In Treatment --  week 9

There are just 3 episodes this week, Wednesday-Friday. So today and tomorrow, let's start looking back.

Monday is Laura's day, Laura who apparently left therapy three weeks ago. We know Paul saw her last week at Alex's funeral but we have no indication that he has seen or talked with her since then. I have said before that Laura's infatuation with Paul is anchored in fantasy and the experience of being in therapy. Having someone pay close attention to what one says and to not ask anything in return is a heady experience and indeed, given the subject matter, feels and is intimate. But it is not the intimacy that grows of two people taking time to get to know each other. As we grow close to another, a lover, we become acquainted with how he or she smells, likes and dislikes, moods, history -- all the details that get knit together in a relationship. But Laura has only a limited view of Paul and her fantasy of what she hopes and wants him to be like. In truth she does not know him at all, as a person outside of his office.

In a very real sense, the same is true of Paul about Laura. He has met with her for one hour a week for a year. Listening to her, offering interpretations and comments as appropriate. He hasn't any idea what she is like when she works or eats or sleeps or any of those ordinary life activities. And his own wife has grown less attentive, less adoring of him. So Laura's adulation and declarations of love become an issue for him. He is not defended in the way he and most therapists are in the usual run of events. It is our families, our friends, our interests and activities outside of the office that keep us anchored in our real lives and able to remain relatively clear about what is happening in the heated atmosphere of the consulting room, for indeed the atmosphere there is not that of the rest of life. It is time out of time, out of place and not the stuff that day to life is made of.

If Paul's marriage and home life were working better, or even if he had a solid therapeutic relationship with his own therapist, he likely would be better equipped to handle Laura's strong erotic transference. It is the weakening of his professional defenses and his failure to develop, either with Gina or someone else, a working therapeutic/clinical supervision relationship that renders him vulnerable so that he falls prey to his fantasies about Laura. And like Laura, these fantasies are all tied up in a pretty big father complex.

Falling prey to an erotic counter-transference has been one of the great bugaboos in psychotherapy. It is never ethical to have sexual relations with a patient and most consider it unethical to develop a romantic relationship with a patient, even after the therapy has ended. But as Gina says to Paul rules can't make the choice. Ultimately each therapist who finds himself or herself (and the research has shown that though both male and female therapists have transgressed, it is far more often a problem among male therapists) struggling with such a relationship must make the choice to remain professional, seek help if necessary, and restrain the impulse to act out. 

I don't know about you, but I still believe that Paul will pull away, that the spell will break before he goes over the edge. 


© Cheryl Fuller, 2018. All  rights reserved.