The journey into the heart of sexual attraction in therapy is now ending by reflecting back. What the book has claimed is that the passionate parts of therapy, not merely those pertaining to love as agape (Greek word for tenderness or selfless love) but Eros as romantic or sexual desire, reveal themselves in therapy more often than we are prepared to acknowledge. An important message arising from the minds of contributors in this book is that when Eros presents itself in the therapy dyad, we need not fear it, that it is meaningful and potentially healing, that it requires understanding and professional handling, and that dialogue or therapist disclosure does not necessarily lead to sexual involvement as long as our language is sensitive and we are mindful and reflective of the impact therapist disclosures can have on clients. A key idea throughout the book is that therapist denial of, or avoidance in working with, sexual attraction, whether on the part of the client or the therapist, often carries within it a missed opportunity to deepen our work. In fact, increasingly modern perspectives on sexual desire postulate that ‘The effectiveness of therapeutic action is in the stirring of desire’ (Celenza, 2010, p. 182).

The purpose of the book has been to demystify and thus to normalize sexual attraction. The reader will have seen through the pages how desire leaps out in therapy relationships to surprise, frighten and delight. As therapists, we cannot predict how a therapy relationship will unfold, but we are required to approach each clinical situation with faith and confidence, so if desire appears, we can be ready to welcome it with curiosity, interest and the will to understand, just like we approach anger, hate, shame and guilt if we as therapists become the object of these emotions. The common thread bringing chapters together is that relationality in therapists is the bedrock of a successful encounter with sexual desire and that by being relational, therapists are not merely gazing at their clients’ world through smoked glass but fully participate in it from this intersubjective position.

Psychotherapy encourages people to become aware of meanings they assign to their life, to become cognizant of how they live their life and to understand the perils of their destructive acts. Therapy does this through radical reflection. If our aim as therapists is to accompany our clients in their life journeys, we must ask ourselves what kinds of companions we are. We have an ethical responsibility to learn to tolerate even the rockiest journey, walk into territories we most fear, gaze at the darkest recesses of our clients’ minds and concern ourselves with the desire to be there despite our fears and because of them. The book has been an invitation to therapists to ponder and deliberate on the landscape of sexual desire, consider its intentions, open themselves to the feelings it evokes in them and allow themselves to be inspired by its force, as a way of appreciating its true colours and learning to handle it appropriately.

Evidently, much has been written about clients’ love or erotic desire for her/his therapist, but little on the therapist’s erotic feelings for her/his client, which, according to Hirsch (1988), are ‘probably inevitable in, and possibly essential for, fruitful long-term analytic experience’ (p. 210). We would add that erotic feelings can and do develop in short-term therapeutic work. Celenza’s (2010) paper title, ‘The Guilty Pleasure of Erotic Countertransference: Searching for Radial True’, captures one of the obstacles to therapists’ moving beyond the taboo of sexual attraction, that is, the guilt from enjoying the Dionysian excess: ‘The discomfort was more in the way of a nagging guilt was I enjoying him too much? Did our play cross over to flirtation in a way that seductively offered something I could not and would not deliver? Though he did not seem to mind, I did not know if this would always be true and more to the point, was I behaving with his best interests in mind?’ (p. 181).

If love and eros have a legitimate place in human nature, it follows that they have a legitimate place in therapeutic practice. By default, what takes place in therapy relationships is a microcosm of the lived experience in the wider world, albeit with more focus and intensity on the internal, psychological aspects of human experience. What differentiates the terms of engagement between people in the wider world from those of clients and therapists is the professional and ethical responsibility we carry to do no harm and to be mindful of what would be in the best interests of our clients.

Contributors in various chapters have resolutely advocated from their unique perspective that this microcosm would be enriched through radical reflection on sexual attraction in therapy. In a common voice and through modality shaped vocabularies, contributors opened up a dialogue with readers on the promises, ambiguities and dangers of sexual attraction in therapy. The imagined reader posed the questions, expressed the fears, guilt, pleasure and anxieties and joy among other feelings, and the consulting rooms opened their doors through clinical material, with the view of illuminating the reader.

As a way of concluding, I would like to show some of the main features from the various chapters. Before this, I would like to say that a common view embedded in all chapters is that therapists should talk about their reactions in encountering sexual attraction to supervisors or colleagues. Speaking from relational vantage points, contributors have expressed personal views on how sexual attraction can be handled therapeutically. Clinical strategies were developed in each of the chapters, which are intended not as fixed ways of working, not as prescriptive truths, but as clinical considerations and types of interventions therapists can utilize fluidly and in a timely fashion. Application would depend upon therapists’ judgement of where a client is at in the therapy process, as well as the readiness of the client to take on board sexual attraction. Fixing interventions would be prescriptive and a contradiction in terms of the relational focus, which is the hub of this book.

Now I should like to turn to Chapter 1, where we have seen how Michael Worrell’s reflections on sexual attraction from a cognitive behavioural therapy (CBT) perspective are embedded in the notion that ‘sexual drama infuses therapy’. He showed how the drama unfolds from the outset, before reminding us of the scarcity of CBT literature on the subject. The chapter advocated that the ‘shutting down’ of exploration and acknowledgement of sexual attraction evident among CBT therapists could be tackled through CBT practitioners having personal therapy and through advancing the model towards a more relational perspective.

In a similar fashion to Chapter 1, John Nuttall in Chapter 2 brought to the fore the relational aspects of sexual attraction captured in vignettes where eros was central. By exploring how sexual desire presents itself through Petruska Clarkson’s five relationship modes, he highlighted the different aspects of sexual relating. He navigated, through the lenses of a personal integration and the foray of the consulting room, to capture the meanings of client erotic communications and therapist responses.

Michael Berry’s existential approach to sexual attraction in Chapter 3 embodies most powerfully the idea of radical reflection mentioned earlier in this section. He situated this as a key principle in the service of an authentic and meaningful encounter. He concluded with the notion that ‘the existential therapist must be prepared to address and discuss the meanings of a sexual attraction, insofar as her/his clinical practice is bound by genuine commitment to the other, and marked by authenticity’, principles every existential therapist aspires to.

In Chapter 4, Doris McIlwain developed the notion of ‘knowing desire but not showing it’ as one would in real life. She stressed the importance of permitting desire to unfold rather than distorting it in defensive ways. McIlwain reminded us that if we fall for the perils of ‘bystander, frightened abandoner, seduced authority who indulges in fantasies, smiling exploiter, briskly business-like overcompensator or intrusive policer of desire, chances are we are taking a stance someone else in the client’s past may have taken. The chapter advocated the use of Facework, a reflective form of detachment and mindful partitioning that can be achieved through a reflective encounter rather than an expressive encounter with desire.

Paul Smith-Pickard’s transcendental phenomenological therapy with sexual desire in Chapter 5 attempted to show therapists how to transcend shame, embarrassment, fear or any other negative feelings through dialogic relatedness and psychological proximity. Using the metaphor of therapist and client as the unconsummated lovers bound to each other by the desire to make a difference to each other, he argued that sexual attraction provides the therapeutic capital for authentic relatedness, a theme also highlighted by Michael Berry in Chapter 3. Negotiating relatedness for Paul Smith-Pickard is a talent and a commitment that requires Socratic questioning. One such question involves how close or how far should I, the therapist, situate my relatedness in order to achieve appropriate proximity or distance, where sexual attraction is present.

Richard Blonna in Chapter 6 explored and clinically situated the principles of acceptance commitment therapy (ACT) through discussing the importance in being mindful as therapists, accepting and coexisting with sexual desire as opposed to controlling, avoiding or attempting to eliminate it from our minds. The chapter assigned a natural state to sexual desire and part of the human condition, arguing that it cannot be regulated by ethical codes of conduct or professional boards. As he candidly stated, ‘The responsibility for managing sexual attraction rests squarely on the shoulders of professionals entrusted with the care and nurturing of clients and students’. However, Blonna did not leave his argument there. He thoroughly expiates a navigation of ACT principles and applied these in helpful and practical step-by-step ACT practices enriched by situational examples, which illustrate how commitment is required in recognizing sexual attraction and how mindfulness (a moment-by-moment awareness) and acceptance (learning to coexist with uncomfortable emotions) are crucial in handling it.

The literature shows that discussing sexual attraction in supervision is avoided. Kirsten Murray and John Sommers-Flanagan in Chapter 7 have dealt with the role supervision as well as the training of therapists can play in dealing with sexual attraction. Consistent with conceptualizations in previous chapters, they have postulated sexual attraction as a common, natural and ordinary therapeutic occurrence, then endorsed and described processes where greater understanding and insight is used to reduce sexual thoughts and feelings. The authors recommend safe training environments that foster open discussion and normalization of sexual attraction, and emphasize that supervisors should develop collaborative and open relationships with supervisees.

Harris and Timm in Chapter 8 highlighted that conjoint therapy takes on additional levels of complexity because of the triad of relationships present in the room, and how the intensity of this can be heightened when it is fuelled by sexual attraction. The authors have drawn attention to how harder it is to address sexual attraction in conjoint therapy when the client’s partner is also in the room. They endorse the approach developed in Chapter 7 by stating that if a therapist believes in honesty as a guiding principle (a subject explored in depth in Chapter 14), it is important that the therapist’s honest feelings are filtered through a collegial consultation or clinical supervision.

Using the metaphor of Odysseus, who wanted to hear the Sirens’ wonderful music but had his crew bound him hand and foot to the mast as his ship approached their island, psychoanalyst Andrea Sabbadini in Chapter 9 took us on a journey to show how the analyst handles the sweet music of erotic desire. Abstinence, Sabbadini argues, is neither about falling prey to the Sirens’ ‘honey-sweet tones’ nor about refusing to hear it by plugging our ears with beeswax. It is about listening to the Sirens’ song, learning from it, but at the same time remaining 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.

In Chapter 10, Luca and Soskice opened the therapeutic stage of the love-obsessed clients who refuse to accept that the therapist will not be their lover. Stalking the therapist, although a rare occurrence, is challenging and at times traumatic for therapists. Client relational intrusion, the chapter argued, can be handled through carefully thought-out strategies, including talking to a supervisor and, where appropriate, reporting incidents to the police.

Part II of the book has provided a qualitative research arena where therapists, as research participants, expressed their views and experiences of sexual attraction to clinician/researchers. These research-informed chapters have brought to the fore actual encounters of sexual attraction in an attempt to bridge, in Castonguay et al.’s (2010) assertion that ‘a gap exists between what researchers write about and what practitioners do in therapy’ (p. xviii). Starting with a grounded theory study, Arcuri and McIlwain in Chapter 11 revealed the attributes that may render a practitioner more (or less) vulnerable to unbidden attraction while recommending the importance of further studies to explore the spectrum of complexities that arise in handling sexual attraction.

Penny and Cross in Chapter 12 presented a brief profile of typical offenders (from existing literature) who become sexually involved with clients, consisting of older males, people who were sexually abused in childhood, have insecure attachments and lack current intimate relationships. They illustrated how discourses of masculinity play an important part in the role and management of sexual attraction. The chapter challenged discourse that perpetuates the position that the client is the cause of the response the therapist feels.

Luca and Boyden’s grounded theory study in Chapter 13 showed how experienced therapists were thrown off balance in encountering sexual desire, became avoidant, felt guilty about and frightened with the implication of not making effective use of it. Their study also captured the paradoxical attitudes of some therapists in the study who considered sexual attraction as potentially relational and transformational and therefore useful to the work, despite feeling thrown off balance. They concluded with clinical strategies that emerged from the study.

Marshall and Milton’s interpretative phenomenological analysis study in Chapter 14, explored the therapeutic use of therapists’ disclosures of their sexual feelings toward clients, suggesting that the need to be honest was found to influence therapists’ decisions to disclose their feelings. However, they warn that the choice to disclose must be made with the client’s best interests at heart.

Some clients, as Chapter 15 by Desa Markovic showed, erroneously believe that therapy includes sexual relations with the therapist and are surprised to learn that therapists are ethically bound to abstain from this. The chapter captures systemic family and marital therapists’ accounts of instances of sexual attraction in their work, including that it is a taboo subject and that it rarely manifests in family work.

The wisdom of scholars featured in this book is not purely an accumulation of academic research but one shaped by many years of clinical practice, which has been instrumental in formulating their ideas. I am indebted to them all for their intellectual rigour and commitment to advance knowledge beyond the taboo of sexual attraction.