I often talk a lot on the podcast about how us as future or current psychotherapists can make our clients feel. Since that is critical to understand, but in this clinical psychology episode, I want to talk about a new study that focuses on what happens when therapists are attracted to
their clients, and why this is critical to look at.
This clinical psychology episode has been sponsored by Psychology of Relationships: The Social Psychology of Friendships, Romantic Relationships And More. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Why Are Therapists Being Attracted To Clients Important To Look At?
There are two critical reasons why we need to look at this topic.
Firstly, our clients will be concerned about finding the right therapists for them and there are plenty of tried and tested methods for helping them with that. But they will still be concerned about will they be comfortable, will they like the therapist among other things.
This is even more important when it comes to clients with a history of emotional and/ or sexual abuse, since they will be concerned about history repeating itself.
Secondly, it is perfectly normal for therapists to find clients attractive for time to time. You can easily compare it to two doctors, nurses, or whoever looking at a patient walking into a doctor’s surgery. They may say that person is hot or handsome, but that’s it.
Of course, it might not be strictly professional but it happens and this is where the research comes in.
What Happens When Therapists Are Attracted To Their Clients?
It turns out many therapists do experience occasional sexual or romantic feelings toward their clients, but only an extremely small percentage actually do anything about it. as well as act on them.
This is what a new study by Vesentini et al. (2022) has discovered and their study will be the focus of this episode.
To quickly explain what they did, they sent a 15-minute long survey to Belgium psychotherapists and it contained sections on “Intimate Feelings and Behaviours related to sexuality and friendship towards clients”. As well as another section that looked at the participant’s sexuality, relationships and/ or friendships with patients and how many of them they had had in the past year, or their entire career.
Finally, the survey collected their demographics. For example, their education level, sexuality, gender and age.
Therapists’ Feelings and Behaviours Towards Clients
The first section of the survey found the response rate was 40% giving them a total final sample of 758 mental health professionals. Naturally (because of the psychology demographic) 69% of them were female, 89% of them were heterosexual and 83% of them were between the ages of 20 and 59 years old.
In terms of their behaviour, it turned out that 71% of the therapists said they sometimes or regularly found one of their clients sexually attractive. And about 23% of them actually fantasized about having a romantic relationship with them but an additional 4% fantasised about having sexual contact with a patient.
Interestingly enough, it was very common for therapists to develop friendship-related behaviours and feelings towards their clients. For example, 80% of therapists had accepted gifts from clients and 72% had had a perception of feeling like a client was a friend.
Personally, I think this is extremely interesting because this would play into the therapeutic alliance. Since both the therapist and the client need to feel comfortable in front of each other.
Mainly so the client wants reveal their past and things about themselves so the therapist can start helping them to relieve their psychological distress.
Therefore, whilst this might sound shocking or very concerning. I think that there are benefits to therapists feeling like friends with their clients, as that helps both parties and strengths the therapeutic alliance. This only comes dangerous or bad if one party takes it too far.
We’ll talk about that in a moment.
Therapists, Clients and Friendships:
In addition, only 15% of the surveyed psychotherapists had started a friendship with a client, and mostly the surveyed therapists had only started this friendship after therapy had ended.
This is a lot better because it ensures that no boundaries were violated.
However, only 3% out of the entire sample had started a sexual relationship with a client, and
only 1% of the sample had done this during therapy.
Of course that 1% would be in extremely dangerous, unethical and uncharted waters. So that was very risky for them, so unofficially I would encourage you to never do that.
Boundary Violations By Therapists:
After looking at Vesentini et al. (2022), I think we can all feel confident in saying that many therapists can experience occasional sexual thoughts, feelings or fantasies about people they’re treating. As well as in 7 out of 10 therapists (more men than women) found a patient sexually attractive and nearly a quarter of therapists had fantasies about being in a romantic relationship with their patients.
Thankfully, so few therapists actually violate boundaries with their clients. Since Vesentini et al. (2022) found less than 1 in 30 therapists actually crosses the line into that dangerous area. Also even in these cases, it tends to be one client in their career.
In addition, there are other studies that find similar rates like Garrett and David (1998), so this does increase the reliability of the results.
Overall, these sexual fantasies and feelings might be common but acting on them is rare.
And that is why I wanted to talk about this topic, because I wanted to dispel myths around therapists praying or hooking up with their clients.
Then what’s more common is the friendship forming after therapy has ended, and 20% of therapists do receive goodbye hugs.
Why Do Therapists Feel Strong Connections With Clients?
Maybe the biggest question this topic has caused us all to ask, is why do therapists get so emotionally involved with their clients?
In all honesty, it is probably because therapists and clients spend a lot of time alone together in a room. Here the client and therapist talk about extremely personal and intimate details of their lives, and as we know from Social Penetration Therapy By Atlman and Taylor (1973) when communication from a shallow level to a deeper level of personal disclosure people tend to feel closer.
As well as with therapists always attending these sessions with empathy and without judgement. This environment is very conducive to intimate feelings developing.
Subsequently, if we flip this over so we focus on the client themselves. They may develop romantic or sexual feelings for the therapist for the same reasons.
Why Are Male Therapists More Likely To Start A Relationship With A Client?
But why did Vesentini et al. (2022) find that compared to female therapists, male ones are more likely to start a sexual relationship with a client?
This could be because men tend to experience stronger and more frequent sexual desires. Or it’s because they are opposed to a lot more opportunities for sexual attraction. Since the vast majority of male therapists are heterosexual and the majority of therapy clients are women.
Although that is probably just because of all the nonsense society teaches men about being tough, don’t show emotions and all the other utter nonsense that is spread about to stop men getting the help they need.
Nevertheless, there is a third possible option here in relation to power, which the authors of Vesentini et al. (2022) note: “The need or ability to dominate and control can also play a role in cases of sexual abuse. Studies of gender differences have shown that men overall desire power more and possess higher levels of power.”
Of course, the point of this episode has not been to give men a bad name. Since the vast majority of men are amazing, wonderful and very good people, who only sometimes need to be reminded not to use sexist language. But it is always the tiny minority that gives the rest of us a bad name, and positions of power, like a therapist, always attracts a few predators. Just like doctors, teachers and Church people.
Therefore, the last point is something to just bear in mind and remember that not all men are like that.
Personally I always like to look at people’s sexual interests, relationships and how social psychology can impact people. So when I found this research that intersected with clinical psychology, I just had to do an episode on it and I’m very glad that I did.
Since if anything else I really hope that it is set your mind at ease (whether you’re a future or current therapist) that it is normal to feel sexual feelings about your clients. And it doesn’t make you some awful person, but it is important to bear in mind that unethical uses of power
and relationships can occur.
And that is something we must all be vigilant against.
I really hope you enjoyed this clinical psychology podcast episode.
If you want to learn more, please check out:
Psychology of Relationships: The Social Psychology of Friendships, Romantic Relationships And More. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it.
Have a great day!
Clinical Psychology and Social Psychology References:
Garrett, T., & Davis, J. D. (1998). The prevalence of sexual contact between British clinical psychologists and their patients. Clinical Psychology & Psychotherapy: An International Journal of Theory and Practice, 5(4), 253-263.
Vesentini, L., Van Overmeire, R., Matthys, F., De Wachter, D., Van Puyenbroeck, H., & Bilsen, J. (2022). Intimacy in Psychotherapy: An Exploratory Survey Among Therapists. Archives of sexual behavior, 51(1), 453–463. https://doi.org/10.1007/s10508-021-02190-7
Whiteley, C (2021) Psychology of Relationships: The Social Psychology of Friendships, Romantic Relationships And More. CGD Publishing. England
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