Understanding the Erotic and Eroticised Transference and Counter-Transference

Ronald Doctor, psychoanalyst and psychiatrist

The major problem Freud posed in 1912 is why transference, basically an erotic phenomenon, is so well suited as a means of resistance in analysis. Freud (1915) recognised the universality of erotic strivings occurring within the transference which he regards as induced by the analytic situation. The conceptualisation of erotic transference as a manifestation of both a strong resistance against treatment and an actualisation of past experience has been clearly expressed by Freud (1915). He convincingly shows that one of the motives for such passionate expressions of love for the therapist is the wish to interrupt the work of the analysis, and to attack the therapist's role by turning him into the patient's lover.

Joseph (1994) states that Freud emphasises how the patients' demand for love, their eroticisation of the transference, can be seen as a resistance, as a force that interferes with the continuation of the treatment; certainly understanding or being understood plays no part in the patient's wishes at such times. We can see how patients who eroticise the transference are bent on nullifying or actually defeating the treatment, of destroying the therapist's separateness as a human being, his capacity to help them, the very stuff of progress and life. However, in every analysis there has to exist moments of love, of falling in love, because the cure reproduces the object relation of the oedipal triad, and it is therefore inevitable (and healthy) for this to occur. The transference love that most concerned Freud in his essay of 1915, because of its irreducible tenacity, the sudden manner of its appearance, its destructive intention and the intolerance of frustration that accompanied it, seems more linked to psychotic than neurotic type of transference.

There are then various forms of transference love which occur as a continuum and go from the healthy, to the neurotic pole of the conflict, to the psychotic one. To distinguish between the neurotic and psychotic pole, one speaks sometimes of erotic and eroticised transference. This differentiation originates with Lionel Blitzen (unpublished) and was taken up by Gitelson (1952) and Rappaport (1959).

In the psychotic transference love, or eroticised transference, it is evident that we can distinguish various forms; the most typical is, as Freud describes, "tenacious, extreme and irreducible ego syntonic and refusing any substitution." Racker (1952) described transference nymphomania in which the patient wants to seduce the analyst sexually. Nymphomania may be part of an erotic delusion, a persecutory delusion or an expression of a manic syndrome, and finally, if the disturbance is more visible at the level of sexual conduct than in the sphere of thought, nymphomania presents itself as a perversion with respect to the sexual object. Marco Chiesa (1994) conceptualises the erotic transference as a delusional manifestation originating from an intrapsychic pathological organisation which is established to protect the subject from the pains of the depressive position and the fragmentation of the paranoid position.

However, Mann (1994) states that unless we take the view that all erotic desire and fantasy is a perversion or neurotic, and psychoanalytic theory tells us this is clearly not the case, then the therapist may experience healthy erotic feeling and these may be useful in the analysis if the therapist deals with the desire appropriately; if the therapist remains unconscious of the desire and does not analyse it effectively, then the erotic feelings are most likely to bring an unhealthy distortion into the work.

Joseph (1985) described the analyst's own experience as very important in sensing how the patient is drawing the analyst in, how our patient act on us for many varied reasons; how they try to draw us into their defensive systems; how they unconsciously act out with us in the transference, trying to get us to act out with them; how they convey aspects of their inner world built up from infancy, elaborated in adulthood and childhood, experiences often beyond the use of words which we can only capture through the feelings aroused in us, through our countertransference.

Etchegoyan (1991) states that in an analysis that evolves normally, the erotic transference waxes and wanes gradually and tends to reach its climax in the final stages as opposed to the eroticised transference which appears at the outset. He also states that the analyst's appearance in the patient's dreams at any time in the analysis - and not only at the beginning - signifies that a real event or fact is in play, be this a countertransferential acting out, great or small, or simply a real and rational action; such as the giving of information on formal aspects of the relationship (change of timetable or fees etc). These dreams imply that the patient has a problem with the real analyst, not with the symbolic figure of the transference. This type of dream then, where the patient alludes to us personally, should always be taken as a warning concerning some real participation of ours, and arguably represent an "error of judgement." However this may also represent a real event or a fact of life.

In patient's eroticisation of the transference, although it can be seen as resistance to the analysis, the resistance is only a part of their way of loving, hating, controlling and preventing any shift in the structure they have established of omnipotent superiority and therefore, avoidance of a more realistic relationship. However, as we have seen, the picture is far from pessimistic, for though the erotic transference may emerge as a resistance to progress in the analysis, the upshot of its appearance can be a way of exhuming ancient psychic relics of the patient which, of course, augurs well for the analysis in the long run.

We can take for granted, not just as Freud describes, that the patient's falling in love with the analyst is inescapable, but that the characteristic nature of the patient's loving will inevitably be enacted in the relationship with the analyst. It may be enacted out noisily, with protestations, demands, or threats as in the cases described by Freud (1915). Or it may not appear as falling in love at all, but the patient's way of loving or not loving, will inevitably emerge in the transference. The patient may be rejecting, silent, withdrawn and independent or subtle and perverse. The analytic situation evokes the patient's love, which is the unavoidable consequence of the treatment; and therefore the whole responsibility for handling the situation must lie with the analyst. It is after all the patient's prerogative to try to misuse the situation, according to his or her personality and pathology, but once we understand the transference, it becomes an opportunity to explore what is going on rather than a burden.