![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 13 to 37 of 79. Go back in thread:
Posted by Penny on October 7, 2003, at 10:49:41
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by Adia on October 7, 2003, at 10:40:19
Don't panic!
I'm going to bring up this topic in therapy today, to see what my therapist says. But I have had the 'transference' talk with both my current and former therapists and pdoc, and none of them have terminated as a result! The only circumstance I can think of that would cause a therapist to terminate as a result of transference would be the therapist's inability to handle those feelings (well, the therapist's experience of countertransference and his or her inability to handle *those* feelings). Or if you were to admit feelings for your therapist (I'm thinking romantic) and they were to admit that they felt the same way - that is unethical.
But a therapist would have to be cold and unfeeling to turn a client away because of transference feelings - in fact, I suspect that could be grounds for malpractice.
Don't panic, Adia! Your therapist isn't going to terminate you b/c you've admitted mother/child feelings toward her. As a skilled practitioner, she's going to take those feelings and use them to help you deal with your issues. That's what she's there for.
She sounds like a wonderful therapist. Mine is too.
P
Posted by jay on October 7, 2003, at 10:50:33
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by Dinah on October 7, 2003, at 8:45:14
> > Hey folks:
> >
> > I have noticed a number of folks who mention extensive attraction to their therapist, which is with no mistake, transference. What you must realize is that this is one of the ultimate *sins* in counselling. Therapists are usually obligated to terminate the client-patient relationship if this occurs. Therapists can face criminal charges and lose their license to practice if they operate outside the boundaries of a client-patient relationship at all.
> >
>
> Whoa, Jay. Gotta say that isn't at all correct. If a therapist terminated every client who was sexually attracted to them, they wouldn't have many left. It is *not* unethical to be the recipient of an erotic transference. It is not even unethical to feel sexual attraction to a client. It *is* unethical to act on that attraction. I don't want people to be scared to mention their erotic transferences for fear they will be terminated. It is *very* important to bring up that sort of material in therapy. Erotic feelings are a natural result of an artificially intimate relationship, are nothing to be ashamed of, and will not end in a person's rejection or termination with a therapist. I would go so far as to say that a therapist who terminates with a client because the client is sexually attracted to them has absolutely no business in the field.
>
> Sorry, Jay. But this is a board that many people come to with their transference issues, and I just don't want people to get the idea that feeling erotic feelings for their therapist will cause their therapist to terminate them.
>
> Only a therapist's *actions* (including words as actions) can be considered unethical.
I understand what you are saying...and the smallest amount of attraction should only be able to be picked up if you where a psychic. I don't mean to be arrogant or whatever, but I have plenty of first-hand experience, twice with me and numerous with other colleagues. The two times with me involved slightly covert, but suspicious questions about *me* as a person, and my personal life.(VERY blatent questions.) Most counsellors who find this is an issue will discuss it with colleagues first.Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. That would be humanly impossible. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
I honestly think we are on the same ground here, but it's just a matter of degrees. I've read many of the posts with transference issues on the board, and I was greatly appalled at some therapists actions. I am sure you would be to. I am also honestly not trying to push people away who have their own issues with this, and want to support anybody as much as possible. What worriers me, though, is of our board members getting taken advantage of, or even abused. It is so common these days, I guess that is why I am super sensitive to the issue. Plus, people pay a heck of amount of money for this counselling, and I don't like to see that abused also by therapists.
Anyhow...thanks very much for your input and suggested readings. :-)
Sincerely,
Jay
Posted by jay on October 7, 2003, at 10:55:04
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
I am expecting an email from the Prof. of Social Work at one of Americas largest universities. I'll post the peoples responses as they come in.
There is no absolute 'right' or 'wrong', and I think Dinah doesn't exactly know what I mean. (I mean that in a nice way.)
Thanks,
Jay
Posted by jay on October 7, 2003, at 10:59:55
In reply to Re: Please read...Code of Ethics Therapy » Adia, posted by Penny on October 7, 2003, at 10:49:41
Here is some further discussion on transference from a discussion site.
-----
Transference or reality?If a client has strong feelings of attraction for his or her therapist, then conventional psychoanalytic doctrine automatically labels these as "transference", that is, the feelings are not really how the client feels about the therapist, but how the client feels about other people who are, or have been, important in the client’s life.
But how can anyone know whether these feelings would not have arisen outside the therapeutic relationship? If the client believes that he or she would have fallen in love with the therapist if they had met in a normal social setting, who has the evidence to show that the client is wrong? Kay is absolutely convinced that her feelings of love for her therapist were genuine.
To this day, I still wonder about that so-called phenomenon called "transference". As much as I have read and learned, there's something in my case that has never changed -- and that is the truth -- that I truly fell in love with my therapist and he knew it. What has been difficult in my healing is to accept the fact that he did take advantage of the so-called "transference", and whether it was only "transference" or if it was "real", he abused me by "acting out" my love for him through the guise of a combined therapy/dual relationship. The man even told me he knew my love for him was "beyond transference" and that we would always have a close relationship even after therapy was over. He testified that he knew and believed that I believed I was really in love with him. Transference? Countertransference?
I wonder.
Alex also offers a counterexample: she has seen many therapists but never yet fallen in love with any of them:
The therapeutic relationship is the only occasion in which feelings for each other receive special names, "transference" and "countertransference", and that's the reason why sometimes I think it's the most neurotic relationship of all.
It is perfectly possible and normal to fall in love with somebody you feel understood by, cared for etc. I have seen many therapists but I have never fallen in love with any of them. If one day I do, why is that called "transference"? Such a generic name for a specific feeling. Nobody would doubt me if I said I had fallen in love with my neighbor, who is cute and talks to me for 15 minutes a day when we are opening our doors to enter our homes. But if I claim I have fallen in love with a therapist then it is transference.
I am not saying that transference does not exist but that sometimes the term transference can be called up to protect the therapist’s responsibilities for awakening in you, and feeding, feelings of love.
If he calls it transference he is dealing with you as a client with problems. If he calls it love he is dealing with a woman's feelings. [To Kay] If your therapist had a dual relationship with you, then for him to call your feelings "transference" is a cowardly way to refer to them.
Natalie is in the process of being converted by Alex to believe in biological factors that explain what seems to be an unlikely attraction between client and therapist. She writes:
Alex and I had a discussion about a month ago which I’m summarising here in case anyone finds it interesting.
…I wrote, "Why does an independent, attractive woman in a stable relationship fall hopelessly and painfully in love with a greying, balding therapist who is old enough to be her father?" [The answer, I said, was transference].
Alex pointed out two things: firstly, that my question could be considered to be offensive because it could be taken to imply that nobody would normally want to be in a relationship with someone who was unattractive; and secondly, that many women do have relationships with older men, and that there isn’t necessarily anything wrong with that. As a biologist, she reminded me that although there is an evolutionary drive for men to prefer younger, fertile, partners, the same does not apply to women, since men are fertile way beyond the age when female fertility stops. In fact, the woman might well have the drive to choose a mate with power and status rather than youth or good looks. Therefore it’s not such an unnatural thing for a female client to fall in love with her therapist.
I felt she had a good point there. In fact, I thought my therapist was still very attractive – it was he who kept going on about his hair, or lack of it.
What I wanted to express was the inappropriateness of the attraction…I think it would be interesting to know whether an erotic transference between a female client and a male therapist is more likely than between a male client and a female therapist.
Syd gives an example of a relationship outside therapy between a young girl and an older man.
Very interesting discussion. I have heard that there is a definite biological component for attraction that we work on at an instinctive level. But maybe due to my naivety, not knowing all the physiological workings, I sometimes think there are other psychological components such as the Electra complex. I have a young friend who is 19 years old. She's intelligent and beautiful. She could probably get the attention of any young man, but she has been involved in a relationship with a 50 year old. Her parents are still having a hard time with that.
I have talked to her on occasions about her relationship with her father and she always tears up. Even though I am not qualified to diagnose, I do feel there is a need being fulfilled by that man that her father never gave her. Her parents are professional people and have an active social life. But what Alex said could explain that attraction, biologically. Also I think that a great majority who go to therapy will have transference if they establish trust with any therapist...a mother figure...father figure...whatever. We are needy when we go to therapy and so we become vulnerable…It is ethically the responsibility of the therapist to de-escalate the situation. Unfortunately there are therapist who have counter transference. They want to rescue [the client]…I do know that there are therapists who are in this role in order to work out their own issues.
Rosie also finds counterexamples, saying that the attraction between therapist and client may seem like sexual attraction, but is not caused by the sexuality of the people involved; it is a different kind of relationship that needs to be examined separately from normal sexual relationships if it is to be understood.
Regarding Natalie’s discussion with Alex about the dynamics of client-therapist attraction, I’d like to suggest that considering it as just another instance of the standard man-woman relationship fudges the issue. The feelings generated in the client by the therapy situation are, it is true, very similar to romantic/sexual desire but often do not correspond with either the sex or the sexual orientation of the persons involved. Thus a fully heterosexual woman may find herself obsessed by another woman, and a male client may be similarly attached to a male therapist.
Unless we recognise the wholly particular nature of the client-therapist relationship we cannot begin to fathom it. I have a few theories about it, as yet undeveloped. Could it be, for example, that both sexual desire and the desire generated in therapy stimulate some pleasure centre in the brain? And once this stimulation starts, could it be that its cessation causes us to suffer withdrawal symptoms like those of an addict deprived of his drug?
My own experience - a craving for complete and exclusive union with my therapist - felt consistent with the notion that in therapy we relive our early relationship with our mother, even from the time we spent in the womb. It could equally well be consistent with something else; if, for example, individual beings are all part of some kind of cosmic consciousness, it could be that therapy puts us in contact with this in some way and that we then feel the desire to be re-subsumed into it.
Does anyone have any comments to make on these ideas, or any different ones of their own?
PPJMB believes that his attraction for her therapist is justified by the therapist’s good qualities, but at the same time he perceives that there is something unreal and disturbing about the feelings he is experiencing.
I am new to this discussion, and I am very impressed by the quality of the submissions. I look forward to seeing more.
I am a heterosexual male in psychoanalysis with a female analyst who, from all appearances, seems heterosexual as well. I find her extraordinarily beautiful, and I think my judgment in this respect would be shared by most men who value taste, intelligence, and delicacy. I don't mean to sound superior or sexist: I believe, though, that my sexual attraction with the therapist is NOT simply a function of the therapeutic relationship or the transference.
For example, I have often thought-- and told my analyst-- that I cannot imagine having this kind of experience with a male therapist, or with a woman who lacked this combination of beauty and overpowering intelligence. I think I would have experienced this same attraction to even if she weren't my analyst. And I've been seeing her four days per week for several years, so I don't think this is a temporary or passing infatuation.
Am I being foolish? I certainly worry that I am: that I am slipping deeper into unreality and illusion. Analysis tends to do that to you, I think.
What should I do? Ignore it? Ride it out? "Explain it away" in that most annoying way that psychoanalysis has?
One thing for sure: the presence of these feelings, and my candid expression of them to my analyst, has raised the stakes at risk in the process. Whatever happens, I expect to receive a serious blow to my self eventually.
Ideas?
Rosie brings the discussion back to feelings of attraction between client and therapist that would not be thought of as being justified by their personal qualities or sexuality.
There have been some interesting responses to my last posting. Kay and PPJMB both talk of having feelings about their therapists which they believe would have been generated (or were generated) in a normal social setting. However, if therapist-client relationships always followed this kind of pattern the notion of transference would probably never have come into existence.
The point I want to emphasise is that, much more often, the therapist-client couple does not correspond to one in which this kind of attraction would normally arise. The fact that it does arise in the most unlikely circumstances is what makes me so curious about what exactly is going on. My first therapist, for example, was a dowdy, down-to-earth matronly figure in her early fifties, yet I was obsessed and besotted with beyond all measure. Pierre Rey, in writing of his analysis with Jacques Lacan, says that if Lacan had offered him a 20-second meeting with him at the opposite side of the world for a fee of 20,000,000 francs he would have found the money and gone. Tilman Moser, in his book Years of Apprenticeship on the Couch, describes equally aberrant examples of his aching desire for his (male) therapist. And there are countless others in the stories that many therapees have to tell.
Another thing which distinguishes the therapy relationship from a romantic one is the regression which often manifests itself in the therapee’s behaviour - thumb-sucking, baby voice, and other childish mannerisms, accompanied of course by the feeling of having travelled back in time to a very young age. As well as this, there is often a dreamlike quality to the therapy which can take over one’s whole life so that the therapee is living in what amounts to an altered state of consciousness.
Does all of this strike any chords for anyone?
Kay replies:
Nope, not for me. As I said, I was in love with HIM -- in and out of therapy. Maybe the focus should be on the damage and confusion from a dual relationship, instead of just the transference itself. No doubt in my case -- it all colluded -- in and out of therapy. And HE even told me toward the end, "the personal and professional collided". Of course, I didn't know what that meant at that time -- and he avoided trying to explain it to me; he avoided all attempts on my part to try to resolve the whole thing with him.
Alex points out the conflicts between biological forces and social expectations. These can create confusion about what is "natural" and "unnatural".
I have in mind, but that is a very personal opinion, that we tend to be confused between those two things: a pathological or psychological problem, and something socially undesirable. Like the case you cited about the 50 year old man and the teenager. As animals we are programmed to do certain things, or putting it another way, we do have a biological potential, which is molded by the culture in which we grow up. In some cultures it is desirable to give your daughter in marriage to an older man, who has accumulated wealth and can protect her and give her children (because that's what men are originally for :), and old men can do it as well, or better, depending on the situation). In our society, we aim to have many things in common and share a living and our children remain dependent for much longer. Things change fast and two consecutive generations have not much in common. In the first case, i.e., in a more "primitive" society, the term "Electra complex" would be totally meaningless (see, I am not saying Freud is wrong, or whatever, just trying to sort things out).
Although I agree that therapist/client relationship is different than any other, it is also molded by biological and social constraints. And what makes the relationship really, but really different, is its very unnatural nature. No other relationship in the world equals this one, as far as I am aware. And as all unnatural things, it can trigger some unnatural reactions.
See the situation. We lock two people potentially attractive to each other in a room, for up to several hours a week. They have only to pay attention to each other, and to themselves. The result we call "transference and counter-transference", without even thinking twice. It might be, but it might be simple attraction as well, why not? Healthy, natural attraction. The next thing we see is that the poor patient going crazy. Because he/she has received some cues from his/her therapist that say, "I am attracted to you too" (and those cues can be pheromones, certain kinds of eye contact, coloration of the skin etc., or even verbal comments, as in Natalie's case) together with this less pleasant message: "no, you are not really attracted, it cannot be because I am older, because I have thin hair, because I like baseball and you do not etc., so let's play "neurotic transference".
Natalie wonders if relationships in therapy follow the same patterns as relationships between people in normal social settings:
I've been looking at relationships in psychology and I think the following things are worth noting:
1. Maybe for everyone there is one person in the world who is the ideal partner. But most of us probably never find that person. The probability of meeting that person is simply too low. So we settle for "the best we can get". Many, many studies have shown that we pick our friends from the people who are located nearest to us (the person sitting at the next desk, the student occupying the next room). Studies of marriage licences have shown that most marriages are between people living a short distance away from each other.
So, I think that the fact that the therapist is seen frequently might be a factor in triggering these biological urges. As Alex says, "We lock two people potentially attractive to each other in a room, for 1 to several hours a week. They have only to pay attention to each other, and to themselves." Well, imagine that a man and woman were the only inhabitants of an island. Biologically, it would make sense for them to form a relationship - if they do not, then their genes die out. I think that we have this drive built into us - if someone is convenient and there's nothing obviously wrong with them, then go for it!
2. The human child has a long childhood and needs protection. It is advantageous for its parents to have a strong bond to keep them together until the child can fend for itself. One way in which we form the bond is by mutual self disclosure. We tell our prospective partners things that we would not tell anyone else. This gives the other person power over us, so we have an interest in staying faithful to them.
In the therapy situation, the self-disclosure is unparalleled. Perhaps the very act of performing self-disclosure triggers the sex drive, since the way is being prepared for a relationship?
Rosie, I know this is by no means the full story. But I think it helps to look at the biological side of things - the urges that we can expect to be awakened anyway, whatever the "therapy" consists of. I am becoming more and more attracted to analysing human behaviour from an evolutionary point of view. I know this will not tell me everything that I need to know, but I think it does lead the way to some very interesting considerations.
Alex does not share Natalie’s views about the power associated with self disclosure, though she thinks it is unnatural to be expected to self disclose to someone who does not respond in kind.
I agree that self disclosure calls for intimacy. I think it is unnatural that I disclose myself to somebody that remains a "blank screen", or whatever one wants to call. But I disagree some that self disclosure is necessarily tied to sexual desire. I often found it easier to disclose myself to a close friend than to a lover. There is a lot of self disclosure between heterosexual women in friendships, for example...
The power the partners have over each other are more "external" to the relationship itself. In most cases, material dependency, and a lot of social constraints...What I have told my husband so far does not make a difference in my decision to divorce, but a bunch of social constraints which were implanted on my mind during all my life can make much more difference.
But of course self-disclosure gives some sort of pleasure. When it can be done properly, it can give a lot of pleasure.
I think it signals a relationship of some kind, not necessarily involving sex. And the frustrating result is that there is no factual relationship. This fact frequently made me feel annoyed and confused. I think therapy is a great place to learn something about ourselves but I never could get real emotional support from it, once there is no real contact with the therapist…
In my opinion saying that we need to have things in common or real intimacy for feeling attracted or aroused by somebody else is a misconception. Sexual attraction is MORE PRIMITIVE, evolutionary speaking, than intimacy. Sex without intimacy is natural, and happens everywhere. Including the therapy room, whether we like it or not.
Syd wonders if making sure that the client and therapist are the same sex might eliminate some of the problems of overwhelming attraction between them:
Great thoughts Natalie!
I was also thinking that since we are talking about the male and female thing and the biological components of attraction the simple remedy for many of us would be to consider not having a male therapist when there is a female client or a female therapist when there is a male client. Men with men and women with women. At least from that stand point we would avoid the possibilities of having those pheromones, etc., kick in and then find ourselves in a situation of greater pain than when we went into therapy. Does that sound stupid?
Alex thinks that this suggestion might work sometimes, but that there is more to it than that:
I think it is somewhat an oversimplification of the problem, but might work sometimes, for some people. I think that being able to handle the problems that arise in therapy is part of the social skills we have to practice anyway, in order to live in society .. Being aware that problems may arise, and keeping your eyes wide open for some signs might suffice for most people...
Some of us have problems when working with therapists our own sex, for one reason or another, too.
A list member suggests:
Could it be that the feelings attributed to the therapist, in the transference, belong to a preverbal period? e.g. between mother and baby in the very early weeks where for the baby the feelings are all encompassing (including sexual) and all consuming (body, mind and spirit) as discussed by Winnicott? The craving for the breast and being one with the mother?
Alex would like some evidence of such a theory:
Yes, it could be. As with many things in psychology: they "could be". Well, many of our emotional reactions have a preverbal COMPONENT anyway. I want to see these hypotheses submitted to some kind of a test.
Where does this idea come from, that a baby wants to become one with the mother? I can imagine that the baby cannot differentiate himself, or herself, from the mother. But to be willing to become one with somebody else, we need first to be differentiated from this "somebody else".
I really have a hard time understanding some concepts in psychology...
Posted by Dinah on October 7, 2003, at 11:15:25
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by jay on October 7, 2003, at 10:50:33
> I understand what you are saying...and the smallest amount of attraction should only be able to be picked up if you where a psychic. I don't mean to be arrogant or whatever, but I have plenty of first-hand experience, twice with me and numerous with other colleagues. The two times with me involved slightly covert, but suspicious questions about *me* as a person, and my personal life.(VERY blatent questions.) Most counsellors who find this is an issue will discuss it with colleagues first.
>
> Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. That would be humanly impossible. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
>
Arrrgh, Jay.....That is not the *common* practice, and you're scaring people. Please check your facts. A therapist who turns feelings into inappropriate words or gestures is wrong and should be terminated. A client who turns feelings into words is doing their job as a client. You are *supposed* to put your feelings into words. You aren't supposed to keep those things to yourself. You would be doing the wrong thing to keep those things to yourself. You aren't supposed to sexually attack your therapist, disrobe, or harass your therapist. But you aren't wrong in *saying* you are attracted to him or her!!!!!!!!!
If a client asks private questions you don't terminate him either. You enforce the boundaries of the therapeutic relationship. You do not terminate a client that easily. You'd be in huge malpractice area for that. You tell them you aren't willing to share that information. You ask them why it's important for them to know that information.
Your average therapist is NOT going to terminate a client for *any* feelings (note I say feelings, not threats) a client reports towards him. Your average therapist will not terminate for covert or overt questions about his private life. Goodness gracious. No therapists would have any clients!!!
What are you saying? That you should treat your therapist like your accountant or lawyer? You are in an intimate relationship where feelings are likely to crop up. You are in a relationship that is intimate if only because you are supposed to discuss your feelings!!!
I'm sorry to get so upset here, but you've already scared Adia. And many people read this board who don't post and may decide never to tell their therapist what they're thinking based on your words. That's the Psychological Babble equivalent of telling people to mix booze and their psych meds on Psycho-Babble. It's harmful to people to say these things. Please check it out first and if your social worker board agrees with you, forward their reply to this board.
Because this is contrary to every thing I have ever heard about therapy. And if your social worker board agrees with you, I have some writing myself to do to the APA, American Social Worker board, and yours as well.
I would be very interested to know if they agree with you. But please check it out before you keep telling people they are bad for expressing their feelings to their therapist.
In fact, if you like, I will forward your posts to the Canadian Board of Social Workers and publicly post their replies on this board.
Posted by Dinah on October 7, 2003, at 11:18:05
In reply to Re: Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 10:59:55
Jay, that reference has nothing to do with a client being terminated for expressing feelings for a therapist.
I am currently copying your posts into an email and will forward them to your professional society. I will forward on their reply, if any, to this board.
Posted by Dinah on October 7, 2003, at 11:20:28
In reply to Re: Please read...Code of Ethics Therapy, posted by Dinah on October 7, 2003, at 11:18:05
Posted by Dinah on October 7, 2003, at 11:32:07
In reply to Re: Jay, is this the society you refer to?, posted by Dinah on October 7, 2003, at 11:20:28
I gave links to your posts so that there would be no misunderstanding. And I'm perfectly willing to post the content of my email.
Dinah
Posted by Penny on October 7, 2003, at 11:34:15
In reply to Re: OK, it's in my outbox, posted by Dinah on October 7, 2003, at 11:32:07
Posted by Dinah on October 7, 2003, at 11:35:52
In reply to Re: Thank you, Dinah. (nm), posted by Penny on October 7, 2003, at 11:34:15
Well, I haven't sent it yet. I want to make sure I'm sending it to the proper association. But I would like them to have a chance to clarify their position.
Posted by Adia on October 7, 2003, at 11:37:09
In reply to Re: Adia, Please don't panic, posted by Dinah on October 7, 2003, at 10:44:32
Dear Dinah,
Thank you :o)
I will hang on to this...
I just panicked, I am not in the best place to read something like that. I get scared to read or be told that talking about feelings is not okay when I am trying hard to convince myself that it is okay to talk or tell my therapist what I feel.
You are right and I can't think that my therapist would ever hurt me so much and terminate with me because of the intensity of my feelings or if I tell her I love her or share my feelings for her.I smiled with what you've told your therapist because I would tell mine just the same :o)
Thank you again for the reassurance..
Adia.> Jay is mistaken. I've told my therapist that I see him as a mother dog to my blind pup. That I see him as a giant breast and smell milk. (well, I told someone, maybe not him). If I were sexually attracted to him, I'd tell him so. I've told him I loved him (not in a sexual way).
>
> Your therapist is not going to refer you to someone else for that.
>
> The only way you might earn a referral is if you disrobed and threw yourself on her, or stalked her or something where she feared for her safety.
>
> PLEASE, don't worry about this.
Posted by Adia on October 7, 2003, at 11:45:08
In reply to Re: Please read...Code of Ethics Therapy » Adia, posted by Penny on October 7, 2003, at 10:49:41
Thank you Penny...
Thanks for explaining this to me...
Thank you for saying my T won't terminate with me because of my feelings for her.
I struggle to convince myself it is okay to tell her my feelings and I always fear she will abandon me if I share my feelings..and I read something like that and I just panic.
But I have absolute trust in her and I trust in my heart that she would never terminate with me because of that, she's always encouraging me to talk or tell her what I feel no matter what.Thank you for your message...It helped me :O)
I am so glad you have such a wonderful therapist. When I read this kind of thing, I feel so fortunate to have found mine too.
Thank you...
Adia.> Don't panic!
>
> I'm going to bring up this topic in therapy today, to see what my therapist says. But I have had the 'transference' talk with both my current and former therapists and pdoc, and none of them have terminated as a result! The only circumstance I can think of that would cause a therapist to terminate as a result of transference would be the therapist's inability to handle those feelings (well, the therapist's experience of countertransference and his or her inability to handle *those* feelings). Or if you were to admit feelings for your therapist (I'm thinking romantic) and they were to admit that they felt the same way - that is unethical.
>
> But a therapist would have to be cold and unfeeling to turn a client away because of transference feelings - in fact, I suspect that could be grounds for malpractice.
>
> Don't panic, Adia! Your therapist isn't going to terminate you b/c you've admitted mother/child feelings toward her. As a skilled practitioner, she's going to take those feelings and use them to help you deal with your issues. That's what she's there for.
>
> She sounds like a wonderful therapist. Mine is too.
>
> P
Posted by underthecs on October 7, 2003, at 13:26:36
In reply to Re: Please read...Code of Ethics Therapy » Dinah, posted by jay on October 7, 2003, at 10:50:33
> Again, I am not trying to say that clients, in their minds, should not harbour any feelings towards a therapist. But, when that line is crossed and feelings turn into words, or an inappropriate gesture, the common practice is to terminate.
geez... what planet are you living on? No line is being "crossed" when a client expresses feelings. i'm glad you're not my therapist. perhaps a little continuing education is in order. and i mean this in the nicest possible way...
Posted by Medusa on October 7, 2003, at 15:29:45
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
Posted by stjames on October 7, 2003, at 15:34:26
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
Way, way off here.
Posted by underthecs on October 7, 2003, at 17:46:15
In reply to oh, no! how am I supposed to get laid then? (nm), posted by Medusa on October 7, 2003, at 15:29:45
Posted by pinkeye on October 7, 2003, at 22:01:05
In reply to Re: Please read...Code of Ethics Therapy » jay, posted by underthecs on October 7, 2003, at 13:26:36
This is a no win situation for both the therapist and the client.
The whole therapy idea is based on creating a pseudo relationship between the client and the therapist, and when the client gets mesmerized by the pseudo stuff and gets involved for real, then the therapist don't know how to deal with it or get scared and run.It is hard to blame the therapist also, because their job requires them to talk lovingly, patiently whereas they know better not to get their heart involved.
And frankly, it is 1000 times more easier for the clients to get attracted to the therapist than vice versa. So poor clients go to therapy, pay for it, and get treated halfway and then are stuck with not progressing any further, either due to the intensity of the feelings and then get stuck with dealing with these things themselves. And therapists are also on a double edge, on one side willing to help the patients as much as possible, and on the other hand knowing the feelings that the client develops towards them but not knowing how to prevent it.
PinkEye.
Posted by jay on October 7, 2003, at 22:34:07
In reply to Re: Please read...Code of Ethics Therapy, posted by stjames on October 7, 2003, at 15:34:26
> Way, way off here.
Say what???? These guidelines where originated by the International Federation of Social Workers. They (and us social workers) have the backing to realize their weight and how they are *properly* used.Jay
Posted by jay on October 7, 2003, at 22:50:29
In reply to Re: Please read...Code of Ethics For Jay» jay, posted by pinkeye on October 7, 2003, at 22:01:05
I honestly think folks don't quite understand the intricacies of therapy. The line between a casual relationship and a professional one is quite distinct for those who have practiced social work. So, I've been talking to a few other of my colleagues about the issue, and they very much echo mine. It is not about having a sterile relationship with your client. I think most of you have read me the wrong way.
Anyhow...here are the couple of notes from fellow social workers...and names are omitted of course.:
This is from the head of Social Work at a major U.S. school:
1) "Some times just restating the fact in a very unemotional, nonjudgmental tone
"So you are feeling a romantic attraction to me?" Works effectively.And next the counselor should tell them that if may be appropriate to refer
them to someone else for counseling. I wouldn't terminate them at that
point, maybe try to make them understand transference and how common these
things can be but they are inappropriate from the counselors point of view.
The other issue is they are going to feel some rejection, so it's an
opportunity to deal with those issues too."2) "First, I think it depends on the type of social work you're doing. Ethics is ethics, but responses will vary depending on whether you're doing therapy, working with children, making resource referrals, working for managed care, etc.
My gut feeling is it's not a problem if a patient develops an attachment to the therapist; this is grist for the therapy mill. The problem is when the therapist develops an attachment to the patient. If you're not highly experienced in managing these feelings, supervision is the best approach."
FWIW, my two cents.
C.
--------------
My main point being, is besides counsellors, clients must take some responsibility for how their actions could affect the professional/client relationship. This is not just an ethical argument, but a legal one also. It differs in many places, but a counsellor can be charged for appearing to any way 'entice' the client. Plus, especially for sexual abuse survivors, this can be deeply dangerous ground. There is plenty of time to socialize out in public or at a bar, but a professional is being paid good money to utilize very complex and intricate skills.Anyhow, I am feeling kinda wiped from all of this, am not looking for a "fight", so let's just say I understand you, and you understand me.
Sincerely,
Jay
Posted by Dinah on October 7, 2003, at 23:10:49
In reply to Re: Please read...Code of Ethics For=== ALL, posted by jay on October 7, 2003, at 22:50:29
No, I'm afraid I *don't* understand you.
I have been on this board for I don't know how long. Trying to help people to see that it is perfectly ok to feel however you feel towards your therapist. That your therapist will not reject you (if he is halfway competent) for expressing your feelings. You said on the other board that clients have to be taught the difference between behavior appropriate to friends and that appropriate to strangers and/or therapists. How on earth can you equate a therapist with a stranger?
This is an important subject to me Jay. And I am not going to let it drop with an "I honestly think folks don't quite understand the intricacies of therapy. The line between a casual relationship and a professional one is quite distinct for those who have practiced social work." Give me a bit of credit, Jay. I may not be a social worker, but I understand transference.
Of course there is a line between a casual relationship and a therapeutic one. The main one being that a therapist must concentrate on the client's wellbeing not his own. So you feel uncomfortable with the tranference. You're going to abandon the client?
Not only am I hitting that send button, because if that is the position of your organization, I think clients have a right to know to choose a different sort of professional than a social worker. But I am also going to send out a blanket invitation to any mental health professional who will hear me to come weigh in on this topic.
I have been urging people to be honest with their therapists. Not to keep their feelings hidden. That there is nothing wrong with feeling strong feelings for your therapist and admitting them. If I've been giving out lousy advice I want to know it so that I can tell people to lie through their teeth so as not to make their therapist feel uncomfortable. Heaven forfend!!!!
Posted by HannahW on October 7, 2003, at 23:30:03
In reply to Please read...Code of Ethics Therapy, posted by jay on October 7, 2003, at 8:13:22
Dinah is absolutely right. And so are your colleagues you quoted. Neither of them said that the client should be dismissed for feeling that way. Both of them said that it is a good opportunity to deal with rejection issues, and that it's not the client's feelings that are the problem, it's the therapist's.
It is absolutely, positively, in no way, shape, or form, unusual or wrong to feel a strong attraction for your therapist. Someimes it's a sexual attraction, sometimes it's not. But it's usually an intense feeling of love or affection. It is genuinely a golden opporunity to deal with issues on a level which could never otherwise be accessed. I speak from personal experience.
I think you're doing a lot of damage here. There are many, many, many schools of therapy that *encourage* transference. If social work isn't one of them, then let that be a warning to us all to stay away from social workers.
Posted by Adia on October 7, 2003, at 23:45:13
In reply to Re: Please read...Code of Ethics Therapy, posted by HannahW on October 7, 2003, at 23:30:03
Just wanted to say thanks to you Hannah and Dinah...
I've been trying to write a post and I can't find words because I feel so triggered ... silly me! :-( But this makes me so frustrated ..and it triggers so many fears.
I hang on to your words here and to what my T has shown me over the years.
It is dangerous or harmful to imply that a patient's feelings could be wrong or cause their therapist to terminate or abandon them...Just wanted to say thanks Hannah and Dinah :-)
sorry I can't contribute much
to this, it just triggers me too much...Adia.
> Dinah is absolutely right. And so are your colleagues you quoted. Neither of them said that the client should be dismissed for feeling that way. Both of them said that it is a good opportunity to deal with rejection issues, and that it's not the client's feelings that are the problem, it's the therapist's.
>
> It is absolutely, positively, in no way, shape, or form, unusual or wrong to feel a strong attraction for your therapist. Someimes it's a sexual attraction, sometimes it's not. But it's usually an intense feeling of love or affection. It is genuinely a golden opporunity to deal with issues on a level which could never otherwise be accessed. I speak from personal experience.
>
> I think you're doing a lot of damage here. There are many, many, many schools of therapy that *encourage* transference. If social work isn't one of them, then let that be a warning to us all to stay away from social workers.
Posted by judy1 on October 8, 2003, at 10:58:53
In reply to Re: Please read...Code of Ethics Therapy » HannahW, posted by Adia on October 7, 2003, at 23:45:13
as a former victim of boundary crossing by a therapist and part of the follow-up investigation by the APA, I do have some thoughts after many conversations regarding this act. transference is a normal part of a therapeutic relationship, and while not recognized nearly enough, counter-transference by the therapist is also part of it. as a client, talking about your feelings are valid and an important part of strengthening the therapeutic relationship. I have never been terminated or hurt in any way when discussing my feelings towards the numerous psycholgists/psychiatrists/ or social workers I have seen. The trouble starts when the therapist cannot control his/her counter-transference feelings. If he/she is able to recognize that these feelings exist then he/she needs to speak to a supervisor or other therapist on how to handle these feelings. Since the client always comes first, and if the therapist is unable to maintain good boundaries (there is nothing wrong with thoughts, I'm writing about inappropriate physical contact or seeing the client outside the office, etc.) then the therapist must refer the client to another therapist. I've seen nothing here (unless I missed it) about boundary crossing-e.g. the physical contact I experienced- just a lot of emotional feelings that I consider part of a good therapeutic relationship. I hope I didn't confuse things further, and these are strictly my experiences.
take care, judy
Posted by Penny on October 8, 2003, at 12:52:07
In reply to Re: Please read...Code of Ethics Therapy, posted by judy1 on October 8, 2003, at 10:58:53
And told her about this topic that was being hashed out on Psychological Babble. And her comment was that it was 'silly' to think that a therapist would terminate a client for feeling any certain way and voicing those feelings.
Granted, she's not a social worker, she's a psychologist. With many years of experience. But I know that my former therapist, a clinical social worker, felt the same way, as we discussed transference many times.
What my therapist emphasized is that the whole point of therapy is to DISCUSS those feelings, rather than acting on them. So BY ALL MEANS tell your therapist how you are feeling so you can address it in therapy via TALKING.
She did say that if the feelings on behalf of the therapist, whether good or bad, became more than the therapist could handle, then it would be the therapist's obligation to refer the patient to another therapist - b/c in such a case, those feelings would be detrimental to the therapy and the client. But this isn't usually a problem, as most therapists are trained to handle such feelings.
And I brought up my point of 'isn't that why so many therapists are in therapy?' and she said of course.
And I won't go any further with what she said, but suffice it to say that, according to MY therapist, there is NOTHING wrong with any feelings you have for your therapist, good or bad, and it is a good idea for you to share your feelings with your therapist, b/c it allows you to work through them in therapy. I would imagine this is especially important if you are feeling particularly troubled by your feelings.
And on a personal note, as someone who is planning on attending social work school to become a therapist - if a therapist gets that freaked out about a client having strong feelings toward him or her, then perhaps they are in the wrong line of work.
P
Posted by Dinah on October 8, 2003, at 13:12:03
In reply to Re: Well, I talked to MY therapist last night..., posted by Penny on October 8, 2003, at 12:52:07
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