Love and sexuality in the therapeutic relationship

We examine sexual and loving feelings, on the part of both the therapist and patient, as they relate to their real relationship, patient transference, and therapist countertransference. Loving feelings (agape) often are part of a strong real relationship and they tend to have a positive effect. Sexual feelings, too, may be part of the real relationship, but they are also often more conflict-based, residing in the transference and countertransference experience. It is deeply important for the therapist to seek understanding of his or her own and the patient's loving and sexual feelings, and to tease apart, as much as possible, the extent to which they are real relationship versus transference-countertransference-based. The patient's loving and sexual feelings toward the therapist need to be explored and understood just as other feelings. Although it is crucial that the therapist seek understanding of his or her own loving and sexual feelings toward the patient, we express serious reservations about the therapeutic value of sharing these with the patient.