Erotic transference and countertransference is a complex and completely normal part of therapy. This article takes a look at 9 key points for therapists working with erotic transference.

To learn more about this topic, you can watch our online CPD workshop: Love in Psychotherapy. Watch the trailer below.

1. What is erotic transference and countertransference?

Erotic transference is a term used to describe the feelings of love and the fantasies of a sexual or sensual nature that a client experiences about their therapist. Erotic countertransference is about the therapist’s feelings about their client.

2. When did erotic transference and countertransference become part of psychotherapy?

Erotic transference and countertransference have been around since the beginning of psychotherapy itself as seen in the case of Anna O, arguably the first psychotherapy patient and the person who coined the phrase ‘talking cure’, and her therapist Joseph Breuer (Freud’s mentor). Anna O was infatuated with Breuer, even having a phantom pregnancy with what she believed to be his child.

Breuer was also enthralled by his patient, and went home every day to tell his wife about her. Increasingly Mrs Breuer became upset, jealous and depressed at her husband’s growing fascination with Anna. On realising this Breuer abruptly ended the therapy with Anna and the following day took his wife away on a second honeymoon. He never again practised ‘the talking cure’.

3. Erotic transference and countertransference in In Treatment

The issue of the erotic transference and countertransference and the dilemmas it raises within the therapeutic dyad are played out brilliantly in the first series of HBO’s TV drama In Treatment with Gabriel Byrne as the psychotherapist Dr Paul Weston.

His first patient of the series, at 9am on Monday morning, is Laura who asks: “Am I the first patient to be in love with you Paul?”. He replies: “I am not an option”, but still ends up in Laura’s bedroom and it destroys his marriage. You can see a clip of how the transference/countertransference plays out between Laura and Paul on You Tube.

Transference is played out in In Treatment between Paul and Laura (Copyright HBO)

4. The problem of love

The most common presenting issue in therapy is the problem of love. If we consider issues such as fear, anxiety, abuse, neglect, abandonment and bereavement (the list goes on), we are essentially talking about a problem about love.

5. Eroticism is present in everyone

We all have an erotic fantasy life, whether we are sexually active or not. And we all have an erotic history: we have all learnt how to relate to ourselves and others in erotic, sensual, and sexual ways. Really there is no escaping the effects of Eros in our life!

“We all have an erotic fantasy life, whether we are sexually active or not. And we all have an erotic history: we have all learnt how to relate to ourselves and others in erotic, sensual, and sexual ways.”

6. Erotic transference and countertransference are common

Feelings of “love” within the counselling and therapy relationship, either from the client’s side or the therapist’s side, are not a bad thing; some would argue they are inevitable given the emotionally intimate nature of therapy. For example, a survey in 2006 found that 90% of psychotherapists reported being sexually attracted to a client on at least one occasion. Working through these feelings can help the client understand and accept their own relationship with love and desire and what was missing for them in their early life that they are seeking to compensate for in the present.

7. It is the therapist’s duty to respond appropriately

The main problem with erotic transference/countertransference in therapy is the therapist’s level of ability to appropriately address and contain these issues and feelings for their client, or when the therapist chooses to act upon the feelings they experience for the client. However, it is the client’s privilege to act out their feelings for their therapist; it is the therapist’s responsibility to do the opposite.

8. Managing erotic transference

There are three main ways to manage erotic transference/countertransference within a therapeutic relationship.

The first way is to not deal with it at all. This is probably what most of us therapists do; we simply just don’t address the issue because we’re not too sure how to go about it. An extreme example of this is Joseph Breuer who ran a mile (literally) when it became clear that there were feelings of “love” within his therapy with Anna O.

The second way to manage the erotic “love” within the therapeutic relationship is to act on it; that is, to have a sexual relationship with your client. This method is clearly not recommended; it is the responsibility of the therapist to maintain appropriate boundaries within the therapy work. An example of a therapist who didn’t manage this is Carl Jung who slept with two of his patients.

The third way is, of course, to talk about it. This is the ‘talking cure’ after all.

9. There are lots of helpful books and articles available if you want to deepen your knowledge about erotic transference and countertransference

Here are a few recommendations:

Desire and the Female Therapist: Engendered Gazes in Psychotherapy and Art Therapy (Routledge, 1995), by Joy Schaverien

Psychotherapy: An Erotic Relationship (Routledge, 1997), by David Mann

Gender, Countertransference and the Erotic Transference: Perspectives from Analytical Psychology and Psychoanalysis (Routledge, 2006), edited by Joy Schaverien

The ‘frame’ as a container for the erotic transference – A case study, by Catherine Rouholamin (Psychodynamic Practice, May 2007, Vol. 13, 2, pp. 167-182)

The Erotic Transference: Dream or Delusion?, by Franco De Masi (Journal of the American Psychoanalytic Association, December 2012, Vol. 60, 6, pp. 1199-1220)

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To learn more about this topic, you can watch our online CPD workshop: Love in Psychotherapy. Watch the trailer below.