Understanding Erotic Transference in Psychotherapy
Erotic transference in psychotherapy involves unconscious feelings and desires that are transferred to the therapist, often presenting as sexual in nature. This phenomenon reflects unmet needs such as attachment, warmth, and validation, and may involve a re-enactment of prior relationships. Early signs of emerging erotic transference may include dream material, direct comments on appearance, bashful behavior, and erotic countertransference.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author. Download presentation by click this link. If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
E N D
Presentation Transcript
Erotic Transference September 30, 2020 Patrick Amar, MD; Negar Fani, PhD; Yudit Jung, PhD, LCSW
How do you understand the construct of erotic transference? (PA) For me, it is a pattern of relating to the analyst which has an sexual and/or romantic component I say pattern because I believe fleeting erotic feelings are common and do not necessarily fall into what we would call transference I add romantic because some patients may not have sexual feelings but have what we would think of as romantic feelings I want to be with you for ever; I want to marry you; I am in love with you.
How do you understand the construct of erotic transference? (NF) Unconscious feelings and desires transferred to the therapist, presenting as sexual Likely to reflect other unmet needs Attachment, warmth, nurturance, belonging, safety, validation Re-enactment of prior relationship that involved unmet needs
How do you understand the construct of erotic transference? (YJ) What s in Freud s Unconscious? Drives: Sources of libidinal/sexual energy, both: erotic and aggressive Conflicts: Over sexual wishes towards a parent Transference: Those unrequited wishes are transferred towards the therapist Repetition Compulsion: If not consciously processed, conflicts will be re-enacted Mentalization: The capacity to envision mental states in self and/or others
What is early evidence that such a transference is emerging? (PA) The earliest evidence I gather that the patient is developing an erotic transference would include dream material, direct comments on my appearance even if critical comments, bashful overly shy behavior, and erotic countertransference. Example of an erotic dream by a female patient: I am riding a big strong horse and he is too powerful for me. I am trying to get him under my control but he just won't obey. Example of erotic countertransference: Male being bashful but looking at me intensely and longingly and me feeling aroused.
What is early evidence that such a transference is emerging?(NF) Patient Frequent personal questions: What s your favorite , I bet you like... Internet stalking: happy birthday! Sending frequent notes (emails, voicemails) about things (art, poetry, etc) that remind them of therapist Directing conversation to what could happen after therapy is terminated Frequent comments about therapist s personal appearance Idealization: You know me better than anyone ever could You are perfect Frequent interpretations of therapist s posture, gesture, comments Relating therapist to past relationship, including sexual partner Anger with therapy boundaries: It feels weird that you know so much about me but I know nothing about you Therapist Desire to avoid any kind of disclosure/guardedness Clock watching Anxiety and irritation: pt s behavior seen as resistance
What is early evidence that such a transference is emerging? (YJ) Changes in the patient s somatic communication: Grooming/ voice-changes/ prosody of speech Changes in the patient s declarative communication: Idealization of the therapist/ flirtatiousness/ teasing/ humor requesting more frequent sessions without clear need for them contact therapist outside session-times increased curiosity about the therapist s personal life/dressing style etc. talking about other people s romantic experiences (displacement)
Can you describe 1 challenging experience you have had related to an erotic transference and your associated countertransference reactions? (PA) In twice weekly therapy, I tired to help a lonely gay male patient with narcissistic personality traits who emoted a sexual longing and I felt aroused. He would pay me in cash and was very open about his desire to have sex with me occasionally I felt like a prostitute. He would bring me gifts, for example a kite, and when it was not in my office the next session he would be wounded. He had a hard time reflecting on these feelings and eventually left because he couldn t have me and I was not under his control. It was both a frustration of longing but also a feeling of rejection when I didn t notice him in a store one time.
Can you describe 1 challenging experience you have had related to an erotic transference and your associated countertransference reactions? (NF) DS 58 year old woman presenting with PTSD and MDD Latina, lesbian, in decades-long partnership with a woman, on LOA due to mental health disruption Chronic sexual abuse history from sister s husband starting during her adolescence, later from a female PE teacher Profound shame about her sexual identity Countertransference reactions: Anxiety Constant self-monitoring, fear that this is emerging b/c of therapeutic missteps Fear of pt experiencing boundaries as rejection Irritation due to feeling this is as barrier to progress
Can you describe 1 challenging experience you have had related to an erotic transference and your associated countertransference reactions? (YJ) Transference: Acted out: pt. stalked me Declarative: getting erotic letters from the pt. Countertransference: Anger: feeling violated/ wanting to push the pt. away Erotic longing: Feeling turned on/ having fantasies of dating/ curiosity about pt. s body
What techniques have you found helpful in addressing and working through an erotic transference? (PA) With more neurotically organized patients, dream work can be useful. It often serves as a playful way to begin to discuss and look at the more difficult aspects of transference. The patient doesn t have to fully own the productions of their mind and it is a type of displacement. Patients do not have control of their dreams but they can begin to see what their mind is capable of creating and expressing. Being aware of one s countertransference or more specifically one s own fantasies while with the patient can help the therapist stay attune to the patient.
What techniques have you found helpful in addressing and working through an erotic transference? (NF) Normalize the experience (both to pt and self) Discuss transference as naturally emerging in the context of a strong therapeutic relationship A way to explore unmet needs Examine own reactions with a colleague Facilitate exploration & discussion of pt s feelings Wait to interpret reasons for transference Facilitates pt s insight Acknowledge the therapist s positive feelings toward pt Consider timing: best to address outside of crises
What techniques have you found helpful in addressing and working through an erotic transference? (YJ) Depends on: Type therapy: CBT/DBT/Psychodynamic Psychotherapy Patient s trauma-history Interventions: With acting-out behavior, set clear and firm boundaries; Refer to professional ethics With declarative erotic love, acknowledge the emotional attachment gift Explain that sensuality is part of every close, personal relationship Discuss the nature of magic fantasies versus the limitations of reality
