The Erotic Countertransference: The Therapist's Sexual Attraction to the Client

In an earlier article, Psychotherapy and the Erotic Transference: Falling "In Love" With Your Psychotherapist, I discussed clients' erotic feelings (also known as transference) for the therapist, the struggle that clients often have with these feelings, and how these feelings can be worked through with the therapist in a way that furthers the work in therapy.  As mentioned in the earlier article, a client's erotic feelings for his therapist is a common issue in therapy.  In this article, I'm focusing on the therapist's erotic feelings (also known as countertransference) for the client.

The Erotic Countertransference: The Therapist's Sexual Attraction to the Client

Psychotherapists who have been trained psychoanalytically are aware that they can develop erotic feelings for some clients. Knowing in advance that this will occur at some point and being trained on how to deal with it in an ethical way helps therapists to be prepared for these encounters, and it allows them to handle these issues in a way that isn't harmful to the client or their work together.

Before I go any further, I want to make it clear that psychotherapists know that it would be a serious boundary violation to get sexually/romantically involved with the client whether that involvement occurred during their work together or even after the client terminated therapy.  Unfortunately, although the vast majority of therapists are ethical, there are some therapists who act unethically.  Fortunately, they are in the minority (see my article: Boundary Violations and Sexual Exploitation in Therapy).

A therapist who has in-depth psychoanalytic experience, knows how to attune to what's going on in her internal world, with the client, and in the intersubjective space between the client and therapist.

She is also able to  momentarily dip into her own subjective experience in a way that's useful for the therapy (see my article: Psychotherapy: A Unique Intersubjective Experience).

For instance, as an example having nothing to do with sexual attraction, while she is listening to the client, a particular song might pop into the therapist's head, and she would ask herself if this song has any relevance to the client or the therapy session. She would ask herself if this is a way for her unconscious mind to give her more information that she might not be picking up on consciously? (see my article: Making the Unconscious Conscious).

There can be many reasons why a therapist might feel sexually attracted to a client.  On the most basic level, some people, including clients in therapy, naturally exude a certain sexual magnetism.  Since part of the therapist's job is to be attuned to the client, she could be picking up on this magnetism.

Another common reason is that the client might be flirting with the therapist as part of a defense mechanism to divert the conversation from things that make him uncomfortable in the session. For an experienced therapist, this is usually easy to see and would need to be addressed by the therapist in a tactful way.

Another issue might be that the therapist might be at a point in her personal life where she is not romantically, sexually or emotionally fulfilled.  As a result, she might experience these unfulfilled needs in the therapy room with the client.  This is why it's so important for psychotherapists to be attuned to their own personal needs so that they don't make ethical mistakes.

The Erotic Countertransference:  The Therapist's Erotic Feelings For the Client
The following fictional vignette is based on many different clinical cases.  It illustrates how the therapist attunes to her own internal experience and how she uses this attunement to discover the meaning of her experience and how it relates to the work with the client.

Gina
Gina, who was an experienced psychotherapist, realized that she felt a sexual attraction for Jim, after their first session together.

As a seasoned psychotherapist whose original training was in psychoanalysis, Gina knew that it was common for both clients and therapists to have attractions for each other.

Not only had she learned about the erotic countertransference in her original analytic training and in her extensive supervision, she also experienced this occasionally with other male clients.  She and her colleagues also discussed this phenomenon in their peer supervision group.

Although she was clear that she wouldn't act on her attraction based on ethical and clinical reasons, there was something different about this experience as compared to other earlier experiences that concerned her.

So, rather than ignoring her sexual attraction, she paid attention to it, and after her second session with Jim, she thought about whether there was something familiar about him that might be triggering these feelings.

She also talked to her own psychotherapist about this sexual attraction in her next therapy session.  Since her therapist, Ruth, knew Gina well from having worked with her in her analysis for over 15 years, Ruth listened intently as Gina described the sexual feelings that came over her during the first two sessions with Jim.

As Ruth listened to Gina describe this attraction, she realized that Jim had similar characteristics to Gina's husband, who died several years before.  She knew that even though Gina had gone through a period of grief and mourning, she still missed her husband a lot.  She also knew that Gina had been unable to motivate herself to begin dating again even though several years had passed, which left Gina feeling lonely.

As they talked about the similarities, including appearance, between Jim and Gina's late husband, Gina felt a deep sadness come over her that she had not felt since Jim died unexpectedly.  Although she saw the striking similarities between Jim and her late husband, Gina also saw the differences, and as she began to differentiate the two men and her feelings towards them, she began to feel a little better.

These feelings for Jim were also a signal to Gina that she needed to take better care of herself and that her loneliness signaled that she might be ready to explore dating again--even though she had mixed feelings about it.

During her next several sessions with her therapist, Gina explored her ambivalence about dating.  Part of her hesitation was that she continued to feel loyal to her late husband, and she wasn't sure how she would feel dating someone new.

But she agreed with her therapist, Ruth, that she could take it one step at a time, and she was under no obligation to date anyone.  So, she thought of her foray into dating as a way to explore her own feelings and the next step in her mourning process, which included an acceptance that her husband would never come back.

This acceptance that her husband was gone forever brought a new and deeper wave of grief for Gina. She knew from her own training and clinical experience that this was a normal part of grief and mourning as time went on.  So, she continued to talk to her therapist to address her own emotional needs in her therapy and separate out these needs from her work with her client, Jim.

As Gina took care of herself emotionally by talking to her therapist about her emotions and to her friends, who were also colleagues, about her attraction to Jim, she noticed that her attraction began to diminish.  Her work with Jim continued without interruption to his clinical process in sessions, and the therapy was going well.

A few weeks after Gina started seeing Jim as a therapy client, she noticed that she no longer felt an attraction to him.  She could see the resemblance and similarities to her late husband, but she also saw Jim clearly for himself as an individual.

Four months later, Gina began dating again.  She met a man who was also a widower and who understood her mixed feelings about dating.  As she continued to see him, she realized that her feelings for her late husband would never change, and there was room in her heart for both her late husband and for the new man that she was beginning to really like (see my article: A New Relationship: Understanding the Loyalty Dilemma For Someone Whose Spouse Died).

As her emotional needs were met in her therapy, with friends and colleagues and with the new man that she was dating, Gina felt more emotionally fulfilled.  With time, her client, Jim no longer reminded her of her husband because, although there was a physical resemblance, she could now differentiate more clearly that they were two very different men.

She was glad that she took care of herself and used her resources in therapy and among friends and colleagues to deal with the countertransference issues related to her therapy with Jim.  She recognized that, in many ways, it was similar to what occurred occasionally with other clients in the past, but she also saw why her feelings were so heightened with the similarities to her husband.

Conclusion
Both clients and therapists can develop sexual attractions for each other.  It's usually related to transference for the client and countertransference for the therapist.

Therapists have an ethical responsibility to be aware of their feelings and, for the sake of the client and the integrity of the therapy, not to act on their feelings.

Occasionally it happens that a therapist, who sought help in her own therapy, in supervision and among colleagues, is still unable to handle the countertransference, she has a ethical responsibility to refer the client to another therapist rather than act on her feelings or continue to be in conflict about them.

It's of utmost importance that therapists have a strong sense of self awareness and engage in self care so that they don't compromise a client's therapy.  As in the fictional scenario above, this means that the therapist must have the necessary skills and training to self reflect on her own internal process and do what she needs to do to take care of herself.

Although it was not discussed in this article, there are times when both the therapist and the client have a sexual attraction for each other.  In those cases, even if the client behaves in a seductive way, it's the therapist's responsibility not to cross a boundary with a client.  She must analyze her own feelings as well as the clients to understand the root of the issue for each of them and then proceed in an ethical manner to do what's best for the client while taking care of herself.

Getting Help in Therapy
Most well-trained psychotherapists are aware that they will occasionally feel an attraction for a client.      This is a common experience.  Most of them will also know that this probably has less to do with the client than it does with whatever is or isn't going on in their life.

Although sexual boundary violations do occur from time to time, most therapists take their Code of Ethics, which states that therapists cannot be in a dual relationship with a client, seriously.  They know it would be devastating to the client, their work together and it would also jeopardize their professional license if they crossed this ethical boundary.

If you're already in therapy and some of the issues in this article resonate with you, you would probably benefit from discussing them with your therapist or, if you're not comfortable with that, seeking a consultation with a different therapist to discuss what's going on in your therapy.  Most of the time these issues can be worked out, but if you tried and they can't be resolved, you can also seek help from another licensed therapist.

We all need help at some point in our lives.  If you're not in therapy and you're struggling with unresolved issues that are creating obstacles in your life, you deserve to get help from an experience licensed mental health professional.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR, AEDP, Somatic Experiencing and Emotionally Focused therapist, also known as EFT (see my article: The Therapeutic Benefits of Integrative Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

What is Transference in Psychotherapy?

I have discussed transference in prior articles (see my articles: Psychotherapy and the Positive Transference and Psychotherapy and the Erotic Transference).  I wanted to discuss transference in more detail in this article so that clients who are in therapy or thinking about going to therapy will have a better understanding of this concept.

What is Transference in Psychotherapy?

The concept of transference was originally developed by Sigmund Freud when he was developing psychoanalysis.  He described various forms of transference in psychotherapy, including the positive transference, negative transference, erotic transference, parental transference and so on.

Here is a simple explanation of transference for psychotherapy clients who might be curious:  Typically, transference occurs when the client unconsciously "transfers" feelings that s/he had during childhood from her primary caregiver to the current psychotherapist.

Since this phenomenon is unconscious on the client's part, s/he usually isn't aware that these old feelings are being superimposed on the relationship with the psychotherapist.

If the transference is positive, it usually means that the client and psychotherapist have a good therapeutic relationship and, in most cases, the therapy is going well.

If the transference is negative, it means that there is some conflict between the client and the psychotherapist or some obstacle in the therapeutic work, and the client has negative feelings about the therapist.

During the course of therapy, the client's transference can switch back and forth between positive and negative or other forms of transference.

Many clients aren't aware of the term "transference" because the term is a form of psychotherapy jargon, and most therapist would find a more accessible way of talking about the therapeutic relationship with the client without resorting to jargon.

But clients who are interested in psychotherapy and possibly thinking about becoming a psychotherapist will often read this term and wonder what it means.

Transference is not a phenomenon that is exclusive to psychotherapy.  We all experience various forms of transference all the time in our personal and work relationships.

For instance, if you resented your authoritative father as a child, you might unconsciously "transfer" the feelings of resentment from your father to your boss at work and develop a negative transference for your boss--regardless of whether your boss is authoritative or not.

This doesn't mean that you still don't resent your authoritative father.  It just means that your boss is a person who is in authority in your life, and regardless of whether your boss has an authoritative personality or not, on an unconscious level, you have similar feelings towards your boss (and possibly other authority figures) as you did (or do) towards your father (see the vignette in my article: Contemporary Psychotherapy: Redefining the Traditional View of "Resistance" in Therapy).

Similarly, if your boss unconsciously reminds you of your grandfather, who was kind to you, you might develop a positive transference for your boss without even realizing how your feelings for your boss are connected to your grandfather.

Many psychotherapy clients "fall in love" with their psychotherapists.  I put "fall in love" in quotes because they're not actually in love with the therapist.

Most of the time, their feelings are based on a fantasy of what it might be like to have a personal relationship with the therapist.

This fantasy might have nothing to do with what it might actually be like to have a personal relationship with the psychotherapist (see my article: Why Your Psychotherapist Can't Be Your Friend).

Clients who experience an erotic transference for their therapist often worry and feel ashamed of their feelings, but this is a common experience in therapy.  Usually, the erotic transference dissipates over time as the client gets a better sense of the therapist as a ordinary person, the client develops more objective feelings for the therapist, and the client finds other attainable love interests in the "real world."

Although transference is an important concept in psychotherapy, not all feelings towards your therapist are about transference and it's important to be aware of this.

For instance, if your psychotherapist has said or done something in therapy that bothers you, your feelings shouldn't be dismissed by the therapist as being only about transference.

The real issue between you and the therapist needs to be addressed (see my article: How to Talk to Your Psychotherapist About Something That's Bothering You in Psychotherapy).

In future articles, I'll discuss other forms of transference.

Conclusion
Everyone experiences transference in all kinds of relationships--not just their relationship with their psychotherapist.

Transference usually happens on an unconscious level.

If you're in therapy and you're uncomfortable with your transferential feelings for your psychotherapist, you can talk to your therapist about it.

Psychotherapists are usually open to talking about transference, and you'll probably feel better to get these feelings out in the open.

Getting Help in Therapy
If you're feeling stuck in your life or you're unable to overcome a problem on your own, you could benefit from attending psychotherapy (see my article: The Benefits of Psychotherapy).

Rather than suffering on your own, you owe it to yourself to get help from a licensed mental health professional (see my article: How to Choose a Psychotherapist).

Whether you need emotional support or if you need help overcoming psychological trauma, a skilled psychotherapist can help you overcome the obstacles that are keeping you from living a more fulfilling life.

About Me
I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist and I use Integrative Psychotherapy (see my article:  The Therapeutic Benefits of Psychotherapy).

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 or email me.

Erotic Transference for Group Leaders

In an earlier blog post, I wrote about the erotic transference that occurs in psychotherapy treatment where a client develops erotic feelings, often unconscious, for the therapist and vice versa.  This is a common phenomenon in psychotherapy and therapists who have psychoanalytic training are trained to deal with this issue, whether it's the client having erotic feelings for the therapist (more commonly) or the other way around.  Much has been written about the erotic transference in therapy.  But erotic transference can occur in groups as well where group members develop erotic feelings for the group leader.

The Erotic Transference of Group Leaders

Group Leaders Are Often Idealized
Group leaders, including schoolteachers, seminar instructors, college professors, and motivational speakers are often embued with certain idealized qualities by participants.  We're all familiar with the school girl or boy who develops a crush on the teacher.

The Erotic Transference of Group Leaders

These crushes can be very intense at times, consuming a student's thoughts with fantasies of going out on a date, having sex or having a romantic relationship with the teacher.  A teenage student might sit dreamy eyed in a classroom, staring at the teacher and thinkng about how wonderful the teacher is.  Most of the time, these crushes pass as teenagers develop the social skills to meet other students their own age and go on to have attainable relationships with their peers.

Erotic Transference for Rock Bands and Musical Groups
We also know that teenagers and young adults develop erotic transference for band members.  When I was 11 or 12, my friends and I used to debate about who was the handsomest and sexiest Beatle.   Some of us wrote stories about the particular Beatle that we liked (in my case, it was Paul McCartney) and then brought our stories into class to share with each other during lunch time.

We would fantasize about meeting our favorite Beatle and what that might be like.  It never once occurred to us that we really didn't know them and that they might be very different than our fantasies about them.

Other teens (and some adults) had an erotic transference for Tom Jones.  Few people of my generation would forget how young girls and women would throw their panties at him while he was on stage singng.  In prior generations, teenagers developed erotic transference for Elvis or Frank Sinatra.

Erotic Transference for Political Leaders
In politics, many women idealized and developed an erotic transference for President Kennedy, who was perceived as a young, handsome leader who would lead the nation into a new era.  He was compared to the legend of King Arthur of Camelot.

Similarly, many people have an erotic transference for President Obama, especially in 2008.  He was compared to President Kennedy and very idealized.

I remember going into a store in Manhattan at the time called East West Books and seeing a picture of President Obama up in the sky with an aura around him, as if he was a saint or a god.  I don't think anyone could live up to so much idealization, and we know that when those who idealized him were disappointed, many of them became disillusioned.  Politics aside, I believe that part of the problem was that, for many people, there was an illusion that he would be the nation's savior.  And who could blame anyone feeling that way given the problems in the country?  But whenever you put someone on a pedestal, whether it's a political leader or your romantic partner, there's no way to go but down.

Erotic Transference in Professional Small Groups
Erotic transference can occur in small group settings as well, even among psychotherapists.  As a psychotherapist, to keep up my skills and develop new skills, I attend professional trainings.  I find it very interesting to observe how therapists, who know about erotic transference, develop their own erotic transferential feelings for professional group leaders, in much the same way that young women develop crushes on rock stars.

For many people, even therapists, the erotic transference is like being  under a magic spell.   A group leader, who appeared to most people as being average looking before the workshop begins, is perceived as being very attractive, intelligent, sexy, and so on, once the workshop starts.  He or she is embued with all kinds of idealized qualities within the fantasies of the participants.  The participants often vie for the workshop leader's attention or want to sit next to him or her.

I remember one colleague telling me that she was in love with one of the workshop leaders, even though, in reality, neither she nor I knew him personally.  When I tactfully brought up the possibility that this could be an erotic transference, or at the very least an idealized transference, she rejected this  as being out of hand.  She was convinced that she loved him.  Inevitably, the spell was broken when he said something that disappointed her .

Erotic transference for group leaders is a common phenomenon.  Group leaders who are ethical don't take advantage of this because they know that this idealization is mostly fantasy, and it would be unethical for them to use it to manipulate or take advantage of the person (or people) with the erotic transference.

Erotic Transference in Group Therapy
Erotic transference also comes up in group therapy.  If a group therapist is properly trained, he or she, at the very least, won't engage in boundary violations.

Erotic Transference in Group Therapy

At best, the erotic transference can be used to explore the inner emotional world of a group member.  This needs to be handled with tact and respect  for all involved, especially the client with the erotic transference for the group therapist, and only if the client is ready and open to exploring it within the group or one-on-one with the therapist in a treatment environment that is safe for everyone involved.

About Me

I am a licensed NYC psychotherapist, hypnotherapist, EMDR and Somatic Experiencing therapist who works with individual adults and couples.

To find out more about me, visit my website:  Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Also see my articles:
Psychotherapy and Erotic Transference
Boundary Violations and Sexual Exploitation in Psychotherapy

Psychotherapy and the Erotic Transference: Falling "In Love" With Your Psychotherapist

When Freud first encountered the erotic transference among his patients, he was very concerned and he didn't think it was a useful part of treatment. But, as he continued to work with these patients and to explore the transference, he discovered that it was, in fact, a very useful part of psychoanalysis, and the transference could be worked through so that the patient could gain insight and grow in treatment.

Psychotherapy and the Erotic Transference:  Falling "In Love With Your Therapist

Psychotherapists who are psychoanalysts have rigorous psychoanalytic training as well as years of their own psychoanalysis so that they are trained to work with the transferential aspects of therapy, including the erotic transference.

But, first let's understand what we mean by the word "transference" in the context of psychoanalysis or psychodynamic psychotherapy.

What is Transference?
There are many explanations for transference but, basically, transference entails, primarily, unconscious feelings that clients develop for their psychotherapists where they usually "transfer" feelings related to their childhood. Transference can be positive, negative, idealized, erotic and so on.

Usually, the clients develop these transferential feelings based on unmet needs from their childhood, so that if their parents were cold and neglectful, they have a strong desire for the psychotherapist to fulfill these needs that weren't met by their parents.

When you consider that psychoanalytic clients meet with their psychoanalysts any where from 2-5 times per week, you can see how transference, in whatever form, would build up quickly. Psychoanalysts also usually delve into the most intimate aspects of a client's interior world, including dreams, which can also fuel transferential feelings.

Psychotherapy and the Erotic Transference:  Falling "In Love" With Your  Therapist

Also, most psychoanalysts, especially at the beginning of treatment, don't reveal that much about themselves because transference is an important part of treatment. Since they want to work with the transference, they are unlikely to reveal a lot of personal information because the more a client knows about his or her therapist, the less room there is for transference to develop. So, the combination of the frequency of sessions, the intimate nature of what the client is sharing in the treatment, and the lack of information about the analyst (where there's lots of room for clients to project their fantasies) can create powerful transferential feelings.

Sometimes, clients' transferential feelings are not totally unconscious. They might be very aware of feelings that they're developing for the therapist, although they might not realize that the basis of these feelings is based on childhood experiences. This is all very common and part of what would be discussed in treatment.

Transference is not a phenomenon that is only found in treatment. In fact, it is a normal part of every day life in many areas of our lives. I'm sure that many of us can think of teachers that we had crushes on in school. This is also usually transference because it's a projection of the student's feelings for the teacher. Usually, students outgrow these crushes and, eventually, develop healthy relationships with their own peers.

What is Countertransference
I've chosen to focus on a particular type of transference in this blog article, namely, erotic transference, but I wanted to add a few words about countertransference. Countertransference is also a form of transference but, in the context of treatment, it's the transferential feelings that the therapist has for the client. Therapists who are psychoanalytically trained know that they will feel countertransference for some clients, and they often experience the same type of transferential feelings as clients do.

The big difference is that therapists who are psychoanalytically trained have the therapeutic skills to deal with these countertransferential feelings, and will usually recognize that it's not really about the client.

Rather, it can point to something that is lacking in their own lives, something from the past, or some unconscious feelings regarding their own unmet needs. Early on, in psychoanalytic training, psychoanalytic candidates in training use their own personal psychoanalysis and supervision to deal with these feelings and learn how to handle them without compromising the treatment. If countertransference becomes an issue for a therapist after his or her training, usually, he or she will seek professional guidance either in his or her personal therapy, in supervision, or among peers.

Erotic Transference:  Falling "In Love" With Your Therapist

When psychoanalysts act on transferential and/or countertransferential feelings, rather than seeing them as a signal for work to be done with the client and/or with themselves, there can be boundary violations, especially sexual boundary violations, which I discussed in an earlier blog post. This type of boundary violation, whether it occurs during the treatment or after the treatment, is usually most harmful to the client. It can leave a client feeling devastated since these types of "relationships," which continue to be unequal even if the treatment is over, almost never work out.

There are some psychotherapists, who are not psychoanalytically trained, who are uncomfortable with clients' transference or their own countertransference, and they avoid dealing with it and don't know how to deal with it. This is usually detrimental to the treatment and has been the cause of many treatment failures.

What is the Erotic Transference?
The erotic transference is a particular form of transference that occurs when the client thinks that he or she has fallen in love with the therapist. Once again, as mentioned previously, feelings can develop quickly in psychoanalysis or psychodynamic psychotherapy due to the intensity of the treatment.

Initially, this can be emotionally painful for clients because, an ethical psychotherapist who maintains the treatment frame, won't gratify these erotic transferential feelings and fantasies, so that clients feel a yearning for their therapists that cannot be satisfied. These feelings are explored in treatment and, usually, as previously mentioned, they have their origins in unmet childhood needs.


It's easy to see how someone who grew up in a home where their emotional needs were not met or not sufficiently met, for whatever reason, would feel like he or she is falling in love with the therapist who is spending so much time listening to his or her most innermost feelings. The early yearning to have these needs met can come roaring to the surface very quickly. Many times, clients have repressed (pushed down) these needs for so long that. before starting treatment, they might not even be aware that they still have these needs. Then, lo and behold, these needs are tapped into and they often erupt with full force.

Note that I emphasized that this can be part of the initial part of treatment. The reason for this is that a skilled psychoanalytically trained therapist will use these transferential feelings not only to explore those unmet needs but also to help the client to develop healthy relationships outside of treatment where those needs can be met. So, although it can be initially painful to feel unrequited love as part of the erotic transference, the client is helped to develop into an adult who can have his or her needs met.

The erotic transference can occur regardless of the client's and therapist's gender or sexual orientation. That means that a heterosexual woman can develop an erotic transference for a heterosexual female therapist, even if this client never had erotic or romantic feelings for women in the past.

It can also occur with a heterosexual man and a gay therapist, even if the client never had sexual or romantic feelings for gay men before. A gay male client can develop an erotic transference for a heterosexual female therapist. And so on. This can be very confusing for clients and, at times, causes them to question their sexual orientation. But, most often, especially if they're not having these romantic and sexual feelings outside of treatment, it's not about a change in their sexual orientation. It's usually about unmet childhood needs and, as an adult, these needs can be transformed into romantic and/or sexual feelings for the therapist.

In a successful psychoanalytic or psychodynamic treatment, the client matures into a person who can work through these early unmet needs and find mature love among his or her own peers rather than continuing to fantasize about the therapist.

But it would be misleading to say that this happens quickly in every psychoanalytic of psychodynamic treatment or that, for some people, it happens at all. Some clients can spend years feeling that they're in love with their therapists and not understanding why the therapist is not willing to satisfy their needs by seeing them outside of the therapy sessions or going out with them or telling them about personal aspects of the therapist's life.

If a therapist is not able to help a client work through the transference so that the client can transfer his or her feelings from the therapist to a healthy, mature relationship with a peer, the therapist might have to refer the client to a different therapist to work out these issues. This can feel very rejecting to the client, who might not understand why this is necessary, but it is sometimes necessary and preferable to allowing a client to spend year after year feeling deprived because his or her therapist won't gratify his erotic or romantic needs.

The fictionalized vignette below demonstrates how the erotic transference can develop in a psychoanalytic treatment. As an aside, I also want to reiterate that, although I'm focusing on psychoanalytic and psychodynamic treatment, transference can develop in any type of therapy and, overall, transference out in the world (outside of the treatment setting) is ubiquitous.

Terry:
When Terry began treatment, she had just ended her third long-term relationship with a man who turned out to be cold and distant. She felt depressed and "a failure" because she continued to choose men who didn't meet her emotional needs.

Terry chose a woman psychotherapist who was recommended to her by her doctor. During the initial few visits, the therapist asked Terry about her childhood history, and Terry recounted a childhood where her parents provided her with everything that she needed and wanted materially, but they were emotionally distant. Whenever she wanted to talk to her parents, they were too preoccupied with other things to listen to her. As an only child, Terry grew up feeling lonely. She loved to go visit her best friend's home because her friend's mother was very warm and affectionate. Terry used to secretly wish that her friend's mother would become her mother.

Since Terry was significantly depressed (although not suicidal), Terry and her therapist agreed to meet three times a week. As the treatment went on, Terry described how she had never felt that anyone close to her ever really listened to her. She was tired of going out with men who turned out to be so much like her parents, and she couldn't understand the unconscious process that compelled her to continue to choose the same type of man over and over again.

After a few weeks, Terry really began to look forward to her therapy sessions. Her therapist provided a safe and nonjudgmental environment for Terry to express her innermost feelings. Terry told her therapist about thoughts and feelings that she had never revealed to anyone else in her life, and she was amazed at how easily she was able to do this with her therapist. Most of all, she felt that her therapist was caring, attentive and really listened to her in a way that she had never been listened to before.

Erotic Transference:  Falling "In Love" With Your Therapist

Soon after that, Terry began having erotic dreams about her therapist. These dreams made her feel very frightened, confused, and embarrassed because she considered herself to be heterosexual, and she had never had romantic or erotic feelings for a woman before. She had gay and lesbian friends, and she didn't think she was prejudice against gays. She was just bewildered by these dreams and wished that she would stop having them.

Terry also began to notice that she was ruminating about her therapist between sessions, wondering what she was doing and with whom. She fantasized about meeting her therapist outside of their sessions for dinner and getting to know her therapist personally. When her fantasies turned erotic, she began to worry because now she was having erotic feelings for her therapist in her dreams as well as her waking hours. In fact, she worried because she was feeling obsessed.

Erotic Transference:  Falling "In Love" With Your Therapist

At that point, whenever she went to therapy, she wished that the session wouldn't end. She looked at her therapist's ring finger to see if she was wearing a wedding ring, but she saw no signs of whether her therapist was married or had a significant other. She felt that, at least, if she knew that her therapist was married, maybe she could stop ruminating about her day and night.

When her therapy session ended and Terry walked out into the waiting room and saw the next client about to go in to see the therapist, she felt jealous. On an emotional level, she wanted the therapist to only spend time with her and it was painful to think that she had to share her with other clients. On a rational level, Terry could step back and look at her feelings and know that they were irrational, but she couldn't stop them.

She had fantasies about standing across the street from her therapist's office, somewhere where the therapist couldn't see her, and waiting to see where she went or if she met up with a husband or lover. She felt that her curiosity and yearning to know more about her therapist's life was overwhelming. And, although she often had this fantasy, she never gave into it because she didn't want to feel like a stalker.

Finally, one day when Terry couldn't tolerate having these erotic feelings for her therapist any more, with much hesitation and embarrassment, she told her therapist about her erotic feelings. Part of her hoped that her therapist would tell her that she felt the same way about her, which she also knew would be terrifying for her. Another part of her was afraid that her therapist would think this was highly inappropriate and she would need treatment with Terry.

Terry's therapist listened intently to what Terry had to say. Terry became tearful because she was confused about what this meant about their therapeutic relationship and also what it meant in terms of Terry's sexual orientation. Terry poured out all the feelings that she had been holding back and allowed her tears to flow.

After she finished, Terry raised her eyes for the first time during that session to meet her therapist's eyes. What she saw was the same empathetic and compassionate look that her therapist usually had. She breathed a sigh of relief that, at least, her therapist wasn't throwing her out of the office. Then, her therapist talked to Terry about transference and, in particular, the erotic transference. Terry was surprised to hear that this is a very common experience in psychoanalytic and psychodynamic psychotherapy. At least, she knew that she was not some odd ball and that many other clients in therapy experienced the same feelings. Most importantly. she learned that most clients work through these feelings as they learn to develop healthy, romantic relationships outside of treatment.

Terry and her therapist continued to explore these feelings as they related to her unmet childhood needs. Terry did a lot of grieving for what she didn't get when she was growing up. Over time, she also learned to accept that her parents, who would never even think of getting into their own therapy, probably would not change. This is often a very hard part of treatment for many clients who still hold onto the wish, no matter how impossible it might seem, that one day their parents would change.

In the meantime, Terry began to date again. Whenever she started to see a man who turned out to be cold and distant as all the other men she dated, she wished that she could be in a romantic relationship with her therapist. Sometimes, these feelings were so strong that she felt they were unbearable. Although she still really didn't know if her therapist was heterosexual or a lesbian and she didn't know if her therapist was in a relationship, she fantasized about her therapist being a single lesbian.

Although she understood that she and her therapist couldn't be romantically or sexually involved while she was still in treatment, she now had fantasies that they could be together after the treatment ended. She even had thoughts about terminating the treatment with her therapist and seeing a different therapist so that she and her current therapist could be together.

This thought made her feel happy and excited her sexually as well. She no longer cared if she considered herself to be heterosexual or a lesbian. It didn't matter. All she could think about at that point was that she and her therapist could be so happy together if she was no longer in treatment with her. She thought to herself, "Why didn't I think about this before? Surely, my therapist must recognize that there's a special feeling between us. She's too ethical to pursue this feeling while I'm in treatment with her, but she'd have no reason not to be with me if I was in treatment with someone else."

Terry was very excited on the day when she decided to bring this up in her psychotherapy session. She had fantasies about having romantic candlelight dinners with her therapist, being sexually intimate, and, in time, even living together. So, when she brought up her feelings about this in therapy, as always, her therapist listened to her intently. Terry was so happy to have someone finally listen to her as if she was the only person in the world, and she imagined how wonderful this would be to experience all the time, and not for 45 minutes several times a week.

Once again, Terry's therapist acknowledged that it is not at all unusual for a client to have these feelings and, in fact, many clients had these feelings. Then, she proceeded to explain to Terry how, even after their treatment ended, whenever it ended, they could never be together or have anything but a therapeutic relationship because it would ruin the treatment that they had together. Also, she explained that these romantic and sexual feelings that Terry had, while very strong, were still based on her unmet childhood needs. And a relationship between a former therapist and a former client would be disastrous for the client.

Even though her therapist normalized her feelings, Terry was extremely disappointed. She thought she had found a way to be with her therapist, only to be rejected. This was the subject of many sessions after that session. Terry's therapist was also able to help her connect her current feelings to her earlier feelings connected to the childhood emotional neglect.

As treatment continued, Terry began to feel deep down that she deserved to be with someone who was emotionally available to her. Since she didn't have attractions for women outside of her therapy sessions, she continued to date men and talk about these experiences in her therapy. She still held onto a wish that her therapist would eventually change her mind and get romantically involved with Terry after the treatment was over. But she also began to choose men who were more emotionally attuned to her.

Several months later, Terry met a man that she really liked and who was very kind and generous with her. Unlike her other relationships, he was attentive and also reciprocated her feelings. Initially, she was almost too afraid to get excited about this man because she feared that she would get disappointed and hurt like she had in the past. But, as she continued to see him, their relationship developed and became more intimate.

At first, Terry felt like she was "cheating" on her therapist, although, rationally, she knew this wasn't true. But, until then, most of her erotic dreams and fantasies had been about her therapist, and it had been the most intense relationship (albeit it a therapeutic relationship) that she had ever had.

Unlike her mother, who had almost never shown much concern for Terry's emotional well being, Terry sensed that her therapist was happy for her that she had met someone that she really cared about and who really cared about her.

As Terry continued to see this man and continued to talk about it in her therapy, gradually, over time, she realized that her feelings for her therapist were changing. Although she felt a deep caring for her therapist, she no longer had romantic or sexual feelings for her therapist.

This surprised Terry greatly because, when she was obsessing about her therapist, she thought these feelings would never change and she worried about what it might be like to terminate treatment and never see her therapist again. Whenever she had those feelings, she worried that she had become "too dependent" on her therapist. But much to her surprise, over time, she was beginning to feel that she could foresee a time when she could end treatment and be all right about it.

Erotic Transference:  Falling "In Love" With Your Therapist

When she discussed this with her therapist, her therapist assured her that, even after she ended this treatment, if she felt that she wanted to work out other issues that had come up after this treatment was over, she could return to see her. She also told Terry that it wasn't unusual for people to return to their therapists after years of being away from treatment. She also told her that Terry had the option in the future of seeing a different therapist, possible someone who worked differently, to get a different perspective.

Soon after that, Terry and her therapist went through the termination process, which lasted a few months. During that time, they saw each other less frequently. They processed the therapy in a way that gave closure to their therapeutic relationship. During that time, Terry realized that her feelings for her therapist had changed to no longer feeling at all erotic, romantic or idealized in any way. Rather, she saw her therapist as being an ordinary person who happened to be very skilled at her work. And, when she looked back at her erotic transferential feelings, she was glad that her therapist was ethical, and maintained the therapeutic frame in a safe and empathic environment.

Terry and her boyfriend eventually got married and, overall, she was happy. After a few years, she returned to see her former therapist for brief treatment to work through particular issues. She was grateful to be able to return for treatment whenever she needed it. And rather than feeling caught up in transferential feelings that were based on unmet childhood needs, she felt that she was with a capable mental health professional who could help her to overcome these problems.

About the Fictionalized Scenario 
The fictionalized scenario that I presented above is one example, among many different types of situations, of the erotic transference and how it might appear in treatment and get worked through. There are times when clients, who feel too uncomfortable with their erotic and romantic feelings for their therapist, leave treatment and never work through these issues or the unmet childhood needs that tend to fuel these feelings.

While there are certainly times, especially if a psychotherapist is crossing professional boundaries, where clients should leave treatment before transferential feelings are worked through (and work them through with another more professional and ethical therapist), most of the time, it is beneficial to stay in treatment and get to the early core issues that are at the heart of the matter.

Getting Help in Therapy
If you're overwhelmed with problems that you've been unable to resolve on your own, you could benefit from seeing a licensed mental health professional who can help you to work through these issues so you can lead a more fulfilling life.

About Me
I am a licensed psychotherapist in New York City, who is psychoanalytically trained.

Since my psychoanalytic training, I have also developed expertise in other treatment modalities, including EMDR, clinical hypnosis, Somatic Experiencing, AEDP, EFT and Sex Therapy.  

I work with individual adults and couples.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist

To set up a consultation, call me at (917) 742-2624 or email me.