 We demystify what goes on behind the therapy room door. Join us on this voyage of discovery and co-creative conversations. This is The Therapy Show, behind closed doors podcast with Bob Cook and Jackie Jones. Welcome back to episode 39 of The Therapy Show behind closed doors with myself Jackie Jones and the wonderful Bob Cook. I'm looking forward to this episode but I'm not quite sure what to expect Bob. So this episode what we're going to be talking about is erotic transference within the therapy process. Another one of your wonderful titles Bob tell me more. Yeah so what isn't spoken about that much in podcast or seminars or videos is sex in the therapy room or the expression of sexual feelings either by the therapist or the client or the absence of the expression of sexual feelings from either the therapist or the client. So you've been working quite a while as a therapist. So how many times have you actually said if at all that you have sexual feelings for a client? Now you may of course decide clinically not to or you may have never had any sexual feelings towards any of the clients you've ever worked with. I don't know but those are my questions to you. One I don't know whether I would and two I never have. Gosh that's extraordinary. What about the other way around then if clients have sent you they've got you know feelings at a romantic level towards you? I haven't experienced that but I have experienced a highly sexualized male client in the therapy room that was openly talking about lots of sexual things but he didn't direct it at me if that makes sense. So there was generalized sexualized talk but he didn't say that anything about me in particular. Okay so that's what I'm surprised at the first particularly. I think majority of therapists have had or do have sexual feelings towards their clients. Unfortunately what they do most of them particularly is shut down part of themselves because they either feel ashamed or they feel the ramifications of what will happen if they mention that they feel attracted to their clients and in this day and age of litigation and ethical processes they I think shut down part of themselves which is a great shame as far as I'm concerned. What I think should happen is is to take it to steeper vision. Yeah I think I probably would if ever I had I'm thinking while you're talking I'm questioning myself have I ever had and the only explanation I could potentially have is that all my long term clients are female and I'm not attracted to females so any male clients that I have they tend to come for short periods of time. So whether that's because I haven't built up a relationship with them over a long period of time that could have had an impact on it I don't know but no I haven't but then I don't think I'm a very sexualized person generally. Let's move away from that to talk about this theoretically and practically really because as a supervisor I have had quite a few times when people have come to me with this dilemma and of course there's been a therapist for a very long time I have had this more talk about here myself quite a lot so I think if this ever happens I think the first question that a therapist needs to ask themselves is who you know where did the sexual feelings originate from them in other words are they projected onto me from the clients or are they actual feelings that I have for myself physically yeah if he answers if we answer the first one the sub projection in terms of projective identification you know projection onto the onto the therapist then the important question is what does the therapist do with that then if they come to that conclusion I think they do need to take the supervision if they come to conclusion that they actually feel attracted to the the client then they need to think about what they do about that yeah first step I think is to take a decision vision and explore both those options I'll just talk about whether it comes from a transferential place where the client for many different reasons could be projecting into the therapist sexual feelings and also to inquire themselves and talk about their sections towards the client and if they can work through that with the client and if they can't and they can't see beyond that they need to refer the client on yes so quite often I do think I do think the therapist and I don't particularly place this onto you jacket because I heard what you said but I think quite a lot of therapists often shut down part of themselves maybe maybe that's what I've done yeah or the because they're afraid of A the consequences of that B they might feel ashamed for some reasons and and C they may not want that clinically make different reasons however you know in the world of relational psychotherapy and intersubjectivity it's I think a dimension missing if you cut down part of yourself you see I think that's actually you should be bringing the whole of yourself to a relational process and not shut down a compartmentalised part of yourself that is a very good point Bob but maybe that part of some of us is already shut down whether we're in the therapy room or out of the therapy room yeah well yeah maybe you're right maybe the therapist or the client has shut down that part of themselves whatever reasons so it's not a conscious thing inside or outside the therapy room it's just shut down yeah I'm talking about I hope I'm talking about really people clients or therapists that actually have to have accesses to all parts of themselves yeah yeah because in there there's lots of reasons why I think it's really important because if we unconsciously or consciously shut down parts of ourselves because we think you know it's bad or we're ashamed of it or that part of ourselves or we think as therapists we shouldn't be having sexual feelings or whatever unconscious or conscious choices we make the problem is the more you compartmentalise those feelings they then could come out with great force and you could end up actioning them and you're heading towards then much more difficult situations yeah so I see I think repression can often lead to an externalisation yeah a bit like a pressure cooker where you keep things underneath and then suddenly it comes out in a much more intensive way than it would have done yes yeah I totally agree with that yeah and the times that people have come to me when they've talked about the expression of sexual feelings and we've worked through it or talked about it and I'll say the first step is to think about who sexual feelings they are and another good question to ask a therapist is who is the client for them in other words to look at their developmental history yes yeah and to spend some time inquiring down that line now of course I don't want to take away the the really nice head earlier on which is it could to be two human people who are just physically attracted to each other or it could be two human people where one person is attracted to the other one and the other one it may or may not be I don't take away that sort of human encounter but what I do want to say is for the therapist to inquire in supervision about who might the client be in the transplants process developmentally for them is a good inquiring road to go down and a good start I think yes yeah yeah and I can see why that is looking at it from more you know a logical level as opposed to a feeling level looking at it that way you're kind of taking it away from the feelings and looking at it in a more logical way well more clinically I have yeah yeah that's what I mean I think the the only thing really that I can relate it to is I've really really really strongly felt somebody else's anxiety when I've been in the room with them so I can kind of equate that with what you're saying about who's you know who does this belong to because you know and it was in group therapy while I was doing my training I was sat next to somebody and I don't class myself as an anxious person but suddenly I felt so anxious it was ridiculous so and it was the person sat next to me you suddenly broke down crying having a panic attack and I kind of thought well it wasn't me after all and I've never experienced anything like it before well that's called projection projective identification in the trade they're projecting feelings into you which if if the sexualization within the therapy room was anything like that I can understand why that would be difficult it was really intense feelings that I felt of anxiety yeah yeah so if we're moving over to that's the client side projecting sexual feelings into you which I think would be good to discuss in a minute because you know we have bilateral transfers here and we stay with the therapist at the moment that if we start off talking number one with the supervisor number one you know it's whose feelings is it yeah right didn't require that number two developmentally within the transference who is the client for me we've got a good template for starting to inquire yes now once we've acquired that and maybe we we find out in the transference there's a lot more to it than we thought and it is next to our feelings there's more projective identification or maybe they remind you of xxx as we call that maybe we've come to a place it's two human people where one therapist is attracted to the where the therapist is attracted to the client which is another story because then we need to talk about whether the therapist can talk about that clinically with these particular clients and be able to work through that in a useful way within the uh intersubjective relationship or if they can't see themselves through that or clinically it would be uh in terms of timing or or have we looked this and not row good row clinically they would need to refer on so these are the discussions the supervisor needs to have it's really important though that the therapist talks about these things because otherwise as i said repression or even unconscious denial will lead i think or could lead down a road which is more difficult yeah and i think it's a really valuable topic to be discussing like you said at the beginning of this in you know the day and age that we are around litigation and complaints and all those sort of things within the therapy room i i can imagine that there are therapists thinking well how would i approach this absolutely protecting myself you know as a clinician yeah how do we go about doing all of this so this is what we do this is the time the first step is we take the supervision yeah in the road i talked about we can take it to our own therapy as well yeah and then we can look at well you know if it is me just on a human level it's not being projected into me and it's not transferential and it's part of a human encounter that i find this person physically attractive and i'm not able to talk to the client for whatever reasons and take ownership about and say well there's you know i'm a therapist professional therapist there's no ways i'm going to act out on this and got boundaries here and ensure the person at all different levels ethically and if the therapist for whatever reasons isn't able to move through that and they need to refer on and i think these discussions are really important because i believe that it would be very odd for me anyway thinking about over many years if i wasn't at some level sexually attracted to some of the clients i mostly work with women or did and you know i've got i have got sexually attracted to women i've taken to supervisors i've talked about the way i'm talking about it here and with some people i've been able to move on and talk about to do with the client and then of course you know it's really important that the client doesn't see it as their fault or yeah they care of the therapist there's many ways where clinically it may be too difficult so the problem of just referring on is if the client then doesn't understand it and doesn't and sees it as their fault or whatever it is so i would really encourage the therapist to bring it out and own it and set the boundaries yeah i'm not saying if both partners can't get through that you wouldn't refer on but i think these avenues and supervision need to be explored first yeah totally there's something going on for me i don't know why it's coming over me that if if this did happen in the the therapy situation and i brought it into the session and the session became about that there's something at the back of my head that's thinking that's how would i charge the client for something where i'm talking about my feelings well let's put it in the way session i don't know put it in that way you're not a robot so you're gonna have lots of feelings anger feelings fright and sketch and you're gonna have lots of feelings now in most situations of course and hopefully all of them you'll stay in your adult but you know we have feelings on our adults so that if we're in a relational psychotherapy world then to the press half yourself court of self a third of yourself you aren't really helping i don't think you're helping the process altogether so it would be very abnormal for therapists not to have feelings in the therapeutic process yes that's not that's not the issue as far as i'm concerned the issue is a who's feelings it is yeah and b um how do you you know talk about these in a way which is which is useful to the therapeutic direction so for example if you feel i don't know angry with the client and after you've worked out well does she remind me off or whatever it is in supervision or you know it's been projected into me i think you could say quite easily to the client you know i've been thinking about this during the week i felt quite frustrated or a sense of rotation with you um last session we were here and i wondered if you were about or how that might be fitting into our relationship and how does that then you know what does that say about the past and have you had you know to have the type of discussion which i think will be really helpful yeah oh i've had discussions like that about yeah so you're talking about yourself aren't you yes yeah i suppose yes yes but mainly it's not it's kind of what's happening in front of me you know if i feel a sudden sadness i will say to the client wow that made me feel really sad what you were saying so i'll i'll bring that into the therapy room that is me talking about you just the same yeah so if you have sexual feelings they're on the same level aren't they they might be more intense less intense or more by me but they are still feelings yes yeah yeah so it's how you use those clinically and especially if they've been projected into you by the client so that on the client side for example they may have been sexualized as children but it might have been a way that the child attempts to have a bonding and dialogue with their father and the only way they know the only way they know how to do that is through seductiveness which might be their real attempt to have close contact with their dad so there's many reasons why clients might project sexual feelings into the therapist what needs to be really iterated and work through is firstly that it's not bad secondly nothing to be ashamed of and thirdly is there any sense that you may do this with other people and not realise you're doing it or it doesn't help you or you end up in situations which are dangerous for you or effective for you so you work through the transfers and talk about the erotic transfers in a way which is clinically positive yeah in fact more than that transformational yes yeah yeah i can see from what you're saying that that would be the case it's a because i think intimacy in in the therapeutic relationship is quite important and you know i might be fantasizing here but for some people intimacy is you know sexualization and it's not about the connection of two human beings on a certain level without it involving sex or sexualized behavior whereas to me i can be intimate and connect with a other other human being without that side of stuff so you know i think part of a therapeutic post process often is a educative therapy where you will teach them the difference between intimacy and sex or whether they might have clients which have you know confusion about sex and love yes yeah and all these things we're talking about so not only can do educative therapy but also you can take you can look back this in ta would be deconfusion or decontamination when i talk about where you know there could have been sexual abuse there could have been sex and appropriateness where the person is it going to be logically confused there could have been a hurt a lot of hurt a lot of healing needed and and that's why i said transformational really yeah and again you know i'm thinking about certain you know personality disorders sexualized behavior and risk taking and things like that is part of the diagnosis that i'm presuming would come up in the therapy room as well well people have been sexually abused sexually traumatized sexually used inappropriately of course let's not forget the trauma of that and the trauma of that leads often to confusion and disorder so it's from that early abuse and trauma that we need to move to healing yeah rather than see this is a pathological disturbance necessarily so what you're alluding to of course is that we'll say multiple personality disorder which is now dissociative identity disorder one of those would be that there's been a lot of trauma a lot of promiscuousness a lot of sexualizations and in the latest dsm5 or diagnostic manual they often talk about that in a quite a pathological way well i see from extreme trauma like that leads often to confusion fragmentation and disorder so by looking back at our or using what might be presented in the third room to go backwards often leads to healing and transformation yeah but none of this will happen unless there's a discussion no no unless there's a conversation i agree yeah yeah now it's very very hard i think for lots of clients to say and talk about feeling them here romantic feelings with a therapist you know i think it's hard enough for therapists who often i said shut themselves down i think their own parts of themselves and then don't take it to supervision and in every case discuss and intellectualize things instead it's often doubly hard for the client because they often feel more vulnerable and more hurt and there's a lot of healing to be on they think it's their fault and all those sorts of things so i think the therapist is the person often needs to initiate conversations if they feel it clinically appropriate yes yeah so i know many clients so i was just going to say i think that's more likely to happen in the therapy room rather than the client actually saying something to the therapist i would imagine there's a lot of fear and shame that you'll stop the sessions that you will end the therapy if they say yeah and about it they'd be abandoned i see most of the what people might call stuffed a nurse or sexualized behavior is often a you know a real desire to be able to talk to their therapist but they just actually don't know how to do it rather than speaking in this sexualized way because that's the way they were programmed to it yes yeah yeah and wouldn't the world be a better place if we just found it easy to talk about every subject then have taboos and limits and on what we can and can't say yeah and i think you know it's interesting there aren't many video seminars discussions about this subject we're talking about here and i think because as i said before i think for the therapist particularly they they cut down part of themselves they're often afraid of any sexual expression they they comes up which leads then to what i call defensive psychotherapy where they shut down and pass themselves and don't even mention the supervisor because they're afraid of ethics and litigation yeah we end we end up in a defensive psychotherapy situation yeah so my biggest plea for people listening to this podcast would be therapists particularly to take all these issues to their supervisor or therapist supervisor i think first step and i think to to be very mindful about you know how a client is dialoguing and talking to them to the therapist because i do really believe that a lot of the traumas that happen mean that clients may talk and or want an attempt to get a relationship with their client but they don't know how to do it so they often unconsciously fall into the process we're talking about here and especially people who have been sexually abused yeah so supervision is the way to go with it yeah and just to pick up on something you said which i just want to say and i hear you you you sort of pups you know it's not in your field of vision but of course you know a lot of female therapists get attracted to their female clients yeah doesn't be because you know in this you know in you know so that's that's what i wanted to say there many many clients you know same sex they're attracted to the same sex in our profession so you can have you know i worked with 90% women but doesn't mean i'm not couldn't be attracted to a man and vice versa so there's this is cross gender it isn't simply you know stereotypically gender orientated orientation here yeah 100% i can only talk from my own experience and he's very very quite clear at the beginning but yeah i think i think that it's an area which i would encourage derp is to talk about more perhaps even think about more and i see it is not something bad or to be ashamed about but actually to learn from and actually may if they could bring it up be transformational for the client in front of them yeah especially if they think about it transparently and developmentally and clinically yeah yeah i agree with what you're saying but because it's never actually presented itself in the therapy room for me would you recommend bringing it up as a topic well you're as the just the general course of therapy that it could be a possibility at some point in the line this happens before it actually happens yes especially well in a podcast i'll probably talk to you about your first sentence about it but if a person if a therapist chooses to cut down part of themselves consciously or unconsciously then that's their choice but i would find it very odd for a therapist not have or a human one human being not to have or at least the expression of sexual feelings if they're working intermittently and closely with other people over many years i am very odd bob but i didn't want to make it personal to you because i'm sure many therapists do cut off part of themselves consciously or unconsciously because they feel it's bad or they feel there's somehow there'll be some catastrophic consequences to having feelings for clients or somehow they feel ashamed about or they feel of litigation et cetera and that is a great shame i think because you're only bringing or the person might only bring the course of themselves to the therapeutic dialogue yeah i mean a total agreement with you bob yeah you know it's an important subject i i'll answer yes i do think it's important for therapists to take it to their supervisors before uh as a general topic of discussion yes yeah yeah i don't think that the the topic is discussed enough 100 yeah but again we've all got our own baggage do you know it's it's one of those things if you know our own life script it comes with us in the therapy room you know my family is is very closed about affection in any form whatsoever whether that's yeah well perhaps this is another podcast you see i which is should be titled some something like our our therapist scripted and programmed to uh we could talk on about of course all therapists have their own scripts and yes yeah their own scripts and that's why that's why of course therapists have their own therapy and that's why therapists especially in i think um competence psychotherapy training programs especially the uk cp ones demand therapist to have therapy and at least i think it's 160 hours in a four year program so i'm very much a believer in people reflecting on how their own script can actually hinder the therapeutic process or not yes yeah totally so we're on the same four part there yeah yeah definitely and maybe there's work to be done for me um the most therapist i don't think it's i just think this particular area is not reflected and talked about no no it's not and i think you you have touched on it about litigation and fear of you know repercussions of the conversation and things and i think that's a really valid thing in this day and age you know because so many therapists are scrutinized yeah there's a good book by david man that came out about 2011 and i think the title is erotic transplants might be a longer type of that but if you put david man into the for the therapist this this thing i'm talking about here um you will come up with that i think it's really important and i think to bear in mind it's also very difficult for clients and also i said this three times i'm aware but i think i'm very passionate about it is for many therapists sorry many clients would be traumatized especially at a sexual level um you know but it's often that they are confused about level sex and it's often a language they the only language they know and it's a way to get talk to the therapist to have some connection yes yeah yeah and i think we need to be mindful of that in the therapy room that you know the the connection can be sought through lots of different means yeah it's at another level of relational need yeah we need to look at and intimacy is one of the needs however we yeah sexual expression yeah that's it yeah yeah so it's a big subject but i i'm glad we're doing a done a podcast on it or doing a podcast on it because it's a subject area which i think that was and i don't point it send to service to people listening perhaps don't reflect on it enough and the clinical implications and the the path the pathways to clinical transformation for the client yeah through these these types of and maybe is one of those situations as well were until it happens in the therapy room or until we're kind of made aware of it we wouldn't do anything with it whereas if people are listening to this podcast and maybe it will open up areas for discussion for them whether that's in supervision or in the therapy room yeah and these are the things that happen behind closed doors and unless it's actually tackled can lead unfortunately to things being acted out which are harmful for the clients and need never have gone down that direction could have been talked about and dealt with in different ways before um harmful yes and and 100% like you've said is you know it's a human feeling we are all human whether we're therapist clients supervisors or whatever yeah i think that's the bit really all humans clients and therapists and therapists we usually always clients as well so in in the world of humanity it's an important area to talk about and not to feel bad about yeah yeah and and you've kind of given permission for that to be discussed which i think is brilliant on a taboo subject or possibly seen as a taboo subject just not talked enough about yeah yeah so what we're going to be discussing in the next one bob is different approaches to therapy and how that guides our work well that'll be really interesting because um it clients who of course who come for assessments and then go into work often don't even know about different approaches yes there's so many that i don't even know about so we're discussing that one in the next podcast bob so i'll see you soon yes see you soon bye bye you've been listening to the therapy show behind closed doors podcast we hope you enjoyed the show don't forget to subscribe and leave us a review we'll be back next week with another episode