What Is The Basis Of Attraction Between Patient And Therapist?
Question: What is the basis of attraction between patient and therapist? Is it the same as any other romantic attraction, or is it viewed differently by health professionals?
Answer (1) The question of attraction in therapy is a complex one. The very nature of therapy stimulates phantasies, longings and other emotions. However, though it seeks to re-activate behaviour that may lead to their being realised, it must be elsewhere. The therapeutic relationship within itself, was never meant to satisfy or actualise phantasies. Whatever the case, I think it is important that any "attraction" be talked about openly, no matter how embarrassing it may be and all aspects of it explored. This can take the awkwardness out of the situation and get the treatment back on track, making previously muddy waters clearer. If it is ever discovered that the feelings are mutual and the intention is to act them out, then any pretence that the relationship is still therapeutic, must ethically cease immediately.
Answer provided by David White, Psychotherapist
Answer (2) Therapists carry into their sessions, sometimes unexamined, culturally prescribed 'normal' ideas about what is good and poor health, good or dangerous therapy, male and female traits, attractive and unattractive clients etc. Clients carry their own set of social prescriptions into a therapy transaction. Some would argue client and therapist ought to have a basis of mutual attraction responsibly managed by the therapist, in order for the client to work effectively on their issues. Others, like Pitman (see below) would argue there is no basis of attraction necessary. I think the idea of romance likewise comes in to this venture because of social conventions about the therapeutic alliance. We have dinner table conversations about falling in love with our therapist. Some therapists include that process of falling in the technical term: transference and in their own reactions, positive and negative to the client as counter transference. However you describe the attraction or lack of it, whether it is even necessary to effective therapy or not, it is first and foremost a business relationship. You can't sell or buy romance. Well, even that can be argued, but it has little purchasing power in therapy. Although therapy occurs in the privacy of a consulting room, it is potentially a public intimacy. The most intimate details can and ought be taken to supervision; reviewed with peers; used as the basis for teaching or when the therapist is required to present a report of her undertakings in a judicial setting, such as that following industrial or motor vehicle accidents. In the latter case, there is no protection of confidentiality as there is with supervision, teaching etc.
'Good therapy is not a chaste love affair between buyer and seller of psychotherapeutic services. The therapist and the customer don't even have to like one another. The therapy may be working best when you don't like your therapist, when you get the firm impression that your therapist doesn't like you very much either, and when you are being told that you have to do something you don't want to do if you are ever to feel good about yourself. In fact, the therapist is hired to scrutinize you sharply and find something about you that is unlikable and unworkable, and then to help you isolate and discard the offending behaviour. If the therapist sees everything the way you do, the therapist would be in the same fix you're in. And if the therapist thinks you're wonderful the way you are and just wants you to realize it, the love affair that results is different from therapy. Therapy is an inherently adversarial process, not an alliance to buffer innocent victims against a world that isn't gentle enough.' Frank Pitman
Answer provided by Peter Fox, Clinical Psychologist
