Is My Therapist’s Behavior Appropriate?

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Reader’s Question

I was diagnosed with severe depression about 10 weeks ago; I’ve been on medication and have been participating in weekly one-to-one CBT/cognitive analytic therapy with a male therapist. I am nineteen and he is 29 years old. He’s quite attractive, funny and well-built, and I have never previously opened up or trusted a man in quite the same way as I trust him. Ever since the beginning, I have been developing strong emotional and sexual feelings towards him.

I have read that this is quite common and is known as transference, and I have read horror stories of therapist-patient affairs. So, rationally, I know that I should never breach the boundaries of my relationship with my therapist and it would only damage me. Yet I can’t help feeling a longing for him and I fear I’m becoming dependent on that one hour session every week to give me a ‘happy fix’ for the week.

I also wonder if in part my therapist is deliberately or unknowingly trying to seduce me or deepen my infatuation. I read somewhere that a good therapist doesn’t tell you anything about their personal life, and yet in therapy we have talked about his unhappy childhood and his family, relationships, medical training, and hobbies — but we talk about me, too. I gather he’s trying to make a point or help me understand something by using his own life as an example.

But other times, he has offered to help by talking to a few of his friends who work in the field in which I expressed interest. Another time, when I mentioned I really wanted a pet, he said I could have his. And I suppose the final red flag was when he followed me on Twitter. Is this inappropriate behavior for a therapist?

How would you recommend I resolve this infatuation / transference?

I personally don’t feel like it’s a serious issue given the fact that he hasn’t tried to initiate physical contact as such, but would like to know your opinion.

Psychologist’s Reply

Therapy can be a very intimate relationship, so I am not surprised that you are drawn to him. Where else can you find someone attractive, funny and well-built who also listens to what you have to say, points out your strengths and helps you feel better? Yes, therapy can be quite seductive, so it is important to remember that the therapist-patient relationship has power differentials, and the dynamics you enjoy now would be impossible to sustain in the real world. These are just two reasons why our ethical code strongly advises against therapist-patient affairs.

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Each counselor has our own theoretical orientation — the way we think about and conduct therapy — so we all tend to do things differently. Thus, some therapists may not disclose anything about themselves (typically a psychoanalytic orientation), while others use self-disclosure sparingly as a way to connect and teach. It’s difficult to know whether your therapist is using self-disclosure appropriately. From your description, it sounds like he may have been, although the breadth of your knowledge about him sounds a bit much.

In addition to appropriate self-disclosure, therapists also have to maintain strict boundaries, and it sounds like his are getting a bit blurry. Talking to his friends may violate confidentiality (depends on how he does it) and giving you his pet and following you on Twitter establishes some connections that go beyond the professional. It is important for our work that we preserve objectivity, and that gets a bit difficult when we associate in ways that go beyond the therapist-patient interaction. While I could make a case that these behaviors are purely innocent, taken together, they seem awkward to say the least.

I agree that it’s probably not a serious issue yet, but I would hate for it to get to a place in which you have to agree to or rebuff physical contact. Consequently, I suggest bringing it up in therapy and telling him what you are thinking. If he is as professional as we hope that he is, he will use this issue as a therapeutic tool to help you understand what you want from a mixed-sex interaction and suggest ways you can continue to work together without the attraction being a concern. He might also use the discussion as a way to explain his behavior so that you feel better about it. If, however, he has been using therapy as a way to ask you out, then at least you will know and no longer have to guess his intentions. If that is the case, then I recommend immediately finding a new therapist because, as you so wisely mentioned, a therapist-patient affair can be extremely damaging.

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