The subject of erotic transference and countertransference in psychoanalysis¹ is close to our profession’s bone, and bringing it up inevitably evokes a certain anxiety even in experienced therapists. It is because of his anxiety in this area, after all, that at the dawn of our profession, Joseph Breuer (Anna O’s therapist) abandoned the newborn practice of psychoanalysis to the fatherly cares of his younger and intellectually more progressive colleague.

‘You must bind me very tight, standing me up against the step of the mast and lashed to the mast itself so that I cannot stir from the spot’, wrote Homer in The Odyssey (1991, Book 12, pp. 161–163). Odysseus wanted to hear the Sirens’ wonderful music, and he had his crew bind him hand and foot to the mast as his ship approached their island. Others had simply fallen prey to their ‘honey-sweet tones’ (Homer, 1991, p. 187), or refused to hear it by plugging their ears with beeswax.

Some years ago, I was referred for analysis a young lecturer, Miss A, who was to stay in London only for a few months to complete her academic research. She was a stunningly beautiful woman who quickly developed an intense erotic transference towards me. She would dress provocatively, yet always in good taste, and talk openly about her sexuality and her attraction for me, making flattering remarks about my looks and personality, and clearly indicating that she would have liked to transform our professional relationship into an intimately personal one. At times, I found Miss A’s seductive behaviour quite irresistible and almost felt tempted to give in to my feelings for her. However, I managed to retain my relatively neutral analytic attitude consisting of the interpretation of her interest in me and the understanding of my interest in her as aspects of the transference and countertransference dynamics. I was helped in that difficult task by two events.

First of all, one evening, Miss A and I coincidentally saw each other at the theatre. We only exchanged a polite greeting there, but the next day she told me how greatly shocked she had been to realize that I existed also outside my consulting room. This made me more clearly aware that, in fact, contrary to my own illusion, I only existed for her as a psychoanalyst – and she for me as a patient – within the transference and countertransference relationship.

Secondly, she once reported an episode from her past that further strengthened my resolve to consider her infatuation for me as being unrealistic, which in turn helped me to put my own attraction for her in its proper countertransferential perspective. Miss A recounted how one morning, when she was an adolescent, she put her mother’s dressing gown on, as she often did, and found in its pocket a passionate letter addressed to her mother from her physician, who was obviously her lover, and who intended to put an end to their affair. Miss A was upset by her discovery and felt deeply betrayed by her mother because of it. This memory involving Miss A’s identification with her mother confirmed to me the repetition compulsion quality of her seductive behaviour towards me. I then felt much freer to listen to her without being distracted, as I had previously been, by countertransference interferences.

Around that time, by the way, I also found it helpful to reread Freud’s masterly article Observations on Transference Love (1915), which in fact also deals with countertransference, and I drew great support from it in my internal struggle, especially reading the beautifully balanced page where he questions the genuineness of love feelings emerging during psychoanalysis. ‘Analytic technique’, Freud wrote in no ambiguous terms, ‘requires of the physician that he should deny the patient who is craving for love the satisfaction she demands. The treatment must be carried out in abstinence’ (Freud, 1915, pp. 164–165). And he added: ‘It is … just as disastrous for the analysis if the patient’s craving for love is gratified as if it is suppressed’ (Freud, 1915, p. 166).

Before she left to go back to her country, I referred Miss A to a colleague with whom she successfully continued the work she had started with me. She wrote to me a few years later to tell me how helpful our analytic relationship had been for her and to announce that she was now happily married and expecting her first baby. I felt delighted.

In the analytic consulting room, we always find, among other fanciful objects, also two bodies. These bodies – with their appearance, clothes, movements, sounds, warts and all – affect one another. It is true that the use of the couch – whatever the patient’s fantasies may be about lying down, concerning issues of sexuality, dependence and loss of control through eye contact – partly removes the most immediate awareness of the bodies from the room; but, alas! it does not remove the bodies themselves.

In my countertransference towards Miss B, a patient who had been abused by her father when she was a child, I often felt like a castrated analyst, unable to penetrate her problems with my interpretations. ‘I cannot imagine you being real’, she once told me, ‘because you would then acquire a penis, and I couldn’t stand that’. Miss B could only relate to men if they represented the good, understanding, affectionate father she had never had – the man without a penis whom she wanted me to be in the transference. Miss B’s dilemma was trying to keep me physically present in her mind in order not to feel abandoned to her own resources as she had felt in childhood, without turning me at the same time into a sexual body, lest she felt again threatened by abuse.

The female analysand lying down in front of a male therapist, seated well out of her sight, allows her sexuality to be exposed to his scrutiny, but has to close her eyes to any transference awareness of the analyst as a man in flesh and blood; while the male analyst could, indeed should, look at (or rather listen to) his patient but could not stand his own sexuality being exposed to her gaze. In one of the famous frescoes in the Cappella Brancacci in Florence, we can observe the opposite situation – that could rather apply to a female analyst and a male analysand (detail from Masaccio’s The Expulsion from the Garden of Eden, ca. 1424–1428). There, Masaccio dramatically represents Adam and Eve at the moment when God chases them away from the Garden of Eden and they suddenly become aware and ashamed of their carnal knowledge. What is remarkable in that painting is that while Eve covers her genitals with a hand and her breasts with the other, Adam is portrayed covering his eyes, as if the painter were trying to tell us that the man would not mind exposing his body but could not tolerate watching Eve’s nudity, while she could look at him but could not stand being seen herself.

Some therapists, adhering to the ‘beeswax in the ears’ stance, claim – as Joseph Breuer did a century ago – that, as the psychoanalytic relationship is a clinical one, there is no room in it for sexual feelings, let alone their expression. It is the mechanism of denial: if something threatens you, pretend it does not exist.

However, the majority of analysts recognize that the therapeutic relationship, insofar as it is an emotional intimate rapport between two people, must be charged with feelings, including erotic ones, which should be openly expressed. Whether this ‘expression’ should only be verbal (the patient being invited to freely talk about her sexual fantasies to which the analyst will offer, when appropriate, his interpretations) or also involve some physical or even explicitly sexual contact will depend on the therapist’s own theoretical, technical and ethical principles.

The view that some amount of bodily contact between analyst and patient (with all sorts of variations on the theme, from a handshake to genital intercourse) is to be allowed, or even encouraged, has been advocated not only in so-called humanistic circles but also among various forms of psychoanalysis, from Ferenczi’s ‘active therapy’ to Alexander’s provision of ‘corrective emotional experiences’. In my view, these approaches do not take into sufficient account the enormous power that the psychoanalyst – through a setting facilitating regression and specifically through the establishment of the transference – holds in relation to his patients. This power derives not just from the analyst’s authoritative professional status but more importantly from his intimate knowledge of his analysand’s internal world. I believe that the risk of such power not being used therapeutically, but abused for reasons of exploitation, becomes intolerably high whenever sexual activity is allowed to break through the boundaries of a relationship the very essence of which rests in the trust that the analysand can allow herself to feel for her analyst.

Seven centuries ago, Dante, showing his profound understanding of narcissism, warned us that ‘Love absolves no-one beloved from loving’ (Amor ch’a nullo amato amar perdona, Alighieri, 1926, p. 103). The psychoanalyst is no exception and has to deal with serious technical as well as ethical problems. Beeswax in his ears is just not good enough. What is he then going to do with his patient’s erotic transference if this evokes in him erotic countertransference feelings towards her? Our analytic practice requires us to follow certain rigorous, if not rigid, principles. In this case, I can see no valid alternative to adhering to the Freudian recommendation of analytic abstinence, whereby the wishes of the patient should be interpreted – often, if not always, within the transference situation – and not fulfilled. Odysseus can only survive the Sirens’ seduction by remaining bound to the mast. The analytic abstinence, which Fox redefined as ‘the guideline for the on-going management of the analytic situation in terms of frustration-gratification’ (Fox, 1984, p. 228), is related to the taboo against incest. Person has found that ‘therapists who act out with patients are often re-enacting problems in their own analyses, much as the parents who abuse their children were themselves abused as children’ (Person, 1983, p. 201). This links the good enough parent to the good enough analyst in the sense that both may have sexual feelings towards their children or patients, but neither can act upon them without causing serious damage.

I find it difficult to conceive of the analyst’s erotic feelings for his patient as other than a countertransference reaction to something that the patient is, consciously or more often unconsciously, conveying to him. This ‘something’ is meaningful (e.g., the patient’s seductive behaviour in a session could be the repetition of a pattern established in childhood to obtain his or her father’s love) and is often overdetermined (e.g., it could also have a defensive function: ‘Look at my legs, not at my problems!’). The boundary violations resulting in acting out of the erotic transference and countertransference are often the result of the analyst’s failure, possibly motivated by anxiety and unresolved personal issues (see, among others, Gabbard, 1994; Gabbard & Lester, 1995; Gabbard & Peltz, 2001), to adequately examine and interpret the sexual component of the analytic relationship. In other words, when an analyst, due to his own unacknowledged countertransference, fails to recognize his patient’s sexual feelings for him as being a manifestation of her erotic transference, he will be unable to interpret them and will instead end up either ignoring or exploiting them.

We do not know how common the acting out of erotic transference and countertransference feelings between analysts and analysands actually is. I suspect it takes place less frequently than we might imagine, the incest taboo being a major obstacle to its actualization, yet more often than we want to believe. In my opinion, such therapeutic sailors (their crew includes many illustrious names, from Carl Gustav Jung to Masud Khan) are set on a destructive course, often implicating more than just themselves and their patients. The scandal within the Italian Psychoanalytical Society a few decades ago is a good example of the domino effect of sexual acting out on the part of an individual analyst. His lack of self-discipline – the slackening of his superego ties to the mast of safe sailing – had dramatic effects not only on himself and his seduced patient but also on large numbers of Italian colleagues, candidates and analysands, eventually leading to the splitting of that society and to repercussions within the international psychoanalytic community at large. The problem of erotic transference and countertransference, whether or not leading to acting out, is a political one, in as much as issues of power and possible abuses of it are part and parcel of all aspects of the analytic relationship.

It is my opinion that we psychoanalysts have no alternative to keeping our personal life well separate from our professional one. Our analytic integrity must have a priority over our individual needs or wishes, including erotic ones. In other words, it is our responsibility to make sure that the reality principle should ultimately prevail over the pleasure principle, which is one of the reasons why our work is so difficult to appear almost ‘impossible’ (Freud, 1937, p. 248). We must listen to the Sirens’ song, and learn from it, but at the same time, we have to remain bound to the superego mast of our principles if our ship is to take us safely to Ithaca through the perilous waters of the analytic journey.