Erotic Transference and the Fantasy Lives of Therapists

My father, a man of uncommon decency, kept an issue of Playboy Magazine in the closet he used for his overcoats. I discovered this item while snooping around the house, not expecting that. The featured model was Jayne Mansfield.

This happened in the late 1950s, long before the unending pornographic video flood undercut the thrill of “dirty photos.US citizens of the time lived in a post-Victorian, white man’s dream world, just prior to birth control pills and the sexual revolution. Then they continued in a non-Victorian, more sexualized version of the same thing.

I was old enough to fathom why a man might be interested in perusing color pictures of the famous blond beauty in all her air-brushed nakedness. I put the magazine back as dad left it, never confessed my discovery, and didn’t try to interrogate.

If my sire had fantasies despite sleeping next to the woman of his dreams every night, I imagined everyone did.

Therapists do, too.

I notice beautiful women still and didn’t close my eyes when they entered the office for psychotherapy. Another psychologist mentioned such beauties energized him, helped him focus his attention on “the person” behind the attractive face and form.

Hmm.

This man maintained an active sex life, by the way. To my knowledge, he didn’t engage in affairs with his patients but acquired a reputation for more than a few of the extramarital variety at one of the hospitals where we both practiced.

Counselors are not eunuchs. Acquiring a license to practice doesn’t require neutering.

We “notice,” and some few do more than take in the visual, feminine glories of the natural world despite ethical codes forbidding the mix of romantic engagement with those who come with personal problems.

Intimacy with a therapist is never the solution to those problems, though some professionals persuade themselves it is a different manner of “helping.In case you haven’t realized it yet, we homo sapiens can convince ourselves of anything, justifying murder, robbing our kids of their credit cards, and more.

I can’t tell you I never fantasized about the women I treated. I don’t recall doing so, however. But then, we don’t remember every dark night dream of body and soul, do we?

Did I have those fantasies or not? I still can’t be certain. Most of the time, I compartmentalized or separated home from work. What fantasies I do recollect didn’t derive from doctor-patient interaction.

I never overstepped professional limits, despite invitations offered in straightforward confessions of love from female clients. These included one lovely who brought a kit of sex toys and a variety of condoms to a session and proceeded to unload them on my desk.

The topic of sexual transference continues to pull in readers to my blog, as well as the writing of others. The humans alive today, every one of us, are here because the drive to procreate remains in the DNA passed to us and through us.

I heard females, a limited number, mention our sessions stimulated their lubrication.

I recall another dear person I referred to a different psychologist because we couldn’t resolve and move beyond her transference, aka, her obsessive wish to be my lover.

In our final meeting, she asked for a parting hug. Weeks before, she presented a pencil drawing of me holding her. Since I couldn’t predict how far she might take an embrace, I refused. Anger followed.

Another woman, paradoxically, could not have been further from capturing my interest. She did refer to her satisfying sex life with her husband, but this wasn’t what prompted her to consult me. Nor was the brief report remarkable.

I found nothing stimulating in her intellect, personality, appearance, or her way of walking or moving, speaking or smiling. She didn’t flirt and didn’t wear revealing clothing. I guess the lady was in her 40s or early 50s.

And yet, I felt drawn to her. By the process of elimination, I can only conclude she produced an oversupply of pheromones.

My boundaries and respect for those who requested guidance stopped me from considering the pursuit of touch outside those limitations, as did my love for my wife and a set of clear principles. I never needed to think about potential public humiliation, financial ruin, and vocational catastrophe.

None of this makes me a saint, in case you wondered. If you can find one, let me know.

But, I heard a few stories from men who did destroy their lives and those of their victims.

Two of my patients, defrocked former ministers, sought my services because they’d taken advantage of their religious authority and charismatic charm with multiple members of their separate congregations. One still retained an imposing presence and a powerful voice, a capacity he’d used to deliver stirring sermons. His shame was almost palpable.

Another man I’m thinking of, a doctor, employed several ex-patients in his office of female employees. Those with whom I spoke all admired him, but people in authority who provide treatment to a person in distress often receive this kind of attachment and appreciation.

This is what erotic transference tends to involve. The transferential object needn’t be Brad Pitt or whoever is the latest heartthrob.

Well, the odd man I’m describing owned lots of “presence,” an indefinable quality of strength or self-assertion, self-confidence, or magnetism setting an individual apart from others. One might describe it as an aura of sorts.

Most of humanity becomes invisible in a crowd, while those with “presence” stand out no matter their size.

Thus, perhaps it should be without surprise to discover the physician I’m describing took one of his employees, a former patient of course, into his office about once a week.

The couch doubled as a foldout bed. If you entered his “castle” after she exited, the scent of sex remained.

Back to me. I confess I sometimes could be a bit too attentive to the faces and bodies seeking psychological assistance. At least my eyes were. As a psychologist, you need to remind yourself of what you are doing, what your duty is and return your attention to the patient’s needs.

This isn’t difficult if your role remains well-defined internally. Most get this right, I suspect. Otherwise, malpractice insurance costs would be closer to those of medical specialists.

Patients test therapists. Not all, but some of those whose life histories included soul-breaking physical and emotional violations.

A few push their new doctor with displays of anger or intimate provocation. They come to the consulting room with memories of people who appeared kind and turned cruel, the ones who offered comfort as an avenue to their own carnal and controlling advantage.

These injured folks don’t want to be hurt again. They plan attire and enticement to assure themselves the kindly and wise Dr. Jekyll won’t become Mr. Hyde. I also encountered a couple of traumatized women who brought small knives into the office in an attempt to menace me.

Safety and testing take many shapes. It can also serve to control the practitioner, rather than submitting to control by him.

I’ve read nothing about erotic transference and countertransference (when the counselor experiences a desire to pursue a client) specific to the new virtual, computer-mediated age of treatment.

It will be interesting if research informs us whether the power of transference can jump over and through the Zoom screen. I imagine it sometimes can.

From a distance of 10 years since retirement, my take on all this is that we psychologists and other helping professionals cannot but bring the whole of our humanity and personality into our vocation. Knowing yourself well as a healer means you should keep your focus and actions in check.

Of course, we are human, and humans do many things they shouldn’t. Be grateful, then, to find those talented professional souls who don’t, no matter their line of work.

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The first photo is of Ingrid Bergman and Mathias Wieman in a promotional shot from the 1954 movie Fear. The following image is a screenshot of Eva Marie Saint from On the Waterfront, also of the same year. Finally, a screenshot of Audrey Hepburn in War and Peace, a 1956 movie. All are sourced from Wikimedia Commons.

17 thoughts on “Erotic Transference and the Fantasy Lives of Therapists

  1. I found this post very interesting. I appreciate your candor! Of course you are human but happy for you and your practice, marriage, etc you’re able to keep hormones in check!

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    • Thank you, Laura. Of course, by the time one reaches “senior” status, there are fewer hormones to keep in check than back when I practiced. I continue to learn more and deal with the new challenges of age and the strange world we live in — a world which your photos reveal as one where we can still find great beauty even in common and abandoned things.

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  2. It is nice to hear the perspective from the other side, that the therapist can be attracted to their patients. I never admitted this when I came here, but my former therapist stroked my bare arm while saying endearments, and then hugged me a couple of months into my therapy, which started me into my very confusing transference issues. I knew his actions were a mistake and not helpful to me, especially since I had started therapy because of abuse I had experienced in my teens from an older man in a position of authority. He got his act together but it was too late for me and my brain, which had been hijacked by his actions. He would occasionally hug me after a session throughout my time with him, which added to the flame. Eventually I left on my own accord, and was heartbroken, but I also knew it was the best thing I could do for myself. Thank you for this article, Dr. Stein.

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    • The nature of transference is such that it is always confusing, Nancy. Your use of the word “hijacked” is a good one. I’m glad you found and are finding a way to free yourself.

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      • He was a good therapist, and a kind, caring and affectionate man. Writing about this was not meant to disparage him, it is what led to my brain being overtaken which I strongly believe was related to my OCD in some way, if this makes sense.

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      • Appreciated, Nancy. I think when a psychotherapist begins to use touch as a routine or regularized part of his treatment he is potentially within a danger zone. Some ethics rules, depending on the type of therapist, are disinclined to support this. Touch finds roots deep within our personal and species history, reaching back to parenting, protection, sexual arousal, etc.

        Well-meaning counselors make mistakes. We wll do. But because we are in a position of authority, it is easy to be overtaken by our own hubris. At that point, “trouble” is simple waiting for its moment to enter the relationship and make it something complicated and untherapeutic if not harmful.

        Liked by 1 person

      • Thank you….you are a good an ethical psychologist.

        Liked by 1 person

  3. lydiahopebakker

    Thankyou so much for your honesty and humbleness!

    If my therapist was male I’d understand transference a bit more…. but mine is female so I’m really confused….

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    • Your are welcome, Lydia. The lines between sex, love, and gender are blurry. You might want to look at a book I found enlightening a number of years ago: Richard Posner’s “Sex and Reason.”

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  4. There is probably more “intimacy” (not the physical kind) in therapy, than between most married couples. 

    The term “transference” somehow negates the true feelings that can develop in the therapy room.  

    Yes, the whys and the hows of the feelings can be explored during sessions, and perhaps need to be answered, however, the fact that the feelings exist are irrefutable.  

    Don’t you think that the “transference” therapists talk about actually happens all the time in real life settings outside of therapy?  Aren’t most of our feelings toward others some form of transference?  How would you differentiate between the “real” and the “imagined” that the word “transference” implies?

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  5. You have echoed some of the comments I’ve made on this broad topic, especially those found here: Is Erotic Transference Ever the Thing We Call Love? Love is a potential “crazy-making” experience, a word encompassing so many feelings and actions, and so hard to define. Therapists need to honor the feelings of the patient, not discount them. One other point. Having feelings at the deepest level doesn’t mean they are useful or ultimately justifiable if they motivate extreme behavior. The contemporary political landscape demonstrates how they can lead to violent and subversive actions, and murder.

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  6. A fascinating topic. It sounds like you managed to survive the pitfalls and temptations of the profession.

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    • drgeraldstein

      Thank you, Rosaliene, but it wasn’t that hard for me. We don’t know our limits until we are tested. We pass some tests. With others, perhaps, not so much.

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  7. I’m in the strange position of seeing a therapist who, in response to something I said that was quite sexually provocative, bluntly acknowledged her attraction to me. It was a year into therapy and we had developed an obvious rapport and ease with each other (despite my initial resistance to it).

    Her response (becoming overwhelmed and flustered in the moment) came as a genuine shock to me, and I wasn’t sure how to react to her comments that she’d never had anything like this at work before, and that she was worried that her feelings were becoming the focus of the work, which wasn’t right. When we ended the session shortly thereafter, I was convinced I’d done something wrong and that therapy would come to an end.

    However in the next session she did something remarkable (at least to me): she fully acknowledged her feelings for me, she ‘owned’ them, and she made no excuses or apologies (apart from putting me in an awkward position). She told me that it wasn’t my fault, and that the feelings were brought about by the intimacy that we had built, and the hard work we had put in together. She also said she didn’t always feel that way with the same level of intensity – and that if she did then she’d have to do the right thing and find me someone else. She’s never gone into detail about her feelings entirely, and I’ve never asked.

    That was two years ago. Since then our mutual attraction has been a source of frustration, excitement, strength and comfort. It’s there in the room with us, although we barely touch on it. Certainly she never initiates discussion about it, and I rarely do. It’s acknowledged, we can smile about it and occasionally enjoy the warmth it creates, and then move on.

    It’s wrapped up in all kinds of other feelings of care, respect and reciprocity and is just one part of a genuinely rewarding and helpful relationship. I know she works hard outside our sessions to manage and understand her own feelings and actions and I have nothing but 100% respect for her dedication to me (and to her career). She also never makes me feel anything other than cared for and considered.

    So it’s a force for good between us. A little odd, I know, but there you go.

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    • drgeraldstein

      This is much appreciated, Elliot. Normally, once the issue of erotic/romantic transference is raised, it usually requires more conversation than it apparently received. The question of your therapist’s feelings not compromising her ability to treat you is half the equation. What it is doing internally to you seems not to have been addressed very much, nor the possibility that it requires more therapeutic attention. All that said, “the fact that you are reporting it to be a “force for good” counts on the side of a continuing and productive formal relationship. Continued good luck with your psychotherapy and in all else in your life.

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  8. Thank you for this article. I am a life coach and a psychedelic integration specialist. I still practice although I am already retired so not having a license to protect, there is not a looming threat of “potential public humiliation, financial ruin, and vocational catastrophe” but I do have malpractice insurance and I can trust myself to honor the basic ethics that should apply to everyone in a helping profession.

    I work with people all around the world and 90% of the time I spend with others is over zoom. That’s why I am writing to let you know that transference and countertransference can definitely happen over zoom.

    I would say that it is more likely to happen when both parties live close enough to physically meet even if they never do.

    I have experienced countertransference and I did physically meet with a client after explaining transference and countertransference to him and then while we were together, I vowed to him that I will honor the ethical standards meaning that I would not pursue any type of unethical relationship with him.

    Admitting our feelings for one another and then making a vow to one another that we would not act on what we both consider to be unethical (since he is married and committed to someone else as well) and this seemed to resolve the issue for both of us.

    We aren’t meeting regularly as much as we had before but we do occasionally meet over zoom and are able to share and talk without any distracting attractions, compulsions or aversions towards one another.

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    • I apologize for this thoughtful comment not appearing on my blog until now. Unfortunately, it landed in spam, which generally absorbs real spam and not worthy thoughts such as those you offered. In any case, your words are much appreciated.

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