WHEN FEELINGS GET IN BETWEEN THERAPISTS AND CLIENTS

Whether we are sexually active or not, we all have erotic fantasy life. We all have erotic history. No escape routes.

Love is magical. It comes with feeling that goes beyond what words can describe. Love can sometimes be more than what it appears on the surface. Have you ever fallen in love with your therapist- doctor, nurse, pharmacist or even counsellor? This might suggest that you had erotic transference. What do we call it when your therapist fall in love with you- erotic countertransference.

This phenomenon is often taken for granted when patients fall in love with their therapists even though it is not an unusual event in clinical settings. The patients experience them as genuine feelings of love and longing. When it happens other way round, the therapist that is besotted with love for a patient often believe that their own feelings toward patients is also genuine but not countertransference.

 

TYPES OF TRANSFERENCE

There are four kinds of transference situations:

  • Heterosexual women in treatment with heterosexual male therapists
  • Heterosexual men in treatment with heterosexual female therapists
  • Homosexual men in treatment with homosexual male therapists
  • Homosexual women with homosexual female therapists

Erotic transference from heterosexual women in treatment with heterosexual male therapist is more common than the reverse. Reason for this is unknown.

WHY THE EROTIC FANTASY?

Transference and countertransference are, by their nature, complex and interrelated. However, they cannot be understood solely within a model of attachment and its re-enactment. Power dynamics (how power affects relationship between two or more people) in interpersonal relationships also play a role. In addition to reviving early erotic attachments to one or another family member, the erotic transference is fueled by wishes for egalitarianism, if not for achieving the power position. Love, after all, serves to equalize power between lovers. Thus, the act of falling in love is connected to power dynamics. Freud recognized that women sometimes used the transference in an attempt to compromise the physician’s authority.

Power can be expressed through what I call weak power; for example, a patient seducing a therapist with appreciation, flattery and admiration. Analogously, therapists may seduce their patients through the awe their position affords them and through what passes for strength. These strategies are more often preconscious than conscious.

The complex dynamics of transference can often be missed if as therapist we fail to look at the hidden yearnings for asserting power or claiming protection for weakness.

 

WHOSE RESPONSIBILITY IS IT TO HANDLE THIS?

Disclosing erotic feelings to a therapist can be a terrifying proposition for patient. How will the therapist respond? Will they change boundaries? Will they feel disgusted? These are common concerns expressed by clients with erotic transference.

Should a client speak up, listen with an open curiosity and without judgement, and crucially, never pushing the client for details which they do not wish to disclose. It’s really important that, as therapists we are examining our motivations for interventions as we work, because a client may feel very vulnerable when discussing erotic transference, and the potential for harm is present.

The therapist’s level of ability to appropriately address and contain these issues for their clients or themselves is very important. It is the client’s privilege to act out their feelings for their therapist; it is the therapist’s responsibility to do the opposite. It is the responsibility of the therapist to maintain appropriate boundaries within the therapy work. Another thing that can also be done is to talk about it- TALKING CURE. Emphasis on cure!

 

FURTHER READING

https://aclientfirst.com/2018/02/06/erotic-transference-in-therapy/

https://www.brightontherapypartnership.org.uk/erotic-transference-and-countertransference/#:~:text=Erotic%20transference%20is%20a%20term,therapist’s%20feelings%20about%20their%20client

https://www.psychiatrictimes.com/view/vaping-what-psychiatrists-need-to-know