![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 3 to 27 of 44. Go back in thread:
Posted by Dinah on July 28, 2005, at 10:38:46
In reply to Re: Lott, Obvious question, posted by daisym on July 28, 2005, at 10:35:17
You'd think I'd have taken the time to formulate a question by now, but I think I need a bit more time.
But I do want to thank you for the book. Whenever a man or woman comes here confused about any feeling whatsoever about a therapist, the first thing we do is recommend they read your book.
And I think we all wish our therapists would read it. Therapists seem awfully unaware sometimes of what is actually going on in our half of the room.
Posted by LittleGirlLost on July 28, 2005, at 12:27:17
In reply to Lott: guest author for a week, posted by Dr. Bob on July 28, 2005, at 8:33:55
"In Session" has got to be one of the best books ever written about the therapeutic relationship. I read it when it first came out, and I loved it! It explained many things that I was also feeling, experiencing, or struggling with. It has since become my Bible as I refer back to it often.
I've always wondered, have you considered writing a second book? A sequal of sorts?
Thanks!!
LGL
Posted by Joslynn on July 28, 2005, at 15:14:37
In reply to Re: Lott: Question, posted by LittleGirlLost on July 28, 2005, at 12:27:17
How much, if any, do you feel it's appropriate for a therapist to disclose about his or her personal life to a patient? Especially when it's male to female or female to male? Is it appropriate for the T to share about marital conflicts in his or her own life, kid problems, etc. There seem to be different theories on what self-disclosure is appropriate and what isn't.
I personally had to come out and set a boundary with a former male T on this, because it made me feel special in a way I really wasn't and fed a transference, but I know some may say the T was trying to make a point of some sort. It worked out in the end and the person respected what I was saying about not disclosing that stuff anymore, but I am curious about your view on therapist self-disclosure.
Thank you!
Posted by deborah anne lott on July 28, 2005, at 20:38:46
In reply to Re: Lott, Obvious question, posted by daisym on July 28, 2005, at 10:35:17
Thanks for your question, Daisy. First off, I'm thrilled to be psych-babble's guest author. I think the bulletin board is terrific (I've been eavesdropping from time to time) and that clients sorting things out with other clients is often the best way to get information and support.
Since I'm going to be a bit inaccessible from August 1-2, and since you've already posted lots for me to respond to, I've suggested to Dr. Bob that I might stick around till maybe the 4th or 5th of August, if you'll have me.
Daisy, I don't find your question at all obvious,and if anyone else out there is hesitating to ask a question because you think it's "obvious," please take the leap of faith. I love what I call the "emperor has no clothes" kind of questions -- I think we all go around thinking everybody else knows something we don't and so don't ask some of the fundamental questions we need to keep asking. In the interviews with clinicians that I conducted for my book, I'm sure that a lot of clinicians thought I was being "dense" or "lame" because I questioned EVERYTHING. So ask away . . .
As for therapists' reactions to my book, I haven't actually been invited to address that many groups of therapists. That alone may tell us something about how therapists react to a non-clinician commenting on how they do their work. On a one-on-one basis, however,therapists have been very supportive of the book, and have thanked me for it. Some have advocated that all therapists should read it and it is being used in some clinical training programs. Whenever I get into a conversation with therapists about boundaries and transference issues, they agree wholeheartedly with the messages of the book. They all think that they are the "good therapists" and it's their colleagues who have bad boundaries or don't understand the transference. But then these same clinicians will sometimes say something to me that indicates an attitude more casual or cavalier about a boundary or transference issue that indicates to me maybe they don't totally "get it." Or that they still attribute intense feelings to the client's pathology. I would say overall that a lot of them still underestimate the extreme importance and delicacy of these issues to their clients, and how much a word or a look can matter.
In terms of learning from their own experiences as clients and extrapolating that to their experience in the room as therapists, I'm not sure what happens. I think it's possible that some don't have strong feelings or attachments for their own therapists -- not everyone does, and not everyone does for every therapist. Another possibility is that they never resolve their own feelings and so don't really know how to work through the feelings of their clients. Or perhaps they understand a particular kind of feeling, but are threatened by others. If you don't know how to handle something, sometimes it's easier to deny it or hope that it will just go away.
As to training in "bedside manner," the trend in psychotherapy is towards "manualized"(based on a how-to kind of book) cognitive behavioral therapies. These work to change the thought-feeling-belief-behavior connections in the here-and-now. They are not so concerned with the past,and generally they conceptualize the therapist-client relationship as one of teacher-student and don't put a lot of focus on the transference. As you probably know, the HMOs and insurance companies don't want to pay for long-term open ended therapy and are encouraging the adoption of these shorter, more results-oriented models.
From my perspective, something is lost in therapies that don't give more weight to childhood, and don't work with the transference potential of the therapist-client relationship. On the other hand, the cognitive-behavioral proponents argue that there is scientific evidence that these therapies are "effective" (of course, we can ask those emperor has no clothes kind of question about whether what they consider "effective" is what we consider effective, and if the "effects" last beyond the ten or twelve weeks when they measure them) and that clients are less likely to get bogged down in therapies that go on interminably. But what happens when the client develops strong feelings that arent' described in the manual? Do cognitive behaviorally oriented therapists know what to do? I'm not certain that they do at all.
I'd be curious to know what kind of therapy those of you who feel the transference has been handled badly were/are in? Was the model cognitive behavioral or more psychodynamic/psychoanalytic? I'm moving on to the next question.> Your book is recommended over and over again here, from client to client. I'm wondering if you've had opportunities to talk to groups of therapists and get feedback as to how they feel about the book. Especially therapists in training.
>
> It seems that the medical profession is moving more towards training psycho/social skills (bedside manner and all that) -- do you think the mental health field is?
>
> And I just can't figure out why therapists, who have to go through their own therapy as part of their training, don't know from experience how clients come to feel about their therapists. You'd think it would make them extra-sensitive to these attachment issues.
>
> Thank you for considering my questions,
> Daisy
Posted by deborah anne lott on July 28, 2005, at 20:44:23
In reply to Re: Lott, Not a Question, Exactly, posted by Dinah on July 28, 2005, at 10:38:46
Thanks, Dinah. It took me a long time (and struggle) to write the book and it is so gratifying to know that it's been helpful.
As for why therapists don't seem to "get it" my only similar experience is in teaching. Whenever I sit in the back of the room as a student, I see so much that is going on in terms of student dynamics, what the teacher isn't hearing, what the teacher should say, and when I'm teaching myself (I teach writing and literature) it's so much harder. It goes by so quickly and sometimes I go almost blank. So I imagine that when it gets intense in the therapy room, it might be similar. And if you're doing it all day with one client after another, and clients aren't saying directly what they're feeling but wishing for their minds to be read (don't we all have that wish whether it's from spouses, lovers, friends, therapists, and of course, going back to MOM AND DAD!!) then I can see why it's so hard. But I'm also afraid that some therapists are attracted to the field for the wrong reasons -- they like being the center of attention and enjoy being watched and listened to more than they enjoy observing and listening. It's not pretty, but I'm afraid that's sometimes the case.
> You'd think I'd have taken the time to formulate a question by now, but I think I need a bit more time.
>
> But I do want to thank you for the book. Whenever a man or woman comes here confused about any feeling whatsoever about a therapist, the first thing we do is recommend they read your book.
>
> And I think we all wish our therapists would read it. Therapists seem awfully unaware sometimes of what is actually going on in our half of the room.
Posted by deborah anne lott on July 28, 2005, at 20:59:48
In reply to Re: Lott: Question, posted by LittleGirlLost on July 28, 2005, at 12:27:17
Oh, you sound like my conscience now. I'd love to write another book. I don't think I could actually get a publisher right now for a book about therapy -- the market is pretty small for such a book from a publisher's perspective. And fewer people are in psychotherapy now or they are in shorter term cognitive behavioral therapies. What would you like to see covered in a sequel?
I'm thinking about writing a book about fear and anxiety disorders -- maybe covering both the physiology and science of fear, following a child through treatment for an anxiety disorder, and interviewing adults who are fearful/were fearful as children. Any reactions?
Oh, and my first love is the more "literary" writing that I do. I have a piece in an anthology called Open Houses: Writers Redefine Home" called Elephant Girl about my childhood, and other childhood memoirs in some literary journals (Alaska Quarterly Review, Puerto del Sol, Crazyhorse) that you could probably find in a library. I'm hoping to put a collection of these childhood memoir pieces together and get it published -- another hard sell to a publisher.
I hate to even talk about it but IN SESSION came very close to not being published at all. The publisher which initially bought it -- Houghton Mifflin -- decided that the market for therapy books was too small and pulled out of the contract. They also thought the book was written at too high a level for general readers!!!!Underestimating the public, I think. Fortunately I was rescued by a prescient editor at another house (someone who'd done therapy, of course!) and by some wonderful therapists such as Drew Westen of Boston University who wrote letters strongly lobbying publishers to put it out. But many many publishers turned me down saying that no one would read a book about therapy by a non-clinician and that therapy books traditionally don't sell well. So I'm probably telling you all way more than you want to know.
> "In Session" has got to be one of the best books ever written about the therapeutic relationship. I read it when it first came out, and I loved it! It explained many things that I was also feeling, experiencing, or struggling with. It has since become my Bible as I refer back to it often.
>
> I've always wondered, have you considered writing a second book? A sequal of sorts?
>
> Thanks!!
> LGL
Posted by gardenergirl on July 28, 2005, at 21:07:02
In reply to Re: Lott, Obvious question, posted by deborah anne lott on July 28, 2005, at 20:38:46
>I'd be curious to know what kind of therapy those of you who feel the transference has been handled badly were/are in? Was the model cognitive behavioral or more psychodynamic/psychoanalytic?
I spent 8 1/2 years with a CBT therapist. She taught me a lot, but I didn't really get "better". She was concerned with my "dependence" and tried to work on that by forcing me to be more independent by reducing sessions. The last months that I spent with her I was sure that she was mad at me, and that I wasn't doing "the right thing" in therapy. I expended enormous energy trying this and that to try to find out what I should be doing so that she wouldn't be mad at me. She kept talking about reducing sessions. Finally, I became very suicidal and decided that as much as I couldn't live without her, I wouldn't live if I stayed with with her, either.
I switched (with much agony) to a psychodynamic therapist. Within 6 weeks, we were in the same transference situation - I was sure that he was mad and that I was failing therapy. Within a handful of sessions I could understand and believe that he wasn't mad at me.
So, yes, transference happens in CBT. But my CBT therapist was completely unaware of how I was feeling (I know this because I asked her if she knew how much agony I had been in for the previous months and she said no). And unable to help me with it.
CBT is very helpful for some people, and when it is a good match, I think it is a wonderful therapy. But in my case, the transference was handled much more helpfully by my psychodynamic therapist.
Posted by Dinah on July 28, 2005, at 21:08:29
In reply to Re: Lott, Obvious question » deborah anne lott, posted by gardenergirl on July 28, 2005, at 21:07:02
Posted by deborah anne lott on July 28, 2005, at 21:12:16
In reply to Lott: a few questions, posted by Joslynn on July 28, 2005, at 15:14:37
Ay yi yi. I do talk about self-disclosure a lot in the book (not all in one place, though) and I think it's very very tricky. I talked to a zillion therapists about it and some did make the argument about using themselves as an example or building rapport or revealing their own weaknesses, etc., etc. and maybe sometimes that's true and it does work out that way. Too often though I think the result is to make the client feel "special" or feel that he or she has to "take care" of the therapist or to censor what is said in light of the therapist's circumstances. The potential for such information to be "seductive" or feel seductive seems very high. If it makes the client feel a certain way, the client should trust that gut reaction. It doesn't really matter what the therapist intended -- what matters is the result and that's something clients need to share forthrightly and immediately. I don't think it's EVER appropriate for a therapist to talk about his or her own romantic relationships, marital problems, etc. What is the client supposed to do with such information? I think a therapist should think long and hard about his or her own motivations for sharing such stories. Too often material is shared impulsively or because the therapist is holed up all day with clients and has nobody to talk to about his or her issues. Or because the normal social convention is back-and-forth. And I also think the responsible clinician will ask the client how he or she feels about what was disclosed and check to see how it's being taken before spilling his or her guts. GOOD FOR YOU drawing the boundary and letting the therapist know that his disclosure was making you feel special and feeding feelings that shouldn't have been fed. BRAVO! Many women can't do this or can't see clearly what's going on or want so so very much to be special that they allow the disclosures to continue. Often those disclosures become more and more intimate, and pretty soon, the question becomes who's the therapist here??? I think a therapist should tell a client enough so that you know that he or she is human and not a god, but not so much that the particulars of his or her humanity get in the way of your therapy. I guess I'm kind of a "hardliner" on this question because I've seen therapies go "south" so many times from therapists' careless self-disclosures.
> How much, if any, do you feel it's appropriate for a therapist to disclose about his or her personal life to a patient? Especially when it's male to female or female to male? Is it appropriate for the T to share about marital conflicts in his or her own life, kid problems, etc. There seem to be different theories on what self-disclosure is appropriate and what isn't.
>
> I personally had to come out and set a boundary with a former male T on this, because it made me feel special in a way I really wasn't and fed a transference, but I know some may say the T was trying to make a point of some sort. It worked out in the end and the person respected what I was saying about not disclosing that stuff anymore, but I am curious about your view on therapist self-disclosure.
>
> Thank you!
>
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Posted by Fallsfall on July 28, 2005, at 21:19:36
In reply to Re: Lott, Obvious question » deborah anne lott, posted by gardenergirl on July 28, 2005, at 21:07:02
Sorry, GG.
That post was from Fallsfall.
I don't post from this computer very often, to I? I wish there was a way to change the poster name on a computer without actually posting someting...
Posted by Dinah on July 28, 2005, at 21:27:37
In reply to Re: Lott: Question, posted by deborah anne lott on July 28, 2005, at 20:59:48
No, you're not telling us more than we want to know. But it is a little scary to think about for us. :)
We do help each other a lot, but we have some guidance because many of us read a *lot*. We wouldn't have been able to help each other as much without the information we gleaned.
Posted by shrinking violet on July 28, 2005, at 21:31:22
In reply to Lott: guest author for a week, posted by Dr. Bob on July 28, 2005, at 8:33:55
Hello Ms. Lott,
Thank you for agreeing to be our guest. :-)
I admit I haven't quite formally prepared this question ahead of time, so forgive me if it's a bit jumbled.
I have read your book, although admittedly it was a while back. I wonder, though, if any and alls feelings the client has for the therapist, and vice versa, are transferential? Must it always be labeled? Can't two people have a special connection and caring for each other without having a term attached to it? I understand that transference is very common, as is projection, etc, and other dynamics in a clinical relationship. But it seems to me that therapists are always so quick to label any feeling from or towards a client, as if they are afraid of the feelings they themselves encourage their clients to express. I spent two years in therapy with a University counselor, and she and I grew to care for each other deeply, and had a very special and warm relationship. I wonder now, was it real and genuine, or was it just a therapeutic tactic on her part? It seems odd to me that everyone jumps to label such interactions just because of how the two people met, just b/c they happen to be client and therapist, but essentially they are two people. I've also read "When Boundaries Betray Us" by Dr. Carter, which touches on this issue.
Again, please forgive any confusions. I'm just curious to hear your opinions on this topic.
Thank you,
sv
Posted by sleepygirl on July 28, 2005, at 21:46:00
In reply to Re: Lott: Question, posted by deborah anne lott on July 28, 2005, at 20:59:48
I'm thinking about writing a book about fear and anxiety disorders -- maybe covering both the physiology and science of fear, following a child through treatment for an anxiety disorder, and interviewing adults who are fearful/were fearful as children. Any reactions?
I think that is a wonderful idea. I spent most of my childhood scared, and I've struggled so much with fear. It would be nice to understand its etiology a bit better.
I am so glad to be able to read your posts. I have not yet read your book, but I plan to. I'm a therapist in training and a therapy patient all too aware of the strong feelings inherent in the psychotherapy relationship. I'm trying to gain an appreciation of what makes an appropriate and effective psychotherapy relationship everyday. This for me will be ongoing for a long time, both in and out of therapy. Thanks for the book and best of luck to you!
-sleepygirl
Posted by sleepygirl on July 28, 2005, at 21:59:54
In reply to Re: Lott: Question, posted by sleepygirl on July 28, 2005, at 21:46:00
Posted by messadivoce on July 28, 2005, at 23:29:05
In reply to Lott: guest author for a week, posted by Dr. Bob on July 28, 2005, at 8:33:55
When I was 16 I went to a therapist who I recognize now was a CBT. She really wasn't very helpful, short term OR long term. I didn't develop any feelings for her, and she didn't encourage them or talk about our relationship. We made lists of the things in my life that were bad and then re-wrote them so they did't seem so bad. The problem was, things were still bad after therapy. She didn't give me any "tools" to deal with my circumstances.
I think with a few well placed questions, she could have discovered a lot and worked with me on deeper issues that my psychodynamic therapist later found. She didn't even communicate to me about my therapy ending. It just kind of ended. I wasn't sad about it because I didn't have any feelings for her either way. She actually expressed annoyance over things I said and did, like when I expressed embarrassment over meeting someone I knew in her waiting room. She could have dug deeper and asked WHY was I embarrassed? What did that mean about people's perceptions of me? And so on.
So I'm not a fan of CBT...but psychodynamic therapy just seems too scary right now since I had such a hard termination with my therapist of that orientation. I'm afraid of getting taken apart and then left with the pieces.
Posted by daisym on July 28, 2005, at 23:55:02
In reply to Re: Lott, Obvious question, posted by deborah anne lott on July 28, 2005, at 20:38:46
I think the idea of transference and boundaries should apply to a lot more professions than therapy, so I sometimes wish the title of your book was a little different. I work with home visitors who work with disabled children 0-3 once per week until they are too old for our program. The attachment parents form is very strong and the loss of your home visitor when your child goes to school is painful. We work a lot with our staff to keep their stuff out of the homes, to minimize personal sharing, but the setting is so very intimate. Maybe we should have you be a guest speaker at a conference! :)
I *think* I have a very good therapist (doesn't everyone think they do?!) -- and we are working on some very hard, very old csa issues. He is psycho-dynamic, almost analytical in his approach. And very open to hearing about my attachment. A friend who is a therapist said that he either 1)understands your issues from personal experience or 2) had a painful therapy himself and has never forgotten it. I asked her why there couldn't be 3) he had a great therapy experience and learned from it...she said hmmmm...hadn't thought of that. I guess therapy isn't a strength based endeavor.
It was also her opinion that therapists sometimes have their natural empathy trained out due to fear and malpractice potential. How sad is that? I know my therapists has said more than once how much he dislikes what managed care does to people. They know they need more therapy, he knows they need it but the insurance company says, "no." It shouldn't be so hard to get help.
Posted by daisym on July 29, 2005, at 0:00:08
In reply to Re: Lott: Question, posted by deborah anne lott on July 28, 2005, at 20:59:48
I would have loved a book like that a few years ago (I'd still buy it). Our son with diagnosed with an anxiety disorder at 11 and we should have figured it out before that. But parents don't talk much about a fearful child to each other, I don't think.
I was our introduction into the chaos of the mental health world and I thought I was a savy parent. I've got stories for you, if and when you are ready!
I'm glad you can hang around with us a little longer. :)
Posted by gardenergirl on July 29, 2005, at 0:06:31
In reply to Re: (Prev. post by Falls, not GG), posted by Fallsfall on July 28, 2005, at 21:19:36
> Sorry, GG.
>
> That post was from Fallsfall.gosh, I was so darned busy all day today, I thought maybe I'd lost it! :)
Hmmm, I don't know how to fix that problem except maybe to clear out all your cookies and then try posting again?
Wish I had more time to enjoy this thread, but I'm glad Ms. Lott might stick around longer.
:)gg
>
> I don't post from this computer very often, to I? I wish there was a way to change the poster name on a computer without actually posting someting...
Posted by deborah anne lott on July 29, 2005, at 10:20:24
In reply to Re: Lott, Obvious question » deborah anne lott, posted by gardenergirl on July 28, 2005, at 21:07:02
Thanks for sharing that experience. I bet it was also instructive for you to see that the same feelings came out regardless of who you were in therapy with. I'm glad you got to somebody who knew how to handle the transference you were feeling. I don't think CBT clinicians get much training in transference -- it's unfortunate because the trend is so strongly towards that kind of treatment. Somebody should do a study of how clients feel about their clinicians in CBT,rather than just measuring very limited measures of "efficacy."
> >I'd be curious to know what kind of therapy those of you who feel the transference has been handled badly were/are in? Was the model cognitive behavioral or more psychodynamic/psychoanalytic?
>
> I spent 8 1/2 years with a CBT therapist. She taught me a lot, but I didn't really get "better". She was concerned with my "dependence" and tried to work on that by forcing me to be more independent by reducing sessions. The last months that I spent with her I was sure that she was mad at me, and that I wasn't doing "the right thing" in therapy. I expended enormous energy trying this and that to try to find out what I should be doing so that she wouldn't be mad at me. She kept talking about reducing sessions. Finally, I became very suicidal and decided that as much as I couldn't live without her, I wouldn't live if I stayed with with her, either.
>
> I switched (with much agony) to a psychodynamic therapist. Within 6 weeks, we were in the same transference situation - I was sure that he was mad and that I was failing therapy. Within a handful of sessions I could understand and believe that he wasn't mad at me.
>
> So, yes, transference happens in CBT. But my CBT therapist was completely unaware of how I was feeling (I know this because I asked her if she knew how much agony I had been in for the previous months and she said no). And unable to help me with it.
>
> CBT is very helpful for some people, and when it is a good match, I think it is a wonderful therapy. But in my case, the transference was handled much more helpfully by my psychodynamic therapist.
Posted by deborah anne lott on July 29, 2005, at 10:23:02
In reply to Re: Lott: Question » deborah anne lott, posted by Dinah on July 28, 2005, at 21:27:37
Thanks for letting me know that some of this is scary to think about. If there's something that's too scary, let me know and I'll try to be more careful.
Posted by deborah anne lott on July 29, 2005, at 10:27:53
In reply to To Ms. Lott: Is it always transference?, posted by shrinking violet on July 28, 2005, at 21:31:22
Of course, some feelings in therapy are real and the connection and bond are real. I do talk quite a bit about this in the book. There are elements of the past and filtering current events through past experience in every relationship. There's no reason to think that a therapist's feelings for a client aren't real and genuine. It's especially important to look at the elements that are transferential in a therapy relationship when they are also occurring in one's real life and getting in the way of happpiness. Or when the client wants >
more than the therapist can provide. Or when both therapist and client are considering taking the relationship out of the room and becoming "friends" "lovers" etc. In my opinion, that nearly never works and is so often disastrous that it probably should never happen. So, no, I don't think everything the client or therapist feels in therapy is transference.
Hello Ms. Lott,
>
> Thank you for agreeing to be our guest. :-)
>
> I admit I haven't quite formally prepared this question ahead of time, so forgive me if it's a bit jumbled.
>
> I have read your book, although admittedly it was a while back. I wonder, though, if any and alls feelings the client has for the therapist, and vice versa, are transferential? Must it always be labeled? Can't two people have a special connection and caring for each other without having a term attached to it? I understand that transference is very common, as is projection, etc, and other dynamics in a clinical relationship. But it seems to me that therapists are always so quick to label any feeling from or towards a client, as if they are afraid of the feelings they themselves encourage their clients to express. I spent two years in therapy with a University counselor, and she and I grew to care for each other deeply, and had a very special and warm relationship. I wonder now, was it real and genuine, or was it just a therapeutic tactic on her part? It seems odd to me that everyone jumps to label such interactions just because of how the two people met, just b/c they happen to be client and therapist, but essentially they are two people. I've also read "When Boundaries Betray Us" by Dr. Carter, which touches on this issue.
>
> Again, please forgive any confusions. I'm just curious to hear your opinions on this topic.
>
> Thank you,
> sv
>
Posted by Dinah on July 29, 2005, at 11:48:28
In reply to Re: Lott: Question, posted by deborah anne lott on July 29, 2005, at 10:23:02
No, no. I didn't mean that. I'm actually glad to hear the story behind it. :)
Posted by happyflower on July 29, 2005, at 12:08:48
In reply to Lott: guest author for a week, posted by Dr. Bob on July 28, 2005, at 8:33:55
You have mentioned that you thought that the subject of transference hasn't been taught very much to CBT therapist. What are you thoughts about erotic countertransferece?
As a women, we can tell when a man is interested in us whether they are a therapist or a guy we meet or know.
Can a therapist be truely attracted to a client and can the feeling be mutual without it being transference? What would be the differences and how could you tell?
Posted by deborah anne lott on July 29, 2005, at 12:38:47
In reply to Re: Lott: countertransference, transference,, posted by happyflower on July 29, 2005, at 12:08:48
Ooooh, erotic transference, such a complicated subject. First off, I don't think that there are really two separate categories: 1) erotic transference and 2) "real" attraction. I think every attraction has elements of both, regardless of where it happens. In the therapy room, though, I think there are factors such as the therapist's being forbidden fruit, an authority figure, only seen for a brief time, seen at his best, etc., that may push the relationship more in the direction of transference. And it's impossible when you are the client to discern clearly what would happen if you were to take the relationship out of the room -- you are bound to idealize the outcome and not to see what the relationship would really be like under other conditions. Sure, a therapist and client can be sexually attracted to one another but the question is then what? If they try to take it out of the room and turn it into a relationship, it almost always ends up disastrously. I think every client who's attracted to her therapist believes that if only he weren't her therapist, if only they had met under different circumstances, they would have a terrific relationship. Maybe even the "perfect" relationship. That is usually an illusion. And some therapists also find the forbidden nature of the relationship, and the client's idealization, irresistable. Often these are therapists who have trouble maintaining their real world relationships and prefer the fantasy. And dwelling on the erotic dimensions of the relationship can sometimes be a way of just avoiding what you should be doing in the therapy. If a client feels an erotic attraction to the therapist, she should try to talk about it in the therapy. If the therapist seems to be enjoying being the object of desire too much, consider that he may be behaving in a seductive fashion that's encouraging those feelings.
> You have mentioned that you thought that the subject of transference hasn't been taught very much to CBT therapist. What are you thoughts about erotic countertransferece?
> As a women, we can tell when a man is interested in us whether they are a therapist or a guy we meet or know.
> Can a therapist be truely attracted to a client and can the feeling be mutual without it being transference? What would be the differences and how could you tell?
Posted by deborah anne lott on July 29, 2005, at 14:56:46
In reply to Re: Lott: Orientation, posted by messadivoce on July 28, 2005, at 23:29:05
Wow. It's possible that maybe the CBT therapist you had just wasn't very good and that none of us should draw general conclusions about CBT. But then again, the training doesn't really focus on probing deeply into the past or working too much with the current therapist-client relationship. Your story points out one of the ironies of therapy: sometimes if you don't feel anything for the therapist you don't get very far but if you feel too much it can be so painful.
And could it be that a lot of therapists are better at taking us apart than at putting us back together afterwards?? Thanks for sharing your very fascinating experiences.
> When I was 16 I went to a therapist who I recognize now was a CBT. She really wasn't very helpful, short term OR long term. I didn't develop any feelings for her, and she didn't encourage them or talk about our relationship. We made lists of the things in my life that were bad and then re-wrote them so they did't seem so bad. The problem was, things were still bad after therapy. She didn't give me any "tools" to deal with my circumstances.
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> I think with a few well placed questions, she could have discovered a lot and worked with me on deeper issues that my psychodynamic therapist later found. She didn't even communicate to me about my therapy ending. It just kind of ended. I wasn't sad about it because I didn't have any feelings for her either way. She actually expressed annoyance over things I said and did, like when I expressed embarrassment over meeting someone I knew in her waiting room. She could have dug deeper and asked WHY was I embarrassed? What did that mean about people's perceptions of me? And so on.
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> So I'm not a fan of CBT...but psychodynamic therapy just seems too scary right now since I had such a hard termination with my therapist of that orientation. I'm afraid of getting taken apart and then left with the pieces.
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