In Bed with our Clients: Should Psychotherapists Play Matchmaker or is this Plain Old Erotic Transference?

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"We were trained to improve people’s mental health and understand relationship patterns so that we can help our clients improve these patterns. We were not trained to assess chemistry and dating potential." Dr. Keely Kolmes

In Bed with our Clients: Should Psychotherapists Play Matchmaker or is this Plain Old Erotic Transference?

By Keely Kolmes, PsyD.

Last January, there was an opinion piece in the New York Times, written by Richard Friedman on whether therapists should play Cupid for clients,
basically performing as a matchmaker, setting them up on dates. The article focused primarily on the fantasies that some clinicians have about wanting to do this and the potential issues that could come up regarding transference. It did not speak directly to erotic transference, but I think this is a key component of such a question.

Following the article, HuffPost Live did a segment on which I was one of four guests interviewed about our points of view on the issue. As expected, the show included diverse opinions and even had the one clinician, Terah Harrison, who has expanded her practice to include matching services.

Another clinician, Dr. Lazarus, argued passionately that we are
"uniquely well positioned" to make such matchmaking recommendations to our clients. Jeff Sumber agreed it was unethical but he admitted to having such strong fantasies about fixing up his clients that he'd deliberately scheduled people in hopes they might meet. (I imagine his clients are now wondering as they arrive for therapy if the person leaving is someone he has chosen for them?)

Guess which role I played on this segment? Yes, I was the conservative fuddy-duddy talking ethics, dual relationships, and risk management.  See the video here:

One of the problems with acting upon these fantasies and meddling with our clients’ love lives is that our clients can come to believe that we know better than they do what is good for them. And we can fall prey to such beliefs ourselves. We can think we know our clients very well, and we often do come to know them deeply. We were trained to improve people’s mental health and understand relationship patterns so that we can help our clients improve these patterns. We were not trained to assess chemistry and dating potential.

In some ways, we already play matchmaker to our patients in other appropriate ways. For example, we may refer an individual patient to a couples therapist or to a psychiatrist, which is one type of matchmaking which actually serves the treatment. But for as many times as I’ve heard that my referral was a good fit, I’ve had clients return and say, “I couldn’t stand that doctor and I hated the other one’s website, and the third never returned my calls. Can you give me some other names?”

This kind of frank feedback might be more difficult to give if the person whose name I’m giving them is a potential romantic partner or someone from my personal life. They might feel pressure to please me or think I know better than they do who they should be dating. One of the truths we must learn as we become experienced clinicians is that our impressions of our clients (and our colleagues and all others in our lives) are not objective. We are all forming subjective impressions of people all of the time. If we mistake these impressions for “the truth,” then we’ve fallen prey to the fantasy of our own omnipotence.

One person in Friedman’s article recalled a boss who tried to set her up with one of his patients. Later, the female subordinate realized it was the boss who had a crush on her. For me, this was the core element to this question of whether we should do this. I would guess that most psychotherapists who become invested in trying to introduce their patients to potential romantic partners are expressing erotic counter transference. Is this a way to "get into bed" with one’s clients figuratively—since it’s very clear that to actually bed a client would be completely unethical?

After all, if you are successful in hooking two of your clients up, you will ultimately find yourself in two therapies listening to two different people telling slightly different stories about one another. Do the stories match up? Is one person expressing more commitment than the other? Are you pulled to protect one of them? If the potential dating partner is not a client of yours, but, rather, someone you know in your personal life, you will then be getting extraneous information about your client, unless you draw a firm boundary and refuse to hear such stories. Either way, you still have to maintain confidentiality and objectivity in that relationship.

Regardless of which scenario unfolds, this is my idea of a psychotherapy nightmare in which I may be forced to try to stay objective and keep silent about two people to whom I have very different allegiances. To maintain balance here would require extremely good boundaries (perhaps beyond my capabilities) and it might likely warrant a referral out of treatment in the event that I have lost my ability to remain objective.

The thought of wanting to intentionally create such a
complication for my practice is unlikely. I do want the best for my patients. This, of course, includes their romantic happiness. But part of what I hope to do is to help them feel empowered to go out and find a partner on their own. I want to help them improve and trust their own judgment and intuition in finding good partners for themselves, not to learn to depend upon my judgement or elevate my perceptions above what they know to be true about themselves. 

Keely Kolmes, Psy.D. is a licensed psychologist in San Francisco, CA with an office in the Financial District. Prior to beginning private practice she worked for six years at Stanford University’s Counseling Center. She is the Founder and President of Bay Area Open Minds. To find out more about her altsex, kink, poly, and sex positive services with adults, please visit her website.

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