Over time, Freud formulated a theory about the relationship between the erotic transference and the experience of love, recognizing that feelings of love, whether in treatment or in real life, draw on earlier life experiences. Researchers of infant behavior and attachment theorists have demonstrated a rather dazzling, virtually identical counterpoint between certain behaviors of mother-infant dyads and lovers. Daniel Stern, M.D., for example, described similar behaviors such as maintaining very close proximity and performing special gestures, such as kissing, hugging and touching. The physical and emotional language of love begins in earliest life, and one of its developmental end-products in our culture is romantic love or--in the treatment situation--the erotic transference.
While the erotic transference and countertransference were first identified in the context of a male therapist and a female patient, there are four primary kinds of transference situations: heterosexual women in treatment with heterosexual male therapists, heterosexual men in treatment with heterosexual female therapists, homosexual men in treatment with homosexual male therapists and homosexual women with homosexual female therapists. The latter two constellations have only recently received attention.
It is still probably true that the erotic transference is more overt in heterosexual women in treatment with heterosexual male therapists than in the reverse situation. What are the reasons for this sex difference and its consequences, if any? Merton M. Gill, M.D., suggested a distinction between transference resis-tance and resistance to awareness of the transference. The erotic transference utilized as resistance is more common among women in analysis--particularly among women in treatment with men--while resistance to the awareness of the erotic transference is more common among male patients.
This is not always the case, however. One of the more famous cases in which a patient married the therapist took place between the analyst Frieda Fromm Reichmann, M.D., and her patient Erich Fromm, Ph.D., both of whom were towering figures in psychoanalysis. Given their example, it might be argued that transference love and authentic love are not necessarily mutually exclusive.
Transference and countertransference are, by their nature, complex and interrelated. However, they cannot be understood solely within a model of attachment and its re-enactment. Power dynamics in interpersonal relationships also play a role. In addition to reviving early erotic attachments to one or another family member, the erotic transference is fueled by wishes for egalitarianism, if not for achieving the power position. Love, after all, serves to equalize power between lovers. Thus, the act of falling in love is connected to power dynamics. Freud recognized that women sometimes used the transference in an attempt to compromise the physician's authority. Freud's insights--and later, Gill's--that transference love may be used as resistance show how it acts as an attempt to exert control over the situation. It is an example of power-seeking, if you will.
The erotic transference sometimes mirrors a young person's struggle to attain parity in the power position as they emerge into adolescence, often by partnering with someone more prestigious--the quarterback, the cheerleader or the class brain. Despite the contemporary attempt among many therapists to achieve a more egalitarian relationship in the therapy situation, the patient generally perceives it in hierarchical terms. Power can be expressed through what I call weak power; for example, a patient seducing a therapist with appreciation, flattery and admiration. Analogously, therapists may seduce their patients through the awe their position affords them and through what passes for strength. These strategies are more often preconscious than conscious.
Compared with other transferences, the erotic transference has always been tainted by unsavory associations and continues to be thought of as slightly disreputable. However, we should not lose sight of the fact that it may confer on the patient a new appreciation of the possibilities inherent in relationships (sometimes through an identification with a therapist's empathy and kindness). The therapeutic usefulness of the erotic transference is twofold: the wealth of psychological material it yields in understanding both erotic and power issues and the strength of the emotional charge that initially sustains the patient through some hard work. However, to the degree that it persists, it becomes a limitation in the analysis.
Consider the following vignette: A psychiatrist asked me to see one of his patients, a woman in her 30s who was stalled in an erotic transference that had become sufficiently intense that it was interfering with their work. The woman was in a marriage that had appeared satisfactory in its early years. The daughter of a successful entrepreneur, favored by her father and rejected by her mother, she had eschewed any potential partner who reminded her of her beloved but overbearing father. Instead, she had married a loving man whom she could dominate, but she lost respect for him when he failed as a businessman. She balanced her life by sexualizing her work relationships and was thus able to make an adaptation that seemed good enough. Her compromised marriage also resonated with her retreat from her childhood Oedipal victory. Such a precarious balancing act was shattered at the onset of a family crisis, during which her husband was unable to give her what she thought was adequate support, and, thus, she entered therapy.