These experiences reflect a wide range in gender and sexual orientation configuration of patient and therapist. As Dr. Rosiello points out, the important area of erotic transference and counter-transference has, for the most part, been neglected in the clinical literature.
She describes these erotic narratives with courage and sophistication. It is clear that the expression of loving and sexual feelings in the transference involves emotional risk taking on the part of the therapist. In these beautifully and sensitively written vignettes, Dr.
Rosiello demonstrates that working with the erotic transference creates the basis for a very special emotional intimacy in the therapeutic relationship. This volume is highly recommended to clinicians at all levels of experience. Rosiello has performed the enormous service of taking the erotic transference and countertransference out of the therapeutic closet. In this scholarly and incisive account of the psychoanalytic view of the erotic transference, she courageously ventures into territory that has tended to be off limits.
With rich illustrations, she vividly shows how both same- and different-gender patients and therapists struggle to make sense of and deal with their erotic feelings in treatment.
Rosiello has significantly enlarged our view of the meaning of the erotic transference to encompass a patient's positive developmental strivings for connection and intimacy. She makes a major contribution to our understanding of the ways in which therapists need to participate with patients during psychotherapy.
She also opened herself to decoding her own countertransference: her annoyance that sessions were being cancelled and her fears of a premature termination. Finally, when her client described her mother-in-law as controlling and said she was going to set firm limits with her, the therapist decided to use a transference interpretation to ask if her client felt able to set limits during sessions. Noting that ambivalence, however, the therapist began helping the client explore possible negative transference.
The client, in turn, stopped canceling sessions. Other theorists tell therapists to expect transferential feelings which are most likely to contribute to the therapeutic alliance, regardless of their closeness to consciousness. On the positive side are feelings of love, calm, and relief resultant from experiences of unconditional acceptance by others being transferred to the therapist who, in turn, provides unconditional positive regard.
But even these feelings might be coupled with fear of the unconditional acceptance becoming conditional. On the negative side are feelings of distrust of a therapist appearing too good to be true, fear of being engulfed, sadness because of previous broken promises, embarrassment because of being shamed, or any combination of these feelings. All are being transferred from experiences with others. In that bonding experiences are at least partly negative, primitive negative feelings can easily combine with each other and with positive feelings.
Falling In Love with the Therapist: Erotic Transference and Psychotherapy
She came late, saying that she had rushed to get to her appointment. She was unsettled, overwrought, and uneasy. When her therapist asked about her rushing, she simply explained that she had not left the house in time. She then received what was a far truer answer. Her client said that she was not sure that the therapist could really help her. A fruitful exploration of the exact nature of their work and the relationship it implied followed, during which it became clear to the therapist that the client was transferring her disappointment with former teachers to her therapist.
Even as therapists decode transferential affect, they must be alert for countertransferential affect, for it can reveal both the interpersonal weaknesses of clients and the work therapists themselves must do to facilitate therapeutic progress. Having had negative experiences with teenagers, for example, therapists can feel demeaned by adolescent clients. They can perceive them as crass and self-centered, even moments after they enter the therapy room. Then, when adolescent clients sense this unspoken attitude, they become self-conscious.
They come across as crass in their anxious response to a person who dislikes them.
Especially challenging for therapists are countertransferential feelings resultant from the projection of displaced feelings that clients cannot tolerate, own, or even put into language because they precede the ability to speak Modell, Like infants who deliver subliminal affect-laden messages before they are able to use language, clients unconsciously hand over their feelings of being unloved, blamed, or confused to therapists who have the ability and readiness to receive them.
Thus, by unconscious design, the truth about clients is discoverable first in countertransference: in what therapists experience on a non-verbal level. Then it is discoverable in transference: in what clients experience as their therapists give evidence of their countertransference. As a general rule, therapists first discover the truth about themselves in feelings that seem excessive or inappropriate for what their clients are sharing Tower, Moreover, it is in advance of the conscious, cognition-based conception of the interpersonal situation therapists are experiencing Heimann, Neuroscientific research has now revealed the far faster speed at which emotions are experienced compared to that of thoughts being formulated LeDoux, ; Pally, ; Schaeffer, She moved from topic to topic as skillfully as a skater circles a rink, returning periodically to certain issues but never completely dealing with them.
Her therapist grew increasingly sleepy but tried to convince herself that a hot day and insufficient sleep was causing her head to feel heavy. She wondered, however, why nothing she did, including getting up to adjust the shades, alleviated her distress. Could it be that you want to disconnect from me? Even as a child, when I said I wanted to play with other children, they never heard me. I need help with how to talk. We will then look at the rarely discussed feeling of envy. Countertransferential sadness usually combines discrete states of feeling worthless, hopeless, helpless, empty, depressed, and sorry for oneself because of loss.
Clients come to therapy because of an unconscious sense of a bad self even as they consciously proclaim a good self in relation to bad others. Occasionally clients project a good self onto their therapist, but more often they project a bad self Epstein, , which they subject to punitive measures in unconscious imitation of prior caregivers Racker, Therapists are especially vulnerable to countertransference sadness when treating discouraging clients such as those with Cluster B personality disorders Betan et al.
In contrast, therapists whose own self-definition is even partially negative may unconsciously add self-punishment to negative transference. First the minister came to therapy; then his son joined him. Their therapist, who had experienced painful humiliation at the hands of adolescent males, thought that in this instance she was secure.
However, as the loose-lipped, surly adolescent attacked first his father and then other members of his family, she had to admit that she was becoming increasingly uptight. Soon afterwards, the father appealed to the therapist to set limits but still allow his son to express himself. People could express their feelings, but feelings would have to be combined with discussion so that both father and son could arrive at a solution they could both endorse. In formulating the plan, of course, the therapist was unconsciously attempting to lessen the negative impact that the adolescent was having on her, even as she was consciously steering the course of therapy from problem to solution.
She would side with the father in his need to get rid of it.
He agreed that the family situation was so bad that it could not be fixed and that therapy was proving to be a waste of time and money. He implied that the therapist was unskillful.
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However, rather than address her painful countertransferential feelings of inferiority and impotence, the therapist again set out to convince the father, if not the son, of the value of patience and hard work, both within and outside therapy, and to convey her hope that things could change. As her professional and psychological survival became uppermost in her mind, she continued to act out — rather than decode — her powerful countertransferential feelings.
Eventually, when the therapist failed with her agenda, she admitted to herself that therapy was going nowhere, that she was incapable of reversing the negativity, and that she could no longer count on her clinical expertise. When the father finally refused another appointment, the therapist merely mentioned her availability if he changed his mind. Had she interpreted her depression to her clients, however, and asked whether they, too, were experiencing painful feelings of inadequacy, victimization, and resentment, the father and son might have found her more like them and thus more able to help them work on solutions.
Deepening Intimacy in Psychotherapy
First it would have been to the problem of the therapy situation itself. Then it would have been to the problems they were facing outside of therapy. As noted in the previous vignette, countertransferential anger includes resentment toward abusive clients — if not outright hatred of them — as well as disdain for victims of abuse combined with revulsion and disgust for what happened to them. Thus, displaced anger manifests itself in various forms of acting-out: withdrawing from clients Plakun, ; becoming irritable and restless because of precious time being taken up with what seem relatively small problems; and feeling bored or sleepy because of mundane therapeutic issues.
This, in turn, can result in inattention, annoyance, and forgetfulness Schwaber, Similarly, therapists treating Cluster B personality disorders are noticeably vulnerable to countertransferential anger Bradley et al.
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On the other hand, in response to aggressive transference, therapists may experience subjugation and victimization. In time, however, even submissive therapists feel vengeful and angry and subsequently fear these feelings Racker, Then, if they actually attempt to resolve their discomfort through subtle recrimination, they experience guilt. It can be a response to having been threatened, hurt, or scared. Similarly, the fruits of elevated anger or aggression can actually be akin to a life force composed of activity and movement that can lead to loving, hating, or both, as therapists interact with the object of their aggression Winnicott, Perhaps the chance of countertransferential anger is more likely to arise because of them.
Countertransferential anxiety, a response to some internal stimulus LeDoux, , usually takes the form of therapists feeling scattered and confused. They are unsure of relating to clients similar to others whom they have found difficult. They are uncertain of therapeutic progress Schafer, Countertransferential fear, in contrast, is a response to the environment. It makes therapists feel disconnected, disorganized, and even unable to think in response to autistic clients Gomberoff et al.
It causes therapists to experience disequilibrium in response to schizophrenic or manic clients Kantrowitz, , or terror in the presence of clients with an Antisocial Personality Disorder. Therapists may become apprehensive, for example, when clients ask them for more time and attention than they can afford to give.
Paradoxically, countertransferential anxiety and fear may combine with guilt feelings and result in actions and words indicative of submissiveness. This submissiveness, in turn, may cause therapists to refer frustrating clients, pamper those they do not refer, or search for quick resolution of complex situations in an effort to get relief Racker, Countertransferential gladness runs the gamut from contentment to joy or elation.
At times, countertransferential gladness lures therapists into engaging in the unwholesome practice of competing with their clients or other professionals, such as teachers, in working with their clients. Therapists can become insistent, for instance, that clients follow their advice rather than think for themselves or consult competent others Blum, a. However, the two-edged sword of countertransferential gladness usually rekindles hope in clients and thus proves extremely helpful.
1. What is erotic transference and countertransference?
It contributes to the formation or repair of the therapeutic alliance. But danger lurks even here, for gladness on the part of therapists may induce in them a desire for sustained positive feelings about therapeutic progress, feelings that are unjustified because they rest on denial of still-needed and difficult therapeutic work. Because envy of clients is considered so shameful and unprofessional even when it is not acted out, therapists rarely admit it.
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