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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by crushedout on January 29, 2004, at 23:37:23
I finished reading "Deepening Intimacy in Psychotherapy: Using the Erotic Transference and Countertransference" and I found it really interesting. My thoughts about whether a T should disclose romantic and/or erotic feelings toward a patient have changed significantly. Reading the book has persuaded me that it can often be -- though perhaps isn't always -- useful and therapeutic for a T to disclose such feelings.
Here are a couple thoughts I had that changed my thinking on this. First, I think that sexuality and attraction can be very powerful feelings in a room and failing to verbalize them does not actually necessarily keep them from the patient's consciousness. So what ends up happening instead is a sort of impasse, where the therapist and patient dance awkwardly around the subject, both too afraid to just say what's going on. It seems to me to be more helpful for the T just to be honest about her feelings. This also can serve as a helpful model for the patient to express her transference feelings, which can be difficult.
Another observation that I gathered from the book was that why, if the T is supposed to bring her feelings into the therapy in every other area, is sexuality out of bounds? Ts are sexual creatures like the rest of us, and it's only natural for them to have sexual or romantic feelings for their patients some of the time. It seems to me a product of our sexually repressive culture that we frown upon them talking about their sexual feelings. (Obviously, it's also a product of many Ts being abusive, and the reaction to that.)
My guess is it's not helpful for every T, every patient, and every situation (i.e., it should depend on many variables whether a T should disclose).
Just some thoughts I wanted to share. I recommend the book.
Posted by alexandra_k on January 30, 2004, at 2:51:55
In reply to New thoughts on T disclosures re: countertransfer., posted by crushedout on January 29, 2004, at 23:37:23
Wow. I have never talked about transference. Especially not that kind. But whenever I have a male clinician who I get along with I get it real bad... I don't know if I would be too embarrased to talk about it though. I don't even talk about relationships or flings or anything like that, or if I do the subject gets changed - for which I am grateful. I think... Does it get better if you talk about it? You won't just end up jumping each others bones???
Posted by crushedout on January 30, 2004, at 10:02:42
In reply to Re: New thoughts on T disclosures re: countertransfer., posted by alexandra_k on January 30, 2004, at 2:51:55
i think it's really good to talk about. i've been told that it tends to diminish after you talk about, but so far that hasn't been my experience. but it does increase the trust and intimacy, and if nothing else, it's an ego boost for your T.no, you're not supposed to end up jumping each others' bones, although i wish that was what happened. if your T is good, he should make sure that doesn't happen. you may both get turned on, though, and that's ok. it's just human.
i've been struggling recently because i've been getting sexually aroused during our sessions and she asks me what i'm feeling and i'm too embarrassed to admit to it. but she should be able to handle this. so i hope i can figure out a way to tell her this next time.
> Wow. I have never talked about transference. Especially not that kind. But whenever I have a male clinician who I get along with I get it real bad... I don't know if I would be too embarrased to talk about it though. I don't even talk about relationships or flings or anything like that, or if I do the subject gets changed - for which I am grateful. I think... Does it get better if you talk about it? You won't just end up jumping each others bones???
Posted by Penny on January 30, 2004, at 10:15:34
In reply to Re: New thoughts on T disclosures re: countertransfer. » alexandra_k, posted by crushedout on January 30, 2004, at 10:02:42
Well, I've had the maternal transference discussion with both of my Ts, but I haven't experienced erotic transference with them, so haven't had to have *that* talk. My pdoc, on the other hand - well, I just love him. I mean, I can't honestly say I like to think of him in 'that way' - I know he's married (I hope happily!) with five kids, and he's older than my dad, and we've discussed transference in general, and he discourages it with his patients - he says he thinks it's quite valuable in therapy, but he tries very hard to not do therapy with his patients. So, he's very open about his life and we just talk. Unfortunately, as I've told him, that hasn't kept me from becoming attached to him. As I told him, he's the only man in my life, really, that I can talk to about pretty much anything.
At the same time, my feelings for my pdoc are confusing in a way. On one hand, I see him as a father figure. On the other hand, I find him attractive, and while I know that my comfort with him is largely due to his 'safety' factor, i.e. that I KNOW nothing would EVER happen between us, so it's okay for me to be open with him, I still find him attractive and I guess, if I had to be brutally honest (and why do I feel a need to be right now?), I do occasionally find myself flustered or overwhelmed with affection for him. For example, he took my bp once, not too long ago, and I couldn't help but blush. Now, it's not as though this man isn't a medical doc, not as though I haven't known him for over 2 years, and so on, not as though he doesn't know most everything about me, but I still blushed and felt, well, I don't know!
But I haven't told him that. And, honestly, I'm not sure what purpose it would serve. I did tell him that I thought my bp was elevated just in his office, not in general, and he said, "Is it the white coat effect?" and I said, "No, I think it's the man effect..." Which is when he thought it might be better if I take my own bp at home... :-b
P
Posted by Karen_kay on January 30, 2004, at 16:16:09
In reply to New thoughts on T disclosures re: countertransfer., posted by crushedout on January 29, 2004, at 23:37:23
Well, my therapist doesn't shy away from expressing sexual feelings. Not that he expresses them towards me. What he does do is allow me to see that having sexual feelings is human and natural. And at this point it has been successful.
But, I think that in sharing sexual feelings common towards a client, wouldn't that defeat the common goal of therapy. Which is to serve the client. I mean as much as I would love to hear my therapist say, "Oh Karen, I'm afraid I've fallen head over heels in love with you." I'd much rather hear him say, "Oh Karen, you're all better." Or better yet, "Oh Karen, you're all better. Here's my number, give me a call in two years after I divorce my wife." Oh! Now that would be the best case scenario!
Back to original subject: If a therapist were to express feelings of a sexual nature towards the client, how would that serve the client? It would just leave the client in an awkward position. The therapist is there to serve the client, not vice versa. Upon hearing that a therapist has developed some feelings, a client may feel a need to please the therapist, or feel that the already unequal power structure has shifted even more. I just can't see how it would be useful to the client. Even though I'd love to hear it myself :) But, we can still always pretend or trust our instincts. Or ask. It could, at the very least start a good discussion.
Posted by alexandra_k on January 30, 2004, at 19:15:00
In reply to Re: New thoughts on T disclosures re: countertransfer., posted by Karen_kay on January 30, 2004, at 16:16:09
Yeah. I don't think that I would like it if a T or p-doc disclosed his feelings for me. Well I might get off on it slightly (depending on what the verdict was) but I don't think that it would help me much. Unless the discussion was about physiological arousal - proper 'feelings' though would be a bit much...
I think that it may well be profitable to talk about why I would get off on that though. I know I have serious issues around being attracted to father-figure types because of my abuse history. Don't feel anything for peers and would like to change that so I figure I will probably need to process that one day. I think I would probably prefer to process it with a female clinician though because if I was working with a guy and he jumped my bones I would reciprocate and it would mess me up bigtime.
Posted by crushedout on January 30, 2004, at 19:33:22
In reply to Re: New thoughts on T disclosures re: countertransfer., posted by Karen_kay on January 30, 2004, at 16:16:09
i think it would serve the client because it would be honest, authentic. and i think that's a large part of what therapy is about. it would also make the client feel good. boundaries would have to also be clarified.
like i said, i think it depends a lot on the situation, the client, etc. I don't know that it would be helpful for all clients.
> Well, my therapist doesn't shy away from expressing sexual feelings. Not that he expresses them towards me. What he does do is allow me to see that having sexual feelings is human and natural. And at this point it has been successful.
> But, I think that in sharing sexual feelings common towards a client, wouldn't that defeat the common goal of therapy. Which is to serve the client. I mean as much as I would love to hear my therapist say, "Oh Karen, I'm afraid I've fallen head over heels in love with you." I'd much rather hear him say, "Oh Karen, you're all better." Or better yet, "Oh Karen, you're all better. Here's my number, give me a call in two years after I divorce my wife." Oh! Now that would be the best case scenario!
> Back to original subject: If a therapist were to express feelings of a sexual nature towards the client, how would that serve the client? It would just leave the client in an awkward position. The therapist is there to serve the client, not vice versa. Upon hearing that a therapist has developed some feelings, a client may feel a need to please the therapist, or feel that the already unequal power structure has shifted even more. I just can't see how it would be useful to the client. Even though I'd love to hear it myself :) But, we can still always pretend or trust our instincts. Or ask. It could, at the very least start a good discussion.
Posted by Karen_kay on January 30, 2004, at 21:35:09
In reply to Re: New thoughts on T disclosures re: countertransfer. » Karen_kay, posted by crushedout on January 30, 2004, at 19:33:22
I realize that it may make the client feel good, but wouldn't it make the client feel awkward? I mean honestly if your therapist were to tell you that she (that's right isn't it?) had sexual feelings about you (are we just talking about sexual or otherwise) how would that honestly make you feel? I have to say, as much as I would LOVE to hear it, it would make me a bit uncomfortable. I mean, it would question the motive behind every piece of advice he gave me. It would make me question every thing he said. It would honestly just play games with my head. I think the fantasy of thinking that he possibly thinks those things would be so much better than the reality.
I'm not trying to be argumentative, please don't get me wrong. And I do think that the relationship should be authentic indeed. But, there is a certain point of honesty that I think is acceptable and in the interest of the client. Then, past that point, I think personally it would only be serving the personal interest of the therapist.
Like, with my therapist for example, saying what he did about having fantasies about clients....Again, since it wasn't about me, I'd say that was acceptable. However, if he had said it was me, that would not be acceptable because that would be fulfilling only his agenda.
I just think that clients go to therapy with enough issues, why try to add to them with the burden of therapist's own, you know? I mean I worry constantly about my therapist now and I didn't worry about him before I knew him. If he were to fire me as a client, that would only add to my plate. And I wouldn't want to think about the added burden of him saying something like, "I can't see you anymore because I'm sexually attracted to you." Oh, bother! I'd just say, "Look, I'll ugly myself up, just for you!"
Posted by crushedout on January 30, 2004, at 21:43:37
In reply to Re: New thoughts on T disclosures re: countertransfer. » crushedout, posted by Karen_kay on January 30, 2004, at 21:35:09
no, i don't think it would make me feel awkward at all. i actually think it would be a breakthrough in the therapy. i think it would help me. and it wouldn't be about advancing her own agenda -- she would have to do it for me, for my therapy. not to get laid or arouse herself or anything.it would help me in the same way it would help me for her to simply tell me that she likes me, enjoys my company (which she's told me before) -- i would be flattered and it would make me feel validated and good about myself. and i would respect her honesty and feel more comfortable opening up to her about my feelings for her.
i just don't see why she SHOULDN'T tell me. i mean, therapists are supposed to be authentic about their feelings. why not their sexual ones as well? those can inform the therapy as much as any other. perhaps it would help me see that i tend to seduce people, or lead them to relate to me in a sexual way, and that could open up a fruitful discussion. basically, i just don't see what the problem would be in her disclosing that. for me.
it seems you think it would be a problem for you. although (i hope you won't mind my saying) i'm not entirely convinced that that's true.
> I realize that it may make the client feel good, but wouldn't it make the client feel awkward? I mean honestly if your therapist were to tell you that she (that's right isn't it?) had sexual feelings about you (are we just talking about sexual or otherwise) how would that honestly make you feel? I have to say, as much as I would LOVE to hear it, it would make me a bit uncomfortable. I mean, it would question the motive behind every piece of advice he gave me. It would make me question every thing he said. It would honestly just play games with my head. I think the fantasy of thinking that he possibly thinks those things would be so much better than the reality.
>
> I'm not trying to be argumentative, please don't get me wrong. And I do think that the relationship should be authentic indeed. But, there is a certain point of honesty that I think is acceptable and in the interest of the client. Then, past that point, I think personally it would only be serving the personal interest of the therapist.
>
> Like, with my therapist for example, saying what he did about having fantasies about clients....Again, since it wasn't about me, I'd say that was acceptable. However, if he had said it was me, that would not be acceptable because that would be fulfilling only his agenda.
>
> I just think that clients go to therapy with enough issues, why try to add to them with the burden of therapist's own, you know? I mean I worry constantly about my therapist now and I didn't worry about him before I knew him. If he were to fire me as a client, that would only add to my plate. And I wouldn't want to think about the added burden of him saying something like, "I can't see you anymore because I'm sexually attracted to you." Oh, bother! I'd just say, "Look, I'll ugly myself up, just for you!"
Posted by crushedout on January 30, 2004, at 21:52:11
In reply to Re: New thoughts on T disclosures re: countertransfer. » crushedout, posted by Karen_kay on January 30, 2004, at 21:35:09
i just want to clarify, karen, that i don't think a therapist should "dump" his or her feelings of sexual attraction on you and then fire you. that's not what i had in mind. i'm talking about just being forthright about them and then using them to increase intimacy and otherwise advance the therapy.and it shouldn't be an "issue" that the therapist is "burdening" you with -- rather, it should be a disclosure that the therapist is comfortable sharing as a natural part of the t's human reaction to you.
if it's an "issue" for the t, the t should be taking it to his or her own t and not to you.
> I realize that it may make the client feel good, but wouldn't it make the client feel awkward? I mean honestly if your therapist were to tell you that she (that's right isn't it?) had sexual feelings about you (are we just talking about sexual or otherwise) how would that honestly make you feel? I have to say, as much as I would LOVE to hear it, it would make me a bit uncomfortable. I mean, it would question the motive behind every piece of advice he gave me. It would make me question every thing he said. It would honestly just play games with my head. I think the fantasy of thinking that he possibly thinks those things would be so much better than the reality.
>
> I'm not trying to be argumentative, please don't get me wrong. And I do think that the relationship should be authentic indeed. But, there is a certain point of honesty that I think is acceptable and in the interest of the client. Then, past that point, I think personally it would only be serving the personal interest of the therapist.
>
> Like, with my therapist for example, saying what he did about having fantasies about clients....Again, since it wasn't about me, I'd say that was acceptable. However, if he had said it was me, that would not be acceptable because that would be fulfilling only his agenda.
>
> I just think that clients go to therapy with enough issues, why try to add to them with the burden of therapist's own, you know? I mean I worry constantly about my therapist now and I didn't worry about him before I knew him. If he were to fire me as a client, that would only add to my plate. And I wouldn't want to think about the added burden of him saying something like, "I can't see you anymore because I'm sexually attracted to you." Oh, bother! I'd just say, "Look, I'll ugly myself up, just for you!"
Posted by alexandra_k on January 30, 2004, at 22:23:09
In reply to Re: New thoughts on T disclosures re: countertransfer. » Karen_kay, posted by crushedout on January 30, 2004, at 21:52:11
Hate to be a party killer but maybe your T doesn't feel this way about you - which may be why she hasn't said anything.
How would that make you feel?
I am not meaning to offend or anything...
Posted by crushedout on January 30, 2004, at 22:27:07
In reply to Re: New thoughts on T disclosures re: countertrans, posted by alexandra_k on January 30, 2004, at 22:23:09
well, i never suggested she did feel this way toward me. i'm just saying that *if* she did, i don't think she should hide it from me.if she didn't, it would hurt very much. thanks for bringing it up. i don't really understand why you are.
> Hate to be a party killer but maybe your T doesn't feel this way about you - which may be why she hasn't said anything.
>
> How would that make you feel?
>
> I am not meaning to offend or anything...
Posted by crushedout on January 30, 2004, at 22:31:17
In reply to Re: New thoughts on T disclosures re: countertrans, posted by alexandra_k on January 30, 2004, at 22:23:09
you did kind of offend me, but...just fyi, that's the very reason why i've never come right out and asked her directly whether she's attracted to me: i would hate to hear that she wasn't.but also fyi, since you seem to be unfamiliar with my history, when i told her i had romantic feelings for her, she responded by telling me she found me very beautiful. also when i made her a mix cd, she responded by making me one (with romantic songs on it). i was alarmed by both of these actions because i thought they were potentially inappropriate, and now i'm rethinking that.
> Hate to be a party killer but maybe your T doesn't feel this way about you - which may be why she hasn't said anything.
>
> How would that make you feel?
>
> I am not meaning to offend or anything...
Posted by alexandra_k on January 31, 2004, at 4:45:37
In reply to Re: New thoughts on T disclosures re: countertrans, posted by crushedout on January 30, 2004, at 22:31:17
I am sorry. I am in a strange mood, it did occur to me that it wasn't sensitive at all - I didn't realise just how much though till after I posted - would have edited it out but I don't know if we can do this???
My thought was that sure having sexual feelings is a part of being human, and is natural and all. But I also know guys who are very 'attractive' in the classic sense (I know there is no standard of 'objective' beauty but 9 out of 10 would agree that they are very good looking...) anyway my point is that they don't turn me on at all. Though I am very very fond of some of them.
Now I am messed up in that respect - but my point is kind of that I don't think one need take offence or feel hurt if someone isn't aroused or strongly attracted to you as they may still like you very much indeed.
Someone can also be physically attracted to you for all the wrong reasons. In which case it is not much of a compliment at all ('100 for a F***?').
I guess what I am trying to say is that sexual arousal can be seperable from closeness and attachment. Things blur for me. I would hate it to blur for my T because I need someone to help me tease them apart. I meant my last question as a genuine question because I want the answer to be 'I wouldn't be upset at all'. I think that discussing with your T why this issue is on your mind may be more useful to you than how your T actually feels that is all.
Once again, I am sorry - I would have felt offended too if I was in your position.
Posted by crushedout on January 31, 2004, at 8:15:04
In reply to Re: New thoughts on T disclosures re: countertrans, posted by alexandra_k on January 31, 2004, at 4:45:37
that's ok. you make an excellent point and i agree with you. it *is* more important why it matters so much to me than how she feels about me.> I am sorry. I am in a strange mood, it did occur to me that it wasn't sensitive at all - I didn't realise just how much though till after I posted - would have edited it out but I don't know if we can do this???
>
> My thought was that sure having sexual feelings is a part of being human, and is natural and all. But I also know guys who are very 'attractive' in the classic sense (I know there is no standard of 'objective' beauty but 9 out of 10 would agree that they are very good looking...) anyway my point is that they don't turn me on at all. Though I am very very fond of some of them.
>
> Now I am messed up in that respect - but my point is kind of that I don't think one need take offence or feel hurt if someone isn't aroused or strongly attracted to you as they may still like you very much indeed.
>
> Someone can also be physically attracted to you for all the wrong reasons. In which case it is not much of a compliment at all ('100 for a F***?').
>
> I guess what I am trying to say is that sexual arousal can be seperable from closeness and attachment. Things blur for me. I would hate it to blur for my T because I need someone to help me tease them apart. I meant my last question as a genuine question because I want the answer to be 'I wouldn't be upset at all'. I think that discussing with your T why this issue is on your mind may be more useful to you than how your T actually feels that is all.
>
> Once again, I am sorry - I would have felt offended too if I was in your position.
Posted by Karen_kay on January 31, 2004, at 12:38:03
In reply to Re: New thoughts on T disclosures re: countertrans » alexandra_k, posted by crushedout on January 31, 2004, at 8:15:04
I'm really sorry if I've offended you in some way. I seem to get the impression that I have. Am I just being paranoid, as that is rather typical of me. Please be honest and tell me if I have. I'd really like to work it out if that's that case. If I'm just being silly, tell me that as well.....
If Bubba (my therapist) were to tell me that he was attrcted to me, it would honestly put me in an awkward position. I was sexually abused as a child and for him to tell me that, I would constantly worry that he had some other motive for every piece of advice he gave me (as in trying to leave my boyfriend), every concern he had for me, ect. I already have trust issues and this would just add to that. I jsut don't think it would be in my best interest for him to disclose something like that to me. I would constantly worry about another man not being able to control his urges and keeping my best interests at heart.
In your case, do you think this is coming from your best interests or more from your desire? (I'm not trying to sound harsh, just trying to give a diferent point of view from an outside viewer looking in) Would you rather have your therapist as a therapist or a lover? I think that sexual feelings are completely natural and wonderful, but to tell a client would only give them false hopes. Or burden them with the idea that "Maybe the therapist won't be able to control those urges and will have to terminate based on that."
What exactly do you mean though.... As in the therapist admitting to sexual fantasies? Or admitting to being in love with the client? I could see the therapist admitting to fantasies if the client asks and there are trust issues involved, ect. But, I can't see a reason for a therapist to say, "I'm in love with you." I jsut can't see how that would be in the best interest of the client...
But, I wonder is this coming more from your desire for your therapist to love you? I really think you should talk to your therapist about this. It seems that your therapist had some loose boundaries in the beginning.
Posted by crushedout on February 1, 2004, at 0:14:54
In reply to Re: New thoughts on T disclosures re: countertrans » crushedout, posted by Karen_kay on January 31, 2004, at 12:38:03
Karen Kay,
You have not offended me in any way. I just find it frustrating arguing with you. I feel like I keep repeating myself.
So, to repeat myself again, I don't think that this is necessarily the right approach for all therapists to take with all clients. In your case, for example, given your history, it might not be such a good idea. On the other hand, what your T did in telling you about his sexual fantasies (which, regardless of whether they were actually about you -- let's please not start another argument about that again --, seems pretty unkosher under most people's ideas about therapist disclosures) you seemed to think helped you. And I thought at the time it was a bad idea, but I'm reconsidering that sort of thinking now.
Nonetheless, you say that if he were to actually come right out and tell you he were attracted to you, that would not be helpful to you. That's good to know. I think it would be helpful if *my* T were to tell *me* that (assuming it were true, which I do not assume, although I may hope it). As I said, simply because it would be honest, would bring us closer, and may actually help me to finally move beyond this transference crap I've been going through for over a year now.
Also my T is not a man, so I think that may change the dynamic significantly. At the risk of sounding sexist, I don't worry about women controlling their sexual urges as much as I do men. So that may be a difference between your situation and mine, among other things.
I've always wanted my T to tell me she's attracted to me, yes. My point, however, is that after reading this book, I've come to think that it might actually be helpful to my therapy if she were to do so. I could be wrong, but that's what I think. It would also be satisfying to me personally, but that's not necessarily at odds with what is good for me therapeutically. However, that's not what I'm talking about.
I've always *felt* that I would rather my therapist be my lover than my therapist, but why are you asking me that? It seems to me to be beside the point. The point of her telling me her romantic or erotic feelings toward me (if she had any) would not be so we could hook up but to advance my therapy. At least, that's the scenario I was envisioning when I started this thread. So my fantasies about us becoming lovers are irrelevant. They would be important to explore, but my point is simply that by her disclosing such feelings, I might be better equipped to explore such fantasies with her, and ideally, move past them at some point.
I already have "false hopes" and worries that my T won't be able to handle her sexual or romantic feelings toward me. By bringing them out in the open, we could address those hopes and fears directly, and perhaps get rid of them.
I'm thinking of a variety of sexual or romantic feelings. I'm not sure I was thinking as far as "I'm in love with you" -- at that point, I think there may be a big problem. But I'm not sure about that. But yes, maybe fantasies if they seem relevant. I think that it has to be done carefully.
Posted by Karen_kay on February 1, 2004, at 11:56:31
In reply to Re: New thoughts on T disclosures re: countertrans » Karen_kay, posted by crushedout on February 1, 2004, at 0:14:54
I'm truly sorry if you think I'm arguing with you. Sometimes I seem to give that impression when I'm really not arguing. I promise I'm not. I wish I could somehow speak, so that you could hear my voice and the sincerity in it.
As for the repeating yourself, I'm sorry about that too :) I have a tendancy to make people talk in circles. But, I really honestly don't believe that hearing that from a therpist would help many people. Maybe it would help you, maybe it wouldn't. You seem convinced that it would. I really seem convinced that it wouldn't help many people.
If you think that hearing those words from your therapist would somehow help with a sort of breakthrough in your therapy, why not just ask about it? I think that bringing this matter out in the open will definitely advance your therapy. I don't necessarily agree that hearing that your therapist is attracted to you will advance therapy, but bringing your feelings out into the open and discussing them will. And also, telling your therapist that you feel she may be attracted to you will also help advance your therapy.
So, again I'm very sorry if you feel I've been arguing with you at any point that we've been communicating. If I've given you that impression, I apologize. If you'd rather I not correspond with you, feel free to let me know. I've just been giving you my honest opinion, as I frequently do with everyone. But I didn't mean to come across as harsh in the least bit. But, I also don't walk around on egg shells either. Again, if you'd rather me not give you my opinion on the matter, I won't. But, when I ask for honest answers, I truly appreciate them.
This is the end of the thread.
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