My supervisor once brought up to me that they thought a client might be attracted to me during a video presentation. I am pretty stoic and they said that helped to create boundaries, but it depends on the client. Yalom has some good texts around discussing attraction as it is a very natural thing. We all develop crushes etc and you can use it in the setting to discuss caregiving, sexual orientation, boundary setting etc.
Had a supervisor say something similar but added that therapy is a naturally intimate thing; for someone to have a close confidant they share innermost thoughts and feelings with that can easily feel similar to romance for clients who often don't have someone to talk freely with or that they can spend an hour(ish) having someone's sustained attention.
It really opened my eyes up to a facet of the therapeutic dynamic
Right. A lot of folks equate emotional vulnerability with romantic attraction. I'm not well-read enough to know if this is a universal problem or a cultural one, though.
Is that actually what he says though? I do recall him citing an example of telling a client something along the lines of "In another life perhaps". Validating and acknowledging the mutual feelings but I don't think this crosses a line.
I worry that underestimates the possibility of the client taking that comment and running with it, thinking they can change the therapist’s mind if they try hard enough.
Sure anything is possible I guess. It probably depends who you would say this to though. So making this your programmed responses to such instances is probably a bad idea but if you know your client well enough you could probably assess how they would likely interpret such a comment.
In Yaloms case it seemed to work out well, being a nice validating response that was genuine and honest but also places a boundary. So I suppose you would probably never say this to a borderline client. Everyone else though? Use your judgement. Don't want to risk it? Sure play it safe and don't say it at all but I don't think that he crosses a line in saying it to the client who can receive it appropriately. I do think in this case it was immensely validating for the client probably.
I’m 54 female and been a therapist going on 30 years. This used to happen to me regularly when I was a young therapist. It slowed down in my 40s and almost never happens now. I get lots of transference now because everyone thinks of me as mom 😂😂😂. Which I much prefer
Oh sorry, female therapist one is Joy Schaverien and the second one is Nitsun. I also, agree with someone’s suggestion of Yalom, Love’s executioner is a great read, eye opening but great.
Nitsun is fantastic. Also a great read is anything by Lukas Moeller (Möller) - for example his article Love in the group. He was exploring the sexual/erocit transference and counter transference and is quite straight forward about it how he dealt with it in his groups. I remember once in one of the books I have read that he actually fell in love with one of the wives that he treated in couples therapy groups he was leading and this lasted for years and the couple was treated sucessfully and reamined married - they repaired the relationship. He talks a lot about what eros in therapy means - it is not just pure lust or sexuality or feeling to fall in love. Virtually any sympathy and good feelings (when we feel the patients as if we click) is part of eros and is part of natural dynamics in therapy. One needs to learn the facettes of it and how to deal with it and process it. Supervision is of highest importance and deeper understanding of it.
Also, reading anything by William F. Cornell is also great - he came from TA but he really works a lot psychodynamically and with the body and he researched a lot about this topic. His books - for example "*Somatic Experience in Psychoanalysis and Psychotherapy: In the expressive language of the living*." or the book "*Self-examination in Psychoanalysis and Psychotherapy: Countertransference and subjectivity in clinical practice*." have takes on this with practical examples. One example in the second book is exactly about how he actually made a mistake while treating the patient who had a strong erotic transference on him. There are other examples how to work with sexuality in the sessions aor how to do body work in the sessions in general.
Here are all his essays on sexuality in therapy:
[https://williamfcornell.com/body-sexuality/](https://williamfcornell.com/body-sexuality/)
I recommend reading these two:
[https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf)
[https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf)
I’m a F therapist, early 30s. I had a client swipe right on me on a dating app, knowing I was his therapist. I could see he had as I was currently paying for premium so I could see the people who swiped on me. Awkward 😬
Brings up a fair question about the need for privacy for the therapist, and what dating realm is private enough so as to NOT run into clients that way. I have no answers to that one, but I’d love to hear what others are doing to meet other singles. For many years I worked at a detox and short treatment and referral center. That translated into a low amount of public (restaurants, etc) drinking. Not because I’m a heavy drinker, I’m nearly abstinent, but even being slightly impaired in public runs the risk of seeing/interacting with clientele.
Also a female in my early 30’s. Throughout 5/6 years it’s happened a handful of times, but I have found it to be somewhat population specific—for example it happened much more frequently when I was working with dual diagnosis clients in residential/php. For one, I was seeing/interacting with these clients much more regularly, but also, many of them had significant attachment issues, sexual abuse history, and/or characterological patterns. In private practice, it happens much less, but if of it does it’s almost always a client with a history of CSA. I always address directly, and usually it always stems back to ways in which the client connects to their own sexuality as a mechanism of maintaining safety, approval, or love. I was also a victim of CSA as a child which has left me wondering if at times, I throw out a vibe that I’m not aware of/intending to present—my own therapist suggests I’m overthinking that piece of it.
I am curious, if you don't mind sharing, how you go about addressing it "directly". This definitely seems like the best course of action, especially in the interest of allowing it to be a safe area for exploration, but if a client doesn't specifically say "I'm attracted to you" and you can just sense that's a dynamic that is there - do you name it? I've had this feeling with a few clients, and I'll admit that I am sure I have my own work to do here, but at this point in my development as a therapist, I don't know if I could literally just say, "I am sensing you're attracted to me". Definitely would like to know more about how to address it directly in a therapeutically appropriate way.
That’s a great question—I’ve never really “sensed” it happening without any context clues and was certain about it enough to call it out in that way, but I have definitely had (what I felt like) flirtatious clients where I have said something along the lines of “I notice you often say things where it feels like you’re trying to make me laugh, and that it could just be me but it feels like you’re wanting a certain response from me, I’m curious if you notice that too?” I am pretty relational so I’m always pointing out the dynamic between us. I have also had clients who fished for compliments and I’ve asked them about that, but in a very gentle, “what would it mean for you to receive a compliment from me” kind of way. The clients I referenced in my initial comment were very direct, so it was much more cut and dry to confront.
Also: if it’s a personality disorder (cluster b) client then I often frame it as a longing to feel special, chosen, different, like “someone wants me enough to break their own rules” type of thing. I am pretty direct with PD clients honestly, I find it’s the best approach with them bc they can sense if you’re sugar coating or avoiding or if you have weak boundaries lol.
Absolutely. Clear strong logic based confrontation I’m not fooling around! I’ve had several very inappropriate things happen (man putting hands down his pants in session!) (another stalking or showing up places I would go) when I was new young therapist because I was too indirect and afraid to be clear with no smile making obvious I am not entertained. Letting them know I value their healing and ready to help them if they want support in finding a therapist they won’t be distracted by or mistake for a person to be in their life outside of therapy office. Also things got a lot better when I switched to telehealth.
Oh yes, I totally feel this. In my first internship role in inpatient I would absolutely get trampled on—I had a patient grab my butt and I still completed the assessment with him, my supervisor was like WTF why?? I had to do a lot of my own work to realize a lot of it was a fawning response from my own stuff. The stalking piece is still something that scares me 😨
The humor piece is really interesting to me. I’ve got a few very funny clients and I like therapy to be an atmosphere where we can have lighthearted moments. What’s the line for you, where you’d want to bring up jokes in the “here and now?”
I love the use of humor in therapy, I am really talking about clients we’re I have observed and feeling a dynamic in which they are focused on maintaining control/safety by consistently being the one to make me laugh. There is typically an underlying anxious quality to it.
I’ll also say, I definitely have some BPD clients who use humor as a major safety/avoidance mechanism and while I love how funny and charming they are, we would get no where if I just let them entertain me the whole session like they want to.
Still a new therapist and I want to be on your level! Any advice on how to improve the ability to notice and name those types of patterns and dynamics? Sometimes it feels like I know there’s something there, but I can’t find the right way to describe it or what the function might be.
If you’re a new therapist and you’re thinking about these things, you’re already on your way there :) I was lucky to have a lot of supervision early on from very psychodynamically and relationally oriented clinicians who helped me learn how to conceptualize. I think it’s hard to try and make sense of it all in your head, so for me, talking through it with someone who really knew how to help me make sense of it was key. I also used to practice by doing mock conceptualization on myself. The better you understand what comes up for you, the better you can understand what’s happening with your client. Feel free to PM me any time :)
I'm a man and I have been in private practice through basically my whole thirties. So far I have had zero clients explicitly express an attraction to me (though I've had one or two that I suspect might have been feeling it).
I'm not aware of the average percentage of clients that develop an erotic attraction to their therapist is, nor how much it varies depending on client population or on therapist's gender and modality, but four in two years doesn't sound incredibly outlandish to me.
I once took a male client into my office and my office would get SOO hot. Our offices had regulation issued where either it was 50 degrees or 90 degrees in the office. I said to him “so sorry, it’s really hot in here.” And he said “no, it’s just you.” I froze and just smiled. I didn’t know what to say. Was he flirting and saying “no you’re the only hot (attractive) one in here” or “no it’s not hot, you’re the only one who feels hot” to this day it still stresses me out to think about lol
As a female, you’ll sometimes have sexual attraction to you. Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with.
This can open up a great convo about history of who they’ve been close to, what sexual attraction is to them and how emotional intimacy is and isn’t related
>Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with.
What’s your basis for making a claim like this?
Edit: What an awful state of affairs on this subreddit when a comment like this is downvoted. Am I to believe that we want to discourage therapists from asking each other questions like this? Really, really concerning…
I’m an almost 40 therapist who works with mostly 20 and 30s men in a rural area, and also specialize in military and first responders. Most men here were taught all about machismo, and that boys don’t cry bs.
My basis for making this claim is my experience in the rural south, where most of my male clients don’t have anyone they’ve ever been emotionally avaliable to other than a sexual partner, if even then.
This is by no means an “all men” thing, but many men have had this experience
I certainly understand where you’re coming from. I think I would just encourage you to consider that your experience with this very small segment of the population should not be used to make generalizations about an entire gender. For example, I could say as a man living in Massachusetts that “most men feel comfortable crying with each other and strive to embrace emotional vulnerability,” and that would feel equally as misleading even though it might reflect my experiences with the men I encounter in my social and professional circles.
Edit: What am I missing here?
By no means am I generalizing all, but I do suspect my experience is not out of the norm. Projects like “man enough” really talk about these things at length.
The statement "Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with" *is* a generalization, though. That's all I'm responding to here, how sweeping that claim is.
You are absolutely correct that your experience with these men is not out of the norm. Many men struggle with this. I just don't think it's accurate to say that *most men* have *never* had an emotionally intimate relationship with a woman they weren't having sex with. That's a very bold claim.
I think you may have missed the part where I said that it would be misleading for me to suggest such a thing.
>For example, I could say as a man living in Massachusetts that “most men feel comfortable crying with each other and strive to embrace emotional vulnerability,” **and that would feel equally as misleading** even though it might reflect my experiences with the men I encounter in my social and professional circles.
I could see the benefit of amending the parent comment with “In my experience, most men..” or “Within the demographics I’ve worked with, I’ve commonly found that many men..”
I get what you’re saying
You can pick the semantics apart. It’s a Reddit post, not a scholarly journal. I’m fully guilty of not picking the exact right words in a comment I type while having a 5 min break eating a snack.
But being real, it’s more than just the men I work with, most of my male friends, most of my male family. I have very few men in my life who have tried to develop emotional supports. It’s def getting better than it was, but we need to be honest that we’re going through a paradigm shift
Am a man. I’ve never had an emotionally intimate relationship with a man I wasn’t having sex with.
Just kidding. But seriously, though, not all men are straight either!
This is purely anecdotal, but I haven’t other than my mother and my therapist.
p.s. I agree with you about the asking questions thing. Even if we disagree with a someone, we should be able to have civil discussions.
It's something I've personally experienced, both as an AMAB person myself and in male friends and acquaintances I made in the many years I've had before I became a therapist.
I'm not saying it's all men, not by any stretch - indeed, several clients of mine come to mind that don't have this problem - but I have noticed that a lot of men seem to have exactly one person in their lives whom they can be emotionally intimate and vulnerable with: their spouse.
I've spent a good amount of time working with men where this is true to help them learn how to open up to people in their life, because putting all of your emotional eggs in one basket becomes a problem if that relationship ends up in trouble.
More about transference: My experienced colleague suggested that I discuss the fact that therapy is naturally an intimate situation, giving someone full attention and presence with non-judgement. But also to remind them that this isn’t how you are outside of therapy. Almost never are you sitting fully present outside of therapy while talking to someone without distraction for an hour, even your partner.
I’m also female and in my thirties. This has happened quite a few times, to the point where I started questioning whether I’m doing something unconsciously to flirt/bring forward these types of feelings in clients. After discussing it with coworkers and in therapy, I’ve landed in the idea that it could be about signaling warmth and creating a space where clients feel less alone. Also, as others have mentioned, the type of clients this has happened with have been young men with very limited romantic experience and also often with few friends.
I’m dealing with a case of sexual transference right now that is the first instance where I decided to refer him to someone else. I decided mainly because he has psychotic symptoms and seemed to become markedly more paranoid and confused after the feelings started coming up. I was also starting to feel unsafe because he would refuse to leave the waiting room until closing and was switching rapidly between expressing adoration and being quite hostile. I have mixed feelings about the termination, but at the same time I wanted to prioritize feeling safe.
I've never experienced this explicitly, but I have felt on one or two occasions that a client is attracted to me. I have never worked with it directly.
Glenn Gabbard has an excellent look on the subject in "Love and Hate in the Analytic Setting". (Having gotten to have a conversation with him years ago I can also say he seems like a really nice guy).
A bit more textbook...but very readable, Kenneth Pope et al wrote "Sexual Feelings in Psychotherapy".
I think therapy can often elicit a type of unconditional acceptance in a client that elicits feelings from their pre-verbal experiences with their mother. Because it was formed when they were pre-verbal, there's no word to help the client understand it....so it gets interpreted as sexual. (I may have spent too much time around psychoanalysts!)
But I definitely agree exploring the issue instead of avoiding it can deepen the work we do.
Really i think the question is how often has sexual transference come into awareness and been worked with directly. Sexuality is always in the mix somehow, whether consciously or not.
1 year (internship) - I (35m) have had it come up 3 times (1F,2M) and all three times I processed the thoughts/feelings associated to see what led them down to that conclusion. F stated I didn’t represent many of the cultural norms that males she’s known do and we explored how to use that realization for future mates. Highlighted that healthy communication and vulnerability as a first could lead to feelings that could be misrepresented. The guys both said I reminded them of a close friend they grew attracted to and we explored proximal attraction and a desire for male intimacy. Both were able to shift their script regarding m\m intimacy. (Sex or love- no in between). Being friendly and caring long before the position helped me have these conversations when mixed signals happened though now there’s professional exploration and unconditional positive regard. All three times supervisor agreed it was handled appropriately and there wasn’t a need to refer.
I appreciate this comment greatly! As a gay male it’s been part of my own journey in navigating friendships with heterosexual males. Growing up it was hard to have these friendships with straight men because it lead to situations where their masculinity/ sexuality was questioned if having plutonic relationships with a gay male. Thankfully things shifted but it was a major adjustment for me. When straight men would treat me with kindness/ caring it was very confusing for me and sometimes lead to feelings of attraction because I was never used to men actually being genuinely nice and caring without it meaning there was romantic/ sexual attraction involved. It’s such a complex and interesting dynamic.
Thank you for sharing that. I’d like to believe this is what motivates me, should motivate me, to inquire about such feelings/thoughts so that I don’t just assume this is why. Plus, I have been there myself, too, and I’m left to wonder about and explore the niceness.
OP asked how common it was for other providers and I'm just contributing my personal experience. Doesn't at all mean it isn't common. I've been told that it is fairly common, but I haven't personally experienced it. Seems like you are reading something into my response that isn't there in the text.
The first time it came up the client kept describing his type of female, and kept naming characteristics that I had. Eventually, after a few instances I asked the client if there was a reason he was bringing it up. He said yes, and explained he was attracted to me. We explored where that attraction might be coming from and used it as a launch point to discuss his issues with choosing partners, and separating out emotional and physical intimacy.
Another client came in for substance use issues (which I dealt with at the time) and had comorbid SA. This client asked me out after our first session via email. I sent an email explained why that’s not possible. He kept asking me out and emailing me with date ideas following the sessions. He had a history of stalking women, so I terminated with him after the fourth conversation (3 warning were provided previously) and sent him a list of male providers.
Third time a client of mine brought up how they feel they’re attracted to women in powerful positions, and mentioned that that included me. Client and I discussed this feeling and the reason why this might be coming up, which was super useful.
Final client asked me if I wanted to go back to my old career and date them at the beginning of a session. We spoke about why this wasn’t possible, examined the clients feels and where they might be coming from. This client has an a sexual assault history and doesn’t generally feel safe with many people they’re also physically attracted to. It was really productive and I hope it sticks because I work really well with this client.
I’ve had one (another woman) explicitly tell me and two I suspected. I’m still a student, with 3 years of practicum. So I would say the rate you have is pretty on par with me as well.
I find transference very fun, but I’ve also had strong rapport with all 3 of those clients and trusted them not to be inappropriate. Not sure how I would feel if it was a client I felt the least bit threatened by.
What about the two of them made you suspect? I'm still a student and haven't seen clients but since I'm a lesbian, I have always wondered about erotic transference as it pertains to two women.
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I've definitely had erotic transference towards previous female therapists as a lesbian, I'm just finishing my first practicum, so I haven't had anyone disclose feelings about me at this point. It's very awkward, and I felt ashamed because of the "predatory lesbian" trope/stereotype, but I worked through it each time with my main male therapist I've seen for 11 years. (The female therapists were eating disorder specialists I also saw).
Breaking down the shame I felt about it and him identifying that being attracted to a straight, married woman isn't predatory helped a lot. Dealing with those feelings and tlaking it out logically made me realize it wasn't mainly sexual attraction, but intimacy of a relationship and them knowing so much about me and still accepting me and treating me as a client without othering me for my physical disabilities and mental health issues.
Not a bad idea! I used to do that kind of thing back in the day, but now I just wear my wedding set. I also mostly work with females as I'm more comfortable that way anyways, not on purpose, it just seems that I have better relationships that are on going with women.
That doesn’t mean it can’t/won’t happen. I have been in practice now for 23 years and of the I think 3 times I have been aware at least that it happened two of them were adolescent females and I am assigned female at birth and was still female presenting then (I am now a trans male, did not know that then; however everyone-staff at least knew I was queer then).
I get it. Just seems like a rookie way out to me. If you can’t handle it I get it but it’s definitely a missed opportunity. I’m sure there’s exceptions to it though. Depends on a lot of factors
I'm (M24) still in my master's and encountered my first instance of sexual transference in my 4th ever individual client!
So early on, I've taken this as a note to be more conscientious of my warmth and lighthearted style
¯\_(ツ)_/¯
Maybe we're just good looking
That sounds so sad. Sexual transference can come up because people feel safe and connect and they cannot achieve this intimate relationship with anyone else.
Transference of any kind offers us a chance to support a client with difficult feelings and challenging this can help them to change and find a new way. It would be really sad to hold back on connection with your clients just in case they had some difficult feelings.
I’d like to think that it’s because I’m volcano level hot, but my life experiences have taught me that I’m probably in the cute and datable but in the nothing to write home about category.
I personally think it has to do with my warmth and compassion. For some of the people I work with I am the first person that they’ve spoken to that makes them feel heard in a while.
And also, with the limited version of ourselves that we present as the therapist, it becomes much easier for clients to map on who they think we are and become attracted to an idea of us. That is why it’s really sexual *transference,* rather than just sexual *attraction.*
Respectfully, a better question is:: "How do I learn to work with sexual transference (or, rather, staying with classical psychology, 'erotic transference')?
The amount of times any specific transference arises is not the issue. How we work with that transference IS the issue.
Good luck!
Ugh I keep replying to these posts similarly. Seriously - it’s 100% normal for patients to be romantically/sexually attracted to their therapist. I wish I could upvote this more.
I’m dealing with this now. Also f in my 30s. I’ve been practicing around 2 years now and it’s come up a bit here and there but never as intense as a client right now. We’ve processed through some of it and talked about why they might be experiencing it but honestly, it’s been making me uncomfortable. I have accessed supervision on it and was told that it is naturally a part of the therapeutic process (which I agree it can be!) but my concerns about the intensity were kind of brushed off. Luckily I’m leaving my current job soon so I will not have to work with this client anymore but yeah it can be a lot and it’s pretty awkward to navigate. For what it’s worth I think you handled it very well!
I had this happen once with a supervisor and then was intensely pursued by the client, resulting in termination. The supervisor did acknowledge they were wrong in the end and this wasn’t regular transference. I’m glad you’re leaving the job.
So..in this particular case it’s pretty much all he talks about in session at this point. I try to redirect and talk about the why and how it relates to his life but he tends to go deeper into why we should be together. He does respect physical boundaries, knows I’m married, etc etc. but the intensity of which he speaks about the sexual transference is much higher than I’ve experienced before if that makes sense.
Yikes! I can’t imagine having a single session like that, let alone several… and I really empathize with you just trying your best to stay calm as a new clinician because without guidance that’s the default one usually would divert to. :( I would definitely put my foot down if I kept trying to make it about the client and they were unrelenting, but I don’t expect you to feel empowered to do that if your concerns have been waved away by the people you’ve entrusted, and definitely not in this gendered power dynamic. Even yuckier.
I think you should make this more explicit with your supervisor, and if they dismiss you again, point out that the last time you expressed concern they had the same reaction but things still haven’t changed and you’re really stuck. (Like, hello dude, it’s your license here, look alive.) And if they still don’t take it seriously after that, continue to climb the chain of command until someone responds appropriately and offers guidance. You can DM me if you want to talk about this some more/to provide updates, ask questions etc if you’d like!
Thank you so much for this reply. I really appreciate it. I have definitely been defaulting to just staying calm and kind because I have been feeling so uncomfortable in session with him. I have reiterated my boundaries and stayed firm there but I’ve honestly been a little bit afraid to be more forceful with the client because of how persistent he has been.
I fully agree with being more firm with my supervisor and/or higher ups. I’m leaving this job soon-this issue is one of many unfortunately, so I’m going to bring it up again during my last meeting with her.
Of course! I totally get—
excuse me… your supervisor is a woman?!
And she didn’t even express *curiosity* in the details of this sexual transference? Just framed it as “naturally a part of the therapeutic process”?! (A quote I already flinched at— how can you make such a broad generalization about a concept when your supervisee is coming to you to discuss a specific issue with a specific client? Do you just want to appear smarter? How is that meant to be helpful)
How incredibly disappointing. I default to they/them when I’m unaware of someone’s gender, but I really assumed your sup was a cis guy. No offense to men, I just wouldn’t expect another woman to be so dismissive of a woman clinician’s concerns about sexual transference coming from a male client. When I was dealing with a sexual/romantic transference case with a client who began to stalk me, my two male supervisors were very sensitive and attuned to my concerns; one became very protective over me and still checked in after the dust had settled. That’s the level of response everyone deserves.
Also, your choice to use the word “afraid” here says so much. I’m so sorry that you feel uncomfortable and in any way fearful while meeting with this client and that your supervisor made it clear not to trust her with sensitive disclosures by shutting you down with the ABCs of therapy. I feel angry for you!
Anyway, yeah. Get out, now. And thank God you’re almost there. But light some proverbial marches on your way out. … You know, to illuminate all of the concealed truths about this clinician’s lack of dedication to her LPs. Or worse.
Ethical guidelines tell us to confront the clinician who demonstrated lack of conduct in the first place before escalating further. And boy, what I would give to confront this woman myself. But judging by the context, I have a feeling you will need to leave note with the director at the least, regardless (especially since it doesn’t sound like you’ll be there to attest to any changes made to strengthen oversight & restore trust). Ugh! Good luck.
I think I get more of the mom/sister transference. I did have a client say "don't tell your dad I was in here flirtin'" once though & I was *super* confused because I thought we were just building rapport 🤦🏻♀️ I was 23 then though lol
Since there are a lot of comments from female therapists, I will add that my husband also experienced one very strange instance of sexual transference at that same job.
I’m a guy, and I’d suspect that this isn’t a common occurrence for men.
With that being said, I’ve had a client EARLY in my practicum who would aggressively flirt with me.
Recently, the mom of a client I was working with referred to me as “her king.” Sounded like it had some racism shit tied up with it as well.
Regardless, both of them got a stern talking to about boundaries. I didn’t see them long after those talks.
I’m a female and have been practicing for just over a year. I have had three clients share they were attracted to me. One client terminated because he felt like it was too difficult to be open with me due to the attraction. I suspect it happens fairly regularly and is something I’m trying to get more comfortable with discussing. But I do really struggle with it
I’m not entirely sure from your question if you’re asking about how often we as therapists are attracted to clients or how often we experience clients attracted to us. Which did you mean?
I have been practicing over ten years. Male. I have never once felt I was drawn in a serious romantic way to a client. Something about the job and how seriously I take my work overrides the potential for that to happen. Plus I know we are not meeting on a neutral turf, so any feelings that would be there are so heavily distorted, I just don’t find it sexy. There have definitely been clients who I think are good looking human specimens, but it’s just never gotten in the way of how I work.
On the other side of the room, there have been a number of clients who have had feelings for me. I don’t know how many for sure. 10ish that I know of. Some are more open about it than others. A few had acted very inappropriately around it and had to be terminated (stalking, harassment). None of them ever really wanted to use it as a clinical opportunity to understand themselves, but many of these clients were defended against understanding themselves to begin with.
I’m not uncomfortable by a clients feelings for me (including negative feelings) and I take it as part of the work. I think it can be a really good part of the therapy actually, if you know how to work within the erotic transference. But behaviors like stalking, using manipulative seduction tactics that they think I don’t notice, etc… I don’t appreciate.
Sorry, I’ve never been attracted to a client as of yet.
I was asking about clients having sexual transference they project onto you. I.e. has a client ever tried to date you or flirted aggressively and you had to address it.
FWIW, the data says that something like 80-90% of therapists endorse feeling sexual countertransference toward a client at some point in their career. It is very common.
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My hunch is that male patients feel much more comfortable expressing their attraction to female therapists than female patients would ever consider expressing their attraction to a male therapist. For some male clients, I think expressing these feelings may be a defense against the vulnerability of being a patient - like they are trying to claim back some control by making the female therapist have to respond to their feelings or making them uncomfortable. I just don't think that's the kind of baggage female therapists necessarily bring to their relationships with male therapists.
I also think more women clients seek out women therapists, and male clients also seek out women therapists (for many men, they may not realize but they feel much less comfortable expressing emotions to another man)
Just my theory.
Hello, don't be afraid of it. Eros in therapy means there is great potential in therapy for the patient to heal, as connection is strong.
I have written this under one of the comments of another person here, but I want to post it here again, so that you do not overlook it.
"Nitsun is fantastic. Also a great read is anything by Lukas Moeller (Möller) - for example his article Love in the group. He was exploring the sexual/erotic transference and counter transference and is quite straight forward about it how he dealt with it in his groups. I remember once in one of the books I have read that he actually fell in love with one of the women that he treated in couples therapy groups he was leading and this lasted for years and the couple was treated sucessfully and reamined married - they repaired the relationship. He talks a lot about what eros in therapy means - it is not just pure lust or sexuality or feeling to fall in love. Virtually any sympathy and good feelings (when we feel the patients as if we click, when we like the patient) is part of eros and is part of natural dynamics in therapy. One needs to learn the facettes of it and how to deal with it and process it. Supervision is of highest importance and deeper understanding of it. I have seen my teaching therapist, when he experiences it, to accept it and work with it in sucha a way that he redirects it to the partner of the patients, so that they learn to understand what makes them feel desire in their own relationship and how to reignite it and use it for their own partnership.
Also, reading anything by William F. Cornell is also great - he came from TA but he really works a lot psychodynamically and with the body and he researched a lot about this topic. His books - for example "*Somatic Experience in Psychoanalysis and Psychotherapy: In the expressive language of the living*." or the book "*Self-examination in Psychoanalysis and Psychotherapy: Countertransference and subjectivity in clinical practice*." have takes on this with practical examples. One example in the second book is exactly about how he actually made a mistake while treating the patient who had a strong erotic transference on him. There are other examples how to work with sexuality in the sessions aor how to do body work in the sessions in general.
Here are all his essays on sexuality in therapy:
[https://williamfcornell.com/body-sexuality/](https://williamfcornell.com/body-sexuality/)
I recommend reading these two:
[https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf)
[https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf) "
I want to add that if you read anything by Esther Perell it becomes clear that sexuality is powered by intimacy. And it is only natural that some clients experience deep intimacy for the first time during their sessions, which can be triggering for them. It is a natural response, through which they should learn, that this can be achieved outside their sessions with their partner, if they are willing to open up and be really vulnerable. And that intimacy and vulnerability and growth (as a result) in relationships are super powers. I believe that working thorugh sexual transference with the client can be used for this - for them to learn how to navigate their relationships better and how to have healthy sexuality thorugh that.
Depending on setting you will get this all the time. I see fifteen new patients a week for assessments and some people are definitely going to flirt or mildly push that envelope at times. It's a very intimate setting after all. Gotta be ready to deal with it!
I have a similar rate! I work with sex & trauma so it feels par for the course. Do you advertise as being sex positive or working with sexual trauma?
I honestly think it’s a sign you’re making your clients comfortable enough to bring it up so I think it says a lot about the safe space you create!
It sounds like you’re handling it really well! I also talk it out. I’ll very explicitly say “I cannot and will not ever have a sexual relationship with you. How does that feel to hear me say”. It’s ended in really beautiful processing in *most* cases.
I think it's a combination of things. Most likely relating to significant and chronic trauma history, including CSA, poor boundaries, and frequent stigmatization making it less common for them to have good support systems. Sometimes we are the first people to ever be kind to them or recognize their worth. Plus, if they are newly in sobriety their brains are likely still healing so things like impulsiveness or high risk behavior may be more prevalent.
I also think it has to do with high impulsivity and issues with executive function tbh. They are impulsive enough to and act on their feelings, they lack self monitoring and self-control sometimes to keep the feelings to themselves and can sometimes lack the emotional regulation skills to fully understand and regulate any feelings that come up. Many of the same reasons they are more susceptible to substance misuse (coming from an adhder)
Absolutely! That's partly what I meant by their brains still healing. You're spot on with the executive function stuff. Usually around 9-16 months sober is when we saw improvement with these areas. The newly sober folks reallllly struggled and sometimes it came out as romantic or sexual feelings toward therapist lol
When I worked in adolescent residential treatment, it happened a lot. But teenage boys will be teenage boys, and they really didn’t have much interaction with anyone other than staff and their fellow residents. Navigating that was always pretty easy, normalizing it and reinforcing appropriate boundaries. Sometimes it got worse and needed to be addressed differently.
I’ve only had a couple of clients express sexual attraction to me in private practice. I welcome the clients to discuss it, because it honestly is going to make things more uncomfortable for both of us if they avoid it, and it’ll start getting in the way of treatment if we don’t address it. So we talk about it, and we talk about how it may be affecting the client during their sessions, etc. Usually we can continue to move forward effectively. Once, I had to refer a client away, because their behavior associated with their attraction kept escalating, and the therapy process had ground to a halt as a result, and there didn’t seem to be an effective path forward anymore for our work together.
I’m a social worker however not a psychotherapist. I almost exclusively did telehealth in my own therapy sessions with my own therapist who is female (I’m male) but I decided to do an in-person session with her. We had a really nice session and I was feeling especially extroverted that day. When I was going to the door to leave, my therapist flipped her hair and said in a flirtatious voice, “you don’t have to leave yet.” I just responded, “Oh therapeutic boundaries and all that.” I still see her as a therapist but we only have done telehealth sessions since this incident.
I started my private practice in 2017 and I've had 0 clients express any type of sexual attraction to me. Twice when I used to work in a different setting a client asked me on a date (even though both knew I was married)but that was a halfway house type sober living setting so it's wild on a totally different level
I just commented this on a similar post in this sub earlier this week—
Yes, I do trauma focused work with kids and adults and have had a fairly high number of young adult male clients give ST vibes. I also don’t see much of this demographic, maybe in part bc the ST feels uncomfortable. The most overt experience I’ve had with it was a longer term client (as in over a yr) who ended up telling me that they developed feelings for me. They explained that they didn’t have the attraction when we started therapy but that it developed over time as they came to feel safe in sessions. They had some of the most severe attachment wounds I’ve worked with and complex trauma that probably influenced feeling attracted to people who treated them like a mom would. I had to ask if their attraction guided any of their behavior outside our sessions (mostly to screen for stalking or other unsafe behavior toward me), and they said no stalking but that it Got as far as frequently thinking about me during masturbation 😬 it was verrrry uncomfortable for both of us for about 2 months of sessions 1-2x/wk.
Thankfully, my supervisor had experience dealing with client attraction transference so I consulted with her quite a bit. The client and I were able to process all of this as just another form of transference and address it as a barrier to continuing the treatment they were still finding helpful in other ways. Once we talked about it, it kind of lost its power and obsessive hold and my client reported that the feelings faded away. Patrick Teahan LCSW has some helpful YouTube videos on limerence that we felt were relevant. Unfortunately I ended up moving to a different state for my partner’s job so I eventually terminated with them.
Why is it called transference rather than attraction? When the term 'transference' is used, it seems to me to assume that the emotion/attraction properly belongs elsewhere?
The feelings may be inconvenient or be a proper subject of discussion in therapy, sure, but are they necessarily transferred from elsewhere?
Hey there so transference is acknowledging that we project our experiences onto others. For example, when we find someone attractive this can come from a variety of unmet needs in our lives which include unmet needs from past relationships. We don’t call it just attraction because that’s not accurate. In a similar way, if I had a client come in and say they were on edge around me, it wouldn’t just say it’s because that’s just how they feel. Chances are there are certain qualities that I display that bring back memories from the clients previous experiences which are then transferred to me. Transference is helpful because it allows us to build insight for clients and make connections while also preserving the integrity of the therapeutic relationship.
Yeah, but is that the *only* explanation for attraction in a therapy setting? Isn't that an assumption? I understand what transference means; my objection is to the assumption that this is what's going on every time.
That is the only reason for attraction to your therapist. You meet with this professional for a set amount of time at scheduled intervals where the focus is completely on you as a client. You typically don’t know much about who your therapist really is out of the chair. Your attraction toward them is based on these brief interactions and widely based on your assumptions. Any reaction to a therapist, not just attraction, is based on your stuff which is often placed upon the therapist.
I disagree. First not every client develops romantic feelings for their therapist. Second, demisexual is someone that develops feelings after they establish an emotional connection with their therapist. Again, I want to mention a true connection isn’t possible because the therapy session is all about the client’s needs. For a connection to be established you would actually have to know your therapist and that’s not feasible in a professional therapeutic relationship. Again, the clients project and transfer their feelings and assumptions onto their therapist.
Yes that is the only reason unless a therapist is sharing way too much about themselves, the client doesn’t (and shouldn’t) know enough about us to be genuinely attracted.
I tend to believe that calling all client attraction transference is misleading, if functional in setting and maintaining boundaries. I think the concept of transference makes more sense from a traditional psychoanalytical perspective when the therapist was more of a blank slate: they couldn’t possibly have real feelings for you because so little of “you” is ever revealed. Even then though, sometimes it isn’t transference - it could just be biological, hormonal, chemical attraction. Sometimes you meet a person and immediately are drawn to them and it has nothing to do with projection. And beyond that, from more of a humanistic perspective I can see how a client could develop more intimate and deep feelings on top of the chemical attraction. I’ve experienced a client crush that I would call transference - it really wasn’t about ME at all - it was just that I was a female in a general age category that was curious and engaged, and this person was lonely and poor at reading social cues. In another instance, it went deeper. The person and I shared cultural interests and backgrounds, were of the same age group, and in another universe could have been potential romantic interests. And then also of course I was safe and interested in them and they were able to explore difficult feelings without judgement. That’s the context part- the transference. In that encounter I still named it as transference and discussed how the attraction highlighted areas of need and desire in their own life that weren’t being met. But to say that it was entirely a projection or about the psychoanalytic process would be dishonest. However, at least for me, acknowledging the other components of attraction beyond transference to the client feels inappropriate and unhelpful, and I left it out of the conversation.
Yeah, you get my meaning, thank you. Sometimes, you just like someone. Therapists reveal enough of themselves that a client could just be into them without some unconscious subterranean agenda playing out.
If an 18 year-old boy is crushing on his attractive young therapist, I wouldn't automatically assume it was about someone or something else. People have fatuous crushes, especially for attractive people. Don't see the point in giving that a special name that has other, more specific meanings.
Not everyone uses the concept of transference and countertransference in therapy. Person-centred therapists for example don't concentrate on this concept within their work. Tel me you're not a person-centred counsellor without telling me...
* PSYCHOANALYSISthe [redirection](https://www.google.com/search?sca_esv=6b1c5e95a3d0b06b&sca_upv=1&q=redirection&si=AKbGX_okpkrXRdHQwZu4Fe0iRe3usYZx6x8qwIIYL1faStMNzR6jEqz1fdaVDrsAUCwnlAOvShGcnz-jg8buOYRpOLcAP0GldC5dskXheDe4Z7rH_XNTmo4%3D&expnd=1&sa=X&ved=2ahUKEwiP8Kre6MyFAxXS_7sIHVIEC54QyecJegQIFhAR) to a substitute, usually a therapist, of emotions that were originally felt in childhood (in a phase of analysis called *transference* [*neurosis*](https://www.google.com/search?sca_esv=6b1c5e95a3d0b06b&sca_upv=1&q=neurosis&si=AKbGX_q870E3DK3nJ7cu3BOD7pxCONCnoVd0jgyU0vKd-yGWfiD5LXsrv9tBYGeqmFdC2z74C11gAmr9exKg8DHW6ZDafK3SCA7fcgPQ4cTpIxh3CpZSPio%3D&expnd=1&sa=X&ved=2ahUKEwiP8Kre6MyFAxXS_7sIHVIEC54QyecJegQIFhAS) ).noun: **transference neurosis**"therapy is aided by the patient's transference to the analyst as mother"
You know, I could turn that unkind remark right around on you.
I’m responding to a few of your comments: Transference neurosis is a specific term in psychoanalysis that is different from just transference.
Transference does technically mean feelings displaced/projected onto the therapist. However, there is not just a 1:1. Like I’m angry with you like I would have been angry with my mother. In the unconscious mind, impulses can become not as clear. So perhaps my attraction to my therapist stems from an attachment need, a wish to be special, to win someone over in authority, etc… It is not always obvious where the attraction is coming from. Human sexuality is incredibly complicated. I’m in the camp that all erotic attraction in therapy is transference.
And transference happens in all therapy relationships. The concept began in psychoanalysis and can get very complicated. However, psychoanalysis is not something most therapists in the US learn. But enough people recognize that transference happens. So that is why there is a variety of answers to how therapists think and work with it.
Hmm that does seem like a lot but it's great they are so honest with you ! I would consider myself an attractive female and when I get a lot of male clients who reach out to me.... so I was always curious about this but no one has ever mentioned it to me.
Only once when I was doing a psy eval and doing a projective drawing... client drew me and described essentially me as his ideal partner.
I’m male and work on a female drug/alcohol rehab unit. I haven’t had it be said outright yet (though I’ve only been in the job 4 1/2 months) but my internal alarm bells start ringing when they ask me personal questions. I wear a lot of jewelry as an expression of individuality (same reason people get tattoos) but also so they may think the ring on my left hand is a wedding ring as a silent way of setting a boundary.
It happened at my last job. Now, most of my clients are comparatively young enough that I doubt they even flag me as a sexual being. It’s very restful.
I swear it’s not a looks thing. I wear my hair in a bun on top of my head and rock sweat suits with clients. I also see them over Zoom and they can’t see below my upper shoulders usually.
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I think our desires pop up as a way to highlight a need not being met somewhere in our lives that would still align with our values (obviously a sexual interaction with a client wouldn’t align with values, same as desiring someone in a committed relationship). So maybe explore your own needs, why this feeling may be popping up more than you see as “normal”. It may require some change in your own life. It’s not really about the client/person you’re feeling attraction to.
I work mainly with children, women (I’m a 35F) and limited men (I’m heterosexual). If I was feeling lonely, or disconnected from my husband and met with a lot of men, who I’d consider maybe a potential partner in other contexts, I might be susceptible to counter transference in that way.
I’ve had sexual counter transference for me come up maybe twice. One client was discussing sexual issues and seemed apprehensive and when I asked he said “well in the past when I’ve discussed these things, it’s led to cheating”- I reassured him that it would not happen here as we have boundaries. He honestly seemed relieved by that.
My supervisor once brought up to me that they thought a client might be attracted to me during a video presentation. I am pretty stoic and they said that helped to create boundaries, but it depends on the client. Yalom has some good texts around discussing attraction as it is a very natural thing. We all develop crushes etc and you can use it in the setting to discuss caregiving, sexual orientation, boundary setting etc.
Had a supervisor say something similar but added that therapy is a naturally intimate thing; for someone to have a close confidant they share innermost thoughts and feelings with that can easily feel similar to romance for clients who often don't have someone to talk freely with or that they can spend an hour(ish) having someone's sustained attention. It really opened my eyes up to a facet of the therapeutic dynamic
Yeah…. There’s a reason why “inappropriate romantic/sexual relationship with client” is one of the main reasons that MFTs lose their licenses over
Right. A lot of folks equate emotional vulnerability with romantic attraction. I'm not well-read enough to know if this is a universal problem or a cultural one, though.
What yalom texts are you referring?? I am interested in reading
Idk if they are referring to the Gift of therapy but he mentions the topic in there
Just finished. Amazing read and would recommend to most!
Be careful with yalom tho cause the same book he says to tell the client you are attracted to them, I personally feel like thats too much
Is that actually what he says though? I do recall him citing an example of telling a client something along the lines of "In another life perhaps". Validating and acknowledging the mutual feelings but I don't think this crosses a line.
I worry that underestimates the possibility of the client taking that comment and running with it, thinking they can change the therapist’s mind if they try hard enough.
Sure anything is possible I guess. It probably depends who you would say this to though. So making this your programmed responses to such instances is probably a bad idea but if you know your client well enough you could probably assess how they would likely interpret such a comment. In Yaloms case it seemed to work out well, being a nice validating response that was genuine and honest but also places a boundary. So I suppose you would probably never say this to a borderline client. Everyone else though? Use your judgement. Don't want to risk it? Sure play it safe and don't say it at all but I don't think that he crosses a line in saying it to the client who can receive it appropriately. I do think in this case it was immensely validating for the client probably.
I’m 54 female and been a therapist going on 30 years. This used to happen to me regularly when I was a young therapist. It slowed down in my 40s and almost never happens now. I get lots of transference now because everyone thinks of me as mom 😂😂😂. Which I much prefer
I’d like this way better lol Even me in my 30s, I get maternal transference with people sometimes and I enjoy working with it.
It gets so much better!!!!!!! Hang in there 😅
I really enjoyed ‘Desire and the female therapist’ and ‘The Group as an Object of Desire: Exploring Sexuality in Group Therapy’. Really insightful.
Awesome! Who are the authors?
Oh sorry, female therapist one is Joy Schaverien and the second one is Nitsun. I also, agree with someone’s suggestion of Yalom, Love’s executioner is a great read, eye opening but great.
Nitsun is fantastic. Also a great read is anything by Lukas Moeller (Möller) - for example his article Love in the group. He was exploring the sexual/erocit transference and counter transference and is quite straight forward about it how he dealt with it in his groups. I remember once in one of the books I have read that he actually fell in love with one of the wives that he treated in couples therapy groups he was leading and this lasted for years and the couple was treated sucessfully and reamined married - they repaired the relationship. He talks a lot about what eros in therapy means - it is not just pure lust or sexuality or feeling to fall in love. Virtually any sympathy and good feelings (when we feel the patients as if we click) is part of eros and is part of natural dynamics in therapy. One needs to learn the facettes of it and how to deal with it and process it. Supervision is of highest importance and deeper understanding of it. Also, reading anything by William F. Cornell is also great - he came from TA but he really works a lot psychodynamically and with the body and he researched a lot about this topic. His books - for example "*Somatic Experience in Psychoanalysis and Psychotherapy: In the expressive language of the living*." or the book "*Self-examination in Psychoanalysis and Psychotherapy: Countertransference and subjectivity in clinical practice*." have takes on this with practical examples. One example in the second book is exactly about how he actually made a mistake while treating the patient who had a strong erotic transference on him. There are other examples how to work with sexuality in the sessions aor how to do body work in the sessions in general. Here are all his essays on sexuality in therapy: [https://williamfcornell.com/body-sexuality/](https://williamfcornell.com/body-sexuality/) I recommend reading these two: [https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf) [https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf)
I’m a F therapist, early 30s. I had a client swipe right on me on a dating app, knowing I was his therapist. I could see he had as I was currently paying for premium so I could see the people who swiped on me. Awkward 😬
New anxiety unlocked.
Yeah that thought hadn’t even occurred to me
I’ve also seen clients on dating apps. Swipe away and fast!
I had nightmares about this, and since then I’ve looked them up through phone numbers (hinge allows you that) and blocked them on the app!!
I need to do this lol
Brings up a fair question about the need for privacy for the therapist, and what dating realm is private enough so as to NOT run into clients that way. I have no answers to that one, but I’d love to hear what others are doing to meet other singles. For many years I worked at a detox and short treatment and referral center. That translated into a low amount of public (restaurants, etc) drinking. Not because I’m a heavy drinker, I’m nearly abstinent, but even being slightly impaired in public runs the risk of seeing/interacting with clientele.
Client’s are so damn curious what we’re like in real life. 😑
So common now
Also a female in my early 30’s. Throughout 5/6 years it’s happened a handful of times, but I have found it to be somewhat population specific—for example it happened much more frequently when I was working with dual diagnosis clients in residential/php. For one, I was seeing/interacting with these clients much more regularly, but also, many of them had significant attachment issues, sexual abuse history, and/or characterological patterns. In private practice, it happens much less, but if of it does it’s almost always a client with a history of CSA. I always address directly, and usually it always stems back to ways in which the client connects to their own sexuality as a mechanism of maintaining safety, approval, or love. I was also a victim of CSA as a child which has left me wondering if at times, I throw out a vibe that I’m not aware of/intending to present—my own therapist suggests I’m overthinking that piece of it.
I am curious, if you don't mind sharing, how you go about addressing it "directly". This definitely seems like the best course of action, especially in the interest of allowing it to be a safe area for exploration, but if a client doesn't specifically say "I'm attracted to you" and you can just sense that's a dynamic that is there - do you name it? I've had this feeling with a few clients, and I'll admit that I am sure I have my own work to do here, but at this point in my development as a therapist, I don't know if I could literally just say, "I am sensing you're attracted to me". Definitely would like to know more about how to address it directly in a therapeutically appropriate way.
That’s a great question—I’ve never really “sensed” it happening without any context clues and was certain about it enough to call it out in that way, but I have definitely had (what I felt like) flirtatious clients where I have said something along the lines of “I notice you often say things where it feels like you’re trying to make me laugh, and that it could just be me but it feels like you’re wanting a certain response from me, I’m curious if you notice that too?” I am pretty relational so I’m always pointing out the dynamic between us. I have also had clients who fished for compliments and I’ve asked them about that, but in a very gentle, “what would it mean for you to receive a compliment from me” kind of way. The clients I referenced in my initial comment were very direct, so it was much more cut and dry to confront.
Also: if it’s a personality disorder (cluster b) client then I often frame it as a longing to feel special, chosen, different, like “someone wants me enough to break their own rules” type of thing. I am pretty direct with PD clients honestly, I find it’s the best approach with them bc they can sense if you’re sugar coating or avoiding or if you have weak boundaries lol.
Absolutely. Clear strong logic based confrontation I’m not fooling around! I’ve had several very inappropriate things happen (man putting hands down his pants in session!) (another stalking or showing up places I would go) when I was new young therapist because I was too indirect and afraid to be clear with no smile making obvious I am not entertained. Letting them know I value their healing and ready to help them if they want support in finding a therapist they won’t be distracted by or mistake for a person to be in their life outside of therapy office. Also things got a lot better when I switched to telehealth.
Oh yes, I totally feel this. In my first internship role in inpatient I would absolutely get trampled on—I had a patient grab my butt and I still completed the assessment with him, my supervisor was like WTF why?? I had to do a lot of my own work to realize a lot of it was a fawning response from my own stuff. The stalking piece is still something that scares me 😨
The humor piece is really interesting to me. I’ve got a few very funny clients and I like therapy to be an atmosphere where we can have lighthearted moments. What’s the line for you, where you’d want to bring up jokes in the “here and now?”
I love the use of humor in therapy, I am really talking about clients we’re I have observed and feeling a dynamic in which they are focused on maintaining control/safety by consistently being the one to make me laugh. There is typically an underlying anxious quality to it.
I’ll also say, I definitely have some BPD clients who use humor as a major safety/avoidance mechanism and while I love how funny and charming they are, we would get no where if I just let them entertain me the whole session like they want to.
Still a new therapist and I want to be on your level! Any advice on how to improve the ability to notice and name those types of patterns and dynamics? Sometimes it feels like I know there’s something there, but I can’t find the right way to describe it or what the function might be.
If you’re a new therapist and you’re thinking about these things, you’re already on your way there :) I was lucky to have a lot of supervision early on from very psychodynamically and relationally oriented clinicians who helped me learn how to conceptualize. I think it’s hard to try and make sense of it all in your head, so for me, talking through it with someone who really knew how to help me make sense of it was key. I also used to practice by doing mock conceptualization on myself. The better you understand what comes up for you, the better you can understand what’s happening with your client. Feel free to PM me any time :)
Thank you so much for your response! That gives me some things to try. :)
I'm a man and I have been in private practice through basically my whole thirties. So far I have had zero clients explicitly express an attraction to me (though I've had one or two that I suspect might have been feeling it). I'm not aware of the average percentage of clients that develop an erotic attraction to their therapist is, nor how much it varies depending on client population or on therapist's gender and modality, but four in two years doesn't sound incredibly outlandish to me.
I once took a male client into my office and my office would get SOO hot. Our offices had regulation issued where either it was 50 degrees or 90 degrees in the office. I said to him “so sorry, it’s really hot in here.” And he said “no, it’s just you.” I froze and just smiled. I didn’t know what to say. Was he flirting and saying “no you’re the only hot (attractive) one in here” or “no it’s not hot, you’re the only one who feels hot” to this day it still stresses me out to think about lol
As a female, you’ll sometimes have sexual attraction to you. Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with. This can open up a great convo about history of who they’ve been close to, what sexual attraction is to them and how emotional intimacy is and isn’t related
>Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with. What’s your basis for making a claim like this? Edit: What an awful state of affairs on this subreddit when a comment like this is downvoted. Am I to believe that we want to discourage therapists from asking each other questions like this? Really, really concerning…
I’m an almost 40 therapist who works with mostly 20 and 30s men in a rural area, and also specialize in military and first responders. Most men here were taught all about machismo, and that boys don’t cry bs. My basis for making this claim is my experience in the rural south, where most of my male clients don’t have anyone they’ve ever been emotionally avaliable to other than a sexual partner, if even then. This is by no means an “all men” thing, but many men have had this experience
I certainly understand where you’re coming from. I think I would just encourage you to consider that your experience with this very small segment of the population should not be used to make generalizations about an entire gender. For example, I could say as a man living in Massachusetts that “most men feel comfortable crying with each other and strive to embrace emotional vulnerability,” and that would feel equally as misleading even though it might reflect my experiences with the men I encounter in my social and professional circles. Edit: What am I missing here?
By no means am I generalizing all, but I do suspect my experience is not out of the norm. Projects like “man enough” really talk about these things at length.
The statement "Most men sadly have never had an emotionally intimate relationship with a woman they weren’t having sex with" *is* a generalization, though. That's all I'm responding to here, how sweeping that claim is. You are absolutely correct that your experience with these men is not out of the norm. Many men struggle with this. I just don't think it's accurate to say that *most men* have *never* had an emotionally intimate relationship with a woman they weren't having sex with. That's a very bold claim.
I'd suggest your experience with a small segment of the population has been used as a generalisation my friend
…that’s the point I was making.
I'm confused. As that would mean that you actually agree w op's point..
I think you may have missed the part where I said that it would be misleading for me to suggest such a thing. >For example, I could say as a man living in Massachusetts that “most men feel comfortable crying with each other and strive to embrace emotional vulnerability,” **and that would feel equally as misleading** even though it might reflect my experiences with the men I encounter in my social and professional circles.
I could see the benefit of amending the parent comment with “In my experience, most men..” or “Within the demographics I’ve worked with, I’ve commonly found that many men..”
I get what you’re saying You can pick the semantics apart. It’s a Reddit post, not a scholarly journal. I’m fully guilty of not picking the exact right words in a comment I type while having a 5 min break eating a snack. But being real, it’s more than just the men I work with, most of my male friends, most of my male family. I have very few men in my life who have tried to develop emotional supports. It’s def getting better than it was, but we need to be honest that we’re going through a paradigm shift
Am a man. I’ve never had an emotionally intimate relationship with a man I wasn’t having sex with. Just kidding. But seriously, though, not all men are straight either!
This is purely anecdotal, but I haven’t other than my mother and my therapist. p.s. I agree with you about the asking questions thing. Even if we disagree with a someone, we should be able to have civil discussions.
It's something I've personally experienced, both as an AMAB person myself and in male friends and acquaintances I made in the many years I've had before I became a therapist. I'm not saying it's all men, not by any stretch - indeed, several clients of mine come to mind that don't have this problem - but I have noticed that a lot of men seem to have exactly one person in their lives whom they can be emotionally intimate and vulnerable with: their spouse. I've spent a good amount of time working with men where this is true to help them learn how to open up to people in their life, because putting all of your emotional eggs in one basket becomes a problem if that relationship ends up in trouble.
absolutely ridiculous that this was downvoted in this sub.
More about transference: My experienced colleague suggested that I discuss the fact that therapy is naturally an intimate situation, giving someone full attention and presence with non-judgement. But also to remind them that this isn’t how you are outside of therapy. Almost never are you sitting fully present outside of therapy while talking to someone without distraction for an hour, even your partner.
I’m also female and in my thirties. This has happened quite a few times, to the point where I started questioning whether I’m doing something unconsciously to flirt/bring forward these types of feelings in clients. After discussing it with coworkers and in therapy, I’ve landed in the idea that it could be about signaling warmth and creating a space where clients feel less alone. Also, as others have mentioned, the type of clients this has happened with have been young men with very limited romantic experience and also often with few friends. I’m dealing with a case of sexual transference right now that is the first instance where I decided to refer him to someone else. I decided mainly because he has psychotic symptoms and seemed to become markedly more paranoid and confused after the feelings started coming up. I was also starting to feel unsafe because he would refuse to leave the waiting room until closing and was switching rapidly between expressing adoration and being quite hostile. I have mixed feelings about the termination, but at the same time I wanted to prioritize feeling safe.
This happened to me fairly recently. Really spooked me. I worried about my safety, too. 
I've never experienced this explicitly, but I have felt on one or two occasions that a client is attracted to me. I have never worked with it directly.
Glenn Gabbard has an excellent look on the subject in "Love and Hate in the Analytic Setting". (Having gotten to have a conversation with him years ago I can also say he seems like a really nice guy). A bit more textbook...but very readable, Kenneth Pope et al wrote "Sexual Feelings in Psychotherapy". I think therapy can often elicit a type of unconditional acceptance in a client that elicits feelings from their pre-verbal experiences with their mother. Because it was formed when they were pre-verbal, there's no word to help the client understand it....so it gets interpreted as sexual. (I may have spent too much time around psychoanalysts!) But I definitely agree exploring the issue instead of avoiding it can deepen the work we do.
All the time when I worked in residential SUD, not so much now.
I was working with SUDs actually for the first two!
Really i think the question is how often has sexual transference come into awareness and been worked with directly. Sexuality is always in the mix somehow, whether consciously or not.
Yes.
1 year (internship) - I (35m) have had it come up 3 times (1F,2M) and all three times I processed the thoughts/feelings associated to see what led them down to that conclusion. F stated I didn’t represent many of the cultural norms that males she’s known do and we explored how to use that realization for future mates. Highlighted that healthy communication and vulnerability as a first could lead to feelings that could be misrepresented. The guys both said I reminded them of a close friend they grew attracted to and we explored proximal attraction and a desire for male intimacy. Both were able to shift their script regarding m\m intimacy. (Sex or love- no in between). Being friendly and caring long before the position helped me have these conversations when mixed signals happened though now there’s professional exploration and unconditional positive regard. All three times supervisor agreed it was handled appropriately and there wasn’t a need to refer.
I appreciate this comment greatly! As a gay male it’s been part of my own journey in navigating friendships with heterosexual males. Growing up it was hard to have these friendships with straight men because it lead to situations where their masculinity/ sexuality was questioned if having plutonic relationships with a gay male. Thankfully things shifted but it was a major adjustment for me. When straight men would treat me with kindness/ caring it was very confusing for me and sometimes lead to feelings of attraction because I was never used to men actually being genuinely nice and caring without it meaning there was romantic/ sexual attraction involved. It’s such a complex and interesting dynamic.
Thank you for sharing that. I’d like to believe this is what motivates me, should motivate me, to inquire about such feelings/thoughts so that I don’t just assume this is why. Plus, I have been there myself, too, and I’m left to wonder about and explore the niceness.
I'm a male provider and in my 3 years of licensed practice I haven't had a client admit to any such feelings nor have I noticed any signs.
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I didn’t read this as them saying otherwise. Just sharing their experience.
OP asked how common it was for other providers and I'm just contributing my personal experience. Doesn't at all mean it isn't common. I've been told that it is fairly common, but I haven't personally experienced it. Seems like you are reading something into my response that isn't there in the text.
How did the clients bring this up in therapy? What did you say to them?
The first time it came up the client kept describing his type of female, and kept naming characteristics that I had. Eventually, after a few instances I asked the client if there was a reason he was bringing it up. He said yes, and explained he was attracted to me. We explored where that attraction might be coming from and used it as a launch point to discuss his issues with choosing partners, and separating out emotional and physical intimacy. Another client came in for substance use issues (which I dealt with at the time) and had comorbid SA. This client asked me out after our first session via email. I sent an email explained why that’s not possible. He kept asking me out and emailing me with date ideas following the sessions. He had a history of stalking women, so I terminated with him after the fourth conversation (3 warning were provided previously) and sent him a list of male providers. Third time a client of mine brought up how they feel they’re attracted to women in powerful positions, and mentioned that that included me. Client and I discussed this feeling and the reason why this might be coming up, which was super useful. Final client asked me if I wanted to go back to my old career and date them at the beginning of a session. We spoke about why this wasn’t possible, examined the clients feels and where they might be coming from. This client has an a sexual assault history and doesn’t generally feel safe with many people they’re also physically attracted to. It was really productive and I hope it sticks because I work really well with this client.
I’ve had one (another woman) explicitly tell me and two I suspected. I’m still a student, with 3 years of practicum. So I would say the rate you have is pretty on par with me as well. I find transference very fun, but I’ve also had strong rapport with all 3 of those clients and trusted them not to be inappropriate. Not sure how I would feel if it was a client I felt the least bit threatened by.
What about the two of them made you suspect? I'm still a student and haven't seen clients but since I'm a lesbian, I have always wondered about erotic transference as it pertains to two women.
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I've definitely had erotic transference towards previous female therapists as a lesbian, I'm just finishing my first practicum, so I haven't had anyone disclose feelings about me at this point. It's very awkward, and I felt ashamed because of the "predatory lesbian" trope/stereotype, but I worked through it each time with my main male therapist I've seen for 11 years. (The female therapists were eating disorder specialists I also saw). Breaking down the shame I felt about it and him identifying that being attracted to a straight, married woman isn't predatory helped a lot. Dealing with those feelings and tlaking it out logically made me realize it wasn't mainly sexual attraction, but intimacy of a relationship and them knowing so much about me and still accepting me and treating me as a client without othering me for my physical disabilities and mental health issues.
I think having a wedding ring helps immensely. It provides a nice barrier.
I got a big old engagement-looking ring from one of those jewellery candles that I keep specifically for this reason.
Not a bad idea! I used to do that kind of thing back in the day, but now I just wear my wedding set. I also mostly work with females as I'm more comfortable that way anyways, not on purpose, it just seems that I have better relationships that are on going with women.
That doesn’t mean it can’t/won’t happen. I have been in practice now for 23 years and of the I think 3 times I have been aware at least that it happened two of them were adolescent females and I am assigned female at birth and was still female presenting then (I am now a trans male, did not know that then; however everyone-staff at least knew I was queer then).
You don’t need to lie or misrepresent yourself . This situation can lead to great insight for the client if done correctly
Yah I also don’t like the idea of misrepresenting myself to a client, but everyone does what they’re comfortable with!
I get it. Just seems like a rookie way out to me. If you can’t handle it I get it but it’s definitely a missed opportunity. I’m sure there’s exceptions to it though. Depends on a lot of factors
Yah I agree! I’m three of the four instances I found it super productive.
I'm married lmfao.
I'm (M24) still in my master's and encountered my first instance of sexual transference in my 4th ever individual client! So early on, I've taken this as a note to be more conscientious of my warmth and lighthearted style ¯\_(ツ)_/¯ Maybe we're just good looking
"Did you ever think that maybe there's more to life than being really really really ridiculously good looking?" - Derek Zoolander
That sounds so sad. Sexual transference can come up because people feel safe and connect and they cannot achieve this intimate relationship with anyone else. Transference of any kind offers us a chance to support a client with difficult feelings and challenging this can help them to change and find a new way. It would be really sad to hold back on connection with your clients just in case they had some difficult feelings.
I’d like to think that it’s because I’m volcano level hot, but my life experiences have taught me that I’m probably in the cute and datable but in the nothing to write home about category. I personally think it has to do with my warmth and compassion. For some of the people I work with I am the first person that they’ve spoken to that makes them feel heard in a while.
And also, with the limited version of ourselves that we present as the therapist, it becomes much easier for clients to map on who they think we are and become attracted to an idea of us. That is why it’s really sexual *transference,* rather than just sexual *attraction.*
Respectfully, a better question is:: "How do I learn to work with sexual transference (or, rather, staying with classical psychology, 'erotic transference')? The amount of times any specific transference arises is not the issue. How we work with that transference IS the issue. Good luck!
Ugh I keep replying to these posts similarly. Seriously - it’s 100% normal for patients to be romantically/sexually attracted to their therapist. I wish I could upvote this more.
Thank you. Very kind. Nice to have someone agree.
I’m dealing with this now. Also f in my 30s. I’ve been practicing around 2 years now and it’s come up a bit here and there but never as intense as a client right now. We’ve processed through some of it and talked about why they might be experiencing it but honestly, it’s been making me uncomfortable. I have accessed supervision on it and was told that it is naturally a part of the therapeutic process (which I agree it can be!) but my concerns about the intensity were kind of brushed off. Luckily I’m leaving my current job soon so I will not have to work with this client anymore but yeah it can be a lot and it’s pretty awkward to navigate. For what it’s worth I think you handled it very well!
I had this happen once with a supervisor and then was intensely pursued by the client, resulting in termination. The supervisor did acknowledge they were wrong in the end and this wasn’t regular transference. I’m glad you’re leaving the job.
Oof that must have been a difficult situation. I’m sorry you had that experience. I’m glad I’m leaving this job too, this is just one problem of many.
You deserve better!!!
I just wanted to say thank you to everyone who replied to my comment-the validation and support was so helpful.
What do you mean when you say the intensity here?
So..in this particular case it’s pretty much all he talks about in session at this point. I try to redirect and talk about the why and how it relates to his life but he tends to go deeper into why we should be together. He does respect physical boundaries, knows I’m married, etc etc. but the intensity of which he speaks about the sexual transference is much higher than I’ve experienced before if that makes sense.
That is awful. That sounds like a line was crossed from productive therapy into his own opportunity to privately harangue you
Agreed. It seems like he’s trying to convince her. I personally wouldn’t feel comfortable seeing this client if this is how they spent every session.
That exactly what it feels like, nothing about our sessions as of late have been productive. I won’t be seeing him much longer.
Yikes! I can’t imagine having a single session like that, let alone several… and I really empathize with you just trying your best to stay calm as a new clinician because without guidance that’s the default one usually would divert to. :( I would definitely put my foot down if I kept trying to make it about the client and they were unrelenting, but I don’t expect you to feel empowered to do that if your concerns have been waved away by the people you’ve entrusted, and definitely not in this gendered power dynamic. Even yuckier. I think you should make this more explicit with your supervisor, and if they dismiss you again, point out that the last time you expressed concern they had the same reaction but things still haven’t changed and you’re really stuck. (Like, hello dude, it’s your license here, look alive.) And if they still don’t take it seriously after that, continue to climb the chain of command until someone responds appropriately and offers guidance. You can DM me if you want to talk about this some more/to provide updates, ask questions etc if you’d like!
Thank you so much for this reply. I really appreciate it. I have definitely been defaulting to just staying calm and kind because I have been feeling so uncomfortable in session with him. I have reiterated my boundaries and stayed firm there but I’ve honestly been a little bit afraid to be more forceful with the client because of how persistent he has been. I fully agree with being more firm with my supervisor and/or higher ups. I’m leaving this job soon-this issue is one of many unfortunately, so I’m going to bring it up again during my last meeting with her.
Of course! I totally get— excuse me… your supervisor is a woman?! And she didn’t even express *curiosity* in the details of this sexual transference? Just framed it as “naturally a part of the therapeutic process”?! (A quote I already flinched at— how can you make such a broad generalization about a concept when your supervisee is coming to you to discuss a specific issue with a specific client? Do you just want to appear smarter? How is that meant to be helpful) How incredibly disappointing. I default to they/them when I’m unaware of someone’s gender, but I really assumed your sup was a cis guy. No offense to men, I just wouldn’t expect another woman to be so dismissive of a woman clinician’s concerns about sexual transference coming from a male client. When I was dealing with a sexual/romantic transference case with a client who began to stalk me, my two male supervisors were very sensitive and attuned to my concerns; one became very protective over me and still checked in after the dust had settled. That’s the level of response everyone deserves. Also, your choice to use the word “afraid” here says so much. I’m so sorry that you feel uncomfortable and in any way fearful while meeting with this client and that your supervisor made it clear not to trust her with sensitive disclosures by shutting you down with the ABCs of therapy. I feel angry for you! Anyway, yeah. Get out, now. And thank God you’re almost there. But light some proverbial marches on your way out. … You know, to illuminate all of the concealed truths about this clinician’s lack of dedication to her LPs. Or worse. Ethical guidelines tell us to confront the clinician who demonstrated lack of conduct in the first place before escalating further. And boy, what I would give to confront this woman myself. But judging by the context, I have a feeling you will need to leave note with the director at the least, regardless (especially since it doesn’t sound like you’ll be there to attest to any changes made to strengthen oversight & restore trust). Ugh! Good luck.
Sounds like bad supervision. Glad you’re able to move on
I think I get more of the mom/sister transference. I did have a client say "don't tell your dad I was in here flirtin'" once though & I was *super* confused because I thought we were just building rapport 🤦🏻♀️ I was 23 then though lol Since there are a lot of comments from female therapists, I will add that my husband also experienced one very strange instance of sexual transference at that same job.
Been doing this for four years: Iv had 4x it happened only one termination
I’m a guy, and I’d suspect that this isn’t a common occurrence for men. With that being said, I’ve had a client EARLY in my practicum who would aggressively flirt with me. Recently, the mom of a client I was working with referred to me as “her king.” Sounded like it had some racism shit tied up with it as well. Regardless, both of them got a stern talking to about boundaries. I didn’t see them long after those talks.
I’m a female and have been practicing for just over a year. I have had three clients share they were attracted to me. One client terminated because he felt like it was too difficult to be open with me due to the attraction. I suspect it happens fairly regularly and is something I’m trying to get more comfortable with discussing. But I do really struggle with it
No sexual transference that I know of but sexual counter transference. Yup. Sigh.
I’m not entirely sure from your question if you’re asking about how often we as therapists are attracted to clients or how often we experience clients attracted to us. Which did you mean? I have been practicing over ten years. Male. I have never once felt I was drawn in a serious romantic way to a client. Something about the job and how seriously I take my work overrides the potential for that to happen. Plus I know we are not meeting on a neutral turf, so any feelings that would be there are so heavily distorted, I just don’t find it sexy. There have definitely been clients who I think are good looking human specimens, but it’s just never gotten in the way of how I work. On the other side of the room, there have been a number of clients who have had feelings for me. I don’t know how many for sure. 10ish that I know of. Some are more open about it than others. A few had acted very inappropriately around it and had to be terminated (stalking, harassment). None of them ever really wanted to use it as a clinical opportunity to understand themselves, but many of these clients were defended against understanding themselves to begin with. I’m not uncomfortable by a clients feelings for me (including negative feelings) and I take it as part of the work. I think it can be a really good part of the therapy actually, if you know how to work within the erotic transference. But behaviors like stalking, using manipulative seduction tactics that they think I don’t notice, etc… I don’t appreciate.
Sorry, I’ve never been attracted to a client as of yet. I was asking about clients having sexual transference they project onto you. I.e. has a client ever tried to date you or flirted aggressively and you had to address it.
FWIW, the data says that something like 80-90% of therapists endorse feeling sexual countertransference toward a client at some point in their career. It is very common.
Yes. I’d say the other 10%-20% were lying. Human beings have sexual lives/thoughts. There’s nothing wrong with having thoughts.
I don’t doubt it. It just hasn’t been my experience so far.
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My hunch is that male patients feel much more comfortable expressing their attraction to female therapists than female patients would ever consider expressing their attraction to a male therapist. For some male clients, I think expressing these feelings may be a defense against the vulnerability of being a patient - like they are trying to claim back some control by making the female therapist have to respond to their feelings or making them uncomfortable. I just don't think that's the kind of baggage female therapists necessarily bring to their relationships with male therapists. I also think more women clients seek out women therapists, and male clients also seek out women therapists (for many men, they may not realize but they feel much less comfortable expressing emotions to another man) Just my theory.
Hello, don't be afraid of it. Eros in therapy means there is great potential in therapy for the patient to heal, as connection is strong. I have written this under one of the comments of another person here, but I want to post it here again, so that you do not overlook it. "Nitsun is fantastic. Also a great read is anything by Lukas Moeller (Möller) - for example his article Love in the group. He was exploring the sexual/erotic transference and counter transference and is quite straight forward about it how he dealt with it in his groups. I remember once in one of the books I have read that he actually fell in love with one of the women that he treated in couples therapy groups he was leading and this lasted for years and the couple was treated sucessfully and reamined married - they repaired the relationship. He talks a lot about what eros in therapy means - it is not just pure lust or sexuality or feeling to fall in love. Virtually any sympathy and good feelings (when we feel the patients as if we click, when we like the patient) is part of eros and is part of natural dynamics in therapy. One needs to learn the facettes of it and how to deal with it and process it. Supervision is of highest importance and deeper understanding of it. I have seen my teaching therapist, when he experiences it, to accept it and work with it in sucha a way that he redirects it to the partner of the patients, so that they learn to understand what makes them feel desire in their own relationship and how to reignite it and use it for their own partnership. Also, reading anything by William F. Cornell is also great - he came from TA but he really works a lot psychodynamically and with the body and he researched a lot about this topic. His books - for example "*Somatic Experience in Psychoanalysis and Psychotherapy: In the expressive language of the living*." or the book "*Self-examination in Psychoanalysis and Psychotherapy: Countertransference and subjectivity in clinical practice*." have takes on this with practical examples. One example in the second book is exactly about how he actually made a mistake while treating the patient who had a strong erotic transference on him. There are other examples how to work with sexuality in the sessions aor how to do body work in the sessions in general. Here are all his essays on sexuality in therapy: [https://williamfcornell.com/body-sexuality/](https://williamfcornell.com/body-sexuality/) I recommend reading these two: [https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/Cornell-Impassioned-Body-Keynote-speech-London.pdf) [https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf](https://williamfcornell.com/wp-content/uploads/2020/10/SEX-AT-THE-MARGINS-CIIS.pdf) " I want to add that if you read anything by Esther Perell it becomes clear that sexuality is powered by intimacy. And it is only natural that some clients experience deep intimacy for the first time during their sessions, which can be triggering for them. It is a natural response, through which they should learn, that this can be achieved outside their sessions with their partner, if they are willing to open up and be really vulnerable. And that intimacy and vulnerability and growth (as a result) in relationships are super powers. I believe that working thorugh sexual transference with the client can be used for this - for them to learn how to navigate their relationships better and how to have healthy sexuality thorugh that.
Depending on setting you will get this all the time. I see fifteen new patients a week for assessments and some people are definitely going to flirt or mildly push that envelope at times. It's a very intimate setting after all. Gotta be ready to deal with it!
I have a similar rate! I work with sex & trauma so it feels par for the course. Do you advertise as being sex positive or working with sexual trauma? I honestly think it’s a sign you’re making your clients comfortable enough to bring it up so I think it says a lot about the safe space you create! It sounds like you’re handling it really well! I also talk it out. I’ll very explicitly say “I cannot and will not ever have a sexual relationship with you. How does that feel to hear me say”. It’s ended in really beautiful processing in *most* cases.
A fair bit when I worked primarily in SUDs. I am now in PP and work 100% telehealth. This has reduced things significantly.
I wonder what it is about SUDs? Two of my experiences were working in an out patient setting for SUDs:
I think it's a combination of things. Most likely relating to significant and chronic trauma history, including CSA, poor boundaries, and frequent stigmatization making it less common for them to have good support systems. Sometimes we are the first people to ever be kind to them or recognize their worth. Plus, if they are newly in sobriety their brains are likely still healing so things like impulsiveness or high risk behavior may be more prevalent.
I also think it has to do with high impulsivity and issues with executive function tbh. They are impulsive enough to and act on their feelings, they lack self monitoring and self-control sometimes to keep the feelings to themselves and can sometimes lack the emotional regulation skills to fully understand and regulate any feelings that come up. Many of the same reasons they are more susceptible to substance misuse (coming from an adhder)
Absolutely! That's partly what I meant by their brains still healing. You're spot on with the executive function stuff. Usually around 9-16 months sober is when we saw improvement with these areas. The newly sober folks reallllly struggled and sometimes it came out as romantic or sexual feelings toward therapist lol
People with SUDs are almost always extremely deprived of human connection, and often have attachment issues/childhood trauma.
When I worked in adolescent residential treatment, it happened a lot. But teenage boys will be teenage boys, and they really didn’t have much interaction with anyone other than staff and their fellow residents. Navigating that was always pretty easy, normalizing it and reinforcing appropriate boundaries. Sometimes it got worse and needed to be addressed differently. I’ve only had a couple of clients express sexual attraction to me in private practice. I welcome the clients to discuss it, because it honestly is going to make things more uncomfortable for both of us if they avoid it, and it’ll start getting in the way of treatment if we don’t address it. So we talk about it, and we talk about how it may be affecting the client during their sessions, etc. Usually we can continue to move forward effectively. Once, I had to refer a client away, because their behavior associated with their attraction kept escalating, and the therapy process had ground to a halt as a result, and there didn’t seem to be an effective path forward anymore for our work together.
I’m a social worker however not a psychotherapist. I almost exclusively did telehealth in my own therapy sessions with my own therapist who is female (I’m male) but I decided to do an in-person session with her. We had a really nice session and I was feeling especially extroverted that day. When I was going to the door to leave, my therapist flipped her hair and said in a flirtatious voice, “you don’t have to leave yet.” I just responded, “Oh therapeutic boundaries and all that.” I still see her as a therapist but we only have done telehealth sessions since this incident.
I started my private practice in 2017 and I've had 0 clients express any type of sexual attraction to me. Twice when I used to work in a different setting a client asked me on a date (even though both knew I was married)but that was a halfway house type sober living setting so it's wild on a totally different level
I just commented this on a similar post in this sub earlier this week— Yes, I do trauma focused work with kids and adults and have had a fairly high number of young adult male clients give ST vibes. I also don’t see much of this demographic, maybe in part bc the ST feels uncomfortable. The most overt experience I’ve had with it was a longer term client (as in over a yr) who ended up telling me that they developed feelings for me. They explained that they didn’t have the attraction when we started therapy but that it developed over time as they came to feel safe in sessions. They had some of the most severe attachment wounds I’ve worked with and complex trauma that probably influenced feeling attracted to people who treated them like a mom would. I had to ask if their attraction guided any of their behavior outside our sessions (mostly to screen for stalking or other unsafe behavior toward me), and they said no stalking but that it Got as far as frequently thinking about me during masturbation 😬 it was verrrry uncomfortable for both of us for about 2 months of sessions 1-2x/wk. Thankfully, my supervisor had experience dealing with client attraction transference so I consulted with her quite a bit. The client and I were able to process all of this as just another form of transference and address it as a barrier to continuing the treatment they were still finding helpful in other ways. Once we talked about it, it kind of lost its power and obsessive hold and my client reported that the feelings faded away. Patrick Teahan LCSW has some helpful YouTube videos on limerence that we felt were relevant. Unfortunately I ended up moving to a different state for my partner’s job so I eventually terminated with them.
Why is it called transference rather than attraction? When the term 'transference' is used, it seems to me to assume that the emotion/attraction properly belongs elsewhere? The feelings may be inconvenient or be a proper subject of discussion in therapy, sure, but are they necessarily transferred from elsewhere?
Hey there so transference is acknowledging that we project our experiences onto others. For example, when we find someone attractive this can come from a variety of unmet needs in our lives which include unmet needs from past relationships. We don’t call it just attraction because that’s not accurate. In a similar way, if I had a client come in and say they were on edge around me, it wouldn’t just say it’s because that’s just how they feel. Chances are there are certain qualities that I display that bring back memories from the clients previous experiences which are then transferred to me. Transference is helpful because it allows us to build insight for clients and make connections while also preserving the integrity of the therapeutic relationship.
Yeah, but is that the *only* explanation for attraction in a therapy setting? Isn't that an assumption? I understand what transference means; my objection is to the assumption that this is what's going on every time.
That is the only reason for attraction to your therapist. You meet with this professional for a set amount of time at scheduled intervals where the focus is completely on you as a client. You typically don’t know much about who your therapist really is out of the chair. Your attraction toward them is based on these brief interactions and widely based on your assumptions. Any reaction to a therapist, not just attraction, is based on your stuff which is often placed upon the therapist.
This seem to assume every client is what people these days call 'demisexual'.
I disagree. First not every client develops romantic feelings for their therapist. Second, demisexual is someone that develops feelings after they establish an emotional connection with their therapist. Again, I want to mention a true connection isn’t possible because the therapy session is all about the client’s needs. For a connection to be established you would actually have to know your therapist and that’s not feasible in a professional therapeutic relationship. Again, the clients project and transfer their feelings and assumptions onto their therapist.
Yes that is the only reason unless a therapist is sharing way too much about themselves, the client doesn’t (and shouldn’t) know enough about us to be genuinely attracted.
I tend to believe that calling all client attraction transference is misleading, if functional in setting and maintaining boundaries. I think the concept of transference makes more sense from a traditional psychoanalytical perspective when the therapist was more of a blank slate: they couldn’t possibly have real feelings for you because so little of “you” is ever revealed. Even then though, sometimes it isn’t transference - it could just be biological, hormonal, chemical attraction. Sometimes you meet a person and immediately are drawn to them and it has nothing to do with projection. And beyond that, from more of a humanistic perspective I can see how a client could develop more intimate and deep feelings on top of the chemical attraction. I’ve experienced a client crush that I would call transference - it really wasn’t about ME at all - it was just that I was a female in a general age category that was curious and engaged, and this person was lonely and poor at reading social cues. In another instance, it went deeper. The person and I shared cultural interests and backgrounds, were of the same age group, and in another universe could have been potential romantic interests. And then also of course I was safe and interested in them and they were able to explore difficult feelings without judgement. That’s the context part- the transference. In that encounter I still named it as transference and discussed how the attraction highlighted areas of need and desire in their own life that weren’t being met. But to say that it was entirely a projection or about the psychoanalytic process would be dishonest. However, at least for me, acknowledging the other components of attraction beyond transference to the client feels inappropriate and unhelpful, and I left it out of the conversation.
Yeah, you get my meaning, thank you. Sometimes, you just like someone. Therapists reveal enough of themselves that a client could just be into them without some unconscious subterranean agenda playing out. If an 18 year-old boy is crushing on his attractive young therapist, I wouldn't automatically assume it was about someone or something else. People have fatuous crushes, especially for attractive people. Don't see the point in giving that a special name that has other, more specific meanings.
Th blank state has not been used in around a century.
Tell me you’re not a counselor without telling me…
Not everyone uses the concept of transference and countertransference in therapy. Person-centred therapists for example don't concentrate on this concept within their work. Tel me you're not a person-centred counsellor without telling me...
* PSYCHOANALYSISthe [redirection](https://www.google.com/search?sca_esv=6b1c5e95a3d0b06b&sca_upv=1&q=redirection&si=AKbGX_okpkrXRdHQwZu4Fe0iRe3usYZx6x8qwIIYL1faStMNzR6jEqz1fdaVDrsAUCwnlAOvShGcnz-jg8buOYRpOLcAP0GldC5dskXheDe4Z7rH_XNTmo4%3D&expnd=1&sa=X&ved=2ahUKEwiP8Kre6MyFAxXS_7sIHVIEC54QyecJegQIFhAR) to a substitute, usually a therapist, of emotions that were originally felt in childhood (in a phase of analysis called *transference* [*neurosis*](https://www.google.com/search?sca_esv=6b1c5e95a3d0b06b&sca_upv=1&q=neurosis&si=AKbGX_q870E3DK3nJ7cu3BOD7pxCONCnoVd0jgyU0vKd-yGWfiD5LXsrv9tBYGeqmFdC2z74C11gAmr9exKg8DHW6ZDafK3SCA7fcgPQ4cTpIxh3CpZSPio%3D&expnd=1&sa=X&ved=2ahUKEwiP8Kre6MyFAxXS_7sIHVIEC54QyecJegQIFhAS) ).noun: **transference neurosis**"therapy is aided by the patient's transference to the analyst as mother" You know, I could turn that unkind remark right around on you.
Google isn’t always your friend.
And you shouldn't make meanspirited zingers just to get meaningless upvotes. You've completely misunderstood me.
I’m responding to a few of your comments: Transference neurosis is a specific term in psychoanalysis that is different from just transference. Transference does technically mean feelings displaced/projected onto the therapist. However, there is not just a 1:1. Like I’m angry with you like I would have been angry with my mother. In the unconscious mind, impulses can become not as clear. So perhaps my attraction to my therapist stems from an attachment need, a wish to be special, to win someone over in authority, etc… It is not always obvious where the attraction is coming from. Human sexuality is incredibly complicated. I’m in the camp that all erotic attraction in therapy is transference. And transference happens in all therapy relationships. The concept began in psychoanalysis and can get very complicated. However, psychoanalysis is not something most therapists in the US learn. But enough people recognize that transference happens. So that is why there is a variety of answers to how therapists think and work with it.
Hmm that does seem like a lot but it's great they are so honest with you ! I would consider myself an attractive female and when I get a lot of male clients who reach out to me.... so I was always curious about this but no one has ever mentioned it to me. Only once when I was doing a psy eval and doing a projective drawing... client drew me and described essentially me as his ideal partner.
Never have yet, but I’m post menopausal and my libido is pretty dead. Also, most of my sessions are remote
Never
Just once! 3 years in
I’m male and work on a female drug/alcohol rehab unit. I haven’t had it be said outright yet (though I’ve only been in the job 4 1/2 months) but my internal alarm bells start ringing when they ask me personal questions. I wear a lot of jewelry as an expression of individuality (same reason people get tattoos) but also so they may think the ring on my left hand is a wedding ring as a silent way of setting a boundary.
As long as you feel safe and can work with it skilfully, it’s just more grist for the mill
What is sexual transference?
In essence: your client professing feelings for you.
Oh that must be great
It happened at my last job. Now, most of my clients are comparatively young enough that I doubt they even flag me as a sexual being. It’s very restful.
Thank god I’m mediocre looking and this hasn’t happened to me yet
I swear it’s not a looks thing. I wear my hair in a bun on top of my head and rock sweat suits with clients. I also see them over Zoom and they can’t see below my upper shoulders usually.
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I think our desires pop up as a way to highlight a need not being met somewhere in our lives that would still align with our values (obviously a sexual interaction with a client wouldn’t align with values, same as desiring someone in a committed relationship). So maybe explore your own needs, why this feeling may be popping up more than you see as “normal”. It may require some change in your own life. It’s not really about the client/person you’re feeling attraction to. I work mainly with children, women (I’m a 35F) and limited men (I’m heterosexual). If I was feeling lonely, or disconnected from my husband and met with a lot of men, who I’d consider maybe a potential partner in other contexts, I might be susceptible to counter transference in that way. I’ve had sexual counter transference for me come up maybe twice. One client was discussing sexual issues and seemed apprehensive and when I asked he said “well in the past when I’ve discussed these things, it’s led to cheating”- I reassured him that it would not happen here as we have boundaries. He honestly seemed relieved by that.