![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 79. This is the beginning of the thread.
Posted by jay on October 7, 2003, at 8:13:22
Hey folks:
I have noticed a number of folks who mention extensive attraction to their therapist, which is with no mistake, transference. What you must realize is that this is one of the ultimate *sins* in counselling. Therapists are usually obligated to terminate the client-patient relationship if this occurs. Therapists can face criminal charges and lose their license to practice if they operate outside the boundaries of a client-patient relationship at all.
I have a 48 page booklet from the organization that represents me, which is the "Ontario Association of Social Service and Social Workers". I don't want to reproduce the whole thing, but here are some general guidelines, and these are also identical to most social work organizations around the world.
Ontario College of Social Workers and Social Service Workers Code of Ethics:
-A social worker or social service worker shall maintain the best interest of the client as the primary professional obligation;
-A social worker or social service worker shall respect the intrinsic worth of the persons she or he serves in her or his professional relationships with them;
-A social worker or social service worker shall carry out her or his professional duties and obligations with integrity and objectivity;
-A social worker or social service worker shall have and maintain competence in the provision of a social work or social service work service to a client;
-A social worker or social service worker shall not exploit the relationship with a client for personal benefit, gain or gratification;
-A social worker or social service worker shall protect the confidentiality of all professionally acquired information. He or she shall disclose such information only when required or allowed by law to do so, or when clients have consented to disclosure;-A social worker or social service worker who engages in another profession, occupation, affiliation or calling shall not allow these outside interests to affect the social work or social service work relationship with the client;
-A social worker or social service worker shall not provide social work or social service work services in a manner that discredits the professional of social work or social service work or diminishes the public’s trust in either profession.
-A social worker or social service worker shall advocate for workplace conditions and policies that are consistent with this Code of Ethics and the Standards of Practice of the Ontario College of Social Workers and Social Service Workers;
-A social worker or social service worker shall promote excellence in his or her respective profession;-A social worker or social service worker shall advocate change in the best interest of the client, and for the overall benefit of society, the environment and the global community.
So, please keep these deeply in mind, as there are very, very rarely ever *any* exceptions to these rules. You can contact your local social work or psychologist organization if you feel these rules have been broken. I want to plug people going to a social worker instead of a 'psychologist', as social work is the largest and most strictly governed therapy-providing field in the world. I know of a social worker who developed a relationship with a client 12 years after they had therapy together, and the social worker had his liscense removed and had to appear before a board.
So, not to be paternalistic, I hope this helps some folks make clear decisions.
Best wishes,
Jay
Posted by Dinah on October 7, 2003, at 8:45:14
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
> Hey folks:
>
> I have noticed a number of folks who mention extensive attraction to their therapist, which is with no mistake, transference. What you must realize is that this is one of the ultimate *sins* in counselling. Therapists are usually obligated to terminate the client-patient relationship if this occurs. Therapists can face criminal charges and lose their license to practice if they operate outside the boundaries of a client-patient relationship at all.
>Whoa, Jay. Gotta say that isn't at all correct. If a therapist terminated every client who was sexually attracted to them, they wouldn't have many left. It is *not* unethical to be the recipient of an erotic transference. It is not even unethical to feel sexual attraction to a client. It *is* unethical to act on that attraction. I don't want people to be scared to mention their erotic transferences for fear they will be terminated. It is *very* important to bring up that sort of material in therapy. Erotic feelings are a natural result of an artificially intimate relationship, are nothing to be ashamed of, and will not end in a person's rejection or termination with a therapist. I would go so far as to say that a therapist who terminates with a client because the client is sexually attracted to them has absolutely no business in the field.
Sorry, Jay. But this is a board that many people come to with their transference issues, and I just don't want people to get the idea that feeling erotic feelings for their therapist will cause their therapist to terminate them.
Only a therapist's *actions* (including words as actions) can be considered unethical.
Posted by Dinah on October 7, 2003, at 9:10:20
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Dinah on October 7, 2003, at 8:45:14
Some references"
"Sexual Feelings in Psychotherapy" by Kenneth Pope
"In Session" by Deborah Lott
Posted by justyourlaugh on October 7, 2003, at 9:19:55
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
so i should put the "slutty" outfit away?
just kidding..
j
Posted by Penny on October 7, 2003, at 9:30:11
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
> I have noticed a number of folks who mention extensive attraction to their therapist, which is with no mistake, transference. What you must realize is that this is one of the ultimate *sins* in counselling. Therapists are usually obligated to terminate the client-patient relationship if this occurs. Therapists can face criminal charges and lose their license to practice if they operate outside the boundaries of a client-patient relationship at all.
I agree with Dinah. Transference is actually one of the most powerful parts of therapy, and that power, when in the hands of a skilled therapist (psychologist or social worker) can create great, positive change in the client. My former therapist was a clinical social worker (in the US) and one of my biggest issues was transference regarding her pregnancy and subsequent maternity leave. While it wasn't sexually oriented transference, it was still quite powerful, and she used it to get at many of the issues I had surrounding my past and current relationships with family.
There is NEVER any excuse for a therapist to ACT ON transference, as in admitting sexual attraction to a client, trying to have an outside relationship with a client, etc. That is unethical b/c it is using the therapist's position of power in a way that would be harmful (regardless of whether the client sees it this way or not) to the client.
The National Association of Social Workers (http://www.socialworkers.org/) addresses situations that might arise in the course of therapy in its code of ethics - for example, it says the following about 'conflicts of interest':
1.06 Conflicts of Interest
(a) Social workers should be alert to and avoid conflicts of interest that interfere with the exercise of professional discretion and impartial judgment.(b) Social workers should not take unfair advantage of any professional relationship or exploit others to further their personal, religious, political, or business interests.
(c) Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client.
(I have left out point (d))
The code of ethics also addresses sexual relationships:
1.09 Sexual Relationships
(a) Social workers should under no circumstances engage in sexual activities or sexual contact with current clients, whether such contact is consensual or forced.(b) Social workers should not engage in sexual activities or sexual contact with clients' relatives or other individuals with whom clients maintain a close personal relationship when there is a risk of exploitation or potential harm to the client.
(c) Social workers should not engage in sexual activities or sexual contact with former clients because of the potential for harm to the client.
(d) Social workers should not provide clinical services to individuals with whom they have had a prior sexual relationship.
And in regards to physical contact:
1.10 Physical Contact
Social workers should not engage in physical contact with clients when there is a possibility of psychological harm to the client as a result of the contact (such as cradling or caressing clients). Social workers who engage in appropriate physical contact with clients are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact.
It seems clear to me that (1) sexual relationships with the client or people the client has close relationships with are against the rules, (2) physical contact between therapist and client is acceptable in a non-sexual, non-threatening, clear boundaries manner (my therapist and I hugged a couple of times), and (3) if the therapist is unable to handle transference in a professional manner in compliance with the code of ethics, *then* they should consider terminating therapy.But to say that a client's extensive attraction to his or her therapist is grounds for termination ... I hope, Jay, that is not really what you meant. It is vitally important for clients to bring up these feelings in therapy. However, it is also important that they be aware of the boundaries set by the code of ethics between client and therapist, and that they listen to their gut feeling if they feel like those boundaries are being crossed.
The full code of ethics for the NASW can be found here:
http://www.socialworkers.org/pubs/code/code.aspSimilarly, here is a link to the code of ethics of the American Psychological Association:
http://www.apa.org/ethics/code2002.htmlP
Posted by jay on October 7, 2003, at 10:07:58
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Penny on October 7, 2003, at 9:30:11
Yes, the NASW code of ethics is identical the Ontario/Canadian Social Work one. (I am legally bound, also, because I am a member...and I pay 400 bucks a year for such!..hehee) I am not saying that your own transference issues, as long as they don't interfere with the professional relationship, are not 'fine'. Should this leave the clients mind and enter into the communication between the two, then the SW has an obligation to terminate. A good therapist can pick this up quite easily.
I am going to talk to some fellow colleagues about this (minus any names and this sight), as well as put it to the biggest list of social workers on the internet. I *really* would like to make sure I am hammering on the issue in a way mean't to be discussed.
Posted by Penny on October 7, 2003, at 10:17:04
In reply to Re: Please read...Code of Ethics Therapy » Penny, posted by jay on October 7, 2003, at 10:07:58
> I am not saying that your own transference issues, as long as they don't interfere with the professional relationship, are not 'fine'. Should this leave the clients mind and enter into the communication between the two, then the SW has an obligation to terminate. A good therapist can pick this up quite easily.
I'm confused - are you still saying that if a client discloses transference-type feelings toward a therapist, then the therapist should terminate? Apologies if I'm misunderstanding what you're trying to say.
P
Posted by Penny on October 7, 2003, at 10:17:33
In reply to Re: Please read...Code of Ethics Therapy, posted by Penny on October 7, 2003, at 10:17:04
Posted by Dinah on October 7, 2003, at 10:23:50
In reply to Re: Please read...Code of Ethics Therapy » Penny, posted by jay on October 7, 2003, at 10:07:58
> Should this leave the clients mind and enter into the communication between the two, then the SW has an obligation to terminate. A good therapist can pick this up quite easily.
>
Jay, please do talk to colleagues and contact your professional organization on this. You're mistaken about this, and your mistake could cause people to be afraid to mention their feelings to their therapist. That would be at the very least, countertherapeutic. A therapist *will not* terminate a client who mentions an erotic transference. The only time a therapist will terminate a client who mentions an erotic transference is if they don't have adequate training to deal with it professionally. And then in my not so humble opinion, said therapist should refrain from practicing psychotherapy until he or she obtains more supervision and training in the area. Boy, talk about causing harm to your patients!
Posted by Penny on October 7, 2003, at 10:36:52
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Dinah on October 7, 2003, at 10:23:50
In fact, in order to deal with these feelings of transference and countertransference, isn't that the reason so many therapists are in or have been in therapy?
This was a subject of another thread...
My pdoc told me that he went through 5 years of psychoanalysis after med school so he could learn to recognize when countertransference was occurring and use those feelings to the benefit of the patient. To me, that makes sense. A therapist does definitely need to be aware when transference is occurring, and needs to be able to handle it effectively and professionally, but to terminate therapy b/c of transference? No!
I, personally, wouldn't want to see a therapist I didn't experience transference with and couldn't share those feelings with. I don't see how that would make the experience very therapeutic.
Of course - this could also go along with the above thread about length of therapy - I suppose transference wouldn't be necessarily as strong or as important in short-term therapy, and I, myself, feel that long-term therapy is more effective for me.
P
Posted by Adia on October 7, 2003, at 10:40:19
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Dinah on October 7, 2003, at 10:23:50
ugh, this whole issue is making me panic!
What do you mean by this?
That if I tell my therapist how I feel, (I don't feel sexual feelings but sometimes I have feelings like a child for her mother) she will terminate with me because my feelings and transference entered our communication?
She says that those feelings are what we most need to work through....(fortunately!) and if she were to terminate me because of that I would be totally devastated...Jay, What you are saying makes me feel or gives me the idea that you're implying that we should keep those feelings to ourselves because if we let our therapist know they will leave..
and I can't believe this is how things are?
At least my therapist hasn't terminated me and she has welcome my feelings or discussions about the feelings that come out as a result of our relationship...The more I read this thread the more I panic..
Adia.
> > Should this leave the clients mind and enter into the communication between the two, then the SW has an obligation to terminate. A good therapist can pick this up quite easily.
> >
> Jay, please do talk to colleagues and contact your professional organization on this. You're mistaken about this, and your mistake could cause people to be afraid to mention their feelings to their therapist. That would be at the very least, countertherapeutic. A therapist *will not* terminate a client who mentions an erotic transference. The only time a therapist will terminate a client who mentions an erotic transference is if they don't have adequate training to deal with it professionally. And then in my not so humble opinion, said therapist should refrain from practicing psychotherapy until he or she obtains more supervision and training in the area. Boy, talk about causing harm to your patients!
>
>
Posted by Dinah on October 7, 2003, at 10:44:32
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by Adia on October 7, 2003, at 10:40:19
Jay is mistaken. I've told my therapist that I see him as a mother dog to my blind pup. That I see him as a giant breast and smell milk. (well, I told someone, maybe not him). If I were sexually attracted to him, I'd tell him so. I've told him I loved him (not in a sexual way).
Your therapist is not going to refer you to someone else for that.
The only way you might earn a referral is if you disrobed and threw yourself on her, or stalked her or something where she feared for her safety.
PLEASE, don't worry about this.
Posted by Penny on October 7, 2003, at 10:49:41
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by Adia on October 7, 2003, at 10:40:19
Don't panic!
I'm going to bring up this topic in therapy today, to see what my therapist says. But I have had the 'transference' talk with both my current and former therapists and pdoc, and none of them have terminated as a result! The only circumstance I can think of that would cause a therapist to terminate as a result of transference would be the therapist's inability to handle those feelings (well, the therapist's experience of countertransference and his or her inability to handle *those* feelings). Or if you were to admit feelings for your therapist (I'm thinking romantic) and they were to admit that they felt the same way - that is unethical.
But a therapist would have to be cold and unfeeling to turn a client away because of transference feelings - in fact, I suspect that could be grounds for malpractice.
Don't panic, Adia! Your therapist isn't going to terminate you b/c you've admitted mother/child feelings toward her. As a skilled practitioner, she's going to take those feelings and use them to help you deal with your issues. That's what she's there for.
She sounds like a wonderful therapist. Mine is too.
P
Posted by jay on October 7, 2003, at 10:50:33
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Dinah on October 7, 2003, at 8:45:14
> > Hey folks:
> >
> > I have noticed a number of folks who mention extensive attraction to their therapist, which is with no mistake, transference. What you must realize is that this is one of the ultimate *sins* in counselling. Therapists are usually obligated to terminate the client-patient relationship if this occurs. Therapists can face criminal charges and lose their license to practice if they operate outside the boundaries of a client-patient relationship at all.
> >
>
> Whoa, Jay. Gotta say that isn't at all correct. If a therapist terminated every client who was sexually attracted to them, they wouldn't have many left. It is *not* unethical to be the recipient of an erotic transference. It is not even unethical to feel sexual attraction to a client. It *is* unethical to act on that attraction. I don't want people to be scared to mention their erotic transferences for fear they will be terminated. It is *very* important to bring up that sort of material in therapy. Erotic feelings are a natural result of an artificially intimate relationship, are nothing to be ashamed of, and will not end in a person's rejection or termination with a therapist. I would go so far as to say that a therapist who terminates with a client because the client is sexually attracted to them has absolutely no business in the field.
>
> Sorry, Jay. But this is a board that many people come to with their transference issues, and I just don't want people to get the idea that feeling erotic feelings for their therapist will cause their therapist to terminate them.
>
> Only a therapist's *actions* (including words as actions) can be considered unethical.
I understand what you are saying...and the smallest amount of attraction should only be able to be picked up if you where a psychic. I don't mean to be arrogant or whatever, but I have plenty of first-hand experience, twice with me and numerous with other colleagues. The two times with me involved slightly covert, but suspicious questions about *me* as a person, and my personal life.(VERY blatent questions.) Most counsellors who find this is an issue will discuss it with colleagues first.Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. That would be humanly impossible. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
I honestly think we are on the same ground here, but it's just a matter of degrees. I've read many of the posts with transference issues on the board, and I was greatly appalled at some therapists actions. I am sure you would be to. I am also honestly not trying to push people away who have their own issues with this, and want to support anybody as much as possible. What worriers me, though, is of our board members getting taken advantage of, or even abused. It is so common these days, I guess that is why I am super sensitive to the issue. Plus, people pay a heck of amount of money for this counselling, and I don't like to see that abused also by therapists.
Anyhow...thanks very much for your input and suggested readings. :-)
Sincerely,
Jay
Posted by jay on October 7, 2003, at 10:55:04
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
I am expecting an email from the Prof. of Social Work at one of Americas largest universities. I'll post the peoples responses as they come in.
There is no absolute 'right' or 'wrong', and I think Dinah doesn't exactly know what I mean. (I mean that in a nice way.)
Thanks,
Jay
Posted by jay on October 7, 2003, at 10:59:55
In reply to Re: Please read...Code of Ethics Therapy » Adia, posted by Penny on October 7, 2003, at 10:49:41
Here is some further discussion on transference from a discussion site.
-----
Transference or reality?If a client has strong feelings of attraction for his or her therapist, then conventional psychoanalytic doctrine automatically labels these as "transference", that is, the feelings are not really how the client feels about the therapist, but how the client feels about other people who are, or have been, important in the client’s life.
But how can anyone know whether these feelings would not have arisen outside the therapeutic relationship? If the client believes that he or she would have fallen in love with the therapist if they had met in a normal social setting, who has the evidence to show that the client is wrong? Kay is absolutely convinced that her feelings of love for her therapist were genuine.
To this day, I still wonder about that so-called phenomenon called "transference". As much as I have read and learned, there's something in my case that has never changed -- and that is the truth -- that I truly fell in love with my therapist and he knew it. What has been difficult in my healing is to accept the fact that he did take advantage of the so-called "transference", and whether it was only "transference" or if it was "real", he abused me by "acting out" my love for him through the guise of a combined therapy/dual relationship. The man even told me he knew my love for him was "beyond transference" and that we would always have a close relationship even after therapy was over. He testified that he knew and believed that I believed I was really in love with him. Transference? Countertransference?
I wonder.
Alex also offers a counterexample: she has seen many therapists but never yet fallen in love with any of them:
The therapeutic relationship is the only occasion in which feelings for each other receive special names, "transference" and "countertransference", and that's the reason why sometimes I think it's the most neurotic relationship of all.
It is perfectly possible and normal to fall in love with somebody you feel understood by, cared for etc. I have seen many therapists but I have never fallen in love with any of them. If one day I do, why is that called "transference"? Such a generic name for a specific feeling. Nobody would doubt me if I said I had fallen in love with my neighbor, who is cute and talks to me for 15 minutes a day when we are opening our doors to enter our homes. But if I claim I have fallen in love with a therapist then it is transference.
I am not saying that transference does not exist but that sometimes the term transference can be called up to protect the therapist’s responsibilities for awakening in you, and feeding, feelings of love.
If he calls it transference he is dealing with you as a client with problems. If he calls it love he is dealing with a woman's feelings. [To Kay] If your therapist had a dual relationship with you, then for him to call your feelings "transference" is a cowardly way to refer to them.
Natalie is in the process of being converted by Alex to believe in biological factors that explain what seems to be an unlikely attraction between client and therapist. She writes:
Alex and I had a discussion about a month ago which I’m summarising here in case anyone finds it interesting.
…I wrote, "Why does an independent, attractive woman in a stable relationship fall hopelessly and painfully in love with a greying, balding therapist who is old enough to be her father?" [The answer, I said, was transference].
Alex pointed out two things: firstly, that my question could be considered to be offensive because it could be taken to imply that nobody would normally want to be in a relationship with someone who was unattractive; and secondly, that many women do have relationships with older men, and that there isn’t necessarily anything wrong with that. As a biologist, she reminded me that although there is an evolutionary drive for men to prefer younger, fertile, partners, the same does not apply to women, since men are fertile way beyond the age when female fertility stops. In fact, the woman might well have the drive to choose a mate with power and status rather than youth or good looks. Therefore it’s not such an unnatural thing for a female client to fall in love with her therapist.
I felt she had a good point there. In fact, I thought my therapist was still very attractive – it was he who kept going on about his hair, or lack of it.
What I wanted to express was the inappropriateness of the attraction…I think it would be interesting to know whether an erotic transference between a female client and a male therapist is more likely than between a male client and a female therapist.
Syd gives an example of a relationship outside therapy between a young girl and an older man.
Very interesting discussion. I have heard that there is a definite biological component for attraction that we work on at an instinctive level. But maybe due to my naivety, not knowing all the physiological workings, I sometimes think there are other psychological components such as the Electra complex. I have a young friend who is 19 years old. She's intelligent and beautiful. She could probably get the attention of any young man, but she has been involved in a relationship with a 50 year old. Her parents are still having a hard time with that.
I have talked to her on occasions about her relationship with her father and she always tears up. Even though I am not qualified to diagnose, I do feel there is a need being fulfilled by that man that her father never gave her. Her parents are professional people and have an active social life. But what Alex said could explain that attraction, biologically. Also I think that a great majority who go to therapy will have transference if they establish trust with any therapist...a mother figure...father figure...whatever. We are needy when we go to therapy and so we become vulnerable…It is ethically the responsibility of the therapist to de-escalate the situation. Unfortunately there are therapist who have counter transference. They want to rescue [the client]…I do know that there are therapists who are in this role in order to work out their own issues.
Rosie also finds counterexamples, saying that the attraction between therapist and client may seem like sexual attraction, but is not caused by the sexuality of the people involved; it is a different kind of relationship that needs to be examined separately from normal sexual relationships if it is to be understood.
Regarding Natalie’s discussion with Alex about the dynamics of client-therapist attraction, I’d like to suggest that considering it as just another instance of the standard man-woman relationship fudges the issue. The feelings generated in the client by the therapy situation are, it is true, very similar to romantic/sexual desire but often do not correspond with either the sex or the sexual orientation of the persons involved. Thus a fully heterosexual woman may find herself obsessed by another woman, and a male client may be similarly attached to a male therapist.
Unless we recognise the wholly particular nature of the client-therapist relationship we cannot begin to fathom it. I have a few theories about it, as yet undeveloped. Could it be, for example, that both sexual desire and the desire generated in therapy stimulate some pleasure centre in the brain? And once this stimulation starts, could it be that its cessation causes us to suffer withdrawal symptoms like those of an addict deprived of his drug?
My own experience - a craving for complete and exclusive union with my therapist - felt consistent with the notion that in therapy we relive our early relationship with our mother, even from the time we spent in the womb. It could equally well be consistent with something else; if, for example, individual beings are all part of some kind of cosmic consciousness, it could be that therapy puts us in contact with this in some way and that we then feel the desire to be re-subsumed into it.
Does anyone have any comments to make on these ideas, or any different ones of their own?
PPJMB believes that his attraction for her therapist is justified by the therapist’s good qualities, but at the same time he perceives that there is something unreal and disturbing about the feelings he is experiencing.
I am new to this discussion, and I am very impressed by the quality of the submissions. I look forward to seeing more.
I am a heterosexual male in psychoanalysis with a female analyst who, from all appearances, seems heterosexual as well. I find her extraordinarily beautiful, and I think my judgment in this respect would be shared by most men who value taste, intelligence, and delicacy. I don't mean to sound superior or sexist: I believe, though, that my sexual attraction with the therapist is NOT simply a function of the therapeutic relationship or the transference.
For example, I have often thought-- and told my analyst-- that I cannot imagine having this kind of experience with a male therapist, or with a woman who lacked this combination of beauty and overpowering intelligence. I think I would have experienced this same attraction to even if she weren't my analyst. And I've been seeing her four days per week for several years, so I don't think this is a temporary or passing infatuation.
Am I being foolish? I certainly worry that I am: that I am slipping deeper into unreality and illusion. Analysis tends to do that to you, I think.
What should I do? Ignore it? Ride it out? "Explain it away" in that most annoying way that psychoanalysis has?
One thing for sure: the presence of these feelings, and my candid expression of them to my analyst, has raised the stakes at risk in the process. Whatever happens, I expect to receive a serious blow to my self eventually.
Ideas?
Rosie brings the discussion back to feelings of attraction between client and therapist that would not be thought of as being justified by their personal qualities or sexuality.
There have been some interesting responses to my last posting. Kay and PPJMB both talk of having feelings about their therapists which they believe would have been generated (or were generated) in a normal social setting. However, if therapist-client relationships always followed this kind of pattern the notion of transference would probably never have come into existence.
The point I want to emphasise is that, much more often, the therapist-client couple does not correspond to one in which this kind of attraction would normally arise. The fact that it does arise in the most unlikely circumstances is what makes me so curious about what exactly is going on. My first therapist, for example, was a dowdy, down-to-earth matronly figure in her early fifties, yet I was obsessed and besotted with beyond all measure. Pierre Rey, in writing of his analysis with Jacques Lacan, says that if Lacan had offered him a 20-second meeting with him at the opposite side of the world for a fee of 20,000,000 francs he would have found the money and gone. Tilman Moser, in his book Years of Apprenticeship on the Couch, describes equally aberrant examples of his aching desire for his (male) therapist. And there are countless others in the stories that many therapees have to tell.
Another thing which distinguishes the therapy relationship from a romantic one is the regression which often manifests itself in the therapee’s behaviour - thumb-sucking, baby voice, and other childish mannerisms, accompanied of course by the feeling of having travelled back in time to a very young age. As well as this, there is often a dreamlike quality to the therapy which can take over one’s whole life so that the therapee is living in what amounts to an altered state of consciousness.
Does all of this strike any chords for anyone?
Kay replies:
Nope, not for me. As I said, I was in love with HIM -- in and out of therapy. Maybe the focus should be on the damage and confusion from a dual relationship, instead of just the transference itself. No doubt in my case -- it all colluded -- in and out of therapy. And HE even told me toward the end, "the personal and professional collided". Of course, I didn't know what that meant at that time -- and he avoided trying to explain it to me; he avoided all attempts on my part to try to resolve the whole thing with him.
Alex points out the conflicts between biological forces and social expectations. These can create confusion about what is "natural" and "unnatural".
I have in mind, but that is a very personal opinion, that we tend to be confused between those two things: a pathological or psychological problem, and something socially undesirable. Like the case you cited about the 50 year old man and the teenager. As animals we are programmed to do certain things, or putting it another way, we do have a biological potential, which is molded by the culture in which we grow up. In some cultures it is desirable to give your daughter in marriage to an older man, who has accumulated wealth and can protect her and give her children (because that's what men are originally for :), and old men can do it as well, or better, depending on the situation). In our society, we aim to have many things in common and share a living and our children remain dependent for much longer. Things change fast and two consecutive generations have not much in common. In the first case, i.e., in a more "primitive" society, the term "Electra complex" would be totally meaningless (see, I am not saying Freud is wrong, or whatever, just trying to sort things out).
Although I agree that therapist/client relationship is different than any other, it is also molded by biological and social constraints. And what makes the relationship really, but really different, is its very unnatural nature. No other relationship in the world equals this one, as far as I am aware. And as all unnatural things, it can trigger some unnatural reactions.
See the situation. We lock two people potentially attractive to each other in a room, for up to several hours a week. They have only to pay attention to each other, and to themselves. The result we call "transference and counter-transference", without even thinking twice. It might be, but it might be simple attraction as well, why not? Healthy, natural attraction. The next thing we see is that the poor patient going crazy. Because he/she has received some cues from his/her therapist that say, "I am attracted to you too" (and those cues can be pheromones, certain kinds of eye contact, coloration of the skin etc., or even verbal comments, as in Natalie's case) together with this less pleasant message: "no, you are not really attracted, it cannot be because I am older, because I have thin hair, because I like baseball and you do not etc., so let's play "neurotic transference".
Natalie wonders if relationships in therapy follow the same patterns as relationships between people in normal social settings:
I've been looking at relationships in psychology and I think the following things are worth noting:
1. Maybe for everyone there is one person in the world who is the ideal partner. But most of us probably never find that person. The probability of meeting that person is simply too low. So we settle for "the best we can get". Many, many studies have shown that we pick our friends from the people who are located nearest to us (the person sitting at the next desk, the student occupying the next room). Studies of marriage licences have shown that most marriages are between people living a short distance away from each other.
So, I think that the fact that the therapist is seen frequently might be a factor in triggering these biological urges. As Alex says, "We lock two people potentially attractive to each other in a room, for 1 to several hours a week. They have only to pay attention to each other, and to themselves." Well, imagine that a man and woman were the only inhabitants of an island. Biologically, it would make sense for them to form a relationship - if they do not, then their genes die out. I think that we have this drive built into us - if someone is convenient and there's nothing obviously wrong with them, then go for it!
2. The human child has a long childhood and needs protection. It is advantageous for its parents to have a strong bond to keep them together until the child can fend for itself. One way in which we form the bond is by mutual self disclosure. We tell our prospective partners things that we would not tell anyone else. This gives the other person power over us, so we have an interest in staying faithful to them.
In the therapy situation, the self-disclosure is unparalleled. Perhaps the very act of performing self-disclosure triggers the sex drive, since the way is being prepared for a relationship?
Rosie, I know this is by no means the full story. But I think it helps to look at the biological side of things - the urges that we can expect to be awakened anyway, whatever the "therapy" consists of. I am becoming more and more attracted to analysing human behaviour from an evolutionary point of view. I know this will not tell me everything that I need to know, but I think it does lead the way to some very interesting considerations.
Alex does not share Natalie’s views about the power associated with self disclosure, though she thinks it is unnatural to be expected to self disclose to someone who does not respond in kind.
I agree that self disclosure calls for intimacy. I think it is unnatural that I disclose myself to somebody that remains a "blank screen", or whatever one wants to call. But I disagree some that self disclosure is necessarily tied to sexual desire. I often found it easier to disclose myself to a close friend than to a lover. There is a lot of self disclosure between heterosexual women in friendships, for example...
The power the partners have over each other are more "external" to the relationship itself. In most cases, material dependency, and a lot of social constraints...What I have told my husband so far does not make a difference in my decision to divorce, but a bunch of social constraints which were implanted on my mind during all my life can make much more difference.
But of course self-disclosure gives some sort of pleasure. When it can be done properly, it can give a lot of pleasure.
I think it signals a relationship of some kind, not necessarily involving sex. And the frustrating result is that there is no factual relationship. This fact frequently made me feel annoyed and confused. I think therapy is a great place to learn something about ourselves but I never could get real emotional support from it, once there is no real contact with the therapist…
In my opinion saying that we need to have things in common or real intimacy for feeling attracted or aroused by somebody else is a misconception. Sexual attraction is MORE PRIMITIVE, evolutionary speaking, than intimacy. Sex without intimacy is natural, and happens everywhere. Including the therapy room, whether we like it or not.
Syd wonders if making sure that the client and therapist are the same sex might eliminate some of the problems of overwhelming attraction between them:
Great thoughts Natalie!
I was also thinking that since we are talking about the male and female thing and the biological components of attraction the simple remedy for many of us would be to consider not having a male therapist when there is a female client or a female therapist when there is a male client. Men with men and women with women. At least from that stand point we would avoid the possibilities of having those pheromones, etc., kick in and then find ourselves in a situation of greater pain than when we went into therapy. Does that sound stupid?
Alex thinks that this suggestion might work sometimes, but that there is more to it than that:
I think it is somewhat an oversimplification of the problem, but might work sometimes, for some people. I think that being able to handle the problems that arise in therapy is part of the social skills we have to practice anyway, in order to live in society .. Being aware that problems may arise, and keeping your eyes wide open for some signs might suffice for most people...
Some of us have problems when working with therapists our own sex, for one reason or another, too.
A list member suggests:
Could it be that the feelings attributed to the therapist, in the transference, belong to a preverbal period? e.g. between mother and baby in the very early weeks where for the baby the feelings are all encompassing (including sexual) and all consuming (body, mind and spirit) as discussed by Winnicott? The craving for the breast and being one with the mother?
Alex would like some evidence of such a theory:
Yes, it could be. As with many things in psychology: they "could be". Well, many of our emotional reactions have a preverbal COMPONENT anyway. I want to see these hypotheses submitted to some kind of a test.
Where does this idea come from, that a baby wants to become one with the mother? I can imagine that the baby cannot differentiate himself, or herself, from the mother. But to be willing to become one with somebody else, we need first to be differentiated from this "somebody else".
I really have a hard time understanding some concepts in psychology...
Posted by Dinah on October 7, 2003, at 11:15:25
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by jay on October 7, 2003, at 10:50:33
> I understand what you are saying...and the smallest amount of attraction should only be able to be picked up if you where a psychic. I don't mean to be arrogant or whatever, but I have plenty of first-hand experience, twice with me and numerous with other colleagues. The two times with me involved slightly covert, but suspicious questions about *me* as a person, and my personal life.(VERY blatent questions.) Most counsellors who find this is an issue will discuss it with colleagues first.
>
> Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. That would be humanly impossible. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
>
Arrrgh, Jay.....That is not the *common* practice, and you're scaring people. Please check your facts. A therapist who turns feelings into inappropriate words or gestures is wrong and should be terminated. A client who turns feelings into words is doing their job as a client. You are *supposed* to put your feelings into words. You aren't supposed to keep those things to yourself. You would be doing the wrong thing to keep those things to yourself. You aren't supposed to sexually attack your therapist, disrobe, or harass your therapist. But you aren't wrong in *saying* you are attracted to him or her!!!!!!!!!
If a client asks private questions you don't terminate him either. You enforce the boundaries of the therapeutic relationship. You do not terminate a client that easily. You'd be in huge malpractice area for that. You tell them you aren't willing to share that information. You ask them why it's important for them to know that information.
Your average therapist is NOT going to terminate a client for *any* feelings (note I say feelings, not threats) a client reports towards him. Your average therapist will not terminate for covert or overt questions about his private life. Goodness gracious. No therapists would have any clients!!!
What are you saying? That you should treat your therapist like your accountant or lawyer? You are in an intimate relationship where feelings are likely to crop up. You are in a relationship that is intimate if only because you are supposed to discuss your feelings!!!
I'm sorry to get so upset here, but you've already scared Adia. And many people read this board who don't post and may decide never to tell their therapist what they're thinking based on your words. That's the Psychological Babble equivalent of telling people to mix booze and their psych meds on Psycho-Babble. It's harmful to people to say these things. Please check it out first and if your social worker board agrees with you, forward their reply to this board.
Because this is contrary to every thing I have ever heard about therapy. And if your social worker board agrees with you, I have some writing myself to do to the APA, American Social Worker board, and yours as well.
I would be very interested to know if they agree with you. But please check it out before you keep telling people they are bad for expressing their feelings to their therapist.
In fact, if you like, I will forward your posts to the Canadian Board of Social Workers and publicly post their replies on this board.
Posted by Dinah on October 7, 2003, at 11:18:05
In reply to Re: Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 10:59:55
Jay, that reference has nothing to do with a client being terminated for expressing feelings for a therapist.
I am currently copying your posts into an email and will forward them to your professional society. I will forward on their reply, if any, to this board.
Posted by Dinah on October 7, 2003, at 11:20:28
In reply to Re: Please read...Code of Ethics Therapy, posted by Dinah on October 7, 2003, at 11:18:05
Posted by Dinah on October 7, 2003, at 11:32:07
In reply to Re: Jay, is this the society you refer to?, posted by Dinah on October 7, 2003, at 11:20:28
I gave links to your posts so that there would be no misunderstanding. And I'm perfectly willing to post the content of my email.
Dinah
Posted by Penny on October 7, 2003, at 11:34:15
In reply to Re: OK, it's in my outbox, posted by Dinah on October 7, 2003, at 11:32:07
Posted by Dinah on October 7, 2003, at 11:35:52
In reply to Re: Thank you, Dinah. (nm), posted by Penny on October 7, 2003, at 11:34:15
Well, I haven't sent it yet. I want to make sure I'm sending it to the proper association. But I would like them to have a chance to clarify their position.
Posted by Adia on October 7, 2003, at 11:37:09
In reply to Re: Adia, Please don't panic, posted by Dinah on October 7, 2003, at 10:44:32
Dear Dinah,
Thank you :o)
I will hang on to this...
I just panicked, I am not in the best place to read something like that. I get scared to read or be told that talking about feelings is not okay when I am trying hard to convince myself that it is okay to talk or tell my therapist what I feel.
You are right and I can't think that my therapist would ever hurt me so much and terminate with me because of the intensity of my feelings or if I tell her I love her or share my feelings for her.I smiled with what you've told your therapist because I would tell mine just the same :o)
Thank you again for the reassurance..
Adia.> Jay is mistaken. I've told my therapist that I see him as a mother dog to my blind pup. That I see him as a giant breast and smell milk. (well, I told someone, maybe not him). If I were sexually attracted to him, I'd tell him so. I've told him I loved him (not in a sexual way).
>
> Your therapist is not going to refer you to someone else for that.
>
> The only way you might earn a referral is if you disrobed and threw yourself on her, or stalked her or something where she feared for her safety.
>
> PLEASE, don't worry about this.
Posted by Adia on October 7, 2003, at 11:45:08
In reply to Re: Please read...Code of Ethics Therapy » Adia, posted by Penny on October 7, 2003, at 10:49:41
Thank you Penny...
Thanks for explaining this to me...
Thank you for saying my T won't terminate with me because of my feelings for her.
I struggle to convince myself it is okay to tell her my feelings and I always fear she will abandon me if I share my feelings..and I read something like that and I just panic.
But I have absolute trust in her and I trust in my heart that she would never terminate with me because of that, she's always encouraging me to talk or tell her what I feel no matter what.Thank you for your message...It helped me :O)
I am so glad you have such a wonderful therapist. When I read this kind of thing, I feel so fortunate to have found mine too.
Thank you...
Adia.> Don't panic!
>
> I'm going to bring up this topic in therapy today, to see what my therapist says. But I have had the 'transference' talk with both my current and former therapists and pdoc, and none of them have terminated as a result! The only circumstance I can think of that would cause a therapist to terminate as a result of transference would be the therapist's inability to handle those feelings (well, the therapist's experience of countertransference and his or her inability to handle *those* feelings). Or if you were to admit feelings for your therapist (I'm thinking romantic) and they were to admit that they felt the same way - that is unethical.
>
> But a therapist would have to be cold and unfeeling to turn a client away because of transference feelings - in fact, I suspect that could be grounds for malpractice.
>
> Don't panic, Adia! Your therapist isn't going to terminate you b/c you've admitted mother/child feelings toward her. As a skilled practitioner, she's going to take those feelings and use them to help you deal with your issues. That's what she's there for.
>
> She sounds like a wonderful therapist. Mine is too.
>
> P
Posted by underthecs on October 7, 2003, at 13:26:36
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by jay on October 7, 2003, at 10:50:33
> Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
geez... what planet are you living on? No line is being "crossed" when a client expresses feelings. i'm glad you're not my therapist. perhaps a little continuing education is in order. and i mean this in the nicest possible way...
Go forward in thread:
Psycho-Babble Psychology | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.