Sexual Feelings In Psychotherapy: Explorations for Therapists and Therapists‐in‐Training

Abstract

Presenting research, theory, and practical guidance, this book examines therapists' experience of and reactions to sexual feelings; the historical resistance to addressing this topic; educational approaches that foster exploration and discovery; and contextual factors (e.g., gender, age, and sexual orientation) that affect the experience of sexual feelings. The book includes structured opportunities for learning about sexual feelings, attitudes, and responses to patients; a review of the research on therapist-paticnl sexual intimacy; and information about treating patients who have been sexually involved with a prior therapist. Finally, the book suggests a systematic strategy for therapists to use when considering how to respond sensitively, iherapeutically, knowledgcably, and ethically to clinical issues raised by their own sexual feelings."Like a trusted confidant, this reassuring yet challenging book shows how research, theory, and the reader's own feelings can be used to guide clinical practice. It is that rarest of books with which the reader shares an intimate dialogue of personal discovery. Powerful, truthful, and adventurous, it will serve as an essential text to which seasoned therapists will return again and again and should be required reading in all training programs."

Sexual Excitement in Therapeutic Relationships

“…Sexual excitement and love in the transference often defend against more painful affects such as loss, mourning, hostility, and/or contempt (Adrian, 1996;Bridges, 1994;Gabbard, 1994b;Gabbard, 1996;Gorkin, 1985;Kernberg, 1994;Pope & Bouhoutsos, 1986;Pope, Sonne & Holroyd, 1993). Chris presents for therapy with a depression secondary to the devastating loss of a beloved younger sibling.…”

“…The phenomenon of sexualized transference often is accompanied by powerful rescue fantasies that may generate reciprocal fantasies in the therapist (Davies, 1994;Ehrenberg, 1992;Gabbard, 1996;Kernberg, 1994;Maroda, 1991;Pope, Sonne & Holroyd, 1993). As Chris becomes attached and begins to recount and relive relational difficulties, a mood of intensity, intimacy, and deep longing for the therapist develops.…”

“…This is evident in Chris's tenacious insistence that the therapist help contain sexualized aggression (Davies, 1994;Ehrenberg, 1992;Gabbard, 1996;Kernberg, 1994;Maroda, 1991;Pope, Sonne & Holroyd, 1993). The profound sense of deficit, a willingness to relinquish personal power and responsibility, and the insistence that someone fix her/him speak to childhood issues.…”

“…Sexuality may be a symbol, distraction, or disguise for other affects and phenomena, including a need for nurturing, admiration, or soothing; avoidance of intimacy; denial of dependency or passivity; reenactment of traumatic object relations; defense against hostility or contempt; or denial of grief, loss, and/or mourning (Benayah & Stern, 1994;Bridges, 1994;Davies, 1994;Ehrenberg, 1992;Gabbard, 1994b;Gabbard, 1995;Gabbard, 1996;Gabbard & Lester, 1995;Gorkin, 1985;Kernberg, 1994;Kohut, 1984;Maroda, 1991;Pope, Sonne & Holroyd, 1993;Tansey, 1994;Tansey & Burke, 1992;Winnicott, 1949;Winnicott, 1965).…”

“…With inadequate preparation, clinicians run the risk of engaging in destructive behavioral enactments or developing restricted practice styles that stunt the psychotherapeutic process (Adrian, 1996;Blackshaw & Patterson, 1992;Bridges, 1995;Carr, Robinson, Stewart et al, 1991;Gartrell, Herman, & Olarte, 1986;Gartrell, Herman, & Olarte, 1988;Gartrell, Milliken, Goodson et al, 1992;Gechtman, 1989;Gorton, Samuel & Zebrowski, 1996;Robinson & Reid, 1985;Rodolfa, Kitzow, Vohra & Wilson, 1990;Roman & Kay, 1997). Additionally, the absence of formal curricula often places the preparation and education for erotic aspects of psychotherapeutic practice on supervisors, many of whom feel inadequately prepared to deal with sexual feelings and resultant complex treatment situations (Bridges, 1995;Gabbard, 1996;Gabbard & Lester, 1995;Gorton, Samuel & Zebrowski, 1996;Pope, Sonne & Holroyd, 1993;Rodolfa, Kitzow, Vohra & Wilson, 1990). This paper, which includes a case and analysis--written collaboratively by a psychotherapist, who teaches and consults on erotic transference/countertransference, and a victim-survivor of sexual abuse by a psychiatrist--is an amalgam of incidents from actual cases and supervision.…”