The threat of male-to-female erotic transference

Vignettes from an ongoing psychoanalysis with a patient, Michael, are presented to illustrate the various dimensions of the erotic transference at different phases of the treatment. The relation to power, the experience and expression of aggression, how these may be organized by gender, and the female analyst's countertransference are discussed as potentially fostering or inhibitory in the development of an erotic transference. Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity. Similarities and differences in cases of sexual boundary violations with opposite-gender pairings are discussed.     

Braving the erotic field in the treatment of adolescents*

Abstract

The psychoanalytic literature on erotic transference and countertransference in adolescence is notably sparse, despite the centrality of the developing sexual body/mind. Erotic feelings in the consulting room with an adolescent can feel taboo, causing the analyst to avoid the immediacy of these feelings. Excessive timidity on the part of the analyst can limit the growth of the capacity for containment of sexual feelings and yield what I term ‘erotic insufficiency’ in our work with adolescents. I offer clinical material from a period of erotic transference and countertransference with a 12-year-old boy to consider these ideas. Further, I suggest that the very terms ‘erotic transference’ and ‘erotic countertransference’ can feel defensively remote and antiseptic. I suggest that ‘erotic field’ better captures the subtle, nuanced interplay of feelings.     

Desire and the female analyst

The literature on erotic transference and countertransference between female analyst and male patient is reviewed and discussed. It is known that female analysts are less likely than their male colleagues to act out sexually with their patients. It has been claimed that a) male patients do not experience sustained erotic transferences, and b) female analysts do not experience erotic countertransferences with female or male patients. These views are challenged and it is argued that, if there is less sexual acting out by female analysts, it is not because of an absence of eros in the therapeutic relationship. The literature review covers material drawn from psychoanalysis, feminist psychotherapy, Jungian analysis, as well as some sociological and cultural sources. It is organized under the following headings: the gender of the analyst, sexual acting out, erotic transference, maternal and paternal transference, gender and power, counter-transference, incest taboo - mothers and sons and sexual themes in the transference.     

Erotic Countertransference and Clinical Social Work Practice: A National Survey of Psychotherapists' Sexual Feelings,Attitudes, and Responses

Male and female social work psychotherapists were surveyed on sexual feelings toward clients, sexual behavior with clients, and utilization of erotic countertransference. Relationships between these variables and therapists' self-reports of training in erotic counter-transference, utilization of supervisory consultation, length of clinical experience, and theoretical orientation were also examined. Male therapists were significantly more likely than females to report sexual attraction toward clients, and to report using erotic countertransference to further treatment goals. The frequency of therapists' discussion of sexual feelings toward clients in supervision was related to the reported frequency of utilization of sexual feelings in treatment. The majority of therapists reported that their social work training did not prepare them adequately to work with erotic countertransference.     

Erotic Transference and Its Relationship to Childhood Seduction

The phenomenon of an erotic transference has long been a difficult, if not mysterious, process within clinical psychoanalysis. Traditionally, the development of an erotic transference has been viewed as a negative clinical event fueled by the analyst's countertransference reaction. A much neglected dimension, the relationship between childhood seduction and the development of an erotic transference, will be introduced and examined. In three clinical cases our data suggest that actual sexual abuse in childhood is a causal factor in the manifestation of an erotic transference in the clinical interaction of an analysis.     

A Farewell to Countertransference

The "discovery" of countertransference provided a much-needed corrective to the one-sided view of transference and a patient's pathology. Even if its usefulness in the development of psychoanalysis was indisputable, its days are numbered. When I present my clinical work at conferences, I am often asked questions about my countertransference. These questions contain numerous assumptions that are challenged in this paper. Treatment is discussed from a self psychological perspective to highlight the therapeutic value of enabling the patient to engage a selfobject transference. The concept of "projective identification" is also challenged. Systems theory, in which the therapeutic relationship is understood as a co-construction between therapist and patient, is proposed as a more effective model to deal with the issues formerly included under transference-countertransference.     

The therapist's pregnancy: Evocative intrusion

This paper is concerned with addressing the complex impact of the therapist's pregnancy on the analytic treatment process. The pregnancy is seen as intensifying the transference and countertransference material so that the therapeutic work becomes more strenuous as well as more fluid, with the potential for significant therapeutic change. The paper is divided into two parts. The first section attempts to conceptualise the meaning of the experience for the therapist and patient within the framework of psychoanalytic theory. Problems of technique and management resulting from the pregnancy are examined. One of the issues considered is the manner and timing of the patient's recognition of the pregnancy. The second section of the paper contains extensive clinical material illustrating the enriched transference and countertransference processes, and the access these allow to psychotic pockets of the personality, hitherto largely unavailable for exploration.     

Listening to the Erotic Commentary on Paper by Eric Sherman

In this commentary I examine homoerotic countertransference within the context of the analyst's erotic countertransference experience. Discussing male analysts' difficulties receiving and experiencing homoerotic feelings as a function of their dominant erotic desires (along gender lines), I propose both cognitive and affective explanations to illuminate their defenses. I suggest that Sherman's erotic countertransference is best understood when viewed as a product of both induced feelings emanating from his patient's dissociated sexual abuse and also his anxiety and shame in response to particular relational configurations with his patient that arouse him. Finally, I point to the site of the transgressive as integral to the construction of erotic desire and suggest shifts that need to occur in the erotic subjectivity of this dyad so that the treatment can move forward.     

The ‘frame’ as a container for the erotic transference – A case study

Abstract

This paper discusses various aspects of the psychotherapeutic frame, and explores the importance of maintaining the boundaries of the frame especially when an erotic transferential relationship is present. Many now agree that erotic transference and counter-transference occur in most therapeutic relationships, and yet it is something that therapists often struggle to work with effectively. The author acknowledges her own difficulties in working with erotic transferences and demonstrates why the adherence to the frame is especially significant in these circumstances. A case study is used to illustrate the difficulties of working with the erotic transference within the constructs of a frame and short-term therapy, and how the author's own counter-transference affected the therapy as well as how this was dealt with in supervision.     

A response to Maggie Turp's paper from a body psychotherapy perspective

Whilst appreciating the quality of containment in Turp's work as a learning point for the Body Psychotherapy tradition, the author argues that Turp does not represent a psychotherapeutic way of ‘working with the body’. This would require a deconstruction of the body/mind dualism inherent in much psychotherapeutic (and psychodynamic) theory, so that the complexity of the spontaneous and reflective body/mind processes, especially in their polar extremes (body/mind dissociation – body/mind integration / ‘psyche/soma unity’), can be contained. An holistic body/mind formulation of countertransference is approached by which – rather than being used as a gratifying or cathartic therapeutic shortcut which avoids the intensity of the transference – the body can be seen to constitute an avenue into the full experience of the transference/countertransference process and its relational sources in early development.     

A Picture Book of Internal Events: The Colours of Rage and Love

The views on countertransference in psychoanalytic theory and practice have undergone a change within the last fifty years. From being considered an impediment to analysis, countertransference is today looked upon as an important potential for a tentative understanding of what is unconsciously communicated from the analysand to the analyst. This implies that the analyst is susceptible to the unconscious interaction in the transference and the countertransference, and that he/she becomes conscious as quickly as possible of what is taking place. This applies especially to erotic feelings which are often intensified in analyses with patients with a serious psychopathology, as well as in analyses with patients in regressive phases where projective identification is the dominant factor used as a defence and a communication. Opinions differ as regards the question of how to deal with such a situation, especially whether it is right to be candid about the analyst's countertransference feelings towards the analysand, something most would caution against. In an example from an analysis, the analyst describes how he was influenced by an unconscious erotic countertransference. After three years of therapy with a patient with a serious psychopathology, he developed ?motherly” feelings, which he interpreted as reflecting a child's longing for closeness and physical contact. The result was that a few times, he ?forgot” to indicate the end of the session, which was then prolonged, and also that he embraced her on several occasions before she left the session. One year later, he had intense sexual fantasies and dreams about the analysand, which he experienced as both enticing and alarming, and as an impediment to the analysis. He soon became aware of the element of projective identification in the interaction, and by interpreting the analysand's unconscious communication, he regained his ability to maintain an analytic attitude and clear boundaries.     

Academic Course Combining Psychological Skills Training and Life Skills Education for University Students and Student-Athletes

In Part II, we present two case studies of erotic transference and countertransference in sport psychology service delivery. We interviewed two seasoned practitioners, both with long histories of working with athletes. These sport psychologists represent two extremes of the spectrum when encountering the erotic in service delivery. One participant's story is about denial, suppression, and repression of anything that hints of the erotic in practitioner-client relationships. The other sport psychologist's story is about a nearly unbridled reveling in the erotic with a client. The practitioners are easy to condemn, one for ignorance and lack of awareness of self and others, the other for adolescent fantasies and objectification of his client. But those responses are facile and uncharitable. We present these two cases as examples, albeit extreme ones, of how truly complex the erotic is in service delivery. Their stories illustrate, in sometimes painful and graphic ways, what it is to be human, all-too-human, in our encounters with the people we serve.     

Spontaneous Personality Synthesis in Group Therapy

Combined therapy is defined as concurrent dyadic and group therapy with the same therapist. This paper focuses on a neglected aspect of combined therapy: broaching and exploring this question with one's individual, patient. The author shows how raising this question: (1) alters the therapeutic field whether or not the patient joins; (2) can sharpen the therapist's understanding of the indications and contraindications for group membership; (3) offers untapped therapeutic approaches and opportunities to clarify issues in the individual treatment; and (4) stirs up countertransference issues related to issues of profitability, the transference of the patient in individual treatment, and the transference of the group-as-a-whole. Several case examples are provided.     

Working in the countertransference

Ferenczi (1988) described the procedure of mutual analysis, in which the patient and analyst switch roles for part of the time in the analysis. This procedure allowed patients in stalled analyses to make progress and enabled the analyst to overcome certain countertransference blocks but was ultimately rejected for certain drawbacks. Working in the countertransference is a modification of mutual analysis that retains some of its benefits and eliminates some of its drawbacks. In such work, the psychoanalyst's personality and psychodynamics become the center stage of the manifest content of the session; the analyst avoids interpretations of the transference and, instead, elicits the patient's detailed understanding of the analyst's psychodynamics. The analyst does not, however, generally volunteer his free associations or facts about his own life. This process allows deep work with patients with a predominance of projective identification. Working in the countertransference may be preferred in cases of severe psychopathology to other procedures for its lessening of the frequency, severity, and persistence of transference psychoses. The procedure is also a useful supplement to transference analysis with neurotic patients, for whom it can break through blocks caused by anxiety‐laden issues or countertransference impediments.     

Working with countertransference

The transference-countertransference relationship is only one of five modalities of relationship that research has identified as potentially present in the therapeutic encounter. This paper gives the background and definition to one aspect of this - the countertransference - and traces the development of the concept from Freud's first use of the term in 1910 to the contemporary view that it is a useful tool of psychotherapy. The first part explains its connection with the Kleinian concept of projective identification and discusses its elaboration by the object relations school. There is general acceptance nowadays that the countertransference contains a great deal of information about the client's psychological world. It is therefore important to understand this process and the authors have identified three main dimensions to countertransference. These are its vector (or direction and force), its variance (the quality it represents), and its valence (its effect on the client). The second part of the article illustrates, through the use of example and metaphor, how these three dimensions are defined and can be recognized. Common themes and paradigms of countertransference are identified and discussed along with some ways in which experience has shown how these might be contained and worked with constructively. Finally, a clinical vignette is presented in which some of the dimensions of countertransference are identified and used to understand the client's psychic world and foster therapeutic change.     

Intimate boundaries: Therapists’ perception and experience of erotic transference within the therapeutic relationship

Aim: This study explored therapists’ understanding and experiences of erotic transference within therapeutic relationships. Method: A small‐scale qualitative research project was undertaken with six therapists working within different counselling contexts. Data was collected through semi‐structured face‐to‐face interviews, and an Interpretative Phenomenological Analysis used for analysis of individual perception and experience. Findings: All participants had experienced what they understood to be erotic transference and/or sexual and loving feelings within therapy. There was little differentiation between the two phenomena, and both were often referred to interchangeably. There were contradictory views as to whether using the phenomena would be beneficial to client work, but there was a strong motivation to learn more about it. Therapists who encountered sexual attraction within therapy experienced feelings including shame and embarrassment. Supervisory support was seen to be beneficial. Implications/conclusion: The importance for therapists to acknowledge a lack of clarity that exists around the understanding of erotic transference and its relationship to sexual attraction within therapy is noted. Also, a recognition that better access to training regarding erotic transference and sexual responsibility within client relationships might be helpful to therapists in their work.     

Too close for comfort: the challenges of engaging with sexuality in work with adolescents

This paper explores some of the ways in which sexuality can intrude into the psychotherapeutic relationship and present both opportunities and risks to our work with adolescents. It highlights some of the complexities of this area of the clinical encounter, exploring the particular difficulties encountered by both patient and therapist when sexuality emerges in the transference and countertransference. While we are well aware of the centrality of sexual development during adolescence, far less has been written about the way in which sexuality and the erotic transference emerges and impacts on both patient and therapist. Given the profoundly unsettling nature of this area of work and its capacity to disrupt our thinking and psychic equilibrium, it is easy to underestimate how much we are drawn to avoid, negate and defend ourselves against registering such experiences. Through the discussion of clinical material with two adolescent patients, this paper explores some of these dynamics, addressing some of the technical dilemmas that frequently challenge us in this area of work. These include questions about whether and when it is therapeutically important and effective to take up and interpret the emergence of sexuality more directly in the transference and some of the risks to our patients when we ‘play safe’ and fail to do so. Most importantly, this paper aims to facilitate further thinking and discussion about an important but uncomfortable and easily neglected area of our work.     

‘Telepathic’ phenomena and separation anxiety

By discussing a treatment characterized by its difficult ending, the author strives to show the dynamic impact of separation on phenomena that can be seen as ‘telepathic’. Led to develop some inalienable attachment to her analyst in the primary transference, the analysand found herself caught up in the contradiction of her visceral dread of dependency, which compelled her to interrupt the work in progress. She then began to work out her analyst's comings and goings and to run into him in public places, as if to be assured of his immovability. This phenomenon arose with high frequency as the effect of some idealization of the maternal object aiming to deny the spatiotemporal gap. The chance that the experience of rejection via indifference may be repeated also entailed the transferential unfurling of a fantasy involving a double, undifferentiation counterbalancing the lived experience of separation. Furthermore, a ‘telepathic’ dream occurred as confirmation of this twin relationship which illustrates the analysand's refusal to renounce her narcissistic object. Projective identifications, agglutinated ego nuclei along with primitive cross‐identifications could, among other concepts, account for such phenomena which are projective in nature yet real all the same. Such mechanisms could have the power to relay thoughts the moment undifferentiated parts of the ego – if not unborn parts of the self – were activated in a potentially symbiotic zone. Marked by a feeling of dispossession, the analyst's countertransference not only seemed to underscore this hypothesis, it also gave a partial explanation for it. Until the analyst could recognize his own nostalgia for a symbiotic relationship, he had to encourage the occurrence of those unexpected meetings which stemmed from a convergence between the transference and the countertransference.     

On the edge: The psychoanalyst's transference1

Countertransference is a central topic in analytic work and in the literature. The concept of countertransference includes a basic question which has been understood in different ways. The author attempts to differentiate between the psychoanalyst's transference and his countertransference in the analytic process. It is hard to draw a line between them; analysts are always on the edge. The analyst's transference will be explored and described using three approaches: narcissism, regression profile and the analyst's phase of life. Regression profile is a new concept developed by the author, which may help us to understand the core of the analyst's transference in the analytic situation. She illustrates the topic by clinical vignettes.     

Race,religion and a cat in the clinical hour

Racial and religious identities are complex, often mired in dynamics of ‘othering’. Such dynamics easily become a means of distancing the pain, fear and rage of intergenerational traumas, thus undermining ways race and religion can be powerful vehicles for the transference and countertransference. Drawing from a history of race in America as well as Jung's anxiety when meeting the stranger within himself, this paper focuses on 17 years of work between a black female patient and white female clinician (me). Together we encountered themes of hatred, silence, guilt and intimacy in the transference and countertransference, themes eventually symbolized by the presence of my cat which was locked into the bathroom for each session. This cat came to represent a bridge through developmental traumas and wounds of racism.