I Have A Crush On My Therapist. What Should I Do?

October 1, 2007 by Shawn Smith

Q: What happens when a person gets a little “crush” on their shrink? – Michelle

Dear Michelle,

bertha and josefAssuming you have a little crush on your therapist – and I’m certainly not suggesting that you do – you wouldn’t be the first. In fact, the first recorded case dates back to 1882 when Sigmund Freud’s buddy, Josef Breuer, was conducting therapy with a patient named Bertha Pappenheim.

After two years of treatment that seemed to be alleviating Bertha’s hysteria (a catch-all diagnosis at the time), the patient professed her love for Breuer. In an act of pure class, Josef panicked, left town, and became the first recorded therapist to abandon his patient. (It was easy to blaze trails back then.) Freud later wrote the first paper on patients who fall for their therapists.

Since then, volumes have been written on the topic, sometimes in excruciating detail. Consider this passage, typical of those who dissect this phenomenon down to the molecular level:

“Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity.”

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…I’m sorry, my head must have hit the keyboard when I dozed off.

When Freud first wrote on the topic, he warned us therapists against taking ourselves too seriously: patients don’t fall for us because we are a hot bunch of superfreaky love machines. (I’m paraphrasing.) Instead, they fall for an idealized version of what they imagine us to be, and the affection usually serves a purpose other than companionship.

Buirski and Haglund (2001) wrote of just such a case. The patient not only fell for her therapist, but also fantasized that he had fallen for her. “I want to make love with you,” Jennifer told her therapist, Theodore. “There’s a difference between sex and making love. Sex is a dime a dozen, right? Making love is like… is kind of like a symbolic culmination of everything.”

Now that’s titillating professional literature.

Jennifer’s affection was justified. For starters, she liked the way Theodore treated her. “Her therapist experienced genuine feelings of concern and care for Jennifer…. She had told him repeatedly how much she appreciated his acceptance and attunement. Also, she had talked about such personal characteristics as his sense of humor and his beard.”

Theo’s style may have lit the fuse, but those aren’t the real reasons behind Jen’s affection, Buirski and Haglund believed. Jennifer spent a good deal of time engaged in fantasy about Theodore – so much so that she even renounced alcohol in order to “immerse herself more purely in the loving feelings.”

During her fantasies, Jennifer was able to focus on something other than painful thoughts about her own inadequacy, particularly when she fantasized about Theodore loving her in return. (I must be lovable if he loves me, right?) While the authors didn’t explicitly make the connection, I can’t help but wonder if alcohol and love for her therapist functioned similarly: they each gave Jennifer a break from herself.

Initially, Jennifer kept her feelings a secret from Theodore. But as her feelings came to light, she and Theodore were able to explore the function of her fantasies, identify her feelings of self-loathing, and find new and better ways to manage them.

What’s Ethics Got to Do With It?

Why wouldn’t you develop a crush on your therapist, Michelle? You’re sitting across from someone who is cleaned and pressed, on his or her very best behavior, and focused entirely on you. Compare that to the hairy-backed lugs that some of us keep at home – clipping their toenails over the kitchen sink and whining about the in-laws – and carrying a torch for your shrink seems like an obvious diversion. Just know that you’re not seeing the true person behind your therapist.

If your therapist is like Theodore, then discussing your feelings can be very therapeutic. Unfortunately, we’re not all like Theodore. Some therapists, for a variety of unacceptable reasons, take advantage of smitten clients. Somewhere between 20% and 50% of all successful cases against psychologists have been for sexual misconduct. That’s why my liability insurance is so dadgum expensive, and that’s why my mandatory disclosure form contains this line: “In a professional relationship, sexual intimacy is never appropriate and should be reported to the Mental Health Occupations Grievance Board.” Every time a shrink breaks the rules, another lawyer gets his wings.

Don’t let that discourage you, Michelle. Those rule-breakin’ psychologists are a small minority. Bottom line is this: it is not OK for a psychologist to take advantage of your affection. It will not work out well for either of you. But in the right hands, your feelings can probably be used to help you understand a great deal more about yourself. That, we hope, translates into a better life for you.

—Shawn

References
Bennet, B.E., Bricklin, P.M., Harris, E., et al. (2006). Assessing and Managing Risk in Psychological Practice. Rockville, Maryland: The Trust.

Buirski, P. & Haglund, P. (2001). Making Sense Together. Northvale, New Jersey: Jason Aronson, Inc.

Celenza, A. (2006). The threat of male-to-female erotic transference. Journal of the American Psychoanalytic Association, 54(4), 1207-1231.