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.

What Does Erotic Countertransference Look Like?

Words are hard labor. Let’s therefore add some pictures. The moving kind in matters of the therapist’s heart.

Much is written about erotic transference, but this is countertransference. Ladson and Wilton (2007) report:

The intense emotional experience of countertransference in psychotherapy … is not rare. Some studies have reported 95 percent of male therapists and 76 percent of female therapists admit they felt sexual feelings toward their patients.

The above video, from the HBO series In Treatment, offers you a glimpse. Enough to know — if you are open to knowing — how a therapist’s erotic countertransference can divert psychotherapy from its intended aim.

Observe TV’s portrayed counselor (Paul). His discomfort is evident in his speech, his body, his silences. The grip on his role is slipping.

The first and last two minutes of the nine-minute excerpt offer the session and the words. The center segment is given over to silent film.

Do you believe their relationship will turn out well? Do you think office hours will remedy the problems for which Laura booked her first appointment?

The second clip begins with Paul looking for guidance from his analyst Gina. He has lost himself to a mutating agenda. Laura came to him to improve her psychological state. This man was sought as an expert healer, not a man soon to be in love.

The pair now struggle with a different goal. Doc Paul is like a person hanging from the wet window ledge of a twenty-story building. The strength and clarity of the woman who is his client will overpower his ambivalence. The flashing EXIT sign makes no difference.

The most remarkable moment in these two fragments opens at 7:47 of the first one. Paul is told who he is, what his weaknesses are, by his perceptive patient … and that she loves him just as he is. No wonder the ledge is slippery. To be known and accepted — here is the ultimate aphrodisiac.

You might be stirred or troubled by your own transferential emotions if you are in treatment yourself. Perhaps you hope for physicality, but should the professional’s self-control crumble, the collapse renders impotent all his education and ethical resolve; and your safety with it.

A therapist must draw a line never to be crossed.

Lower your eyes to his office floor. The indelible mark was present long before your meeting.

Any other barrier, more movable or less precise and clear to him, risks injury to both of you.
STOP signs help only if you recognize where to look, and the brakes still work.

Interview with a Therapist

Who knows what a therapist might say under the influence of truth serum? Well, upcoming are unguarded words from this writer, a counselor retired, but not retiring from the challenge of interrogation. No drugs were necessary, but some background first.

I recently was named one of the 2017 Top Therapy Bloggers by Online Counseling Programs. How nice, I thought. Yet mingled with my gratitude came a second nagging question: why not the one and only Top Blogger of 2017? And then, why just 2017? Why not the top therapy writer of the decade? Or top blogger in the universe? Ah, well, I’ll have to make do. Life is tough.

Oh yes, the interview. The kind folks at Online Counseling Programs asked me nine questions. If you’d like an overview of my perspective on sexual attraction to patients, the training of psychologists, the challenge of maintaining boundaries, how the therapist (not the client) is changed by therapy, and the specifics of my career, you’ll find a good deal in my interview responses.

Another therapist would give different answers, although those currently in practice are careful not to share much about themselves. My retirement gives me the freedom to say a few things active counselors are wise not to touch. Please don’t assume they’d respond in the same way even if they were retired. What I offer is my perspective only, not unassailable truth.

Here are the questions:

  1. When and why did you originally create your psychotherapy blog?
  2. What do you hope to achieve by maintaining it?
  3. We highlighted your recent post, “The Arc of a Therapist’s Emotional Life,” because you offer such insightful musings on the therapist’s emotional life as it informs and is shaped by his professional work. One of the points you make is the difference in sympathizing versus empathizing with clients’ emotional states. How would you recommend that mental health professionals in training maintain emotional boundaries with their clients?
  4. Can you walk us through what motivated you to become a psychotherapist, as well as the educational journey you took to get there?
  5. How have you seen your blog and profession evolve over the years?
  6. During your nearly three decades as a practicing psychotherapist, what would you say were your most challenging and rewarding experiences, and why?
  7. What advice would you offer to aspiring psychotherapists?
  8. Music plays a major role in your blog. What has been the value and influence of music in your practice of psychotherapy?
  9. Is there anything else you’d like to add?

My answers? Click here.

The top image is a still photo of Harold Lloyd from his 1920 silent movie, High and Dizzy.