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The Impossibility of Sex: Stories of the Intimate Relationship Between Therapist and Patient

The Impossibility of Sex: Stories of the Intimate Relationship Between Therapist and Patient

by Susie Orbach

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The conventional view of a patient in therapy has been that of someone who forms a powerful, erotic bond with the therapist. On the other hand, the view of the therapist has been that of a neutral listener, emotionally unaffected by the patient. But what really does go on within the sacrosanct space of the therapist's office?

Distinguished psychotherapist Susie


The conventional view of a patient in therapy has been that of someone who forms a powerful, erotic bond with the therapist. On the other hand, the view of the therapist has been that of a neutral listener, emotionally unaffected by the patient. But what really does go on within the sacrosanct space of the therapist's office?

Distinguished psychotherapist Susie Orbach provides the answers as she presents six stories of patients, all of whom suffer from such common afflictions as depression, loneliness, compulsive eating, consuming sexual desires, and fear of attachment. In each story, Orbach reveals not just the client's problems, but — with startling honesty — the effect the client has on her as therapist.

The Impossibility of Sex breaks new ground by taking us into the center of the therapy relationship, one usually shrouded by therapist-client confidentiality. From the unlikely role the therapist plays in the troubled relationship of two lesbians to the unsettling dreams the therapist experiences while treating a man consumed by sexual desire, Orbach illuminates the complex human interactions at the heart of the therapeutic process and the "joint discoveries" that contribute to its effectiveness.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
Those who have ever surrendered themselves on an analyst's couch, or considered doing so, will want to read this vibrant book about therapy from the therapist's perspective. A seasoned analyst who was recently revealed to have counseled the late Princess Diana, Orbach (author of the '70s classic Fat Is a Feminist Issue) reveals what happens during therapy from the therapist's point of view with honesty, dashes of wit and a refreshing lack of sensationalism. Those who suspect that therapists sleep through their sessions will be gratified to find out how involving some find their patients. Orbach's examples (based on composites of patients she's seen over the years) fascinate but never read like case studies: Belle is a compulsive liar who moves from crisis to crisis; Joanna's distress threatens Orbach's sense of self by touching her deepest emotions; Carol and Maria are an interracial lesbian couple whose marriage counseling provokes Orbach to consider the role of trust and sex in relationships; Adam, an erstwhile Lothario, almost lures Orbach into his sexual web before she is able to help him relinquish his own libidinousness in favor of deep passion. Orbach elucidates the analytic process with verve, grace and erudition, invoking Freud and a host of other psychoanalysts while unveiling her own feelings about life, love, sex, passion and, of course, the therapeutic process. (Mar.) Copyright 2000 Cahners Business Information.|
Library Journal - Library Journal
Therapist Orbach (Fat Is a Feminist Issue) explains that the point of this misleadingly titled book is to convey "the feel of the relationship developed between the therapist and patient." Using six therapy case histories based on her real-life clients, she investigates their problems (some of them sexual)--which, from a voyeuristic perspective, is fun--and her own reactions, which are somewhat narcissistic and distracting. In the midst of the case histories, she also discusses psychoanalysis. Two different typefaces are used to distinguish the case histories from the digressions on psychoanalysis, and a third would have been helpful to offset Orbach's reactions. The concluding discussion of the female psyche is interesting but seems tacked on. Although somewhat confusing in execution, this bizarre little book is recommended for academic and public libraries, as the publisher notes that Orbach was Princess Diana's therapist.--Margaret Cardwell, Georgia Perimeter Coll., Clarkston Copyright 2000 Cahners Business Information.\
Lisa Jennifer Selzman
Orbach, the author of Fat Is a Feminist Issue, has a knack for making psychological material accessible and engrossing...The prevailing theme of this artful book is not the impossibility of sex, but rather the possibility of transcending violation and loneliness.
The New York Times Book Review

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The Vampire Casanova

I felt twitches in my vagina, pleasurable contractions. It was a sunny Sunday morning in spring, two years after I had stopped seeing Adam. I was chopping some fennel when he not so much entered my mind as tapped on my body, as he had so many times during the course of a five-year therapy. Adam was a chef and from time to time when I was preparing food, his presence would insinuate itself and I would be back in the physical ambiance of our therapy time together.

Adam was a fornicator, a lover, a stud; a man whose daily life was shaped by sexual desire and sexual conquest in a spiral of infatuation, seduction and vanquishing. There were never less than one love interest and two or three gorgeous "girls" on the go, not of course counting on the previously conquered, who would return for occasional trysts when they were in town or between boyfriends.

The year before he embarked on therapy the then 36-year-old Adam developed a problem that jeopardized his perception of himself. He had started to ejaculate too soon. Desperate to make the problem go away, he came to therapy. "Too soon for whom?" I asked. "Too soon for me. You know, too soon for me to really give it to her. To fuck her real special. Like no one else. Take her places she's never been."

The imperative of his sexuality and the potency of his penis fascinated me. It was so present and insistent that I felt swept back twenty years to before my generation's encounter with feminism thought it had remade sexual relations both in and out of bed.

What did coming too soon mean to him? That it wasn't complete? That his orgasm was a squib rather than a release and a connection? Was he anxious? Didhe have to concentrate too hard on giving to the woman? Was he insecure?

"All of those, sure," he said on his first session. "See, I really love women," he said, slowing down as he realized he was sobbing. "Take Sarah who I was with last week. Now she's something special." He paused another second. "While I was romancing her, I really believed, you know, that I loved her."

Before self-reflection could count, before he could register how hearing himself was a new experience, he pulled himself out of his pain and slowly spoke what would be ours to sort out over the next few years.

"I'm a physically passionate man," he said as he looked into my eyes and mimed Me Tarzan, You Jane. "It's just nature. But something is getting in the way of mine. So, figure it out, Doc. Come on. Without fucking what's the point. Fucking is my life."

The bluntness of his words and the flip between Southern American formality and crudeness jarred with the softness, almost a sweetness, in his persona. I wondered about the clash.

Adam began to tell his story. Although few feelings came through, the preliminary shape he gave his life had a certain coherence to it. He was born on Long Island in the working-class community of Huntington Station shortly before the end of the Second World War. His father and mother had been childhood sweethearts and she had become pregnant before he went off to serve in Europe. The photos Adam had of his father in uniform and the stories his mother told about him portrayed him as an eager, if somewhat naive, young man, ready to serve his country and see a bit of Gay Paree. War was a romantic moment rather than the reality of bombs, scarcity, cold and death. While he was stationed in England, Adam's father got involved with a Yorkshire woman, who also became pregnant. He promised to take her with him to the United States (Adam often wondered if his father had entered into a fraudulent marriage with her). On returning to New York, Adam's father moved in with his mother and him for a year but when it came out that he had fathered another child, there were terrible fights and eventually he left for California. He kept in sporadic touch with Adam for a few years, coming back once for a few months when Adam was six, but his father dropped out of his life after his eighth birthday when he turned from being a heroic husband and father to a maligned bigamist.

Adam grew up very close to his mother. He was her companion, her little man. At twelve he was making decisions for the two of them, carrying the money she earned as a beautician, telling her how much they could spend. They moved around a lot, from New York to Florida and then around the state, either to catch up with some new man she was after or chasing a job opportunity that did not quite pan out. He learned to make friends quickly and to let them go easily. He was distracted from the pain of his dislocations by the abundant dramas his mother wrought in their lives.

At seventeen, after finishing high school in Vero Beach, Florida, Adam went back to New York, tried butchering, his father's trade, then acting and moved on to selling art and doing exquisite dinner-party cooking. He found his way into a glitzy social scene and discovered how sexy he could be to neglected married women. Wonderful at paying them attention, knowing what they longed for and dressed like a man with twenty times his income, Adam became extremely desirable. In 1972 when he was twenty-seven he married Elizabeth, a wealthy divorcée.

Elizabeth misconstrued Adam's pursuit of her as true love (which it was at the time) and she was crushed by his philandering. She divorced him quickly, giving him enough money to start a restaurant. Designed by a friend, hung with paintings on loan from artists he used to represent, and given sufficient publicity as New York's coolest restaurant just at the time when food and eateries became a leisure pursuit of a large segment of New York's middle class, his restaurant soon took off. He became a respected chef and restaurateur. Meanwhile, his mother, who had moved to New York to be nearer to him after a failed love affair, died of cancer at the age of fifty-five.

Before Adam came to see me in 1980 his life was shaped by two preoccupations: being a celebrity chef — rushing around judging competitions, doing guest-chef stints in other restaurants, creating beautiful tables for photo shoots, writing a cookbook with his assistant — and having girlfriends, dozens and dozens of them.

His hectic life and pursuit of women worked well enough for him. He felt gratified by the attention he received, pleased to be the consummate lover and part of a glamorous set. There was plenty of excitement. He was always living in a mini-drama, often of his own making, where one or two of the women he was sleeping with would be on the verge of finding out about another. Concealment and the fear of discovery excited him enormously. I thought of the analyst Winnicott's observation: "It is a joy to be hidden but a disaster not to be found" and wondered what it foretold of what needed finding in therapy.

The scrapes Adam got himself into and the tension of his many work commitments helped him feel valued. He was clearly needed by others. If he had not hit this problem of early ejaculation, he never, he assured me, would be seeing me. "Everything was coming up roses till that point. Hell, I wouldn't have been here sitting with you, ma'am. I'd a been making you sweet sweet love." Extreme intensity exuded from him even in this play tease and I could sense how compelling the turn of his attention to a woman might be.

His discomfort in seeking help from a woman after many years of looking after women in one way or another was pronounced. He was awkward as he tried to give a fuller account of himself, to show some vulnerability, not to be the big guy who was always in charge.

Yet he settled well into therapy. He was relieved to be able to talk about his life, the ins and outs of his love affairs and the emotional patterns he wove. As we got to know each other better, more details emerged about sex and loving. He now frequently sought a different kind of sex, a more violent encounter teetering on the edge of bondage and rape. His sexual fantasy life had moved in that direction when he started to come too soon, and he had discovered that while masturbating he could sustain his excitement long enough with a violent fantasy to give him a satisfying orgasm. It did not work when he was actually with someone. With a woman, however much he wanted her, he felt precarious, anxious and that he "came too soon."

Adam was indeed a sensual man. I could feel it in greeting him. When I put out my hand to shake his on our first encounter, the presence of his hand stayed with me. After he left the consulting room, his smell was in my nose. When he stood up to leave it was as though the room were being emptied. When he talked about women, I could feel his love. Clichéd words which I might have tended to laugh at if they had come from a friend took on a lush, rich tone. He found women miraculous, beautiful, sexy, delicious and inviting; their movements, their smells, their pretty lingerie draped nature with tenderness. His open appreciation and joy gave me a new perspective on my gender's sexuality and I could almost see women from his perspective as wondrous, luscious, magical, holding secrets desperately worth penetrating.

He was nothing if he wasn't a lover, he said. He needed to pursue, to please, to have a woman's pleasure in his sexual capacities reflected back to him. He wanted to get to the heart of women, emotionally and sexually, so that they would be forever transformed by his touch. And they were. His intensity, interest and sexual certainty made it possible for his lovers to open up, to feel as though they were discovering their sexuality as adult women and to go where "they'd never been before." But despite his and their evident satisfaction and pleasure, Adam was always on to the next encounter, the next woman who could confirm him, who by opening her legs and her heart would make him feel he existed. Until his sexual problem.

The sexual problem that so dismayed Adam brought to a stop his habitual way of going about life, his way of understanding himself, his way of being with a woman, his way of giving and receiving love and his way of feeling good. All that he knew about himself was now thrown into question. In choosing psychoanalytic therapy, he was embarking on a journey to make some sense of the way he organized his emotional and sexual life, to question what motivated him, to fathom why his penis was forsaking him, to connect up, as he might say, with his emotional heartbeat.

While Adam was desperate to get his penis working for him again and had consulted physicians about techniques to forestall orgasm, he found that he was curiously relieved when I suggested that his "coming too soon" might hold clues about aspects of himself that as yet he did not recognize.

The issue of symptom relief has always been a thorny one for psychoanalysis. In Freud's work it was the symptom, principally the hysterical, non-organic symptom that disabled the individual in many different ways that psychoanalysis at first sought to comprehend. Anna O's tortured limbs, Cäcilie M's paralysis and the widespread phenomenon of physical anesthesia were the material that Freud and Breuer drew on in 1895 in their groundbreaking Studies on Hysteria. Since that time psychoanalysis has swung between treating symptoms and interpreting them as metaphors, regarding them as manifestations of unconscious processes. Sometimes psychoanalytic patients have been relieved that in the analytic space they can speak of whatever enters their minds, that they need not slot everything about their experience into the narrow confines of their symptom. Sometimes they have been alarmed because their symptom, despite a most thorough analysis, remains entrenched. Clinicians walk an uneasy line between addressing the symptom per se, giving the person space to talk about it and how the symptom expresses, disables, enables and enunciates aspects of the individual, and at the same time offering the possibility that there are other ways of experiencing that the patient may not be allowing herself to acknowledge.

Adam was quite interested to know what stories he had invented for himself about his magical phallus and why, if it was so magical, these powers had now deserted him. He could see at once that his self-conception as a lover was a lens through which all his experience passed and although part of him longed to be free of sexual anxiety and to return to the status quo, he was intrigued by the notion that there was something to know beyond his symptom and perhaps beyond his sexuality too.

It was not long into the therapy before Adam registered that I was a woman. Since his only repertoire with women was either to look after them or make love to them, seeing me as a woman put him in a quandary. Interested as he was that I be the doctor in a metaphorical white coat who would help him examine his life, he could not keep me in that category. He had to flirt.

It would be inaccurate to say that he would flirt when he was anxious or to fill the space or, as happens in normal social life, as a way of smoothing over those awkward moments that can occur between women and men. No. Such a description would strip Adam of his essence. Adam was flirtation incarnate. He could not help but flirt. When we first met, this flirtation had been expressed as charm. As his therapy continued, however, he beamed his seductiveness toward me and the analysis of it, including his active sexual pursuit of me, became a central feature of our sessions.

For a few months Adam and I explored the life of his penis. Through this valued part of himself he felt able to give and receive love, to make women desire and need him. His penis, he felt, let him convey to a woman that he was interested in her emotionally and sexually as she had never been noticed before. The intensity of his appeal, the promise he held out that he would reach and move her, spiritually and sexually, became irresistible. A woman who gave a hint of returning his interest would receive an emotional assault that not only had her longing for him but left her feeling that without his attention she was somehow lost.

As I listened to his accounts of seductions I felt acute sorrow for Adam in his fierce search to connect. I felt scared too for the woman he was currently after. I would not have wanted to be in her position. I could sense that he picked his women up in one place, twirled them around and then pulled them inside out, so that when they were dropped they had been through a sexual and emotional revolution that left them reeling as they tried to pick up the pieces of their pre-Adam selves. Although he played it as a game — game, set, match — it was the women who would be knocked out by him. He could always go on to the next conquest, the next woman who showed him how much she desired him.

In pursuit of a woman Adam was alive. Although he was aware that his encounters had a predictable pattern of pursuit, seduction and loss of interest, the chase worked for him. Adam's well-being, his sense of self, his raison d'être required a sexual quest, the challenge of teasing and coaxing the heart of a woman to open up so that he could capture her. When he secured the woman he was desperate for, there was a moment — sometimes a longish moment before his interest dissolved — when Adam felt loved and accepted.

He knew that he was sexually appealing. His distress over coming too soon humiliated him. It humiliated him that he had had to come to see me. By flirting in therapy he was bringing forward what he felt to be the best of him, inviting me to be entranced by those aspects of himself that he esteemed, so that as we entered into the not-so-nice bits, he was reassured that I could see his charm and accept him.

At first his flirting tickled me, somewhat as a teacher might feel at the predictable unfolding and development of a student she enjoyed. I had been flirted with in the consulting room before. I could anticipate that something of Adam's flirtatiousness would enter our relationship and, remembering Freud's injunction to analyze rather than take personally the professed love of a patient, I was not much worried about this entry of the erotic into the therapeutic space. It was not that Freud thought that the entreaties of a patient were disingenuous or unworthy but that we could learn much more about the patient through applying ourself to understanding the entreaties. Freud's caution to the analyst was that such seductions were an undeserving love, a transferred or transference love (from a parent to the analyst). Such love clothed that which must be uncovered if psychoanalysis was to be of value. The analyst need not be flattered by, or taken in by the sexual displays and exhortations of love emanating from his female patients. "He has no grounds for being proud of such a 'conquest,'" Freud warned.

So I was not surprised when Adam came on strong. He had been able to tell me that without the pursuit of a woman, he felt cavernously empty, as though he did not exist. I could imagine that at some point in our sessions I might briefly become the object of his desire. That, when or should this occur, I would be pointing out to him how his flirtation or desire could steer us in the direction of understanding what it concealed. I was surprised though by how strong and how explicit his appeal to me was.

"I have to make love to you," he said. "I need you more than I need therapy. It's killing me coming here session after session dreaming about you, thinking about you, smelling you — your sweet body smell and your perfume." He was really revving up now. "I imagine caressing you. My hands between your silky legs, my body aching, desperate to be with you. I know you feel it. I know you want me. I know you're just holding back because you're my doctor. I know you are."

No, Adam, that's not quite right is what I was thinking, but as he was declaring his desire and I was formulating my response I could feel my body tingle, Freud's injunction notwithstanding.

"You don't believe I'm for real because I told you about all those other girls. But this is different. You know it. You can feel it. I know you can. We'd both be missing something we've never had before if we said no to it. This is big. Something that comes round once."

I said nothing. I thought about Adam and his mother and how confusing it might have been for him to be her little man. I thought about how hard the renunciation of his childhood sexual desire for her might have been for him when she treated him so much as her partner rather than as her son. The togetherness he craved, the being reached and reaching out that were his refrain with women, could have been too tantalizingly for him. I wondered about her seductiveness, how much sexual play had passed from mother to son to bridge the gaps she felt in her sexual and emotional life.

My thoughts were intended as much to calm me down as they were to analyze the situation. This was not a little flirting around the edges but Adam's powerful declaration of desire. I was being given the treatment.

The problem for me was that I was not unmoved. I found Adam's entreaties attractive. I talked to myself in an attempt to slow down the emotional steamroller coming at me.

"I've never opened up like this," he continued in an approach modified to turn on a psychotherapist. "I've never been touched like this. No one has ever let me find myself before."

"Perhaps you're feeling some relief, sensing that it is possible to be understood more fully instead of having to rush in and out of relationships looking for some brief magical contact," I said, hoping that a bland comment could slow time and defuse the erotic.

Adam steamrollered on. "I know you think this is me doing my number but you've got to believe me. I've never bared myself before anyone else. All my honesty before was bullshit. My nakedness was a sham." I could feel him shifting into his Southern gentleman mode as he continued. "I thought I was bringing myself to the other person but it was a pretense. Listen to me, will you. Don't analyze this all away. I'm serious. Really serious. I want to, I have to, make love to you."

As Adam beamed his interest at me beyond the come-on line, his insistence, his passion, his desire was palpable. I was his prey. I could almost watch it happening in front of me except that I was part of who it was happening to. I could tell I was going to have a hard time with it. If I did not take it seriously, the therapy would be ruined but if I took it too seriously, the therapy would also be ruined. I was going to have to find the line to walk. Was I in danger, like his other women, of being tossed up, twirled around and then spat out?

I could sense him getting under my skin. I tried to analyze what was going on, to understand and to calm myself. This is nothing different in kind, I reminded myself, from the emotional places I have been to with other patients. It is different in quality because this is about sex and the erotic. I am feeling scared but if I do not get to what this is for him, if I do not take my experience as a sounding-board — a version of what he is feeling, needing or has felt — then as a therapist I am letting him down.

I said this to myself, hoping that by formulating it this way I would be able to keep my vision clear. I would be able to feel his attractiveness, what drove him and pulled women to him in a way that was useful to him. If I was not to believe this would happen in the course of my becoming awash in the effects of his seductiveness, then I would have had to stop being his therapist. And although I considered that option, it was too naive and clinically irresponsible. Adam was doing what he needed to be doing, what he could not help but do. If he could not act in his therapy the way he did in the world and so have this behavior understood, there was little hope that what troubled him could be grappled with.

The genuineness of his appeal landed on me much as it had landed on the dozens — no, the hundreds — of women he had bewitched before. While most of my channels were caught up in his appeals, an observing channel remained open. As I felt drawn by his allure, I was fascinated by how incredibly sincere and authentic it felt. It was as though his whole being exuded something utterly appealing. I saw and felt that I wanted to love him. The divide between the thought and what might happen felt precarious. He pulled on me in some irresistible way. The opportunist Casanova I had imagined him to be when he had talked earlier about his capacities as a romancer was effaced. Instead there sat before me a beguiling mixture of an eager virgin heart and a self-confident lover. So this is what hooks his women, I thought, even as I felt more than flattered and pleased by his attention.

I went to bed that night full of Adam. He stayed with me through the night so that when I awoke I was not sure whose bed I was in or who was in mine. My senses were sharpened as they can be in the throes of an infatuation. As I went about the pedestrian tasks of putting fresh flowers in the consulting room, reading the morning's mail and processing the news, I thought how wondrous life can be. When a friend phoned about some plans for the evening and heard an unfamiliar lilt in my eight A.M. voice her inquiry about my good mood made me try to get a hold of myself. Just where was this singing inside me coming from? Was I letting the countertransference — the feelings the therapist has for the patient — get a bit heady? I chuckled to myself. I was not prepared to give up the good feelings so hurriedly. So much of the psychotherapist's day is spent entering painful places, processing anxiety, buffeting the sorrow, anger, confusion and terror that patients bring. I went into the shower and as I let the water run on my body, I felt with pleasure its silkiness, the sensual flow of the water's pulse from the showerhead on to my body.

All at once the image of an enormous showerhead in a hotel bathroom I had glimpsed years before melded into a picture of Adam and me making love. He was trying to touch an erotic part of me that had never been awakened. I found myself smiling, even blushing, as I realized how exquisite, but also how ridiculous, it felt. I was in a state of sexual reverie, no doubt about that. Could I trust it to stay there? Every therapy is an adventure, I told myself. Unpacking it was part of the job, feeling it enough to know what was going on.

Ten percent of patients are vulnerable to sexual advances from their therapists. It is not only therapists leaping onto their patients that creates such a worrying picture, but also the danger that Freud highlighted of how an erotic transference encourages a therapist to act on rather than to analyze erotic feelings which can lead to an abuse of the therapeutic situation. To protect patients, therapists until recently felt it best to deny or sidestep their arousal but, if it continued, to rush back into therapy themselves and to case supervision to sort themselves out and to untangle the particulars of a case in which they felt the threat of becoming unprofessionally ensnared.

This undoubtedly helpful protocol is mandatory for a therapist for whom sexual arousal during the course of a therapy is not a single experience but a habitual trouble. However, alongside this minimum protection for the patient, a body of thought has begun to emerge over the last decade suggesting that a therapist who finds herself aroused might best help her patient if she can become less afraid of her responses and keep herself consciously aware of them long enough to think about them privately. Indeed Michael Tansey suggests that it is precisely analysts' fear of their own sexual feelings toward their patients that needs to be addressed so that the erotic transference can be explored. If analysts cannot countenance such feelings within themselves but suppress or deny them or separate them from conscious awareness, there is a much higher chance of inappropriate sexuality being unwittingly enacted in the therapy. This danger is decreased if the analyst can think about erotic feelings for a patient (and what they signify) without fear of censure.

Although part of me envisioned professional reproof for the thoughts I was having, another part of me knew that I had to go on with this exploration and receive the feelings I was having as part of the treatment. Bodily sensations were as valid and useful as any others. It was just a question of holding on long enough and being alert enough to the idiosyncrasies of this arousal to untangle the bits that belonged to me personally from those that emanated from or were created between Adam and myself. The important thing, I told myself as I stepped out of the shower, was to be aware of any desire on my part to exploit the situation for my own sexual ends. Was being wanted in this way a buzz to a woman in a long-term relationship, used to great intensity but removed from the insistence of early sexual passion? If this was the case, and I knew I would have to question myself hard and honestly here, was I unconsciously encouraging a flirtation with Adam? Did I need him to confirm some aspect of my desirability?

Ugh. I did not much like that thought. If it was accurate I would have to take special care of what message I was sending Adam. Did I have a wish to be found desirable? Was this the chink of receptivity he had referred to in seeking women? I was not seeing Adam today. I had time to reflect on myself later. For now I focused on what I thought Adam was up to.

In one way Adam was taking up residence inside me in the manner he did with others. I accepted that this was his way of being attached. I recognized that in privately surrendering to his flirting I was wrapping myself up in his idiom. It was a way of speaking his language, of becoming close in the way that he could. That might be how he would be imprinted on me for now, just as other patients with a different psychic grammar would become emotionally imprinted in their unique ways. As I realized this I let his flirting stay with me. If this was the way he was finding a psychic home with me, so be it.

I went about my sessions that day grateful for the ones in which the engagement was more straightforward. That night I went through a list of the unexpected emotional journeys that I had been swept up in during years of being a therapist, journeys choked with difficult, powerful, unpleasant feelings.

I recalled the times when I felt hated. Unable to provide what a patient felt she needed from me, and unable to repair the horror of her past, I felt her hatred of her parent blending with her hatred of me and I became a useless, contemptible punching bag. The discomfort of that had been as hard to bear as the occasions when I felt dropped, jerked around or intensely needed.

I also remembered times when I felt clinically lost, when my brain scrambled, when I tumbled into another's psychic world not sure that I would find myself and my psychic footing again and having little to hold on to except a certain knowledge of the inevitability and the necessity of it all. I reminded myself that the therapist's lot is to be both in the place that is demanded by the patient while being able to recover oneself. I knew I needed to be affected, to be disturbed, to experience something of the patient's psychological state. I had always recovered myself and I had learned that it was an easier ride if I allowed myself to register rather than resist the pressure exerted on me in the therapy relationship. That way I was responding to only one emotional assault at a time. To have interfered by resisting would have doubled my confusion.

At least, I consoled myself, I had an inkling of what this emotional journey might entail. Adam had been so forthcoming about what he did with women, I had such a graphic picture of the way he picked them up and spewed them out, that I was well forewarned. If I were to surrender to his exhortation, not literally but inside myself, then I had a fair idea of the territory. It was not going to be a mystery.

The session following the weekend, Adam started right in. He had spent the weekend making love to Laura while thinking about me. Some love, I was thinking mockingly, rebuked by my own conceit. But before I could let myself off the hook, Adam's seduction took on a particular twist.

"The thing is this, Doc — and I know you can't believe that I'm getting into someone else's panties if I love you so much — the thing is, listen, please listen, 'cause this is weird. I could come right and I could be with this woman long enough because, because of what's happening between us."

In case I was slow to catch on, he repeated himself, refining it as he did so.

"Listen, I'm saying something about how you've helped me. Sex was what it was meant to be. The only thing was I wasn't making love to Laura. I was making love with you."

My mind rushed to interpret. Well, of course, that made a certain sense. Since he had lost his mother, his love felt unsafe. He might be engulfed by another woman. His attachment to his mother with its sexual taboo kept him relatively protected. He could love his mother and be sexual with other women. While it was not wholly satisfactory, at least he was not overwhelmed. He did not have to deal with his erotic feelings toward his mother (or hers to him). He could stay emotionally loyal to her, not desert her by ever really loving someone else. But when she died, this compromise had c

Meet the Author

Susie Orbach is a cofounder of the Women's Therapy Centre in London and a visiting professor at the London School of Economics. Author of Fat Is a Feminist Issue, she is also a cofounder of the Women's Therapy Centre Institute in New York. Orbach lives in London with her partner and two children.

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