Clinician's Digest - Page 8

A Petri Dish for Sexual Attraction

For an endeavor that endorses the intense, honest connection between human beings, couples therapy training too often tends to ignore the elephant in the living room of the therapy session: the sexual attraction clients often feel and may indirectly express toward their therapists, says University of Minnesota marriage and family therapist Steven Harris. When disgruntled couples enter therapy, the lack of closeness in their relationship can make the therapist a lightning rod for attraction. All the same factors involved in mate selection—close proximity in an emotionally charged situation, self-disclosure, and shared values and goals—are present in therapy and, according to Harris, make it "a petri dish for developing attraction."

Too many MFTs ignore this dimension of treatment when it surfaces, because it's usually expressed indirectly. A client may invite her partner and the therapist to lunch or comment approvingly on a therapist's new shirt.

Harris believes that ethically utilizing, instead of ignoring, expressions of attraction brings important issues to the surface. When a wife asks a male therapist about going to lunch, for example, what's the husband thinking or fearing? Is this a pattern in their social life? Is she being innocent and oblivious to how he might be viewing such gambits or is she taking a slap at him? The therapist, says Harris, should openly acknowledge what's just happened, saying something like, "It seems as if you'd like this relationship to be something other than what it is. I'm wondering what's going on for both of you at this moment?"

Part of the reason therapists avoid commenting on overtures or undercurrents in treatment may be because newer models of treatment focus on problem-solving and deemphasize the highly charged therapist–client relationship (or neuter it by talking about "alliances"). Another contributing factor may be the increasing emphasis on teaching ethics to students, which, while undeniably important, may have the unintended effect of making therapists shy away from addressing even indirect sexual feelings.

In a study in the May American Journal of Family Therapy, Harris and Texas A&M University graduate student Dinah Harriger surveyed 259 master's students in marriage and family therapy training programs about how they might handle client–therapist sexual feelings. The study finds that, beyond knowing the ethical boundaries, the students are fairly clueless about what to do. About a third of the respondents said they'd be afraid to bring up their own feelings of sexual attraction with a supervisor.

Therapists, says Harris, should never acknowledge their own erotic feelings toward a client with the client; but they should definitely bring it up with colleagues or supervisors. MFTs, he concludes, sorely need training in how to normalize and utilize the sexual attraction that occurs in therapy.

Resources

Cosmetic Neurology: Nature 456, no. 7223 (December 11, 2008): 702-07; New Yorker (April 27, 2009): 32-43. APA & Ethics: British Medical Journal 338, no. 7704 (May 16, 2009): 1178-80. For APA and other responses, see www.bmj.com/cgi/eletters/338/
apr30_2/b1653. Lure of Porn: Sexual Addiction & Compulsivity 16, no. 1 (January 2009): 55-78. Newer Not Better: Lancet 373, no. 9657 (January 3, 2009): 31-41 and 373, no. 9665 (February 28, 2009): 746-58. Sexual Attraction: American Journal of Family Therapy 37, no. 3 (May 2009): 209-216.

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