Sam Wants to Talk About Our Relationship

In the summer of 2020, just a few months after she’d closed her office due to Covid and we’d started seeing each other over video, she told me that she thought we should talk about “our relationship” — specifically “who we are to each other.”

I objected. “Who we are to each other is you are my therapist. We don’t have a relationship. I don’t pay people with whom I have a relationship to talk to me, I don’t make weekly appointments with them, and relationships are mutual and not all about me and my problems.”

I brought up the boundaries inherent in our “relationship” and she agreed that ours was a “transactional relationship,” though she also said that keeping to the boundaries was “excruciating” for her. I didn’t know if she meant in general, in her practice (in which case she should have been actively seeking consultation or further training with more experienced therapists), or with me specifically.

Despite my dismissal of the idea that we had a relationship in any way that I think about relationships, she kept coming back to it.

I understand that in psychoanalysis, the relationship between therapist and patient—the “dyad”—can be used as a mirror to reflect the patient’s other relationships, that what plays out in the therapy room may be what plays out in the rest of the patient’s life. Frued conjured the word “transference” to mean that a patient might impose on the psychologist the unregulated feelings they have about someone else (stereotypically, a parent).

Freud himself had no boundaries. He lent money to patients. He had sex with them. He assumed women all had father fixations when, in fact, women seeking psychological help from him were probably, like many women at the time, sexually abused by their fathers. His concept of “penis envy” is laughably from a time where women were by definition second class citizens to men and he mistook an un-realizable desire for equal power as a feeling of castration. Freud came up with a lot of insightful stuff, but he was also an uninformed idiot from the perspective of today. Nevertheless, I was seeing someone who considered herself as coming from a psychoanalytical orientation.

There is also the concept of counter-transference. That is, unconscious needs and feelings about others that the therapist superimposes on their patient. The therapist, trained and presumed sensitive to monitoring themselves for their own countertransference reactions, must understand and control for it. It’s not necessarily a bad thing–countertransference can lead to insight as a therapist examines the feelings that their patient inspires in them. Like: “Did Matt unintentionally trigger a narcissistic injury in me when he said we wouldn’t be friends and rejected the idea that we are in any kind of real relationship and thereby rejected the feelings I have counter-transfered on him? And if so, how do I acknowledge formative feelings and adjust so they can be productive in my work with him rather than let them steer me in a wrong direction?”

What the therapist might have done, had she consciously been able to reckon those countertransference feelings, is to try to understand whether “Matt” (in quotes here because I am hypothesizing a description of her countertransference) had triggered her own feelings of inadequacy because he made a pattern of pushing back on people he cared about. She would have used that to try to work with him to understand whether that is indeed the case and what he might do to move past that. (To be clear, that’s not how I understand myself.)

And if her countertransference were impairing her ability to put the patient first because she could not handle the injury Matt’s pattern caused in her, her duty would have been to refer him to another therapist to complete the work.

Which is what I think she should have done. But I’m getting ahead of the story.

Over the summer of 2020, I observed to Sam that in the past, when a session would begin, she would always have a very neutral, almost studiedly sympathetic and almost sad facial expression, but that recently I’d noticed that whenever we came up on screen she would break into a broad smile. She acknowledged that this was so and that the neutral face was part of her standard way of beginning sessions so clients could set the tone, but that she too had noticed that she was happy to see me, and she let her smile out rather than maintain that strategic neutrality. This made me feel that the nature of our (ok) relationship was unlike that of her other patients. And that if it was unlike her other patients, I wondered what that meant about me that she was dropping her professional exterior for me and showing me something else. It felt like I was special to her in some way.

In the same way that it feels good when someone in your regular life tells you that you matter to them, it felt somewhat extraordinary to see this happen with someone who I knew was supposed to be professionally constrained from doing so.

But the constant refrain of talking about our relationship was mystifying to me. Why was my therapist bringing an agenda to the conversation? Before, I had come in with what I wanted to talk about—something from my week, a feeling I wanted to explore, a dream I had had the night before, very often a family interaction centered on my son. Now, she kept trying to steer the conversation towards our “connection.”

Another friend, my age and male, was also seeing a female therapist while he was in the midst of a rather horrible divorce. I asked him if his therapist had put any emphasis on discussing their relationship. “Not at all. Yours does? Is she hitting on you?”

I didn’t know.