I had never considered that there might ever be a time when such self-disclosure of a sexual interest is necessary, albeit in the course of a therapists failure to control their own expression of their internal experience.
One thing that seems to be missing though, is that there is research about the routine overestimation by men of women’s interest in or attraction towards them. I think this context should give even more reason for a male therapist to consider such self-disclosure as a “last resort”, to be used only when a therapeutic rupture is already quite likely. Another aspect is the profound betrayal experienced by many women when platonic relationships are discovered to not in fact be mutual, but to contain hidden motivations and expectations on the part of their male friends, colleagues, and other relationships. In a world where many, many women have experienced even deeper betrayal with CSA and abuse within their adult relationships, the establishment of a safe vulnerability with a man can be an incredibly healing container, even apart from any other work accomplished within. Much of our societal conditioning already sets our worth on our desirability and truly, on our utility to men, so this disclosure risks rupturing what may be the only safe male/female relationship a patient has ever had. The likely cost is simply too high for a perceived benefit that in its very nature is likely to be interpreted through a deeply flawed lens.
This must remain a very last resort, and even that with serious understanding of a likely need for an outside perspective and emergency support for both therapist and patient.
I would have liked to read exactly HOW he disclosed in that moment. I agree it was probably the least bad option in the situation (would be worse to gaslight the patient "no you're wrong, I wasn't looking at you at all, certainly not looking in any SPECIAL way!!!"). But seems like a situation where the exact wording and tone would have been important to minimize damage.
Yes, this is a great point. The way he discloses is paramount - it is a great article if you have time to read and Slavin describes disclosure more in detail
This article is a great argument for mandatory psychotherapy for anyone wanting to practice in mental health on a professional level. Thanks for writing it.
I went back and had a look at the Davies paper--inspired quite the controversy and discussion at the time. I miss those theoretical imbroglios/debates!
Fantastic post. Very helpful as I explore the idea of non-touch through bell hooks and Lacan. Thanks so much for putting all these thoughts into words so eloquently.
Thank you for this really wonderful article! I read Davies as part of a psychoanalytic course on love in psychotherapy. I remember finding her work fascinating and original, this idea that love or even sexual attraction might require acknowledgment in some circumstances.
I so appreciate being reminded of her; I will now have to go back and read again. And I appreciate the additional references and context for this whole conversation. Your piece is extremely balanced and thoughtful, and I think I’ll even print it out and save it. Thank you!
Hi Franny, we write on many of the same topics in the therapeutic space. I focus on defense mechanisms, digital dissociation of the self into performative online ego states, and analytic review of films. Are you open to doing a livestream sometime, a podcast, or written back and forth interview?
"as Avgi Saketopoulou states, “something in us always resists being grasped and understood, and in that sense, opacity may be seen as a sturdiness in us... that connects to self-sovereignty."
If my daughter thinks too consciously of her first dim childish love affair with her dad (me), she will be less able to see a handsome man her 20s as being a great guy and 'kind of like dad.'. Likewise a therapist's disclosure has a regressive effect. It seems that to make the unconscious conscious is not necessarily the goal, but if taken too far it is a perversion of our field? What do you think?
Yes, I like the analogy re: father/daughter - often we reach developmental milestones while never fully realizing what was getting worked through unconsciously - true for childhood and, to some degree, therapy. Thank you for the kind words!
Nobody knows in any thoroughgoing way what he is up to while disclosing. Our capacity for rationalisation is remarkable. Both lines are in the piece. Every safeguard that follows them runs through the therapist checking his own motives. The gauge is reported faulty and left to test itself.
One in ten male therapists cross the sexual line at some point in a career. Most are ashamed afterwards. The piece reads that as fragility calling for vigilance. It is a failure rate, and vigilance is the thing that failed.
An archive changes what gets said. What most needs saying is what a person would least want kept, and a recording seats courts, insurers and the clinic at the table beside the two people already there. Nothing about that comes back.
Which puts the weight on the key and not the tape. One copy, and the patient can burn it. Evidence with no audience. Nobody in the field will want it arranged that way, because control of the record would sit with whoever has less power in the room, and every tape in existence now sits on a server owned by the clinic.
This interesting post can be summarized more clearly as: 1) two people are in a relationship which they agree is "pretend". 2) One person "pretends" all sorts of ideas and feelings about the other person. 3) The other person does not allow him/herself to "pretend" anything special about the relationship. 4) Sometimes the other person allows him/herself to "pretend" anyway. 5) The other person's "pretend" feelings must not interfere with the first person's ability to recognize that it is all "pretend". The parallel with WInnicott's transitional concepts is important but easily used to mislead. Notice how rarely the female therapist is "accused" of violating the boundary. Why is this?
As a former analysand, I read this with a lot of interest. All of the various clinicians quoted have valuable ideas, and I particularly resonated with the idea that there are very early, infantile parts of ourselves that may be deeply traumatized by an analyst's disclosure of erotic feelings.
At the same time, the artist in me -- I'm a playwright -- recognizes some similar arguments often made about not representing certain areas of human experience in art due to their potential to traumatize. I think it is very easy to confuse respect for the infantile with an infantilizing stance. When the author writes that "the therapist creates an environment where the patient can explore endlessly, without fear of being shut down," my thought is that this should not prohibit an exploration of the patient's attempt to put the reality of shared sexual feelings in the dyad into words.
In therapy, as in art, ultimately everything should be able to be explored in a representational way -- story in narrative art, language in an analysis. If we decide that some areas of reality are simply "too much" to be dealt with in explicit, representational ways, that is a loss for human understanding, and its own kind of trauma.
Everything should be able to be explored in a representational way, absolutely, especially by the analysand. What the analyst specifically discloses on his own part is a bit of a different question. Thank you for reading and your thoughtful response!
The article impeccably mimics clinical reflection, but in reality it is a political manifesto disguised as psychoanalysis. The author narrows a universal ethical dilemma down to a single "oppressed" dyad, as if erotic countertransference in women and homosexual therapists were inherently safe. Patriarchy, #MeToo, power - these labels are substituted for the complexity of the unconscious, while the central argument ("be careful, men") is passed off as a neutral clinical principle. But if a principle is neutral, it cuts both ways. Its absence here is not science - it is a political choice..
Constructively, this misconception is even more dangerous. A living psychotherapist is valuable precisely because his consciousness does not merely mirror the patient's request back into the patient's own abysses; rather, it offers a procedural reading of reality through an inevitably lived biography - his own, singular, asymmetrical. This biographical inevitability is the working instrument, not a party line. Gender bifurcation in this context looks deliberately obtuse, especially when the patient has autonomously and voluntarily chosen a psychotherapist of the opposite sex - in that choice already resides his subjective request, his trauma, his desire, which the author simply overwrites with her "victim-oppressor" template. Such an approach does not heal - it programs, replacing living dialogue with an ideological label..
I can’t believe Freudian psychoanalysis is still being practiced. I assumed it had joined trepanation, hydrotherapy, mesmerism, forced bed rest, and morphine therapy on the junk heap of archaic mental remedies.
Who knows? Maybe disciples of Wilhelm Fleiss are out there today, busily operating on the nasal septae of anxious women.
The psychoanalytic and psychodynamic tradition has definitely evolved beyond Freud (although Freud remains quite relevant to that tradition), and psychodynamic psychotherapy remains well-established as a psychotherapy modality for good reasons. The idea of psychoanalysis being something outdated and discredited akin to mesmerism, whether clinically or scientifically, is simply false.
What is the science behind psychoanalysis? I understand there may be studies comparing clinical outcomes with Freud vs. Jung, or Adler vs. ECT, and certainly myriad case studies as well. But the claim that Freudian therapy is not outdated scientifically automatically posits the question “What are the scientific underpinnings of psychoanalysis and how have these claims and explanations been empirically tested?”
This isn’t science. It’s social science. Big difference.
The paper by Solms starts by introducing suppositions but treats them as fact, and then subjects the non-facts to rudimentary statistical analysis.
It’s as if someone wrote a paper saying “We know that there are seven chakras and twelve meridians channelling Qi throughout the body” and then using that as a pretext for scientific analysis.
It’s fine. Some people find psychoanalysis helpful and are wiling to pay for it while others are eager to provide it. The market at work.
There are different tiers of scientific-ness, for lack of a better word. Obviously hard science (physics, math, chemistry) is the most rigorously scientific.
My field, critical care, is very scientific and quantifiable, although not at the level of mathematics.
Somewhere in the mix are the social sciences….economics, psychology, sociology, etc. These attempt to apply scientific methods to phenomena that resist both qualitative and quantitative analysis. “Rage”, “inferiority complex”, and “id” cannot be measured, isolated, weighed, or synthesised. They are concepts.
Basically, any field in which there are two or more different and/or competing schools of thought is not truly scientific. Psychotherapy is one of them.
As much as I love psychoanalysis, I was disappointed with the lack of math in these papers. The p values are certainly convincing but also historically susceptible to hacking and do not inspire confidence like a mathematical model. How would one model feelings mathematically? I’m not sure, but coming from an engineering background I find myself reaching for it. At least psychiatry has tangible items like serotonin to play with. Is this a case of Listening To Feelings wherein our lack of access to source material forces us to approach the black box from the other end, prodding and probing and using the findings as proof that the process works?
I had never considered that there might ever be a time when such self-disclosure of a sexual interest is necessary, albeit in the course of a therapists failure to control their own expression of their internal experience.
One thing that seems to be missing though, is that there is research about the routine overestimation by men of women’s interest in or attraction towards them. I think this context should give even more reason for a male therapist to consider such self-disclosure as a “last resort”, to be used only when a therapeutic rupture is already quite likely. Another aspect is the profound betrayal experienced by many women when platonic relationships are discovered to not in fact be mutual, but to contain hidden motivations and expectations on the part of their male friends, colleagues, and other relationships. In a world where many, many women have experienced even deeper betrayal with CSA and abuse within their adult relationships, the establishment of a safe vulnerability with a man can be an incredibly healing container, even apart from any other work accomplished within. Much of our societal conditioning already sets our worth on our desirability and truly, on our utility to men, so this disclosure risks rupturing what may be the only safe male/female relationship a patient has ever had. The likely cost is simply too high for a perceived benefit that in its very nature is likely to be interpreted through a deeply flawed lens.
This must remain a very last resort, and even that with serious understanding of a likely need for an outside perspective and emergency support for both therapist and patient.
I would have liked to read exactly HOW he disclosed in that moment. I agree it was probably the least bad option in the situation (would be worse to gaslight the patient "no you're wrong, I wasn't looking at you at all, certainly not looking in any SPECIAL way!!!"). But seems like a situation where the exact wording and tone would have been important to minimize damage.
Yes, this is a great point. The way he discloses is paramount - it is a great article if you have time to read and Slavin describes disclosure more in detail
This article is a great argument for mandatory psychotherapy for anyone wanting to practice in mental health on a professional level. Thanks for writing it.
Very in-depth discussion of maybe the most fascinating aspect of psychotherapy.
What a superbly grounded, balanced essay. Very provoking theoretically and well thought through!
Thank you, Darren! 🙏🏼
I went back and had a look at the Davies paper--inspired quite the controversy and discussion at the time. I miss those theoretical imbroglios/debates!
Fantastic post. Very helpful as I explore the idea of non-touch through bell hooks and Lacan. Thanks so much for putting all these thoughts into words so eloquently.
🙏🏼thank you!
Thank you for this really wonderful article! I read Davies as part of a psychoanalytic course on love in psychotherapy. I remember finding her work fascinating and original, this idea that love or even sexual attraction might require acknowledgment in some circumstances.
I so appreciate being reminded of her; I will now have to go back and read again. And I appreciate the additional references and context for this whole conversation. Your piece is extremely balanced and thoughtful, and I think I’ll even print it out and save it. Thank you!
thank you so very much for this.
Hi Franny, we write on many of the same topics in the therapeutic space. I focus on defense mechanisms, digital dissociation of the self into performative online ego states, and analytic review of films. Are you open to doing a livestream sometime, a podcast, or written back and forth interview?
Therapists, among other things, should definitely have and use an “off” switch.
I enjoy reading your work.
"as Avgi Saketopoulou states, “something in us always resists being grasped and understood, and in that sense, opacity may be seen as a sturdiness in us... that connects to self-sovereignty."
If my daughter thinks too consciously of her first dim childish love affair with her dad (me), she will be less able to see a handsome man her 20s as being a great guy and 'kind of like dad.'. Likewise a therapist's disclosure has a regressive effect. It seems that to make the unconscious conscious is not necessarily the goal, but if taken too far it is a perversion of our field? What do you think?
Yes, I like the analogy re: father/daughter - often we reach developmental milestones while never fully realizing what was getting worked through unconsciously - true for childhood and, to some degree, therapy. Thank you for the kind words!
Nobody knows in any thoroughgoing way what he is up to while disclosing. Our capacity for rationalisation is remarkable. Both lines are in the piece. Every safeguard that follows them runs through the therapist checking his own motives. The gauge is reported faulty and left to test itself.
One in ten male therapists cross the sexual line at some point in a career. Most are ashamed afterwards. The piece reads that as fragility calling for vigilance. It is a failure rate, and vigilance is the thing that failed.
An archive changes what gets said. What most needs saying is what a person would least want kept, and a recording seats courts, insurers and the clinic at the table beside the two people already there. Nothing about that comes back.
Which puts the weight on the key and not the tape. One copy, and the patient can burn it. Evidence with no audience. Nobody in the field will want it arranged that way, because control of the record would sit with whoever has less power in the room, and every tape in existence now sits on a server owned by the clinic.
Thank you for such a beautifully written and thorough look at how to manage erotic dynamics. So important!
This interesting post can be summarized more clearly as: 1) two people are in a relationship which they agree is "pretend". 2) One person "pretends" all sorts of ideas and feelings about the other person. 3) The other person does not allow him/herself to "pretend" anything special about the relationship. 4) Sometimes the other person allows him/herself to "pretend" anyway. 5) The other person's "pretend" feelings must not interfere with the first person's ability to recognize that it is all "pretend". The parallel with WInnicott's transitional concepts is important but easily used to mislead. Notice how rarely the female therapist is "accused" of violating the boundary. Why is this?
As a former analysand, I read this with a lot of interest. All of the various clinicians quoted have valuable ideas, and I particularly resonated with the idea that there are very early, infantile parts of ourselves that may be deeply traumatized by an analyst's disclosure of erotic feelings.
At the same time, the artist in me -- I'm a playwright -- recognizes some similar arguments often made about not representing certain areas of human experience in art due to their potential to traumatize. I think it is very easy to confuse respect for the infantile with an infantilizing stance. When the author writes that "the therapist creates an environment where the patient can explore endlessly, without fear of being shut down," my thought is that this should not prohibit an exploration of the patient's attempt to put the reality of shared sexual feelings in the dyad into words.
In therapy, as in art, ultimately everything should be able to be explored in a representational way -- story in narrative art, language in an analysis. If we decide that some areas of reality are simply "too much" to be dealt with in explicit, representational ways, that is a loss for human understanding, and its own kind of trauma.
Everything should be able to be explored in a representational way, absolutely, especially by the analysand. What the analyst specifically discloses on his own part is a bit of a different question. Thank you for reading and your thoughtful response!
I’m an analysand and this is where I land, too. Thanks for sharing!
The article impeccably mimics clinical reflection, but in reality it is a political manifesto disguised as psychoanalysis. The author narrows a universal ethical dilemma down to a single "oppressed" dyad, as if erotic countertransference in women and homosexual therapists were inherently safe. Patriarchy, #MeToo, power - these labels are substituted for the complexity of the unconscious, while the central argument ("be careful, men") is passed off as a neutral clinical principle. But if a principle is neutral, it cuts both ways. Its absence here is not science - it is a political choice..
Constructively, this misconception is even more dangerous. A living psychotherapist is valuable precisely because his consciousness does not merely mirror the patient's request back into the patient's own abysses; rather, it offers a procedural reading of reality through an inevitably lived biography - his own, singular, asymmetrical. This biographical inevitability is the working instrument, not a party line. Gender bifurcation in this context looks deliberately obtuse, especially when the patient has autonomously and voluntarily chosen a psychotherapist of the opposite sex - in that choice already resides his subjective request, his trauma, his desire, which the author simply overwrites with her "victim-oppressor" template. Such an approach does not heal - it programs, replacing living dialogue with an ideological label..
I can’t believe Freudian psychoanalysis is still being practiced. I assumed it had joined trepanation, hydrotherapy, mesmerism, forced bed rest, and morphine therapy on the junk heap of archaic mental remedies.
Who knows? Maybe disciples of Wilhelm Fleiss are out there today, busily operating on the nasal septae of anxious women.
The psychoanalytic and psychodynamic tradition has definitely evolved beyond Freud (although Freud remains quite relevant to that tradition), and psychodynamic psychotherapy remains well-established as a psychotherapy modality for good reasons. The idea of psychoanalysis being something outdated and discredited akin to mesmerism, whether clinically or scientifically, is simply false.
What is the science behind psychoanalysis? I understand there may be studies comparing clinical outcomes with Freud vs. Jung, or Adler vs. ECT, and certainly myriad case studies as well. But the claim that Freudian therapy is not outdated scientifically automatically posits the question “What are the scientific underpinnings of psychoanalysis and how have these claims and explanations been empirically tested?”
These 2 papers would be a good place to start:
1) https://www.cambridge.org/core/services/aop-cambridge-core/content/view/C35CBB2112D180525EE95D11C474D13C/S2056474017000046a.pdf/the-scientific-standing-of-psychoanalysis.pdf
2) https://jonathanshedler.com/wp-content/uploads/2023/02/Shedler-2022-that-Was-Then-This-Is-Now-Psychoanalytic-Psychotherapy-For-The-Rest-Of-Us-1.pdf
This isn’t science. It’s social science. Big difference.
The paper by Solms starts by introducing suppositions but treats them as fact, and then subjects the non-facts to rudimentary statistical analysis.
It’s as if someone wrote a paper saying “We know that there are seven chakras and twelve meridians channelling Qi throughout the body” and then using that as a pretext for scientific analysis.
It’s fine. Some people find psychoanalysis helpful and are wiling to pay for it while others are eager to provide it. The market at work.
No need to dress it up as science.
Do you think *any* psychotherapy approach is scientific or is it all chakras and woo woo to you?
There are different tiers of scientific-ness, for lack of a better word. Obviously hard science (physics, math, chemistry) is the most rigorously scientific.
My field, critical care, is very scientific and quantifiable, although not at the level of mathematics.
Somewhere in the mix are the social sciences….economics, psychology, sociology, etc. These attempt to apply scientific methods to phenomena that resist both qualitative and quantitative analysis. “Rage”, “inferiority complex”, and “id” cannot be measured, isolated, weighed, or synthesised. They are concepts.
Basically, any field in which there are two or more different and/or competing schools of thought is not truly scientific. Psychotherapy is one of them.
As much as I love psychoanalysis, I was disappointed with the lack of math in these papers. The p values are certainly convincing but also historically susceptible to hacking and do not inspire confidence like a mathematical model. How would one model feelings mathematically? I’m not sure, but coming from an engineering background I find myself reaching for it. At least psychiatry has tangible items like serotonin to play with. Is this a case of Listening To Feelings wherein our lack of access to source material forces us to approach the black box from the other end, prodding and probing and using the findings as proof that the process works?