The “Sex” of Therapy and the Road to Erotic Transference

The internet is filled with worried psychotherapy patients: worried over their therapists. They are brimming with fear of being discarded, frustrated at their inability to get closer: wanting a permanent relationship, a kind of family tie, or the therapist’s touch. Much of the day is preoccupied with worries involving the counselor, a fresh slant on the distress that brought them into the consulting room initially.

On offer today is the likeness between the “desire” implicit in the client’s wanting the safety and secure guidance of a caregiver … and the romance and caring of a new love.

Treatment begins with a “getting to know you” phase, entirely one-sided, except for the therapist’s way of interacting, the knowledge he imparts, and the questions he asks and answers. But there is more:

• his attention, concentration, intensity of focus
• the tone of his voice
• his physical state of being
• the office setting (if he approved the decoration)
• his consideration and understanding
• the comfort he offers
• his “presence”

The contact is not so different from meeting a new, potential romantic interest, and going on a date. An appointment is made, a limited time is expected, and the initial stage of acquaintance with “who he is” is part of the agenda. Many questions after the first contacts will still be unanswered in both situations. The newness makes it electric, whether the charge is one of excitement or trepidation.

As feelings unfold, therapy offers a kind of seduction or foreplay: a back-and-forth in conversation, a dance without movement. If there is a desire for physical contact, then the patient experiences the ache before touch, enlarged because he cannot touch: a yearning magnified by the boundary the doctor will not cross (assuming he follows a therapy model insisting on such an invisible moat). The appeal is ancient: the forbidden fruit in the Garden of Eden.

Allowing the therapist inside is an intermediate goal of psychodynamic treatment: to permit release of material in need of expression, of grieving, of working-through. Transference is expected: the development of feelings about the counselor similar to those tied to significant people in the client’s past, including parents. Without the patient “exposing himself” and dropping his guard, a dynamic therapy will be unsuccessful. To continue the many metaphors here, you are giving yourself over to the other, putting yourself in his hands.

Jealousy may develop. There are significant-others in the counselor’s life, known or unknown: lovers, children, and friends. He also maintains a practice full of patients, competitors for his time. The weekly session is but a mini-slice of him, something shared when you are starving and have shared too much in your life already. In the course of working-through the transference, such feelings diminish. The counselor steps more “off-the-pedestal” than earlier, if not fully off. Only, that is, if the transference has been resolved.

Not all treatment models include enough time, in my opinion, on launching the patient into the world. Outside, sympathetic others represent a more appropriate target for strong and continuing attachment once the client is ready.

Part of the reason therapy is often eroticized is because of our instinctive desire for contact and kindness, a buffer against the inherent loneliness of the human condition. We want permanence and protection to face the transitory inevitability of life. Many of us wish to crawl into another’s skin, not be the solitary creatures we are, manufactured by nature into different sausage casings. We yearn for merging and this yearning is easily sexualized because intercourse involves momentary joining.

The illusion of the perfect therapist can create something of the honeymoon period. The blindness of new love enabled our species to survive. We need the illusion to bond in both treatment and everyday life. A persuasive mirage is not inevitable, but the risk of it is.

Powerful emotional attachment, assuming it happens, is maintained (in part) because of the distance and lack of consummation. Marriage, in contrast, involves consummation, routinized closeness, and repetitive exposure and over exposure. The illusion disappears, at least to some extent. The honeymoon ends and marriages fall into the world of reality from the lofty plateau of apparition and romance. Without a continuous fight against this gravitational force, starry nights and champagne morph into partly cloudy daylight and carbonated soft drinks that have lost their fizz.

A couple of additional thoughts: not everyone develops the sort of attachment I’ve described. Nor is there a way for those vulnerable to enchantment to protect themselves against it. Remember, however, some therapy models depend on the development of strong transference for ultimate healing.

Life teaches us we can’t have everything we want, nor forever keep what we have won. Yet our time here offers the possibility of joy even though many wishes are denied. We adapt. We must adapt.

If impermanence is the nature of things, the sooner one accepts that truth, the sooner one will come to appreciate and enjoy what is still possible here: on a rich, confusing, dark, but dazzling place called Earth.

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Two versions of a Starry Night, above: the first by Van Gogh and the second, Edvard Munch. Both come from WikiArt.org.