Talk But Don't Touch

Carlin Flora

Therapists are often the objects of their patients' desire. Male or female, a therapist's power and authority lend a certain sexual appeal.

Jacqueline Wren* thought about him quite a lot. When she knew she would see him, she made sure she looked good. She dissected his every comment and studied his face for clues. Could he feel the same way? Though they talked openly for months, she censored herself, at times concealing the less palatable parts of her personality. "I wish I could say it was reciprocated," she says of her longing. Wren had a crush on her psychiatrist.

Therapists are often the objects of their patients' desire. Male or female, a therapist's power and authority lend a certain sexual appeal. The process of transference—in which a patient's emotions for parents and other figures are channeled toward the therapist—leads people to harbor feelings sparked by the therapist's role, not the actual person. And the qualities that make for effective therapy, such as careful listening and unconditional acceptance, are inherently seductive.

The professional boundary is clear: Therapy should never include sexual contact. Such a relationship could cost a therapist his license or even land him in jail, not to mention the emotional harm it could cause the patient. But humans being humans, attraction does play into therapeutic interactions, and not always to bad effect.

"I was just out of college, and he was 40-something," says Wren, a 30-year-old administrator, of her former psychiatrist. "He was not really attractive. Had I met him socially, I don't think I would have liked him. But I was single, and he was the only man who was taking an active interest in me." Her feelings eventually subsided, in part because she caught a glimpse of a family portrait on his desk. "That drove home the inappropriateness of the situation for me."

Transference that includes erotic feelings is less likely to occur in cognitive-behavioral therapy (CBT)—wherein the therapist challenges a patient's irrational beliefs in a structured manner—than within a more psychodynamic variety of treatment, says John Jacobs, New York-based psychiatrist and author. "With CBT, you're not just talking about internal feelings, you are focused on solving a problem." The free-associative outpouring of intimacies and memories that characterize psychodynamic therapy, on the other hand, is in some ways akin to opening up to a loved one.

No matter what techniques a therapist uses, the basic architecture of the one-on-one meeting provides an intimate setting where romantic feelings can grow. Ellen O'Conner*, a 29-year-old banker, has seen three psychiatrists in the past decade. "In a world of Blackberries and text messages, just sitting across from someone for an hour is unique," she says. "It would be hard not to love that time in a quiet room where you can think about your life, and also the person listening to you and looking into your eyes."