When the Analyst is Sexually Aroused

Continuing with the presentation to the Tampa Bay Psychoanalytic Society by Janine de Peyer on October 5, 2019, the afternoon session was about the analyst’s sexual arousal in the therapeutic session, a rarely discussed topic among mental health professionals. The ‘erotic transference’ is commonly discussed, but not ‘erotic countertransference.’ The analyst’s anger, fear, and love all seem more mentionable; we strive to refrain from being inappropriate, seductive or exploitative with our patients. Because the therapist must not act on her sexual desire, what becomes of this natural human response? Does one disclose it to the patient (Davies) despite a cultural prohibition to do so?  What about the dangers? 

[So many questions...] Can one ‘neutralize’ her erotic attraction without becoming overly constricted? Is the maternal countertransference safer, particularly when the erotic may connote the female sterotype of submission? Is the analyst comfortable being the object of desire? Was there trauma associated with this in the analyst’s own history? (The aging female analyst, unlike her male counterpart, must grapple with becoming less and less likely to be an erotic object for the patient.) Is there a co-created avoidance of the erotic transference? Also, the analyst might consider whether she is the one in the room holding the erotic feelings for a patient who has dissociated them. Sometimes for the patient, too, the maternal transference seems safer. Perhaps the patient needs to fend off hostility, impotence or felt power. In what ways might the analyst be inhibiting the patient’s erotic transference? Can the analyst be open to self states without causing trauma? Does the analyst want the patient to titillate her? 

Some of the countertransferential behaviors noted by de Peyer when attracted to a patient included presenting one’s best self (wardrobe, posture), and feeling resentful or betrayed when the patient recounts sexual encounters. 

Holding longing in contempt, desire may mean weakness. [This author sees the erotic transference/countertransference as an opportunity for mourning the loss of what one cannot have.] One attendee noted that, were the erotic feelings in the clinical situation to remain unmentioned, they might be acted out in life outside the therapy. [I might then, ala Lewis Aron, place the dilemma of the erotic countertransference on the table letting the patient know, for example, that while I share his joy I worry I might have had undue influence.] When there is shame surrounding erotic feelings, the other may have to hold the shame. de Peyer notes that perhaps the greatest gift an analyst can give her patient is her own shame. [owning it].

Davies, J.M. (1994). Love in the Afternoon: A Relational Reconsideration of Desire and Dread in the Countertransference. Psychoanal. Dial., 4(2):153-170. […]