Monthly Archives: February 2013

Handling the Erotic Transference: Male Patient, Female Therapist

Seem to be getting lots of queries about erotic transference, otherwise known as falling for your shrink.  Since I specialize in treating men, thought I’d take a crack at the subject from the particular angle of male patient/female therapist.

Male patients – all patients – bring to therapy the gender role expectations, attitudes and behaviors they experience in their other male-female relationships. But because the doctor/patient  relationship  in psychotherapy is a unique – and often new – experience, male patients often do not know quite how to proceed.  And this can make for discomfort difficult to tolerate.  For both the patient and his therapist.

In part this is so because there are so few models for an intimate professional relationship.   In fact, it’s often rare for a man to have a relationship that is intellectually and emotionally intimate but with no physical/sexual intimacy.  They tend to go together for many, if not most, men.   And for countless men, intimacy is physical intimacy.  Women are likely to share private thoughts and feelings with a variety of platonic co-workers, neighbors, friends and family.  For many men, particularly men of a certain age,  vulnerability, attunement, expression of deep feelings most often occur in the context of a sexually intimate encounter – and seldom elsewhere.  The notion of  intimacy without a sexual component simply does not compute.  “Intimacy” is code for “sexual intimacy.”

In these instances, it’s crucial that the woman therapist establish and maintain strict behavioral boundaries – at the same time as she encourages verbal exploration of uncomfortable thoughts, feelings, and yes, even sexual fantasies.  Talking, not doing.  This requires constant vigilance.  Therapists can get uncomfortable and awkward.  Patients can attempt to catch the therapist off-guard and deprofessionalize the relationship, particularly when they fear becoming too vulnerable or losing control.  The male patient whose glance lingers a bit too long shifts the discomfort from himself to his therapist.  Not that his therapist isn’t uncomfortable herself…

Discussing all this can prove amazingly beneficial.  By delving into all this rather than avoiding, by talking but not doing, the therapist provides reassurance of the safety of the therapeutic alliance, necessary for the trust effective psychotherapy requires.  (And make no mistake:  it is the therapist’s job to make sure “nothing happens.”   Always.)  The shared, in vivo context provides common ground for exploring sexual and emotional intimacy issues, often the very issues that prompted therapy.

And talking about sex, sexual feelings, without doing?  Well, that’s apt to be a rather novel experience.  How often do men and women talk honestly, openly, about sex – without engaging in sex?  Lots to learn, lots to learn…

Copyright © 2013 Marlin S. Potash. All rights reserved.