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Navigating Erotic Transference in Psychotherapy

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Erotic transference refers to feelings of romantic or sexual attraction that a client may develop toward their therapist during the course of therapy. These feelings may stem from unconscious processes and can complicate the therapeutic relationship.

Understanding erotic transference is important because it can influence the dynamics of the therapeutic relationship and the progress of treatment. Recognizing and addressing these feelings allows therapists to maintain professional boundaries and focus on the client's needs without interference from personal or romantic distractions.

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Therapists have an ethical responsibility to handle erotic transference with sensitivity and professionalism. This includes acknowledging the client's feelings without judgment, exploring their underlying meaning within therapy, and maintaining appropriate boundaries to ensure the client's emotional safety and well-being. By addressing erotic transference with care, therapists uphold the integrity of the therapeutic process and promote trust and therapeutic progress.

What is Erotic Transference?

Erotic transference is when a client develops romantic or sexual feelings towards their therapist during therapy sessions. It's a type of emotional connection that goes beyond the typical therapeutic relationship.

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Erotic transference differs from other types of transference, such as positive or negative transference, which involve the client projecting feelings onto the therapist based on past experiences with authority figures or relationships.

While positive transference involves admiration or trust, erotic transference specifically involves romantic or sexual attraction.

Email Samples of Erotic Transference

1) "......Erotic transference at first feels like falling in love and has a euphoric quality, but my experience is that it has the potential to be quite emotionally damaging and lingering. For me, after nearly two years, there is still a deep longing, restlessness, and melancholy that will not subside. The pain is also much deeper than a regular crush/unrequited love. It's described as torturous by some of the patients on this website and I think that pretty much sums it up. Also, it seems there are different forms of transference, and my experience is with the most serious – eroticized transference.

they've made a wrong move. But I have to say, with all due respect, that many therapists appear to be clueless and have no idea how to deal with this or understand what the patient is going through...... For me, it's an experience that is unprecedented in its intensity and will probably stay with me."

2) "...a part of my brain was pricked during therapy and a poison was released and I can't clear it out. I've also thought about writing about my experience in hopes it would help the pain go away..."

3) "I've been in psychodynamic therapy for over 10 years with a female therapist. I have suffered eroticized transference to her for nearly the whole time. While I have become accustomed to the idea of it, recognizing that it derives from my deficient attachment to my neglecting mother as a young child, for several years this was highly upsetting to me, as I am a heterosexual married female. 

I have discussed my feelings with my therapist at length.  Still we are stuck......

This doctor is committed to my healing. Her boundaries are in tact. She has helped me in rebuilding my life in countless other ways. Yet, the pain of missing her and yearning for her remains."

Discussion of Erotic Transference Examples

These three are excellent examples of the types of pain some people have experienced in the erotic transference to their therapists. These patients are women but the erotic transference happens to male patients in relation to female therapists or homosexually to male therapists.

This is what is called transference. When transference involves sexual feelings it is called erotic transference.

Transference

Transference refers to a person bringing their past experiences into the relationship with the therapist. The most important types of experiences that are transferred are those carried from earliest infancy but are not remembered. Those early experiences are repressed (forgotten) and, later, become attached to the inappropriate figure of the therapist in the present. The therapist is inappropriate because he cannot gratify wishes coming from the past. In terms of psychoanalytic psychotherapy, this is called transference neurosis. In other words, the patient reenacts those experiences from early childhood in the therapeutic relationship. This "transference neurosis becomes the focal point of the therapy and the ultimate cure. Just for clarification, it is important to keep in mind that even though a person has a "forgotten memory" it remains stored in the brain where it can interfere with how that person functions.

Transference occurs in all types of psychotherapy. Therapists who use cognitive behavioral therapy, brief psychotherapy, family therapy, and group therapy, can become the target of transference feelings and wishes. In the other types of therapy, the therapist does not focus on transference. In these cases, there is no need to intensify the therapeutic relationship because that is not the goal of the treatment. Instead, the focus is on the here and now in the life of the patient and not on the past.

It is only in psychoanalysis or long-term psychoanalytic therapy that the transference is discussed in detail and resolved before the patient is ready to leave treatment. One of the major features of psychoanalytic therapy is that it is very intense. That intensity is fostered by the fact patient and therapist meet three or more times per week. When the patient and therapist discuss the transference treatment is further intensified.

The therapist must be fully aware of the power of the patient's transference feelings and never allow him or herself to be seduced and act upon those feelings. For one thing, patient transference emotions are not realistic. Instead of acting, the therapist must provide a safe and secure environment in which relationship problems can be unraveled, and understood in order that this person can resume their lives in ways that are healthier and more fulfilling than previously.

Types of Transference

In other types of psychotherapy, it is hoped that the relationship between therapist and patient is a positive one. This is called a "positive transference" and the positive nature of the relationship is what makes the work possible. It is difficult to accomplish cognitive behavioral therapy if the patient has angry feelings towards the therapist. Of course, this can happen but the work is then to look at the patient's thoughts, determine if there is evidence for those thoughts, and then look at more realistic ways of thinking. This is far different from psychoanalytic psychotherapy. Even if the patient mentions some feelings about the therapist the focus remains on the present time in the life of this individual.

Sometimes a person may develop a "negative transference" to the therapist, meaning that the therapist has lost the trust of his patient. The angry feelings are so intense that, in most circumstances, the patient leaves the treatment.

There are many reasons a patient might develop a negative transference towards the therapist. The very young and childlike feelings of the patient cause him to believe that the therapy charges should be much lower. After all, would mommy or daddy charge money for care? Another reason might be that the therapist takes vacations and this is viewed as unfair. In this case, the wish of the patient might be to go on vacation with the therapist or to feel very abandoned when he leaves for vacation. Then, too, it is common for children to wish they could be the only child in the family. In the context of therapy, this can lead to resentment of and jealousy towards the therapist's other patients.

There is something called an "idealizing transference" in which the patient holds the therapist in the highest regard possible. In fact, such a person may identify with and want to become like the therapist. In such cases, the individual may decide to pursue a career in psychology or mental health. Other people with such a transference may wish to emulate the therapist but in the way of pursuing higher educational goals. This idealizing transference is very positive and often leads to the successful completion of many therapies with the patient going on to become quite successful.

Erotic Transference

Erotic transference is just what it implies. It occurs when the transference begins to include sexual feelings directed to the person of the therapist. Because of the nature of erotic transference, the patient is yearning for and even demanding sexual intercourse. This patient is convinced that only when the therapist satisfies these cravings can real happiness be achieved. The patient explains that only in this way can the love of the therapist be proven. There is a repetitive and compulsive nature to these demands. Frequently, the flip side of the erotic transference is hatred. This hatred is expressed through the endless demands for the love and sexual attention that is so desired.

Erotic transference does not always occur. In other words, there is nothing inevitable about it. The reason why one patient develops an erotic transference and another does not has a lot to do with the patient's diagnosis and therefore, with the types of things they experienced from their earliest life. A person who may have felt ignored or neglected by their parents may become someone who has endless cravings that are placed onto the therapist. In this type of scenario, the patient actually believes that the therapist has the power to gratify these wishes and that such gratification would be curative. Of course, this is never true.

There are times when the erotic transference cannot be resolved and the patient leaves treatment angry and disappointed. I suspect this is what happened in cases #1 and #3.  In fact, case #3 went on for ten years and ended unsuccessfully.

The fact is that the purpose of all psychotherapy is to help the patient improve their functioning. Therefore, in the context of psychoanalysis, it is the goal to resolve the transference, erotic or not, in order that the patient find appropriate intimate partners in the outside world and live well-adjusted lives. This translates into the patient entering into adult relationships in the outside world where they can live fully intimate and satisfying lives with the appropriate type of partner who can gratify adult wishes for love, sexuality, and family.

Signs of Erotic Transference

You may not realize that you are experiencing erotic transference if you are in therapy, especially if you don’t know what to look for. Here are some signs of erotic transference:

  • Excessive flirtation: The client may engage in flirtatious behavior or make suggestive comments during therapy sessions.
  • Idealization: The client may idealize the therapist, viewing them as perfect or extraordinary.
  • Jealousy: The client may express jealousy or resentment toward others in the therapist's life, such as their partner or other clients.
  • Fantasies: The client may have romantic or sexual fantasies involving the therapist outside of therapy sessions.
  • Physical touch: The client may seek physical contact or closeness with the therapist beyond what is typical in therapy settings.
  • Unwarranted gifts: The client may give gifts to the therapist as expressions of affection or admiration.

You can tell the difference between erotic transference and other types because erotic is specifically romantic or sexual. However, here are some indicators of other types of transference in therapy:

  • Positive transference: In positive transference, the client may express admiration, respect, or trust toward the therapist but without romantic or sexual undertones.
  • Negative transference: Negative transference involves feelings of anger, distrust, or resentment toward the therapist, often stemming from unresolved issues or past experiences.
  • Parental transference: Parental transference involves projecting parental figures onto the therapist, seeking nurturing or guidance similar to that of a parent-child relationship.
  • Authority transference: Authority transference involves viewing the therapist as an authority figure and complying with their suggestions or directives out of respect or obedience.

Guidance for Patients Experiencing Erotic Transference

Once you realize you are experiencing erotic transference, you may feel stressed, overwhelmed, or helpless, but there are things you can do to cope, such as:

  • Acknowledge your feelings: Recognize and accept that feelings of attraction toward your therapist, known as erotic transference, can sometimes happen during therapy. It's okay to feel this way, and it doesn't mean anything is wrong with you.
  • Understand boundaries: Remember that therapy is a professional relationship designed to help you work through your challenges. Your therapist is there to support you in a therapeutic capacity, not as a romantic partner.
  • Explore underlying emotions: Reflect on what might be triggering these feelings. Sometimes, erotic transference can stem from unresolved issues or past experiences. Exploring these emotions with your therapist can help you gain insight into their origins.
  • Maintain open communication: Be honest with yourself and your therapist about your feelings. Sharing your experience of erotic transference can be uncomfortable but important for your therapeutic progress.
  • Respect therapeutic boundaries: Recognize and respect the boundaries of the therapeutic relationship. Avoid engaging in behavior that could compromise these boundaries, such as excessive flirting or seeking non-therapeutic contact with your therapist.

Once you recognize that you are experiencing erotic transference, you should talk to your therapist about it so you two can work on it together. Here is some advice on how to communicate with them:

  • Be open and honest: Trust that your therapist is there to help you navigate difficult emotions, including transference. Share your feelings openly, without fear of judgment or repercussion.
  • Use "I" statements: When discussing transference with your therapist, use "I" statements to express your own thoughts and feelings rather than making assumptions about the therapist's intentions or reactions.
  • Ask for clarification: If you're unsure how to broach the topic of transference, ask your therapist for guidance. They can help facilitate the conversation in a safe and supportive environment.
  • Be patient with yourself: Recognize that exploring transference can be a gradual process. Be patient with yourself as you work through your emotions and trust in the therapeutic process.

Remember, therapy is a collaborative journey, and your therapist is there to support you every step of the way. By communicating openly and honestly about transference, you can deepen your understanding of yourself and your relationships, ultimately leading to personal growth and healing.

Transference, Erotic Transference, and Therapist Training

One of the pre-conditions for those psychiatrists, psychologists, and clinical social workers who become psychoanalysts is that they receive many years of their own psychoanalysis. The reason for this is that they come to make conscious and come to understand their individual transference issues. In addition to their own therapy, these types of therapists receive large numbers of hour of supervision for their psychoanalytic cases. The purpose is to help them come to grips with the powerful transference feelings that the patient brings to the office and places in them.

In fact, long after their training and supervision are done, psychoanalytic therapists meet either in groups or on an individual basis to receive continued supervision and guidance with the patients presenting especially challenging transference problems.

All of this training and supervision and ongoing education is necessary because of the powerful nature of transference, whether it be erotic, negative, idealizing or seemingly absent or blank.

Did the therapists seen by case 1 and 3 seek supervision with these difficult cases? There is no way to know but one hopes this was true. It is even respectable and permissible for a therapist to refer the patient to another therapist in order to help the transference move along. The purpose is not to reject the patient, although there is always the risk of a patient feeling rejected. However, it is sometimes necessary to refer to someone with greater skill and ability, if nothing else works.

Do all therapists receive this type of training?

The answer to the above question is largely "no" because not all therapists are psychoanalytic. Cognitive behavioral therapists work in a very different way, in which the relationship with the patient is important but looked at in terms of present-day thinking that leads to depression or anxiety. In addition, the training that psychiatrists receive today is largely nonpsychoanalytic as compared to thirty years ago. Psychiatry tends to look at mental illness biologically and neurologically. Therefore, their approach tends to be more medication-oriented. Certainly, people trained to become marriage and family therapists do not dwell on transferential issues but on patterns of interaction within the family.

None of this implies that these professionals are not excellent. It only means that the way they see mental illness and work with people is quite different and equally if not more effective than psychoanalytic therapy.

Who Should Go to Psychoanalytic Psychotherapy?

If an individual wants to learn more about their inner mind, their unconscious self, and their deeper motivations, then psychoanalysis is a good idea. I suspect, and there is some research to support my suspicion, that some people with personality disorders can benefit a lot from psychoanalytic therapy. I have also found that people in the arts, such as musicians, painters, actors, and writers, are helped a lot in their personal and professional pursuits because the very nature of psychoanalysis helps them unlock their creativity.

This is a complex issue. Therefore, I invite the reader to submit questions, in addition to making comments and sharing experiences.

Allan N. Schwartz, PhD

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