encouraged Monique to move to Newburyport, which would be cheaper than New York.

She almost went through with it.

Monique had recently married a man after a four-year engagement, yet her ambivalence about him persisted. Dr. Ablow knew all about this. In fact, when she emailed him on the eve of her wedding, he gave her confounding advice. In his reply, he implicitly encouraged her to go through with it, at the same time remarking that marriage itself was “absurd.”

On the day she planned to move and leave her husband behind, in January 2011, a tremendous storm hit the Northeast. She decided to stay in New York, where she continued to see Dr. Ablow for another six months.

Once she made the decision to leave Dr. Ablow, Monique met with a Manhattan lawyer, Audrey Bedolis, who has concentrated in psychotherapeutic malpractice since the early 1990s.

Ms. Bedolis knew that cases without accusations of sexual misconduct, clear physical abuse or some other singular, dramatic incident are typically hard to litigate; she and her client eventually abandoned plans for a lawsuit. But Ms. Bedolis believed that the sheer volume of Dr. Ablow’s boundary trespasses would surely result in disciplinary action from state authorities.

In the dynamic between Monique and Dr. Ablow, Ms. Bedolis saw something all too familiar. Though she knew only Monique’s side of the story, it seemed to her a clear case of exploitation that, while it did not involve sex, was just as devastating. “First he medicated her when she never thought she should be medicated,’’ Ms. Bedolis said. “Then he lured her in as the only person who could help her.”

For several years, Monique waited to hear something from the conduct office in New York. In October 2017, the office finally wrote to say that it had found “insufficient evidence’’ to bring any charges of misconduct against Dr. Ablow.

One week after the New York board wrote to Monique saying that it would not sanction him, it sent a separate letter to Dr. Ablow, stating that in her case, he had failed to render proper care and treatment and that he prescribed medications inappropriately. He was told to refrain from boundary violations.

But there was no punishment for this; his license to practice psychiatry in New York remained in good standing.

This spring, however, based on Monique’s claims and the testimonies of four other female patients, as well as several former employees of Dr. Ablow’s, the Massachusetts Board of Registration in Medicine ruled that Dr. Ablow practiced “in violation of law, regulations, and/or good and accepted medical practice.” As a result of that suspension, he consented to cease practice in New York, where a renewed investigation by the conduct office is underway.

Three of the women — like Monique, all young — told an investigator for the Massachusetts board that Dr. Ablow had become sexually involved with them during the course of their treatment. One of them said that he introduced her to sadomasochism and hit her with a belt during their encounters, exclaiming, “I own you.”

In a formal written response to the board, Dr. Ablow denied this, as well as the charges that he had been physically intimate with the other patients involved in the case.

In a statement issued in August, Dr. Ablow’s lawyer, Mr. Cirel, addressed the charges in a series of malpractice lawsuits brought against Dr. Ablow, which were settled out of court this year, as well as the allegations in the complaint to the state, writing: “We are pleased that the civil matters have been amicably resolved. Dr. Ablow can now focus his attention and resources on overturning the Board of Medicine’s order of temporary suspension, so that he can restore his medical license and resume helping patients into the future, as he has countless times in the past.”

Last winter, before the suits were settled, Dr. Ablow appeared on a Boston-area news show, where he addressed them and claimed to be a target of cancel culture. “A male, a public person and a Trump supporter,” Dr. Ablow said in the interview. “So am I surprised? Yeah. But shocked? No.”

In his rebuttal to the Massachusetts board, Dr. Ablow said that one of his accusers had a history of falsely accusing men of sexual misbehavior and that she had essentially confused what happened between them with the actions of a recurring character in his novels.

The documents filed in conjunction with Dr. Ablow’s suspension reveal something else as well — that in three separate instances in which his medical license came up for renewal in Massachusetts, between 2013 and 2017, he failed to notify the state that he was under investigation in New York. During the renewal process, an applicant is asked specifically if he or she is under investigation in a different state. Dr. Ablow said that he wasn’t.

After her time with Dr. Ablow, Monique was apprehensive about trusting a new therapist. Eventually she returned to the psychoanalyst she saw during her first year of graduate school, Robert Katz. Recently, she gave permission to Dr. Katz to speak about her experience with Dr. Ablow.

Monique entered treatment with him shaken by what had happened to her under Dr. Ablow’s care, he said. Dr. Katz viewed the boundary violations she described as a means of grooming her for a sexual relationship.

Of everything she brought up, Dr. Katz added, one detail stuck out most in his mind: that Dr. Ablow had suggested to Monique that she become an escort to earn the extra money she needed. (Dr. Ablow has denied ever saying this, and denied it again when another patient made the same claim.)

In recent years Monique has settled into a successful private practice (this is why she insisted on anonymity in exchange for participating in this article).

Still, even now, after all she has come to understand, she finds herself occasionally missing the connection she had with Dr. Ablow, longing again to experience how much she imagined she meant to him.

When a psychiatrist, psychologist or social worker is barred from practicing, it does not necessarily mean that they are prevented from dispensing advice, in an office, for profit. Life-coaching is a career open to almost anyone; requiring no credentials, it is largely unregulated.

After the suspension of his license, Dr. Ablow repositioned himself. The Ablow Center for Mind and Soul in Newburyport identifies Dr. Ablow on its website as someone who “practiced psychiatry for over 25 years before developing his own life-coaching, mentoring and spiritual counseling system.” Over the summer, he took courses in pastoral counseling at Liberty University, the evangelical Christian college in Lynchburg, Va.

The Ablow Center is expanding its services, including free therapy for veterans once a month. It also announced an essay contest for high-school and college students considering a career in counseling.

Beyond that, visitors to the center’s website can find regular blog posts from Dr. Ablow, like a recent entry with the headline, “Why a Depression and Anxiety Consultant Could Be the Key to Recovering.”

For anyone “still’’ feeling anxious or low, Dr. Ablow had some wisdom: “It may have nothing to do with you,” he wrote, “and everything to do with the treatments being offered to you.”

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