Erotic transference is troublesome. Counselors are trained to view its occurrence in one way only: a counterfeit of real love. Sexual feelings toward the therapist are pathologized, made into a kind of specimen for microscopic examination rather than something more basic. Is there another way? Are a patient’s affection and desire for the counselor ever no different than the early stages of romance? Perhaps we therapists go too far in making something unusual of a thing we might otherwise call love.

For those unfamiliar with the topic, I’d suggest you read my 2015 essay before proceeding. The psychoanalytic view of erotic transference refers to its infantile nature, an unrealistic and intense quality of “wanting” presumably not found in other romantic attachments. The contrast with non-clinical love is emphasized more than the likeness.

What I wrote in 2015 reflected the field’s accumulated wisdom and the observations of countless practitioners who recognized the amorous gaze of the patient across the room: the look that signaled “I only have eyes for you.” The allegedly misplaced affection is a common therapeutic occurrence, marked down because of its commonness and the clinician’s need to guide the process toward a therapeutic end, not a romantic one.

I am not talking about the extreme of erotic transference, where desire becomes obsession and stalking. Within the less acute expression of feelings, however, I would include those patients who profess their love (or keep it secret), say their genitals lubricate (or, for men, become erect) in session; offer themselves in words, dress to seduce, and bring suggestive gifts to the doctor. All these happened in my practice. They happen in every practice.

More than rejection frustrates such clients. They can feel discounted, their yearning made into another treatment issue to be worked on, worked through, and worked-over. They are told their emotions will likely disappear even if those stirrings are the most enlivening experience in their lifetime. The therapist’s intellectualization of the heart-throb and heartache makes the matter of the client’s heart a conundrum for the doctor’s head. The patient and practitioner then operate in two universes: the former feeling the issue, the latter thinking about it, unless he reciprocates the patient’s sentiments.

My profession considers erotic transference a kind of mistaken identity due to your history and because of the nature of treatment. A sensitive and wise healer gives all his attention, looks in your eyes, and accepts you without judging. You know little about his personal life. You automatically infer qualities in him for which you have no evidence, unconsciously imagining he is like the loving parent you never had (for example). He seems to fill a vast, cavernous, lonely gap in your heart. All true, but not so different from other infatuations.

Perhaps we would do better to recognize that love often depends on what we don’t know about the other, not only what we do. How many people understand the partner well before they fall in love? Many questions have not been asked – may never be asked and answered by words or observation. This is true in the extreme for young people, where the right questions are not yet known. They do not even know themselves. Hormones rule the day.

Counselors also should admit – especially in this day of therapists’ websites describing their practices, listing credentials and schools attended, and maybe even including a blog (!) – that we aren’t the blank slates we believe ourselves to be. Unless seated behind the reclining patient’s pillowed head, we have always had a physical presence, tone of voice, a smile, laughter, and movement. No, the client is not dealing with a shadow or computerized speech.

In almost all fresh attractions, aren’t the fantasy, the newness, and imagination what it means to be in any romantic, early-stage love? Throw in uncertainty, idealization and physical urging. These are among the most magical and wondrous qualities of romance. Over the long haul it can be argued that loyalty, devotion, kindness, respect, similar interests, proportion, compatible values, pulling together, and shared experience are more important, but they do not send a shiver down the spine.

Devotion does not levitate, no matter however precious and essential.

Therapists are not the only people about whom one experiences transference (or stimulus generalization). Has not a new person reminded you of someone else in your past? Think for a moment:

• Bosses, teachers, the next door neighbor.
• The neighborhood bully, father and mother figures.
• Political leaders.
• Mentors, the people we instinctively dislike, and those we are automatically drawn to.

If I am right, the therapeutic management of transference requires a different kind of sympathy, more recognition for the genuine nature of what is in the patient’s heart and the sensual pulse in her being. This will be difficult for the therapist, rather like dealing with someone who says “I love you” outside the controlled atmosphere of his sealed-off office; with its sex-discouraging moat, doctor-patient ethical boundaries, and the requirement of therapeutic distance.

All this suggests that the process of her “getting-over” erotic transference may not only be a matter of uncovering the mistaken identity nature of feelings more properly attached to other people and earlier times, and releasing emotions derived from past relationships. The unrequited love then demands grieving not unlike other lost loves. Perhaps such grief-work can only be managed with a different therapist, although – one hopes – after the remaining treatment goals have been accomplished.

Though many counselors know better, those who believe the mistaken identity only happens in the office need to think again. The same patient who falls for you might already have fallen for others who reminded her of a loved one, with as little ability to look past the transferential aura to the truth of who her partner really was.

One more thought. Should therapists give a written warning to all their new clients?

BEWARE! YOU MIGHT FALL IN LOVE WITH ME!!!

If you are laughing for more than a few seconds, begin reading again at the top.

—

The first (undated) photo, School Cafeteria, was taken by the Adolph B. Rice Studios and comes from the Library of Virginia. The following picture of Swimmers Annette Kellerman and C.M. Daniels was taken in 1907 by G.G. Bain and is the property of the Library of Congress. Both are sourced from Wikimedia Commons.