Negative reactions to sexual attraction

A substantial amount of data from this study suggest that the wide range of therapists’ reactions to implicit or explicit sexual attraction towards them from clients has thrown them off balance. In their experience, this does not seem to be the case with other difficult presentations such as a client’s anger. The majority of therapists experienced discomfort, consisting of anxiety, awkwardness, confusion, fear, a sense of danger, disorientation, embarrassment and vulnerability resulting in a reduced capacity to think and avoidance in handling sexual attraction.

Fear was a common reaction to sexual attraction among participants in our study. As one therapist put it:

What also became clear was that some therapists’ fear was captured in describing sexual attraction as ‘too dangerous’ as a therapist put it:

Several therapists felt guilty if they believed that they might have unwittingly encouraged the client’s desire, leading them to feel confused and guarded. Kane gave a very honest example, highlighting how his confusion over sexual matters in everyday life found its way into his therapy room:

He went on to describe it as a double bind (Bateson, 1972) that, given the intimacy of the therapy situation, emerges naturally only to clash with the counterintuitive and decidedly asymmetrical constraints of the therapeutic relationship.

A number of participants handled the attraction by deflecting or ignoring its presence, stating that in such situations, they would not want to work with a client:

Kyle also voiced his fears that the clients ‘could see you as seductive. … It could be too much for them’. Another therapist, Pam, stated that ‘I used to feel frightened and revolted and I managed them by going to see [my supervisor]. I managed them at the time just by acknowledging them; it was all I could do’. Hugh referred to training supervision, in which ‘there was a time when it was scary for me to admit it, you mightn’t be understood by your peers or by a tutor, you might be labelled’. He added that “talking about it, discovering that it was a common event, that it was human’ came as a relief”. Caley’s description captures therapists’ negative reaction to sexual attraction: ‘I wouldn’t want it in the room unless it erupted into the room’. The word eruption illustrates that it is only through force that sexual attraction could enter Caley’s consulting room.

Defensive management of discomfort

One of the most universal responses among the therapists was that of fear: not just fear of behaving in an unethical way but of having the power to hurt the client experiencing unrequited sexual feelings for the therapist. In Omar’s words, ‘I don’t think I really had the nerve to challenge him with what was going on’. Peter felt that ‘one has to be able to hold the context and hold the intensity of the bubble. If you burst the bubble too early, you can shame the patient … but if you damage the context in the moment you have big problems, so the question is: how do you hold these two factors?’ Pam would use a breathing technique to manage her discomfort: ‘I would just sort of breathe through it’. This might be taken to indicate that the effect the phenomenon had on Pam may have been quite intense.

The data suggest that some therapists have formed the impression that sexual attraction must be handled ‘differently’ from other aspects of the therapeutic relationship in some often non-definable way. This might take the form of feeling they must inform the client that they did not share the sexual attraction or ‘go professional’, as Peter put it. This also seemed to result for some in espousing the notion that the best course of action is to ignore what seemed to be happening, based on the belief that saying anything at all would be harmful to the client: ‘Unless it becomes an obstacle in the therapy – unless it becomes a resistance – if it’s part of the flow, I don’t see there is any particular point in naming it or doing anything with it actually’ (Kane). Peter puts it as ‘I think that I consciously forgot it (sexual attraction) so that I just had to deal with the other presenting issues’.

Defensive clinical interventions

It became evident from the data that by tightening up therapeutic boundaries, by becoming more formal and less relational with the client, the danger of sexual attraction becoming overwhelming could be contained:

Sanitizing sexual attraction was also a way of avoiding acknowledgement of it. This is captured in Caley’s words: ‘I always imagine that my clients look on me as a maternal figure rather than a sexual being … [or] like a goddess maybe. … idealization, yes’. Speaking of a specific client, Caley added the following:

Becoming firm with a client and keeping rigid boundaries can also tie in with another response elicited by the research findings. Therapists commented on ‘bracketing’ their own thoughts and responses: ‘It’s a kind of relaxation and disengagement. … This [SA] is not thera­­peutic for the person so I am not going to engage with this so I somehow manage to disengage myself. I do it physically. … It’s a kind of relaxation’ (Kane).

Positive reactions to sexual attraction

Although virtually all therapists experienced some level of discomfort, a minority of them found the fact that a client was sexually attracted to them to be a narcissistically validating experience. Therapists described a boost of confidence as well as feelings of affirmation, arousal, excitement, enjoyment, flattery and power. In some cases, this positive experience was associated with shame in what was seen by them as a pathological narcissistic need to be validated by a client in this way. Their reaction to this kind of validation was therefore paradoxical and is associated with the therapeutic ethos that as therapists, if seduced or flattered, we should not act upon our own needs for validation and focus on a professional handling of client erotic desires.

Gail mentioned a number of positives – in addition to anxieties – about working with sexual attraction. She described a ‘kind of arousal’ emerging from a heightened sense of working relationally, which she understood to be a therapeutic response to a client’s seductiveness and an oppor­­tunity to be seized to help the client understand their emotional situa­­tion. According to Gail, this arousal could cause a heightened level of stimulation in the therapeutic interaction, which could be an ally to the therapeutic alliance. At the same time, she described what she thought was the need for a skilled approach that only comes from experience:

Related posts:

Acknowledgements I: Relational Perspectives on Sexual Attraction in Therapy The Role of Psychological Proximity and Sexual Feelings in Negotiating Relatedness in the Consulting Room: A Phenomenological Perspective An Acceptance Commitment Therapy Approach to Sexual Attraction Sexual Attraction in Conjoint Couple Therapy Index

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