Being attracted to clients?

[psych84]

The online dating thread made me think of this. So it seems pretty natural to possibly be attracted to certain clients. How is one taught to deal with this in training? And how have you dealt with these situations in your own professional careers?

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[CheetahGirl]

You will be able to discuss this topic in depth in your ethics classes, practicums, and individual supervision (if the situation arises with a specific patient). And vice versa, I remember discussing with professors their patients' expressed desires & longings to be with him/her (the therapist). Awkward.

 

[MCParent]

If you have good trainers, you talk about it before it happens and de-shame it so trainees feel able to talk about it in supervision. I've seen people who had those reactions shamed, and they're afraid to talk about it which causes problems. It's not shameful at all and is an excellent growth opportunity in your supervision.

I was taught by a great trainer who helped us to deshame the feeling and to look for cues to see what you're doing (eg days when you spend a little more time picking your clothes on a day you see a client you are attracted to, challenging a client less than usual, etc.).

 

[WisNeuro]

We had ample opportunities to discuss this across the settings that Cheetah mentioned. Probably varies person by person. I've had physically attractive patients before, but I compartmentalize pretty well in a therapy setting, so it's never been a big problem on my end. With some BPD patients I've had to have discussions with patients the other way around (i.e., they being sexually attracted to me), so it's a discussion that I'm not uncomfortable having. Having good supervisors to discuss it with is the key.

 

[erg923]

Worse: Patient with hot wife.

 

[psych84]

Worse: Patient with hot wife.

haha.

 

[psych84]

You will be able to discuss this topic in depth in your ethics classes, practicums, and individual supervision (if the situation arises with a specific patient). And vice versa, I remember discussing with professors their patients' expressed desires & longings to be with him/her (the therapist). Awkward.

Is it ethical (this is half a joke btw), to meet a patient, say that you are attracted to them, and that you can't give them therapy, but you would take them out on a date? lol

 

[MCParent]

Is it ethical (this is half a joke btw), to meet a patient, say that you are attracted to them, and that you can't give them therapy, but you would take them out on a date? lol

I know you said it was a half joke, but this is a good question. In some other health professions, you just need to end the treatment and can date a former patient. In psych, at least by my read of the ethics code, ANY services, from years of therapy to just giving someone an intake or WAIS, precludes a romantic relationship (except by the weird two years without contact thing).

 

[AcronymAllergy]

I know you said it was a half joke, but this is a good question. In some other health professions, you just need to end the treatment and can date a former patient. In psych, at least by my read of the ethics code, ANY services, from years of therapy to just giving someone an intake or WAIS, precludes a romantic relationship (except by the weird two years without contact thing).

And related to this, I can't recall if it's in the ethics code or if I read/saw it somewhere else, but there was specific mention of essentially referring the patient out for the sole purpose of then being able to date and/or sleep them, and how this was unethical as well.

My own quick-and-dirty rule of thumb: if I have clinical contact with a patient in any capacity or context, there's no longer any chance for anything other than a clinical/professional relationship.

 

[psych84]

And related to this, I can't recall if it's in the ethics code or if I read/saw it somewhere else, but there was specific mention of essentially referring the patient out for the sole purpose of then being able to date and/or sleep them, and how this was unethical as well.

Well that is totally not cool. I intended to get my Dr. status to improve my dating life.

jk

 

[CheetahGirl]

Is it ethical (this is half a joke btw), to meet a patient, say that you are attracted to them, and that you can't give them therapy, but you would take them out on a date? lol

Look at it in this hypothetical way...suppose the patient was referred to you for a substance use problem alone (BEFORE you had any awareness of that this person had a history of ongoing childhood sexual abuse, string of unfulfilled relationships where the patient was mostly an object for someone else's gratification, and just recently ended a longer-term abusive romantic relationship...and BTW this person is smoking hot, which is mutually exclusive to the aforementioned history). Because I do conceptualize from a psychodynamic viewpoint & work with traumatized individuals, do you see how problematic your joke scenario may be? This person is looking for clinical assistance, not an reenactment of a reoccurring pattern of being objectified and sexualized. It would disingenuous to our profession if dating becomes a plan of action.

Also as MCParent mentioned, it is important not to shame the therapist for having very real feelings, but be open to discussing them with trusted supervisors/colleagues because a friendly "Man, she/he's hot!" may be all that needs to be put out there for one to resume their duties. Then, you put your 'clinical hat' back on, develop a trusting, respectful clinical relationship with your smoking hot client, and like a parent (very dynamic of me), you see your client blossom with her/ his newly-found mental health & stability...or refer them out and hope to never see them again.

Because you never know who will walk through you intake session door, I agree that the only way to handle this situation is AA's quick-and-dirty rule of thumb: if I have clinical contact with a patient in any capacity or context, there's no longer any chance for anything other than a clinical/professional relationship.

 

[Doctor Eliza]

I've often heard people just starting their training worrying about this. In reality, I don't think it happens every day and when it does happen, it is rarely with such great intensity that it cannot be controlled. When someone is telling you about all their neuroses and problem behaviors, they automatically seem less attractive. And being in the professional role just changes your mindset. To me, it is feels a little like noticing an attractive teenager when you are an adult. You can say, "hey, that person is nice looking" without any thought that you would ever want to be involved with them.

 

[WisNeuro]

I've often heard people just starting their training worrying about this. In reality, I don't think it happens every day and when it does happen, it is rarely with such great intensity that it cannot be controlled. When someone is telling you about all their neuroses and problem behaviors, they automatically seem less attractive. And being in the professional role just changes your mindset. To me, it is feels a little like noticing an attractive teenager when you are an adult. You can say, "hey, that person is nice looking" without any thought that you would ever want to be involved with them.

Exactly, I see people every day that are attractive. It doesn't mean that I want to date them all.

 

[MCParent]

I've often heard people just starting their training worrying about this. In reality, I don't think it happens every day and when it does happen, it is rarely with such great intensity that it cannot be controlled. When someone is telling you about all their neuroses and problem behaviors, they automatically seem less attractive. And being in the professional role just changes your mindset. To me, it is feels a little like noticing an attractive teenager when you are an adult. You can say, "hey, that person is nice looking" without any thought that you would ever want to be involved with them.

Well, there are different questions. If you mean a risk of an ethical violation that's one thing. I was chatting the a state board person once and he told me that if there are 10 complaints in one area, 9 will be able the same person. So, for some that revealing of neuroses is an indication of weak prey. Obviously that 9/10 specification was hyperbole, but I would tend to think that most complaints are due to unethical, predatory therapists rather than slip ups by normal therapists.

I'd say that how attraction (and many, many other reactions) influences our behaviors toward our clients is a different question and also vital to address without minimizing. One can have a solid ethical base and never do something *unethical*, and it can also still impact quality of therapy. I'd caution against people thinking that "intensity" of attraction is what matters; it might not be a good way of thinking about this.

I think endorsing the implication that attraction = wanting to date someone is missing nuances, and can contribute to supervisee reluctance to talk about attraction at all (if they were to perceive that admitting that would mean to you that they are at risk of an ethical violation).

 

[psych84]

Exactly, I see people every day that are attractive. It doesn't mean that I want to date them all.

I do, though.

 

[WisNeuro]

Don't worry, puberty only lasts several years, and then all the awkwardness goes away. Usually.

 

[smalltownpsych]

I develop very strong feelings for many of my clients. At a practicum site, we had a running joke about adopting kids who had horrible home lives because the paternal/maternal feelings that this provoked were so strong. Sexual feelings are just another part of what occurs during therapy. Our ethics professor, who had been on a licensing board, really emphasized the importance of dealing with counter-transference and self-care to prevent going down that road.

On another note, you don't have to date patients. People love to talk to someone who is a good listener so I would think our skill set gives us an edge in that realm. Of course, that also means most of us are in stable relationships so we don't get to try that out much! My own smoking hot wife hates that when we go to a social function, invariably women will be talking to me about psychology. Of course, the men love to chat with her about anything at all.

 

[psych84]

I develop very strong feelings for many of my clients. At a practicum site, we had a running joke about adopting kids who had horrible home lives because the paternal/maternal feelings that this provoked were so strong. Sexual feelings are just another part of what occurs during therapy. Our ethics professor, who had been on a licensing board, really emphasized the importance of dealing with counter-transference and self-care to prevent going down that road.

On another note, you don't have to date patients. People love to talk to someone who is a good listener so I would think our skill set gives us an edge in that realm. Of course, that also means most of us are in stable relationships so we don't get to try that out much! My own smoking hot wife hates that when we go to a social function, invariably women will be talking to me about psychology. Of course, the men love to chat with her about anything at all.

For some reason I always assumed you were a girl.

One potential issue for me is that Forensics interests me the most, but I am also the most attracted to guys with a a bit of jam.

 

[smalltownpsych]

For some reason I always assumed you were a girl.

One potential issue for me is that Forensics interests me the most, but I am also the most attracted to guys with a a bit of jam.

That is one of the first times that has happened in my life which I guess is a good thing.
I need a more manly photo maybe or I need to skip shaving a few days or type with a deeper tone of voice or stop posting with cute little smilies.

 

[CaliMac]

I am also the most attracted to guys with a a bit of jam.

Jam? As in personal issues or something? I am so not hip...

 

[smalltownpsych]

Jam? As in personal issues or something? I am so not hip...

I was trying to make sense of the jam thing too.

 

[psych84]

I just meant I tend to like the bad boys.

 

[CaliMac]

I just meant I tend to like the bad boys.

Ha! That's what I guessed. Good luck w that one

 

[iPsych]

One potential issue for me is that Forensics interests me the most, but I am also the most attracted to guys with a a bit of jam.

That was classic!