Chapter 2: Varieties of Erotic Transference and Countertransference
In this chapter I present three clinical illustrations that focus on erotic transference/countertransference created by male patients with a female therapist. This chapter highlights mutuality in treatment and discusses "who goes first" in developing reciprocity between therapist and patient. This second chapter is subdivided into three sections. 'The first concerns the therapist's unconscious erotic countertransference with a patient, Benjamin, where erotic transference/countertransference issues were illuminated by the therapist's dream about this patient. The second section is about the therapist's response to the patient's conscious erotic transference. In this section the erotic transference is complicated by Michael's personal history of sexual abuse during his childhood, and sexual abuse from his previous male therapist. The third section concerns the patient's response to the therapist's conscious transference. This section focuses on a patient, Peter, who has compulsive sex with women. He began treatment desiring the therapist's help in stopping his sexual compulsion, as well as his desire to include me on his list.
Chapter 3: On Lust and Loathing: Erotic Transference and Countertransference Between a Female Analyst and Female Patients
This essay grew from my frustration at failed attempts to find psychoanalytic literature on same-sex desire between heterosexuals. While some writing does exist, papers on this topic make up little more than a handful of essays.
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The chapter focuses on three women, one who identified as bisexual, another who identified as heterosexual, and one who identified as lesbian, All three develop an erotic transference and in varying degrees, as with the three mate patients in the previous chapter, I experienced erotic countertransference. In the first case illustration with the patient who identifies as bisexual, Pauline, the treatment focused on the patient's desire for the analyst as sexual subject/object, in the patient's exploration of herself as sexual subject. The second clinical example addresses homoerotic feelings of a heterosexual woman, Simone, and those counter-homoerotic feelings that developed in me, as well. This section details a phase of treatment where both women struggled with unknown erotic feelings within themselves as intimacy between them intensified. The question of "What makes sex, sex?" is posited in this section. In the last clinical illustration of the lesbian patient, June, lustful Feelings develop into loathing as her desires for my surrender to her emotional deadness locked us into a fierce battle for survival.
Chapter 4: Impasse as an Expression of Erotic Countertransference
This
was the most difficult chapter to write because it discusses a failed treatment that is never resolved. This chapter focuses on a female patient's desire for self-differentiation through masquerade of two different types of clothing, one set of clothing performed her identification with her mother, and the other set of clothing performed her identification with me. This essay also addresses how a patient can masquerade changes in her outside life to look as though these changes were motivated by inner world alterations. My own erotic countertransference in this treatment masqueraded as awareness as well as desire, it masked not seeing what I thought I saw, and not knowing what I knew was in this treatment and in the patient, an unfulfilled desire.
Chapter 5: Gender Performance: Possibility or Regret?
In this chapter
I discuss two clinical examples. One example is a biological man who identifies as a transgender male-to-female (MTF) lesbian. The second clinical example is of a gay man who performed drag at nightclubs. This chapter on transgenderism had its origins with another patient who began one of her own sessions questioning my sexual identification and ended up wondering about my biological gender. Her questions only highlighted my own internal dialogue on my work with MTF patients.
In this chapter I also discuss masquerade, not as a mask of things hidden as in Chapter 4, but rather a masquerade of what exists, of emotions that perform gender, of presentation of self, of gender as an illustrated preference. The theme of this chapter on transgenderism is regret: For my transgendered patients it is the regret of not being in the biological body they desire, and for myself in treating transgendered individuals it is the regret that "anything is not possible."
Chapter 6: The Sacrificed Sister
This
chapter is the most personally revealing in that it originated in a real life event where I was "found" by an adult half sister who hadn't known I existed. My thoughts about this experience, and the effect it had on me, prompted questions about my patients who had similar dynamics with their sisters. This chapter presents two clinical examples, as well as my own personal example of self and other sacrifice. The dynamics inherent in same-sex sibling relationships with a mother who is excessively available and desiring merger with one child, creates the potential for a sacrificed sibling, allowing the other sibling to escape emotional sacrifice... or not.
Chapter 7: The Tango, Female Fetish, and Phobia
In this
chapter, I discuss a phase of treatment with a patient who after years of therapy told me of a long-held secret sexual fetish. The origins of her sexual fetish were told in relation to the origins of her pigeon phobia, having told about the latter when she began treatment. Listening to narratives on a phobia, however, are quite different than listening to a sexual fetish which I found emotionally upsetting. In my desire to know her inner life and tolerate stories about her fetish, I realized my fantasy of dancing the tango played a major part in mutating my countertransference disgust. My inner world fantasy created an opportunity to tolerate and listen to another's inner fantasy, which until then had been unavailable to me.
Chapter 8, Supervision: Braving Surrender
This chapter
is about the process of surrendering to another as a means of altering the self. While the notion of a patient surrendering in treatment as an aspect of object usage or "being known by an other" is an accepted idea by quite a few therapists, surrender as part of the supervisory process is not considered a necessary development. A basic assumption in therapy is that each patient has different needs and therapists modify responses to best fit each patient. Perhaps this assumption needs to be generalized to supervision as well for those supervisors who use experiential and didactic instruction with supervisees.
Chapter 8 is about supervision with one particular female therapist who I supervised for a year. She was treating a young man who developed an erotic transference. This therapist came to supervision for help in working with the patient's transference as well as to explore her own erotic countertransference. Her personal experience in supervision is included as a companion essay at the end of this chapter.
This chapter also includes a second look at my AIDS group experience. In a sense, this book comes full circle regarding clinical examples since the first chapter included this same AIDS group therapy experience but from the perspective of aggression in erotic transference. In Chapter 8, however, I explore the notion of mutual surrender, in the AIDS group, in the desire to know and recognize self and other, and mutual risk between therapist and patient in being emotionally honest in intimacy. This means the therapist constructs emotional responses that are real and intimate with the patient, rather than a presentation of emotionally distant, intellectual interpretations, Intrapsychic and interpersonal motivations and meanings are not ignored. Instead, they are presented in the emotional moment, with more personal cost to the therapist's involvement.
Chapter 9: The Absent Sex
This chapter focuses on a clinical illustration of a male patient who presents as having no understanding or experience of love or sexuality. He feels he is destined to live out an isolated existence as punishment for the crime of being born to parents who did not want him and who physically abused him. Classical literature created a foray into this patient's story and classical literature is the structure this patient uses to understand life around him. This chapter opens with Dostoevsky's Crime and Punishment and Mario's identification with Dostoevsky's main character, Raskolnikov, in that they both live as tortured souls relegated to piteous living for a crime against humanity.
The book ends with this chapter "The Absent Sex" because it addresses a treatment of an asexual man who has structured his life to never experience another's touch or desire of him which highlights the importance of sexuality in its absence. Sex is non-existent for this patient and because it is "nowhere" in the consulting room, its absence creates an enormous presence of regret and of [regretted] sex. In this last chapter, I have returned to the notion of regret as sorrow and remorse, and loss, as well as regret as a polite refusal of another's invitation for involvement in a function.
Praise for Deepening intimacy in psychotherapy; using the erotic transference and countertransference:
"Today's psychotherapist is faced with the important challenge of making use of his or her individual voice and temperament. Florence Rosiello takes up this challenge where others might avoid it, in the difficult arena of the erotic transference and countertransference experience. Dr. Rosiello uses creativity laced with humor to demonstrate how her unique point of view can be used in this context to deepen the relationship between therapist and patient."
~Emmanuel Kaftal, Ph.D., Institute for Contemporary Psychotherapy
"Dr. Florence Rosiello has written an important, pioneering book. It is composed of a collection of clinical experiences with patients who have developed erotic transferences. These experiences reflect a wide range in gender and sexual orientation configuration of patient and therapist. As Dr. Rosiello points out, the important area of erotic transference and countertransference has, for the most part, been neglected in the clinical literature. She describes those erotic narratives with courage and sophistication. It is clear that the expression of loving and sexual feelings in the transference involves emotional risk-taking on the part of the therapist. In these beautifully and sensitively written vignettes, Dr. Rosiello demonstrates that working with the erotic transference creates the basis for a very special emotional intimacy in the therapeutic relationship. This volume is highly recommended to clinicians at all levels of experience."
~ Jeffrey Seinfeld, Ph.D., Professor, Ehrenkranz School of Social Work at New York University
"Dr. Rosiello has performed the enormous service of taking the erotic transference and countertransference out of the therapeutic closet. In this scholarly and incisive account of the psychoanalytic view of the erotic transference, she courageously ventures into territory that has tended to be off limits. With rich illustrations, she vividly shows how both same- and different-gender patients and therapists struggle to make sense of and deal with their erotic feelings in treatment. Dr. Rosiello has significantly enlarged our view of the meaning of the erotic transference to encompass a patient's positive developmental strivings for connection and intimacy. She makes a major contribution to our understanding of the ways in which therapists need to participate with patients during psychotherapy."
~ Eda G. Goldstein, DSW, Professor and Director, Ph.D. Program in Clinical Social Work, Ehrenkranz School of Social Work at New York University
