I feel badly for this young Psychiatric resident at Baylor, who discussed a mutual romantic attraction to a patient with a supervisor (my bolds):
“I think you need to take this one to Dr Gabbard. I have never seen a resident with this problem before.” “Never!?” I thought, “I’m the only one!?” I worried incessantly about what was wrong with me to feel so incapacitated, unable to feel in control of the therapy in this particular case. I kept thinking in circular fashion, “I should not have this problem. I must stop it. I can’t stop it. I should not have this problem”—and on and on.
Well, I am glad she finally got to Dr. Gabbard, because he is one smart guy. Still, I found her supervisor's reponse deeply disheartening and soulless - if not neutered.
Fact is, as everybody knows, humans are prone to affection, attraction and attachment and there is nothing necessarily different about whether that occurs in a shrink's office, or between a businessman and his secretary, teacher and student, clergyman and congregant, trainer and client, doctor and nurse, lawyer and client, classmates, or business associates and office colleagues. Romantic feelings in offices (like many other emotions) are ubiquitous. Sometimes it's mutual. The proximity and intimacy of some associations naturally builds more closeness than the usual and more contentless (but sometimes powerful) chemistry of strangers in bars.
When you put people together, things of all sorts happen. Analysts and psychotherapists have the peculiar and challenging task of figuring those things out rather than acting on them.
So rather than viewing this resident's issue as a "problem," I see it as a healthy sign of vitality. Humans are, among many other things, relentlessly sexual machines and attachment machines, and no PC baloney, laws, psychoanalytic exploration, or rules could or should ever change that.
Obviously, acting on such feelings can destroy the doctor's role, potentially ruin a doctor's life, and end a patient's hope for real internal improvement. That's why analytically-oriented therapists maintain various sorts of rules and boundaries. The doc's gratification is meant to come from doing a job and from getting paid for it, but it's impossible and undesirable to remove the human elements - emotions, fantasies, etc. People fall for each other all the time: it's basic biology.
Mr. Spock would not make a good shrink.
I would go so far as to say that a shrink who never has such emotional experiences with patients is too robotic to practice in the field of intense and confusing human emotion. Of course, one must ask oneself about transference and countertransference and transference resistance and acting out and patient seductive manipulations and the state of one's own psychology and all that stuff we analytically-oriented shrinks get paid the big bucks to think about - but sometimes a cigar is just a cigar. The world is full of charming and appealing people.
Can a shrink effectively treat a patient they have lasting romantic feelings about, whether it's mutual or not? Probably not, if a chat with a colleague and a little introspection can't deal with it. Refer them out, same as one would with a patient you strongly disliked or distrusted so you can get back to doing your job.
(If any resourceful reader can figure out how to forward this post to the honest Baylor Psychiatry resident, Dr. Raymer, who wrote the linked piece, I think she might appreciate it.)
