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Monday, 16 Nov 2020

Erotic Transference – How To Recognise It And What To Do

By Dr Becky Spelman

Erotic transference is something that happens relatively frequently in therapy, and while it is nothing to be ashamed of per se, it does have to be dealt with quite promptly, in order to preserve the integrity of the therapeutic relationship.

Sometimes, a patient finds themselves becoming sexually or romantically attracted to their therapist. This can happen for various reasons. For example, someone who was extremely sexualised, or who was abused, in childhood may have grown up with the feeling that they have to behave in a sexual manner with people whom they experience as having some power over them, or who they want to please. Most often, as therapy by definition calls for discussing our deepest secrets and innermost fears with someone, the patient can feel a sense of intimacy and closeness with their therapist deriving from these disclosures that is easy to confuse for feelings of love or sexual attraction.

Unless the matter of erotic transference is addressed, the person undergoing therapy will find it increasingly difficult to engage in it without indulging in sexual or romantic fantasies about what their relationship with the therapist could be like. The situation may even escalate to them flirting or even requesting or demanding sexual attention. When this happens, it is important for the therapist to raise the matter of transference in a calm and respectful manner, while also clarifying that these feelings are not, and cannot, be returned.

The term “erotic transference” is also used to describe the situation in which a therapist starts to feel attracted to their client. As with transference involving the patient’s feelings for the therapist, this is relatively common and natural. Needless to say, however, acting on these feelings of attraction is very unethical, and there are both laws and ethical guidelines in place to prevent therapists from doing so.

It is crucial for anyone providing therapy to remain professional at all times, which means that even if they find a patient attractive, they should retain a professional relationship with them. Crossing that boundary is not only inappropriate, but can damage the patient’s treatment and their prognosis.

How can and should erotic transference be managed? In the case of feelings of attraction on the part of the patient, it may be possible to discuss these in light of the findings and revelations emerging from therapy, and to explore them in a rational and useful way. However, if these feelings are disruptive to therapy, then it may be time to find another therapist.

In the case of feelings of attraction on the part of the therapist, if he or she is able to keep them to themselves and to maintain strict professional boundaries, then the therapeutic relationship can continue. However, if they find that they are seriously tempted to break through these boundaries, then it is time for the patient to be referred to a different therapist.

Above all, it is important to recognise that feelings of attraction are natural, and that anyone can experience them. What really matters is how the situation is dealt with.


For help with the issues discussed in this article speak to one of our therapists here at Private Therapy Clinic for a free initial chat or to make an appointment.


Mann D., Erotic Transference and Countertransference: Clinical Practice in Psychotherapy,London: Routledge; 1999.

Matheson M. Broken Boundaries. London: Witness; 2008.

Nutt D, Sharp M. “Uncritical Positive Regard? Issues in the Efficacy and Safety of Psychotherapy.”Journal of Psychopharmacology 2008; 22: 3–6.

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