Deepening Intimacy in Psychotherapy: Using the Erotic Transference and Countertransference

by Florence Rosiello

In this provocative volume, Dr. Florence W. Rosiello addresses erotic dynamics in the treatment relationship within the context of a two-person therapy, emphasizing the necessity of mutuality and emotional reciprocity between patient and therapist. With rich clinical illustrations, she demonstrates how the intimacy created by working within the sexual dimension of the therapeutic relationship may present opportunities for insight and growth that could easily be missed if one seeks to avoid these highly charged issues. Focusing on those patients who are predisposed to relating to others in a sexualized manner, Dr. Rosiello has discovered that mutual exploration of both the therapist's and the patient's subjective experience offers a valuable and effective means of enhancing the treatment.

Genres: Psychology, Nonfiction

234 pages, Hardcover

First published September 1, 2000

Reviews

[Guido Colacci · Rating 5 out of 5]

She nails it. This is what's wrong with psychotherapy and the harsh truth of why it doesn't work in 99% of all cases. This book is a collection of therapeutic experiences between therapists and patients who have developed erotic transferences. These experiences reflect a wide range of sexual orientations. As Dr. Rosiello points out, the important area of erotic transference and counter-transference has, for the most part, been neglected in the clinical literature and in the scholastic training of psychologists. Anyone who has been in therapy knows that the boundaries are set in stone at the discretion of the therapist. She describes these narratives with courage and sophistication. It is clear that the expression of loving and sexual feelings in the transference involves emotional risk-taking on the part of the therapist. Dr. Rosiello demonstrates that working with the erotic transference creates the basis for a very special emotional intimacy in the therapeutic relationship. Dr. Rosiello has performed the enormous service of taking the erotic transference out of the therapeutic taboo closet. Dr. Rosiello has significantly enlarged our view of the meaning of the erotic transference to encompass a patient's positive developmental strivings for connection and intimacy. She makes a major contribution to our understanding of the ways in which therapists need to participate with patients during psychotherapy. Treating patients who develop erotic transferences and working with one's own erotic countertransference create treatment and professional vulnerabilities for the therapist. Discussing sexual or loving feelings in therapy, while risky, can deepen or create emotional intimacy that no other aspect of human relatedness can accomplish. Most importantly, therapists should not concern themselves or their patients with what is “appropriate” and what “boundaries” you should be keeping in mind! In your therapy, out of all places, you needn’t be monitoring your communications. During therapy, after a traumatic experience, whether during childhood or something more recent, it sometimes brings with it deep feelings of loss, sadness, pain, hopelessness, or a bottomless void that manifests in physical pain, deadened feelings or exaggerated response, the patient may reach out to and come to the therapist expecting some comforting, whether it’s a hug or holding your hand. If the therapist fails to offer this or some form of safety and comfort and ease the pain, the patient may actually be more devastated and more damaged than before they came to the therapist for help. Having boundaries as a therapist is all well and good and boundaries need to be there, but the failure on the part of the therapist to be human in extraordinary or specific situations while standing firm on their rigid personal boundaries may be a more grievous and egregious error than giving a hug or holding a hand for the welfare, healing, and emotional and mental relief of the patient.
I truly feel it is their responsibility to not make us feel like we are abandoned again as in childhood, or whenever the trauma happened to us, but it seems especially today, 99% of psychotherapists mainly care about boundaries than they do about the welfare of their patient. The truth is they will go more out of their way to make sure boundaries are not crossed than to do what is best for the patient. As long as the needs of the patient do NOT cross the boundaries that are carved in stone and black and white, don't trade your empathy, compassion, and humanity for an unmovable boundary that is a very subjective abstract thing. A MUST READ for EVERYONE, patients and therapists alike.

[Henry · Rating 5 out of 5]

First of all - regards to transference and counter-transference in clinical psychotherapy. Author has noted several times that she disagree with the common notion that such topic is a taboo. And that a clinician ought to stay rational, even cold, when transference occurs. As the author quoted from Freud that the client's projection of transference is a mere "illusion".

However, the author points out that often at times, transference (or counter transference) is a large part of the talk therapy process. In order to be a good clinician, perhaps it's unavoidable - even encouraged for the clinician to use transference.

The author also points out that it seems like transference occurs to her vastly more often than her peers. Her looks, and her clothing/make up choices might contribute to that greatly (as she overheard other female clinicians attempt to tone down their look to be as asexual as possible).

Second of all - transference, including erotic transference, occurs when a clinician has something the client desperately need. Seduction, as well as erotic love stem fundamentally from a person's inability to decipher from unmet needs and the means to capture that needs (the author points out that many people have noted things like, they "love a baby so much that they want to eat the baby"). In talk therapy, oftentimes absent of the actual "cure" of the client's need, the clinician, became the cure. And the relationship between the client and the clinician became more than professional (as the author noted that at times, she feels like she is giving away pieces of herself to the client). When the client realized - internally, often - that the client desperately need the clinician (and in the case of counter-interference, the clinician herself often have a "favorite client" and she can't wait to see him every week) in his/her lives, the client will then internalize the feeling, and have attempt to seduce the clinician in order to retain the relationship permanently.

The client-clinician relationship is a complicated one. Since the client voluntarily allows someone else to go into the deep, internal life of him/herself. And it seems that when the clinician is able to pin-point the exact unmet needs of the client, the client often use transference as a means to delay the process - knowingly or not.

- Some of the early signs of transference could be patient beginning to provide more sexual material, or intentionally eliminate sexual materials, from conversations

- A good way to pierce through a narcissistic is to mirror the narcissistic through empathy, to gain insight into how the narcissistic thinks

- "Taking a risk as an analyst means putting one's own emotions on the line, risking the disclosure of one's own feelings at times, and thus stretching the boundaries of the analytic playground through emotional risk without being out of control"

- Leveling: people, in order to feel more secure, often attempt to ask personal questions in order to feel bonding towards the other person. In psychotherapy, the client would often ask personal questions first, "are you married?", "where do you live" etc. As the relationship gets closer, the client would ask even more personal questions. If the clinician stays away from this, then the client will often feel the clinician being cold and distant

- "Each gender envies the other for many reasons, and that aggressive envy is not so much a function of gender as it is a function of all humans"

- "Drag is an enactment or acting out of unacknowledged early childhood loss that was never grieved" (author's rephrase of Butler (1995))... "through fantasy in an attempt to hold on to the object or as a way of refusing to let it go" (p. 176).

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