Erotic Feelings Towards Patients in the Psychotherapy Session: Investigating Their Relationship With the Characteristics of the Therapist, the Patient, and the Treatment.

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a series of characteristics of therapist, patient, and treatment. Between April and June 2022, 547 psychotherapists completed an online survey investigating their affective and behavioral responses toward their most recently treated patient. Compared to female therapists, males showed significantly higher prevalence of SA alone (p < .001) or in combination with RA (p < .01), FB (p < .01), or both (p < .05). Multivariate adjusted regression models showed that RA was associated with patient age ≤40 years (OR:39.49 for age 18-29; OR:28.44 for age 30-39), male sex (OR:10.40), and diagnosis of mood disorder (OR:14.08). Furthermore, RA was associated with intense countertransference feelings of tenderness towards the patient (OR:79.77) and hostility towards significant figures in their life (OR: 77.93). SA was associated with the therapist's male sex/gender (OR: 16.14), psychoanalytic orientation (OR:13.34), post-license experience ≤20 years (OR:6.12 for 1-9 years; OR:6.08 for 10-19 years). Lastly, FB was associated with the therapist's male sex/gender (OR:16.94).

[1]  E. Youngstrom,et al.  Clinicians’ Emotional Reactions toward Patients with Depressive Symptoms in Mood Disorders: A Narrative Scoping Review of Empirical Research , 2022, International journal of environmental research and public health.

[2]  D. De Wachter,et al.  Intimacy in Psychotherapy: An Exploratory Survey Among Therapists , 2022, Archives of Sexual Behavior.

[3]  E. Youngstrom,et al.  Empirical support for the use and further study of the countertransference construct in the clinical care of patients with bipolar disorder , 2021, Bipolar disorders.

[4]  D. De Wachter,et al.  Sexual Feelings Toward Clients in the Psychotherapeutic Relationship: The Taboo Revealed , 2021, Qualitative health research.

[5]  E. Youngstrom,et al.  Patient personality and psychotherapist reactions in individual psychotherapy setting: a systematic review. , 2020, Clinical psychology & psychotherapy.

[6]  J. Hook,et al.  Sexual boundary violations: victims, perpetrators and risk reduction , 2018, BJPsych Advances.

[7]  A. Stefana.  Erotic Transference: Erotic Transference , 2017 .

[8]  A. Stefana.  History of Countertransference: From Freud to the British Object Relations School , 2017 .

[9]  Shimon A. Sarraf,et al.  How Important are High Response Rates for College Surveys? , 2016 .

[10]  M. Capawana.  Intimate attractions and sexual misconduct in the therapeutic relationship: Implications for socially just practice , 2016 .

[11]  A. Stefana.  The Origins of the Notion of Countertransference. , 2015, Psychoanalytic review.

[12]  V. Kumari,et al.  Executive function processes mediate the impact of working memory impairment on intelligence in schizophrenia , 2015, European Psychiatry.

[13]  J. Sonne,et al.  The "vicissitudes of love" between therapist and patient: a review of the research on romantic and sexual feelings, thoughts, and behaviors in psychotherapy. , 2014, Journal of clinical psychology.

[14]  J. Hayes.  "Well I got a few of my own": therapists' reactions to attraction, sex, and love in psychotherapy. , 2014, Journal of clinical psychology.

[15]  J. E. Barnett.  Sexual feelings and behaviors in the psychotherapy relationship: an ethics perspective. , 2014, Journal of clinical psychology.

[16]  R. Tourangeau,et al.  Where Do We Go from Here? Nonresponse and Social Measurement , 2013, The Annals of the American Academy of Political and Social Science.

[17]  Craig D. Fisher.  Ethical Issues in Therapy: Therapist Self-Disclosure of Sexual Feelings , 2004, Ethics & behavior.

[18]  Theodoros Giovazolias,et al.  How common is sexual attraction towards clients? The experiences of sexual attraction of counselling psychologists toward their clients and its impact on the therapeutic process , 2001 .

[19]  G. Gabbard,et al.  Speaking the Unspeakable: Institutional Reactions To Boundary Violations By Training Analysts , 2001, Journal of the American Psychoanalytic Association.

[20]  Nancy J. Nickell,et al.  Marriage and family therapists' sexual attraction to clients: An exploratory study , 1995 .

[21]  G. Gabbard.  The Early History of Boundary Violations in Psychoanalysis , 1995, Journal of the American Psychoanalytic Association.

[22]  R. Simon.  The Natural History of Therapist Sexual Misconduct: Identification and Prevention , 1995 .

[23]  K. Pope,et al.  Sexual Feelings in Psychotherapy: Explorations for Therapists and Therapists-In-Training , 1993 .

[24]  T. Gutheil,et al.  The concept of boundaries in clinical practice: theoretical and risk-management dimensions. , 1993, The American journal of psychiatry.

[25]  L. Jorgenson,et al.  The prevention of psychotherapist sexual misconduct: avoiding the slippery slope. , 1992, American journal of psychotherapy.

[26]  P. Casement.  The Meeting Of Needs In Psychoanalysis , 1990 .

[27]  S. Ferenczi.  Confusion of tongues between adults and the child , 1988 .

[28]  B. R. Forer,et al.  Sexual intimacy between psychotherapists and patients. , 1983, Professional psychology, research and practice.

[29]  A. Celenza.  Precursors to therapist sexual misconduct: Preliminary findings. , 1998 .

[30]  Valerie A. Vetter,et al.  Prior therapist-patient sexual involvement among patients seen by psychologists. , 1991 .