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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
Dr. Schwartz's Weblog

Transference: The Patient's Love for the Therapist and an Answer to a Graduate Student's Question

Allan N. Schwartz, LCSW, Ph.D. Updated: Dec 10th 2007

Some time ago, someone sent an E. Mail question to," Ask Dr. Schwartz," about her love for her therapist. Soon after, a bright and astute psychology graduate student read my response to the patient and asked the following excellent questions:

The patient:

"I'm in love with my therapist: Man; but how do I deal with the feelings I have, the love I feel for him? There's nothing I want more than to be with him. And yet, I realize it can't happen. How do I deal with this? Thank you for your advice."

My response to the patient may be found by clicking this link . It will be necessary to read my response in order to make sense of this essay.

Graduate Student’s Question:

"I am a graduate student in clinical psychology and I was hoping that you could clarify your response? I agree that feelings that clients have toward their psychologist is often transference. However, I was confused when you suggested that this feeling and the knowledge that it was inappropriate meant that the client knew that he or she was unlovable, perhaps that information was part of the correspondence that was not shared? Based on what was discussed, if I was this person's therapist, I would also explore the possibility that he or she was afraid of getting injured in a romantic relationship and was using his or her feelings toward me as a way to not have to engage in a more appropriate peer relationship. Another possibility is that this person frequently chooses love interests that he or she feels have more power (likes to be the submissive partner, lower status partner in a relationship.) Yet another possibility is that he or she feels more safe with the therapist than in other relationships in his or her life. In this case he or she may be exploring scary emotional and romantic feelings in a safer environment. If you have more information about this person's reason for attending therapy in the first place, maybe that would help me to understand your response? Thanks for participating in a venue to help people understand some of these complex psychological problems!"

My Answer to the Graduate Student and to All Readers:

My purpose here is not only to answer the student but to help people understand the complexity of psychotherapy and the human mind.

There are many definitions of transference . To keep the concept as simple as possible for our purposes here we will use the following definition of transference: Transference refers to the repetition of childhood experiences with parents, redirected onto the therapist today. In other words, feelings and desires felt towards the parents during childhood are redirected and placed onto the therapist. The transference is important for the therapist to understand, as it gives him a picture of what this patient experienced during childhood.

First, we must understand that there is very little we know about the individual who wrote the E. Mail. We have no way of knowing why this patient attended therapy in the first place. What we can deduce from what she writes is that her experience of love for the therapist, and her wish to be with him, is painful. The painful nature of her experience is surely due to the fact that she feels that it is hopeless to have her wishes realized. Perhaps and most likely, this is a depressed woman.

In terms of transference, it is possible that she experienced her love for her parents as frustrating and hopeless. Why? Perhaps they did not love her? Perhaps she was not allowed to love them or her love of them went unacknowledged and unappreciated? Perhaps she was made to believe that her love for her father was "inappropriate?" There is also a chance that she experienced loss as love from one or both parents as proof that she is unlovable. Children blame themselves for problems and not their parents. All of these and more are possible explanations but we do not have adequate information.

What we do know is that this patient now has a powerful transference relationship with the therapist. She loves her therapist and wants to be with him. She states that she knows that she "cannot be with him." Is this last sentence transference from the father or from both parents onto the therapist? If this is true then the experience of painful rejection is a repeat from the past. Similar to her thinking and feeling during her childhood, she concludes that she is not loveable and that is why the therapist "rejects her." In other words, what she experiences as rejection by the therapist, she probably experienced as rejection from her parents.

Again, it is common for children to blame themselves for most of the things that parents do, even when parents are being abusive toward the child and/or toward one another. In other words, it is not that the patient "knew" she was unlovable, but that she unconsciously experiences being unlovable when she is in relationships that end in disappointment or failure. The problem becomes "her fault," and not the fault of other people. She does not "know" any of this because the feelings of depression and self hate she experiences have unconscious causes rooted in her early past. The therapy provides a chance to work through and correct this self concept.

It is also true that if the patient was abused as a child, then the transference could be her expectation of repeated abuse at the hands of other people and of the therapist. When that does not happen, she comes to feel safe with the therapist. The therapist becomes a good object. However, he continues to refuse to "be with her," and she finds this intolerable. In this intolerable situation, she concludes that he does not make love to her because she is not worthy. Worse than that, he does not even beat her as her parents did when they abused her. Freud talked about this in his famous essay, "A Child is Being Beaten." The patient has learned to confuse love with being abused. This could be the source of her wanting to be in a relationship in which she is submissive. The therapist does not beat her and that is frustrating. In other words, it is not that she is avoiding being injured but that she is disappointed that the therapist does not beat her. All of these are examples of transference. However, in the case of this patient we can only make guesses.

The transference is enormously important in order for the patient to be able to move toward recovery. This person, in her love for the therapist, is experiencing a positive transference. The high regard the patient has for the therapist is the important ingredient that helps the therapist and patient move forward toward health as the patient’s misunderstandings are resolved.

The graduate student is absolutely correct in stating that this individual's therapist should explore the various parameters of her feelings of love, depending on what the patient is presenting. So, for example, it is entirely possible that the patient wishes to be in a relationship in which she is submissive. If this is the nature of the transference, then it is entirely possible that this woman is using the safety of therapy to explore her romantic feelings without the risk of harm.

My suggestion to this patient in my E. Mail response was meant to convey the hope that some day she would be able to gratify her wishes for a romantic relationship with a safe person of her own choosing in the outside world. Of course, this response jumps way ahead of where she is at this point. Perhaps I should have just assured her that it is a good thing, although painful, that she has these feelings.

Today, psychologists, social workers, and psychiatrists to talk in terms of cognitive behavioral treatment and medication. Transference is based on psychodynamic and psychoanalytic psychotherapy and psychoanalysis. Therefore, there is a tendency to dismiss the importance of transference in the therapy. I think that is a mistake. In any type of psychotherapy transference is going to play a role and should be carefully examined by the therapist.

I want to thank the graduate student for her question and observation. I only hope that she and all readers can make sense out my attempt at explanations of some of these complexities. It is said that, "Excellence is not found in being the best, but in doing your best." I am not the best explainer, but I have done my best here!

Your comments, questions and observations are welcome and encouraged.

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    its not love - isabella - Oct 7th 2010

    For me it is not love, but a desire to seduce.  I do truly respect my therapist. I do not love her or even desire her sexually.  I am a lesbian female, she is also female, however, i am unsure of her sexual orientation. I find that in relationships I seduce the other person in an attempt to feel in control. I may not truley desire them, but I need them to desire me.   It is a pattern I have repeated and find myself starting to think of ways to seduce her.  I am in a commited loving relationship which i have no intention of wrecking.  I have sent my therapist a letter to inform her of my thoughts.  I am sure that now I will be able to discuss the reasons for my behavior instead of focusing on the process of seduction.

    My therapist told me she loved me - Dean - Jan 17th 2010

    I saw my female therapist for several years or about 150 sessions.  I was in my later 30's and she was in her later 20's.  I grew up in a severely strict religious home and never have had any real romantic experience in my entire life.  After counseling was over I told my therapist that I loved her.  I asked her if she loved me and she said yes.  After several more years of post-counseling phone calls between me and her she told me she no longer wanted to have contact with me.  She was getting married.  I was crushed and haven't dated in five years.  Isn't there something wrong with her behavior?

    Transference - Allan N. Schwartz, PhD - Dec 26th 2009

    Hello Kathryn,

    Your experience is a good example of why it is better to  not cross boundaries when in a professional relationship in which you are the client. It does not matter if the professional is your medical doctor, lawyer, boss or psychotherapist. In point of fact, your former therapist and now brother-in-law violated all the rules of ethics and violated the law. You could have and should have sued him for sexual harassment and sexual abuse. He could have been reported to the police. Now, I do not know what rights, if any, you still have. He is guilty of gross misconduct. And, that is completely his fault and not yours.

    As to your present marital situation, I am baffled and do not know what to advise you.

    Your experience is a good example of why and how the prior post done by Eve, is quite wrong.

    Dr. Schwartz

    Life Ruined - Kathryn - Dec 25th 2009

    There was major transference and counter-transference between me (female) and my therapist (male). Boundaries were violated when it came to hugging and kisses on the mouth. Also I was allowed to sit by him and touch him.

    Long story, short we became involved socially, I met his brother and ended up marrying his brother. Remember, I was in love with the therapist though. The whole thing is the biggest mess you could imagine.

    Saddest part about it is that I divorced my 1st husband, a man I truly loved, just to go down this path of hell. I am still married to my ex-therapist's brother and am miserable. (He is not an appropriate husband for me by the way.)

    Any suggestions?

    Hooray to you, Love Truly, Madly, Deeply??? - Eve - Jul 31st 2009

    I have been pouring over hundreds of articles and comments regarding "transference" as it relates to therapists/patient relationships & I have to say it was refreshing to hear from someone who seems to be in line with my feelings as well.  I very well understand that protections are in place because there are some therapists (and patients) who cross the line and end up doing more harm than good, but some of the conclusions that are reached by the so-called "experts" strike me as so far-fetched, I wonder if these are issues in THEIR lives that they try to broadly project onto the general population as a whole.  For instance, when the "experts" start talking about patients early childhood and being "in love" with or wanting to "merge" with their mothers or fathers, I feel disgusted by these sick beliefs of theirs.  My best friend put it bluntly.  She said that she has "never been in love with her father!" For the record, neither have I.  But what is more bothersome is to broadly say that real love can never be between a patient and therapist.  The real narcissisist appears to be the so-called "experts" who keep parroting Freud without really understanding human nature.  Believe it or not, even "experts" can BE WRONG!!! Not everyone who enters into a relationship with their therapist will wind up scarred & traumatized. In the case of Truly, Madly, Deeply, if the two of you still are connected 3 years after therapy, then that is not an ordinary feeling or a passing fancy.  You two obviously care about each other or you would have lost touch quite a while ago.  Hopefully your friend/therapist will stop listening to the naysayers and return to a full relationship with you.  You represent that one in a million real connection that does happen between therapist and patient.  The real traumatization in my opinion comes from so-called "experts" who go on and on about the perils of such relationships yet believe that two HUMAN BEINGS, regardless of how they met, couldn't possibly, absolutely never, unthinkable, actuallly feel, dare I say it...the God given emotion...of...LOVE!  I wish the two of you all the best.

    Love truly, madly, deeply ...???? - - Jun 15th 2009

    I have been in a post-therapy relationship with my ex-therapist for 3 years now. I have been trying to convince him that I was not scarred or hurt or traumatised by the whole thing for about the same lenghth of time. It has been sexual ( and how I long for it!), but not fully sexual. I had several by-thought: maybe he was gay after all ... was I attractive enough. But no: I am wonderful, full of life, acceptably neurotic ... eventually healthy enough... (he said ... and I believe him).

    His 'rejection' had run me down dreadfulluy. It affected my mood, ability to do my job ... I had other reasons to feel bad too: widowed with 2 teenage daughters, a bully for a boss ... you name it. I did not feel loved, apreciated by anyone ... but him. He did not want to sleep with me; but he liked me.  Better than nothing at all (?).

    I am still in the same boat after 3 years: we slept once together ... a friend of his convinced him that it was not fair on me (and it was not!). But after that he felt so guilty, that he just could not go on!

    He is the one who is affected. I feel quite OK; just very frustrated and ... I might give up on him: is it good for him ?? or me??? Just a missed opportunity, if you ask me .. We get on really well on all other levels: music, gardening, hiking, eccology ... etc. I think he is the love of my life ... I had therapy before and I was never in love with any of the previous therapists ... were they just useless ??? or is this real love afterall ???

     

    Transference Experience - Ellie - Apr 7th 2009

    I felt a good fit with my male therapist from the start.  Then after month I was overwhelmed by my feelings, just like for my favorite professor in college 25 yr ago! From reading articles, I knew I needed to tell the therapist. He said he didn't focus much on transference as a function in his practice - but I kept bringing it up because it was SO uncomfortable/painful and it mattered to ME to address it. So we talked about it, what it meant. I also talked to my husband, told him I was sad that I can't hug the therapist - he was amused but still comforted me nicely and agreed to accept all the hugs. Now the discomfort has dissipated. I feel a nice level of affection for the T, as I do for my long-time primary care doc or my priest. I know it is not a forever relationship, and that's OK. I've also spent time learning about the therapy profession, esp. the use of boundaries to protect the therapist personally from the patient's pain/issues and to avoid strong reactions in the therapy room. It's like what I do in my own job, to keep it separate from home life with my husband and kids, and how I have to control my responses in tense work situations.

    I am quite relieved to be moved past those stong feelings into something more mellow; I was very worried I would not and would end up terminating just to get away from the intensity.

    happy, still suffering - - Jul 22nd 2008

    I started seeing my therapist for many issues, including inappropriate feelings for another man, Soon I was in love with him...I stayed in therapy months longer, growing more in love, while he started to reciprocate my feelings....I left after a number of episodes involving touch ( they were not full intercourse, but heavenly) I didn't want to be a full adulteress or hurt my husband, my therapist, or myself anymore. Now I'm busy, fairly happy, full  of longing,lustful joyful....I know I have to give it time, fill my life with good things, and wait for the feelings to recede...any other ideas?

    Thank you for your explanations! - - Jan 13th 2008

     

      Dear dr Schwarc, thank you very much for I think I have realised something about my feelings for my therapist after reading your story. My parents were divorced, and I lived with my mother and grandmother, without father or any man`s figure, and I was taught that my father was an evil man, silly creature, stupid, and similar. I was a baby when they had divorced, so I dont know did I love him or not.

    When I entered the therapy with male therapist ( I am female) I felt as if I had to be rude with him, verbaly agressive sometimes, though I have loved him very much. it is a specific type of therapy ( CBT, and somethig like a training), so he didnt want to talk much about my feelings  for him and I felt as if I were acting a role in the course of the therapy hour... All the time, I had an irracional fear that if somebody ( a woman ) knew I loved him, he would have been hurt, or something bad would have happened...

    I showed my real emotions after he had told me he is going abroad for a long time. I was crying for days and it was the hardest time of my life in spite of all difficulties I had to deal with in my real life... Actually, he wasnt going for a long period, it was a therapy method or something, and I am still in the therapy, though he doesnt want me to go there often. Now, he is rude with me, called me an intruder last time ( as a joke), which was very painful for me.. My real father died this summer (mother died 10 years ago ), and I am very confused. I have a real boyfriend, he loves me, but it is not enough for me, I am seeking for my therapist all the time... How could I ever escape from that circle?

    Thanks!  

    transferince - - Dec 31st 2007
    i too suffer from this i fell in love with my therapist and we are both of the same gender,i was very scared but i talked to her about it. she explained a little abut it. but i still feel great love for er. the good thing that came out of this was for the fist time in my life, im now 50 i was able to tell omeone that i always was attracted to my own sex. and my thrapistwas the one i told she was very uderstanding and was very pleased that i could open up enough to tell her, i have never until that day ver told anyone about my true feelings for other women, and ive never ever even ried to explore i was lways scared. but i feel somuch freer knowig its out that i now am ready to explore. i guess what im trying to say is that if i didnt feel that tranferance thing for my therapist i would still be hideing a lonely life inside.   but at the same timethe love i fel for her is so overwhelming, that soetims i cant function right hinkng of her, i oly see her as a women i want to kiss hug and hold i cant see her ay other waythats the only sexual attraction i feel for her,  and that i aways want her to be part of my life.  so i agree that transferrance is a form of something youve missed in yourlife

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