Conference on Countertransference and Ethics

An erotic transference can stir up anxiety in the analyst. I recently had opportunity to view a teaching film in which a male analyst is asked by a female client whether or not he is attracted to her. 

She begins the session modeling her new dress. The analyst says she must be going somewhere [after]. She sits and looks glum. The analyst asks her ‘what’s the matter?’ She says she had felt so foolish because she had gotten “no response” from him upon revealing in their previous session that she had a “crush” on the analyst. He disagrees that she should feel foolish [attacking her point of view/ the validity of her experience] and she reiterates that she indeed felt foolish. Again he disagrees and tells her that her revelation took courage. The client again complains that the analyst had said nothing about how he felt about her. The analyst gives an explanation about the asymmetry of the therapeutic relationship.The client persists in saying she felt stupid because the analyst did not speak to his feelings about her. He empathizes with her difficulty [saying nothing about his own]. He does state a dilemma: if he tells her he is not attracted to her she will be devastated and feel more like the fool; If he says he is attracted to her, the atmosphere will shift and she will feel less safe to say what she feels [He apparently does not consider the possibility that his honesty might model and engender further honesty from her]. The client stated again [third or fourth time, by now] that she still wanted to know if he finds her attractive.The analyst complains that what he is saying is being ignored. The client persists, “Am I attractive?” and the analyst complains he is being steamrolled in the way that her previous boyfriends have complained she tried to control them and dismissed their POV.  The client persists, wanting an answer to the question asked at the beginning of the session. The analyst [in an attempt to force mentalization, I think] accuses the client of not caring what he feels. The client says the analyst is being “stubborn” by not answering “a simple question.” The analyst says the client does not want him to be her therapist. She denies this and becomes tearful as she complains that he will not do what she wants. The analyst seizes this opportunity to tell her she wants to control men. The client acquiesces [or has insight?] and says she does not know why [controlling men] is so important to her.  The analyst tells her that she fantasizes if she can control men then they won’t leave her. Hanging her head, moving her tongue side to side pressing the insides of her cheeks, she says she can see that. The analyst adds that her father, asserting his independence, left her and her mom, so the client repeats the same thing over and over not getting the outcome she wants [you know, the definition of stupidity]. The client says she sees, but does not like it.

If an analyst’s anxiety can be measured by how much he/she talks and/or intellectualizes, the audience was certainly privy to the anxiety of this analyst in the video who talked significantly more than his patient did and who intellectualized with her instead of speaking to the affective relationship in the room. The audience was divided in their response, some seeing the analyst as deflecting, using ‘neutrality’ and abstinence and accusation [interpretation] as a shield; some seeing the analyst as handling the transference perfectly appropriately and using interpretation to impart insight. In this situation, I, too, have been made anxious. It is difficult for the analyst to stay empathically immersed (as Geist was able to in his 2009 paper on mutually constructed boundaries) when faced with confusion about the best way to proceed. How do we validate the client’s POV and still have a differing one conveyed? How do we speak to the emotions in the room present in both therapist and client and still keep open the potential space [instead of foreclosing space by reifying through action]?  Certainly I have failed multiple times in this regard. What is missing in the therapeutic relationship in the consulting room that the client, or analyst, is willing to throw it over in favor of something else? How do client and therapist alike speak to and mourn what cannot be, and still remain in relationship? Analysis, in addition to everything else it is, after all, is also simply 'two people in a relationship.'