Let’s talk about sex: female therapists’ experience of working with male clients who are sexually attracted to them

Sexual attraction in psychotherapy is an under researched area of psychotherapeutic practice. Literature suggests that the direction of the work with sexual attraction is determined by the therapist’s emotional reaction to it which can either halt or spur its exploration with the client and occasionally cause serious ethical misconduct such as sexual acting out and premature therapeutic termination.

Given the suggestion that our socio-cultural context is particularly prohibitive of the exploration of the male client’s erotic feelings towards his female therapist, this study focused on female therapists, exploring the nature of their experience working with male clients who are sexually attracted to them and the extent to which they used the experience in their work.

The study used Hollway and Jefferson’s (2008) hybrid method ‘Free association narrative interview’. This involved multiple unstructured interviews with five female participants. Follow up interviews provided opportunities for building trust, consideration of non-conscious communication and permitted collaborative meaning-making with participants as co-researchers, considered particularly important given the ‘taboo’ status of the topic.

Each participant’s data was initially analysed on its own merit after which data was compared across participants.

The results of the study included participants’ emphasis on the uniqueness of working with each different client, the importance of confidentiality, trust and supervision in the work and the link between issues of sexual attraction and our identity. Participants’ experience differed depending on whether they felt reciprocally towards their clients or not. On occasions when therapists were not attracted towards their clients, they expressed a sense of vulnerability, discomfort with power inequality and a sense of being at fault. Conversely, when therapists felt sexually attracted to their clients, they experienced a sense of the splitting of the roles of being a woman and a therapist, as well as the experience of love and mutuality in relation to clients.

In terms of the therapists’ use of the experience in their work, the ability to do so was reported within both categories of responses, albeit it seemed that this was easier done in the context of a therapeutic relationship which was described as ‘mutual and loving’.

The implications of these results are manifold. In practical terms, my research suggests a need for therapists to consider the safety of the location at which they work. In relation to therapy training, the findings suggest that working with sexual dynamics is not something which can be learnt and mastered but instead needs to be explored reflectively and reflexively. From the clinical point of view, this research suggests that sexual dynamics can be experienced as merging the gap between ‘personal’ and ‘professional’ parts of therapists’ identity because of which the role of personal therapy and clinical supervision are highlighted as particularly important.

Finally, my study considered the impact of power inequality on the therapists’ sense of authority from the clinical perspective as well as the context of wider societal dynamics and offered links with previously published research, suggesting future areas for research and clinical practice.