Sex With Therapist

[Oraf]

I am going to be very blunt here and say that I'm baffled at the lack of insight about the therapeutic process in this thread. Every therapist worth their salt understands the value of transference in therapy. It is THE single most fruitful occurrence that can happen to unlock the very reasons the client came to therapy in the first place.

This is very true in traditional therapy models.

This is not true in trauma therapy, specifically. The client knows why they are in therapy. They often don't understand the ramifications of the trauma, but they haven't gone there because of a vague dissatisfaction they can't pin down, or frustration in the life, or any of the myriad reasons individuals may seek out therapy.

Trauma therapy, specifically, is not built on transference - in any model.

Transference is carefully used to address attachment disorder issues that may have arisen because of the trauma. But that is not about working out your sexual power dynamics.

The OP actually has a pretty clear handle on why they thought at first the sex was necessary, and then why it was actually about something completely different.

You don't do transference on sexual projection with a client who is dealing with trauma from sexual assault. Think about it for just a minute, and you will understand.

 

[Oro]

This is very true in traditional therapy models.

I meant to say, true in many traditional therapy models. By traditional, I mean 19th and early 20th century.

 

[Misiva]

Point taken, I agree with much that has been said in response to my post. However, as the OP herself has stated, the therapist has repeatedly insisted on their safe environment, that he was not and will not be coming on to her, and that he will not become sexual with a client. Once that is established, trauma therapy, especially with clients as "advanced" and aware of their relational issues as the OP, can and should include transference synthesis in the roundabout way that has been described, as the client's own interpretation of the relationship and therapeutic approach is key to revealing larger relational issues in the here and now.

The issue at hand seems to be that, even thought the OP was up front on the topic, she projected her desires onto the therapist, which left him no other option than to inquire into its nature. As I said, repeatedly affirming that no sex will be had is not enough in this context. From the perspective of a therapist, NOT inquiring as to the nature of the transference, but ever-too bluntly stating that that has never crossed his mind, say, he's not even attracted to her, and no chance in the world, end of discussion, could have been JUST as traumatizing (read, rejection of sexual emergence) as leaving the question dangle until the source of the transference has been found. To assume that only a clear and repeated NO on part of the therapist would have been the only safe and painless solution is a projection on our part. It just as easily could have backfired - that is the complex nature of therapeutic relationships.

 

[Nusata]

Once that is established, trauma therapy, especially with clients as "advanced" and aware of their relational issues as the OP, can and should include transference synthesis in the roundabout way that has been described, as the client's own interpretation of the relationship and therapeutic approach is key to revealing larger relational issues in the here and now.

I don't think it's a case of "can and should", and I didn't see anyone suggesting that a clear "no, end of discussion" was the best or most painless way to deal with it. Clear and unambiguous doesn't need to be blunt, harsh or indeed the end of the discussion. The difficulty with Freudian theory is the insurance that everything represent something else, other modalities would view the client's feelings around sex and sexuality as belonging in the relationship - that is to say real feelings in the room in the space between client and therapist, not a projection, transference or representation of what ha happened elsewhere.

That creates the possibility of exploring what's happening in the here and now, what the client hopes for, what sex would mean in this setting and how it feels to know that won't happen without the roundabout, frankly gamey discussion that can happen in psychodynamic therapy.

If this were traditional analytic therapy with someone whose own sexual boundaries were clear and safe, I'd agree using this as a transferential issue would be useful. I don't think it has a place in trauma therapy addressing issues around CSA. Can you see how taking something that already has skewed meaning and representation for the client and conceptualising it even further could recreate abuse dynamics in the therapy?

 

[Misiva]

I do not see anything gamey about the line of questioning the OP described. Asking what she thinks would be in it for him is quite a straightforward and necessary question to ask, one that very much pertains to real feelings in the room: her trust in and vision of him as a therapist, the power dynamic that may have been at play thus far. On a very basic level, depending on her answer, he could learn very much about how she views him and the trust he has been able to establish. On a larger level, he could learn a lot about her need and willingness to turn even a therapeutic relationship sexual, which, in turn could inform his view on other relationships dynamics they have discussed.

Admittedly, we all know very little about what has and hasn't been said on part of this therapist. All the information we have is filtered through the OP's particular lens. I, for one, am inclined to believe that the OP, given the nature of the trauma she has shared, came to this therapist with a heavy dose of projection about her own desires and desirability, which, unless she bluntly stated "I want to have sex with you right now, please" and he had said "yes!" would have left the situation ambiguous for the OP no matter what.

 

[Akoto]

...trauma therapy, especially with clients as "advanced" and aware of their relational issues as the OP, can and should include transference synthesis...

Any research or citation to back that up? I'm not familiar with any, myself.

Have you done trauma therapy, or are you speaking more conceptually?

 

[Misiva]

I'm afraid I will have to do go back and research the proper sources. If you're interested, I will do my best and find the citations - it's been a while since I have consulted the literature. As such this just stands as my opinion based on my own training in the field, which I don't like to divulge on this forum, but alas, it's anonymous :)

 

[Erot]

As such this just stands as my opinion based on my own training in the field, which I don't like to divulge on this forum, but alas, it's anonymous

Gotcha. Do you have PTSD?

 

[Misiva]

I don't myself have PTSD, no. I'm coming to this from the opposite end of the table, plus am in a relationship with PTSD sufferer. So, I'm by no means an expert, just my humble professional opinion here.

 

[Ginan]

I am going to be very blunt here and say that I'm baffled at the lack of insight about the therapeutic process in this...

What an insightful and helpful response. I went to my therapist yesterday for a final session. It was the first time I had ever cried in front of him. I was so destraught. We discussed, even argued about how he responds to my suggestions of sex between us or my sexual dreams about him. He did say several times he 'would never be sexual with a client'. He kept saying he's always been clear about this and I kept insisting if it's not clear to me that sex is off the table then you haven't been clear enough! I told him since day one it's taken tremendous restraint not to come on to him and I've always been convinced he would do it. Every issue in therapy seems like it could be solved if we just had sex. I am constantly battling this and when it comes up he doesn't seem to close that door. He just lets me say this stuff and I always assume we'll have sex as a last resort all else fails.

My entire experience with him has been really heavy issues of transference. I have stayed with him not only because I am attached but because I can't believe how intensely he draws this out of me. I rarely seem to feel better or reassured. I just get more aware of my dissociated past. He's always the predator in these experiences but I am getting better over time because of the awareness I am getting from this process. I'm constantly battling feeling betrayal, abandonment, sexual advances, I feel like he sadistic when he watches me relive the trauma, I feel like he's making me relive this and then leaving me dissociated and alone in the street afterwards...I am reliving every second of my experience as a young adolescent when I was isolated as a sex slave for a maniac.

I read of everyone else's experiences in therapy and how reassured and supported they feel and for me it's one long mind f*ck pulling up history that was largely forgotten. We've spent hours and hours arguing because I'm accusing him of this stuff that feels so real but in the end he convinces me none of it happened. It feels like gas lighting at times but I suppose that's another accusation on my part.

Doss this sound like therapy or someone f*cking with me? My therapist and I discuss this a lot. I frequently tell him this can't be therapeutic for me to be nearly hallucinating that he is a perpetrator. His response is always that I'm getting better. Which is very true. I do get better and better every month so I keep going back.

Yes he convinced me to come back next week. I told him I will but after that I need at least a month off to try and gain some clarity from time away. I have scheduled with a new therapist because I need to see if this arguing/betrayal type of experience comes up with someone else. Essentially none of this comes home or to work. All of my insanity is in therapy so it's easy for me to think he's making me crazy.

 

[Aturur]

Ginan, I am glad you found my reply helpful. Thankfully, it landed in the right place. And thank you for your candid response here. A few things come to mind with what you describe happened in the last session and what has been happening to you with this therapist in general.

First, and most importantly, I believe sometimes it is not very helpful to go back and go back and go back to the trauma in which one was essentially powerless. What for? To relive it and remember how powerless one was? It's only helpful to a point. So in that, I think it is totally acceptable to relate to your therapist that it is not helpful to you to go back and relive the trauma in detail. There are approaches that entirely leave out the details of what has occurred and instead focus on what its effects are in the here and now. A much more productive approach and one that brings me to...

...the projections you mention toward your therapist and also the awareness you are gathering through the process. You mention "arguing" with him, which, of course, might be an incompatibility in communication style. When he believes he is challenging your notion that he is "sadistic" (because he is not. Not my judgement, just an option) you might interpret it as gaslighting. What he may be trying to do is not so much discount your reality, but open your eyes to WHY you are interpreting his words as such. I sincerely hope, however, that he has stated plenty of times that you are entitled to feeling about it however you feel about it, and doesn't blame or belittle you for feeling this way.

Therapy can often feel like someone is f*cking with you, simply because one's reality, everything you believe in, is profoundly challenged. The fact that you went into therapy aware you would be or already are in a sexually vulnerable position (because he is a man,) plus the myriad of projections you mention, makes for a volatile therapeutic environment to begin with, so it is not surprising you leave feeling confused and messed with.

I think the issues here is no so much whether or not he was/is angling for an affair (from what I've read, there is no evidence of that,) but rather the trust issues you have developed out of a combination of his maleness and perhaps personality (hey, therapists are people too.)

You could be just short of going through a breakthrough with this therapist. An A-ha moment in which he can help you understand your underlying beliefs and traumatized parts regarding sex and men by hand of your struggle with him (which is what transference analysis is about,) OR you could be becoming aware that your work needs to be done with a female therapist, just to take the sexual component out of the equation if it is too much of a distraction for other, more pressing issues you need solved.

 

[Aturur]

*sorry, I was the "blunt" one up there. Forgot to change the name...