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Dear Dr. Saltzman,

My therapist treats my revelations of my obsessive infatuation with him and the accompanying pain the same way he treats the pain I experience from the loss of my mom, the same as the frustrations i have over my boyfriend.  He does not see me as directly confronting him, in the here and now.  What do i expect?  I no longer expect him to declare deep feelings for me, or to be completely honest with me either way.  I've stopped deluding myself that we will ever share equally in this forum.  But the transference issue has created an seemingly insurmountable block in my being able to open up to him about all the other issues in my life, even when he asks about them.  In order to open up to him again, I believe I need--not just desire--compassion and human empathy for the difficulty I go through at the moment that I reveal my feelings, that vulnerability of telling him.  Is that too much to ask from a therapist?   I'm not talking about the past or someone else, I'm addressing him, that man across from me.  No doubt there is transference, no doubt that most of what i feel are projections of what i'd like him to be for me based on my past, but does it make it any less pressing or emotionally real in the course of treatment?  The distance he cultivates--to analyze first, last and always--is alienating me.  My first question is how do you think he should respond to help me get through this?  I know that I'll ultimately grow from laying myself bare, but the only time it feels unbearable is when it concerns my affection for that person across from me, prodding me to open yet maintaining his shield. 

I've long had some social anxiety and to a greater extent with men.  He said i could benefit in this therapy from new types of interactions with men.  As though i could experiment with this kind of interaction in the supposedly safe space of therapy.  This all sounds great in theory, but it hasn't prevented me from feeling how I would feel if all this happened outside of that sealed environment.  With my vulnerability and attraction part of this heady mix, I enjoy the exchange.  Then I crash under the realization that I can't take these emotions for this man out of the room.  They're meant to be transferable to other men, other circumstances, but this interaction itself is hopelessly bounded.  As this infatuation generated from therapy seeps into my real life, how do I manage it? I have to make a decision about returning to see him or to start with another therapist.  God knows I'd love to stay because I feel we've built something together, but I'm afraid that this will be an ongoing issue and the last thing i need is an ongoing obsession.  In your experience, do people manage their transference issues with time and attention so as to channel them successfully?  This is a lot of questions.  I'd be grateful for a response to one or more of them.  

Thank you very much,

A.H.







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Dear A.H.--

There are many styles of psychotherapy. Some work better for one kind of person or one kind of problem, while a different person or someone with a different kind of problem might be helped better by another style entirely. In other words, there is no one style of therapeutic interaction which is simply right or best suited for everyone or every problem. Judging from what you have written—and not knowing anything else, naturally—your therapist might be the kind who likes to keep a measure of emotional distance from everyone he sees, or he might be keeping his distance from you specifically because in his opinion that style of therapy is what you need, while with another person with different needs he might be more outgoing. There really is no way to tell.





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You say he is not being honest, but that misses the point. You are finding his style frustrating because you wish to establish a warm relationship which will gratify some of your desires for merger with him which you call "infatuation." In other words, it is entirely possible—and probably likely—that your therapist has chosen to help you grow beyond the desire for merger with another personality specifically by frustrating that desire instead of gratifying it. Naturally no one likes frustration, but it might be the best kind of treatment for what ails you. I cannot know that from here, having only your version of events, but take a look at it please.

Now, your understanding of transference seems confused. This is not unusual. I have rarely found a lay person who does understand much about that phenomenon, and even some therapists find themselves a bit a sea regarding it. The idea is certainly not that your feelings for your therapist are "meant to be transferable to other men," as you wrote. That is not at all what transference means or how it occurs and how it is used in depth psychotherapy.

In its simplest form, transference means that feelings and emotions which you had for early caregivers are projected (transferred) onto the person of the therapist--not that you transfer the feelings you have for the therapist onto other men you meet outside of therapy. Transference occurs naturally in most, if not all, therapies, and is useful as a source of information for the therapist in present time about the emotional tone and content of your interactions with early caregivers in past times. Eventually, when properly interpreted (analyzed, you might say) for you by the therapist's words and actions (or possibly by means of a dearth of words and actions which you are calling, incorrectly, a "lack of sharing equally"), the transference may become useful as a source of information for you about how you have been going through life projecting your feelings for early caregivers onto the people you meet as a adult, thereby confusing those relationships with baggage they should not be carrying.

In my opinion, the best way to proceed involves staying with the therapy and continuing to express your feelings—including your doubts and frustrations—to your present therapist. Along those lines, you might consider sharing this correspondence with him. Things might go better for you if you stop imagining that your therapist should provide you with what you want so that you will feel less obsessed or more at ease, and instead decide to let him be the doctor. If you cannot trust him, you might need a different therapist, but trusting is not the same as liking what he says or doesn't say.

Now you say that, "I'm afraid that this will be an ongoing issue and the last thing I need is an ongoing obsession," but therapy is not about avoiding obsessions if that is what arises, but admitting them, working with them, understanding them, and transcending them with the help of the therapist. Most often that help does not come from the therapist's indulging your needs and desires, but from his thwarting them so that they are thrown into relief and so can be observed and known. I advise you not to run away from this, but simply to face up to the fact that a problem which you have anyway now has a personal face (that of your therapist), and will have to be worked through with his help.

Be well.




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