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.

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5 responses to “Handling the Erotic Transference: Male Patient, Female Therapist

  1. Reblogged this on Tales of a Boundary Ninja and commented:
    Interesting take on Erotic Transference in the female therapist/male client dynamic, but I think there’;s a lot here that applies in general. Written by a therapist and provides a glimpse into their perspective, I thought a lot of people would be interested.

  2. Nice post. I appreciate your sense of optimism about the good that comes out of a genuine discussion of uncomfortable feelings. Tim Ferriss (Of the 4 Hour Workweek) says “your level of success in life is directly proportional to the number of difficult conversations you are willing to have.”

  3. Love that quote! It’s gratifying to know that another experienced practitioner struggles with some of the same challenges – and finds the struggle worthwhile!

    Thanks.

  4. Really enjoyed this post. Thought you might enjoy my post on transference – well the tv show mad men and transference.

    http://costigdj.wordpress.com/2013/06/06/the-pain-of-mad-men/

  5. Very interesting ….it is so difficult to find honest accounts and sharing in this area ! Why has it become so taboo? Surely this is expected in such an intimate relationship . Worthy of a share on my LinkedIn

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