Erotic Transference in a World of Online Therapy

 
What happened when therapy became virtual at the pandemic’s beginning? Did erotic transference die quietly because of the physical separation of counselor and client? Did the small screen reduce the scope of sexual feelings?
 
Perhaps not, since I read no obituary in the news. Still, it is worth thinking about what has become of the inevitability of desire in the human interaction of some who seek treatment.
 
Erotic transference refers to the patient’s growing sexualized affections for the clinician in talking about her feelings and the significant players in the drama of her life. Parents, caretakers, past lovers, abusers, or others might metaphorically slip into these one-to-one settings unseen, producing an outsized and complicated response to the therapist.
 
The analyst begins to evoke dormant emotions he didn’t create.
 
In the pre-pandemic period, all sorts of detailed cues existed within the office, qualities that might have contributed to the sexualization of the other. The consulting room made these accessible to the client in a way they are not on a computer screen.

A shortlist included the following:

  • A view of the entire face and clothed body, front and back, bottom to top.
  • More noticeable eye contact.
  • Grooming characteristics and their impact on the sensory organs of the observer. Subtle skin tones, makeup, natural bodily scents or odors, perfumes, shampoo emanations, cologne, and pheromone production could encourage sexual arousal.
  • The way the person walked, moved, sat, reached, and shook hands.
  • His attire.
  • An intimate and unvarying background domain, quiet and the same each week.
  • The healthcare professional’s voice was unaffected by the distortion of a computer speaker or headphones.
  • Small facial expressions.
  • An absence of distractions as opposed to a less controlled setting.

Put simply, the office was an environment decorated and modified by the healer, made consistent and safe by him. It included objects little changed in successive sessions. Physical nearness to him was one of those stabled features.

Unintended changes from the old way of doing things should have worked against the emergence of passion in post-COVID treatment relationships. But perhaps there are other considerations:

  • The current unavailability of nearness to a doctor or psychiatric social worker might make them more attractive to some people. Imagine a client whose past experience with parents or lovers included their tendency to push her away or display inconsistency in expressing affection.
  • A new analyst, “out of reach” due to a change in the provision of psychotherapeutic services, could serve unconsciously as another chance to achieve the kind of love she’s searched for, the person “difficult to get.”
  • Unlike the doctor’s office, online contact gives the patient possible control of 50% of the framework for the meeting. Clients set up computers in bedrooms, bathrooms, automobiles, nearby pools, and other locations.
  • Although not all possess the ease of finding privacy, some capacity to arrange the decoration, lighting, and background is more available than prevails in another person’s building.
  • Since travel to and from the psychologist’s location is unnecessary, attire can also be controlled and sexualized.
  • Without the need to leave home, it becomes easier to drink alcohol or use other substances to disinhibit one’s emotions and become more provocative.
  • Many people watch TV and movies on their computers, iPads, and phones. The device thus transforms into a place of “performances.The sexualization of the session exists in a world of potential unreality, encouraging a client’s inclination to take a performative risk.
  • The power of words, an analyst’s kindness, and a level of attention the patient might never have experienced can still serve as potent aphrodisiacs. Remember, love relationships began and survived in the pre-computer age of letter writing.
  • In 2020 pet ownership rose to 70% of American households. Pandemic-driven starvation for physical contact and touch (skin hunger) may explain a part of this phenomenon. It might motivate an increased want for the caress (and more) from someone who appears devoted to your wellbeing.

To sum up, we don’t know the extent to which virtual (online) therapy increases or diminishes erotic transference. Many of the various effects of the pandemic are little studied, leaving anecdotal evidence at best.

We all recognize that humanity would not exist but for sexual appetite. Sex and love endure through wartime, plagues, environmental destruction, and more.

Think of Penelope, the wife of Odysseus, in Homer’s Odyssey. She waited 20 years for her husband’s return when he left to fight in the Trojan War.

The power of another’s gaze, warmth, careful listening, and voice remain available to us, no matter the change in therapeutic format. The enlarged distance from the therapist might even enhance his sense of mystery.

The hope for intimacy and the heartbeat of desire have survived with less assistance.

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The first image is called Sculpture in Paradise by Philip Jackson, located at the center of the cloisters of Chichester Cathedral. The photo is by surreyblonde from Pinterest. Next comes Khao Luang Cave Temple, Phetchaburi, Thailand, sourced from Cheezburger.com/ Finally, Factory Butte, Utah, a 2019 work by Laura Hedien with her permission: Laura Hedien Official Website.

16 thoughts on “Erotic Transference in a World of Online Therapy

  1. https://tamarakulish.com/

    I was wondering how the pandemic affected people in therapy. I suppose we’ll find out more as time goes by.

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  2. drgeraldstein

    Absolutely, Tamara. What I hear anecdotally is probably what you read in the news. Sessions reportedly involve much more talk of disease, fears of many kinds for children and family members due to future uncertainties, political concerns and loneliness. It is a difficult moment in or out of treatment. Thank you for commenting.

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  3. Very insightful post and so right on target. I find it somewhat more relaxing and easier to “chat” when in my own environment on Zoom/facetime. Less distractions.

    Liked by 1 person

    • drgeraldstein

      Thank you, Laura. I might add that therapists I’ve talked to tell me that their experience is also a complicated one. Some say the needed intensity they must bring to virtual treatment (because their observations of the clients do not come so easily as they do in the office), causes them to be drained more easily. Their remedy is to shorten their days and build in more rest between sessions if they are able.

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  4. Dr. Stein, since I’m not in therapy, in person or online, I have no meaningful contribution to make to the topic raised. However, I have experienced what may be described as erotic transference with two men in Brazil–one married, another gay–who were very sympathetic and caring about my plight.

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    • drgeraldstein

      Your comments are always enlightening, Rosaliene. Even in this instance. I think your experience with these two men produced something analogous to what psychotherapy patients feel.

      Liked by 1 person

  5. I can’t speak to the erotic transference topic as regards teletherapy, but can say that I find it somewhat impersonal and lacking a certain connection or intimacy. It’s talking to a head/face on a screen, a person but not really…just an image of a person. And, to boot, there’s also a little nagging worry of who else could be listening in behind the scenes, be it someone else in the therapist’s residence or a computer geek who hacked one or the other participant’s account.

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    • drgeraldstein

      Very interesting ideas, Brewdun. I think you aren’t alone re: impersonality. As to other listeners, therapists worry about it, too, as well as what the patient is doing that they cannot see. Thus far, the limited data suggests patients are just as happy with virtual therapy, but I wonder whether that is also true for those whose past experiences allow them to compare one kind to the other.

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  6. I was initially resistant to Telehealth, but I have found it to be an excellent experience. I feel as if we are conversing in the same room, we have an easy rapport, and my therapy has been effective. I also have the added bonus of not having to drive an hour to see him. The only transference I feel for my psychologist is warmth and appreciation for a job well done and awe for someone who is smart, well-educated in many ways, and caring without being mushy. I consider Telehealth a win win. I also chuckled at the first photo on this post. Where do you find this pics?

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    • drgeraldstein

      The absence of travel is certainly a win-win by all reports, Nancy. And the initial reviews of therapy outcomes are positive. I am also sure there are individual differences, as Brewdun’s comments suggest. The photos not from Laura Hedien are from sites like Pinterest, wikiart.org/, the Art Institute of Chicago, and other places. In the course of searching them out, I discover I am also learning more about visual art, sculpture, and photography.

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  7. I agree with Bewdun about her experience, and I have read comments in other forums that parallel her experience. I would like to meet my therapist one day in person and hopefully this will happen if the virus subsides. You make appropriate choices to match the theme of your articles, which shows you have a keen eye.

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  8. drgeraldstein

    Thanks, Nancy.

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  9. I am seeing my therapist in person, for nearly 5 months now, and wonder if it all would be different over zoom. I have strong transference, in a few different ways (depending on the day!), and question if my feelings would be this intense if we met via telehealth. I also wonder if the therapy would be as effective…my feelings for him have clearly dragged up things in my life that need some attention, and it happened pretty quickly. (Your posts were some of the first I read on the subject, a few months ago, and they helped so much! Thank you!) I could really go off topic here but am reigning it in. 🙂 My theory is that I’d still have felt the same things but it may have taken longer if we met virtually. These feelings now feel nearly as big as what I came into therapy for, but it’s all less scary as we continue on. Thankfully in person. 🙂

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    • drgeraldstein

      Thank you for your praise, Steph. I’m glad my posts helped.

      You raise an interesting question about possible differences in the emotional/relational impact of Zoom vs. in-person contact. The proliferation of Zoom as a therapeutic medium is so new I doubt the question has been adequately researched. As to the effectiveness of virtual vs. in-person treatment, the early reviews don’t point to one being better than the other. If that holds up, however, I wouldn’t be surprised if virtual treatment is better for some folks and in-person for others. Thank you again for commenting. Take care.

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  10. To me, having online therapy for the first time in my life during this pandemic has really helped me to feel safe. I initially felt some erotic transference with my female therapist during the first few months of being online with her – first by phone for March and maybe April of 2020, then via the VA’s video connect system from May 2020 on forward (I believe, if I’m remembering correctly – give or take a month or so). But I, having dissociative identity disorder, was able to express more freely with her and others helping in the Vet Center’s office when she wasn’t available during my crises. My alters came out more (given that the pandemic was itself traumatic, along with Asian-hate trauma that I, being Asian, had also experienced online and even among “friends”). I was in perpetual crises in 2020 and parts of 2021, and the many hotlines at my disposal truly helped me cope at that time. In 2021, my therapist was finally able to see me twice per week online. She had left the Vet Center and worked in private practice, but she accepted my Medicare, which allowed me to continue care with her. I now pay copayments out of pocket, but she is really worth it!

    I now see her via a different telehealth system, but I’ve managed to truly benefit from our biweekly sessions online. I was able to slowly work through my fear of leaving my apartment, and I’m still working on it. I’ve been able to go on walks with my recreational rehabilitation therapist at the VA, who meets me at my home and walks with me in the local area where I live, since I reside about a mile from the VA. I’ve also sold many things through Craigslist by meeting people outside (I still double-mask whenever I leave my apartment, even just to get mail). And I’ve went on walks at the VA with other veterans – sometimes removing my mask while outside, if the test positivity rates are below 5%.

    Overall, my erotic transference had increased in the beginning of our online sessions and then dissipated a few months later. By about the middle of 2020, that form of transference was gone.

    I can’t speak for other people, but it was always harder for me to do therapy in person, though I do miss seeing my current therapist in person. But being that I have chronic fatigue syndrome, fibromyalgia, and other medical issues, telehealth has been a tremendous help for me. I used to cancel many of my in-person appointments throughout my life (as well as call in sick from work or school) because of my CFS/ME. But with the options to do many things from home, I was able to be more consistent. I used to average missing a session about once every month. But with my current therapist, I’ve not missed one session at all!

    Perhaps erotic transference occurred faster yet shorter for me because of our online platform (being in person would have meant a longer time to experience erotic transference and I think a longer time to resolve it, if it was ever resolved). But perhaps that’s just me and my different types of comorbid mental illnesses.

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  11. A terrific set of developments, Dragon Fly! I am delighted with your progress. You sound as if you are in good “virtual” hands. You remain a brave soul!

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