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Dr. Robert,


I love my therapist.  I have been going to her for 3 years and I think she is beautiful, sexy, and most of all, I am in love with who she is and how she thinks about life. I am not over-idealizing her because she is in an authority position. As a person of reasonable intelligence, I can see imperfections.  I have a read all the stuff about transference.  Talked with her about all of this.  Cried my eyes out in front of her and by myself.  And the pain of not having her as part of my real life sears my heart. 


It seems to be getting worse.  Without rehashing all of the reasons I went to her with problems to resolve including a crisis of infidelity, issues in my marriage--and the continued shit in my life from a childhood of neglected needs.  But now with my crises in the past, the pain of not being with her hurts as I never imagined it could.  This pain is so great that I wonder if I need to leave this therapy, thank her for all she has done, but to now have someone else help me deal with the fact that she is happily married (though I know very little about her marriage, I know she is in a good marriage--BTW that jealousy tears me up inside.)


I really don't know what to do.  I am in tears, as I write this--longing for her to be a part of my life for more than my 50 minutes a couple of times a week.  It is so painful knowing that I am a patient, whom she cares about, but about whom she does not have the same feelings in return.  She has told me that of course she cares for me and recognizes that I am an attractive man--but her dedication is to help me address the problems in my life. But now she has become the problem.


Your response I fear will be that this is going well and that I can work through the issues using this transference as a vehicle for healing the childhood issues that caused this situation.  Whatever...what about the heartache I feel that is real today?  And should I consider ending the therapy now to find someone who can help me with the wonderful new problem this amazing woman has become in my life?


Please keep this letter anonymous. 

ask dr-robert

Dear Anonymous--

You have anticipated my response quite accurately. In my opinion (and based solely on what you have written, of course), your therapy is going well, and your therapist will use your strong positive transference as a vehicle for learning and understanding more about you, and for helping you to untangle your emotional life. I certainly would not recommend that you end the therapy and begin again with someone else unless your therapist agrees on that course of action, for it seems to me that she is, after three years of work, the person best situated to help you with your "wonderful new problem." Nevertheless, your pain is real—I have seen the same kind of thing played out in my own consulting room--and I would like to address that part of your question to me.

The issue of therapeutic transference (not to mention counter-transference) is extremely complex. Without a great deal of study, informed by clinical experience forged in the light of the requisite ethical commitment, I doubt that anyone can even begin to plumb its its depths. I mean an ethics which restrains the therapist from stepping out of that role and into something more personal ever while presiding over the therapy of another human being. (That ethics, by the way, is based, as I see it, on the same species of natural revulsion one feels when an adult has sex with a child. When the ethical boundary which is meant to forestall such sexual abuse is breached, the therapy invariably is destroyed, and the client is usually left in a dire situation.) I have read hundreds of letters which touch upon transference--my apologies again for not having sufficient time to reply to all of them--and not one of them indicated anything like a full comprehension of that phenomenon.

For example, in your letter you say that you are not "over-idealizing" your therapist, but what does that mean? Obviously you do idealize her, and powerfully, so how much more idealization would be needed to constitute "over-idealization?" In other words, your claim that, since you see a few "imperfections," your feelings for your therapist are not the usual idealizing transference, but "love," is a kind of self-deception which makes your yearning for her much more painful than it would be if you could see matters truthfully. In this regard, I suggest you listen to the audio presentation of one of my therapy hours which goes into the difference between pain (inevitable), and the "pain of pain" (self-inflicted).

Your mistaking therapeutic transference for love is understandable because the human phenomenon of falling in love includes idealization, and so the experience of a positive transference can feel a lot like falling in love. Then why not just call such feelings love? After all, love is love, isn’t it? If those feelings in the consulting room aren’t love, then why are the feelings between husband and wife love? The answers to this question are complex, and here I cannot go into them fully, but let me address just one aspect of the difference between transference and love in hopes that you will grasp why you should not end this therapy, but stick with it, continuing to suffer your thwarted feelings until you are able, with the help of your therapist, to transcend them by allowing infatuation to change into self-understanding.

You say that your therapist is, in your eyes, beautiful and sexy, but millions of women meet those criteria, and you aren't in love with them, so why her? "Well," you would say, "it isn't just her looks and her sexy manner (although that's certainly a part of it). I love who she is and how she views life, so this is not simply infatuation with a sexy woman, but love for the essence of this particular woman—love for her ideas and way of living."

Now you are going to hate hearing this, but a good deal of that "love" is simply illusion, for you do not know what she really thinks about life or who she is. All you know about this person, besides her sexy looks which have captured your erotic interest, is her ideas and way of being in her professional capacity as your therapist, in her role as doctor, and that is only a part of who she really is. Unlike a normal social situation in which various aspects of a companion's personality, both the attractive and the unattractive, are revealed gradually, in this situation—the controlled situation of a therapeutic alliance—you are allowed to see, and you keep seeing, only the same limited fraction of this woman's way of being, that part of her which is dedicated, in her role as therapist, to helping you understand and work with your emotional limitations.

In her position as your therapist she intentionally keeps a great deal of herself to herself, so you do not know, and never will know, much about her needs, her fears, her doubts, her anger, her depression, her resentment, her sexual kinks, her existential angst—none of it really. In other words, your meetings are, and always have been, only about you—not about her at all, and so, although you imagine that you know this person, most of that "knowing" is only in your imagination, for you really have very little information on which to base your "knowing." That is why--but only part of why--this kind of attraction is not called love, but "transference." Although the intimacy of the consulting room might lead you to believe that you know a lot about her, she is so unknown to you that you are forced to project your ideas upon the rather blank screen she offers you, transferring earlier ideas and feelings, based on experience with others, onto this relationship, and none of that has much to do with her at all.

Of course, all love relationships begin with some elements of transference (often a lot of transference), but, in a normal social situation, the veneer of transference gradually erodes as real information is exchanged in the give and take, the two-way street, of "getting to know you." In therapy, conversely, most of the getting to know you is a one way street. She gets to know you, and you get to know yourself, but you do not get to know her; you only get to know her professional persona.

You mentioned that she is happily married as if that were the reason why your attraction to her cannot be fulfilled, but that is not the reason. Even if she were unmarried, or unhappily married, your situation would be precisely the same. She is your doctor, not a potential girlfriend no matter what her life outside the office may be like, and no matter how much you desire her. Please think this through, and I believe you will understand it. You may not like it, but you will understand it. Eventually, you may even see the wisdom in it.

Be well.

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