Erotic Feelings Towards Patients in the Psychotherapy Session: Investigating Their Relationship With the Characteristics of the Therapist, the Patient, and the Treatment

Abstract

Experiencing erotic feelings towards a patient is a fairly common occurrence, not pathological per se, during phases of psychotherapy. This study aims to analyze associations between, on the one hand, the presence in therapists of romantic attraction (RA), sexual attraction (SA), or flirting behavior (FB) toward patients and, on the other hand, a series of characteristics of therapist, patient, and treatment. Between April and June 2022, 547 psychotherapists completed an online survey investigating their affective and behavioral responses toward their most recently treated patient. Compared to female therapists, males showed significantly higher prevalence of SA alone ( p < .001) or in combination with RA ( p < .01), FB ( p < .01), or both ( p < .05). Multivariate adjusted regression models showed that RA was associated with patient age ≤40 years (OR:39.49 for age 18–29; OR:28.44 for age 30–39), male sex (OR:10.40), and diagnosis of mood disorder (OR:14.08). Furthermore, RA was associated with intense countertransference feelings of tenderness towards the patient (OR:79.77) and hostility towards significant figures in their life (OR: 77.93). SA was associated with the therapist’s male sex/gender (OR: 16.14), psychoanalytic orientation (OR:13.34), post-license experience ≤20 years (OR:6.12 for 1–9 years; OR:6.08 for 10–19 years). Lastly, FB was associated with the therapist’s male sex/gender (OR:16.94).