Its the waning moments of my fourth session with a new therapist. Im holding back and she knows it. My entire body feels tense, not ideal for the setting. I try to relax, but the plush leather couch crumples under me when I shift, making the movements extraordinary. Ive barely looked into my therapists blue eyes at all, and yet I think the hour has gone very well. Of course it has. On the surface, when the patient has been highly selective of the discussion topics, therapy always resembles a friendly get-together.

Well, my therapist, Lori, says, the millisecond after I become certain our time is up and I might be in the clear. I dont think I should let you go until weve at least touched on what was put out there at the end of last weeks session.

I so supremely wanted this not to come up. My eyelids tighten, my mouth puckers to the left, and my head tilts, as though Im asking her to clarify.

When you said youre attracted to me, she continues.

Oh, yeah, I say. That.

Back in session three Lori was trying to build my self-esteem, the lack of which is one of the reasons Im in treatment. Within the confines of my family, Ive always been the biggest target of ridicule. We all throw verbal darts around as though were engaged in a massive, drunken tournament at a bar, but the most poisonous ones seem to hit me the most often, admittedly somewhat a consequence of my own sensitivity. Ive been told it was historically all part of an effort to toughen me up, but instead I was filled with towering doubts about my own worth. And since 2012, when I gave up a stable, tenured teaching career for the wildly inconsistent life of a freelance writer, Ive had great difficulty trusting my own instincts and capabilities. I told Lori that I wish I was better at dealing with lifes daily struggles instead of constantly wondering if Ill be able to wade through the thick.

She quickly and convincingly pointed out that I work rather hard and am, ultimately, paying my bills on time, that I have friends, an appreciation for arts and culture, and so on. In short, I am, in fact, strong, responsible and pretty good at life.

Then Lori heightened the discussion a bit. I also feel that it is your sensitivity that makes you a great catch out there in the dating world, she said, to which I involuntarily smiled, blushed and quickly buried my chin in my chest. I was too insecure and too single to handle such a compliment from a beautiful woman.

Why are you reacting that way? Lori asked.

I shrugged my shoulders, only half looking up.

Is it because youre attracted to me?

I laughed a little, uncomfortably. How did you know?

She gently explained she could tell the day I walked into her office for the first time, after I flashed a bright smile and casually asked where she was from.

Now, a week after dropping that bomb, Lori asks, So, why havent we talked about it?

I was hoping to avoid it, I suppose. I tell her the whole notion of having the hots for a therapist is such a sizable clich that I was embarrassed to admit it. For Christs sake, I say, throwing my hands up, Tony Soprano even fell in love with his therapist.

Lori snorts, rolls her eyes. I knew you were going to say that.

I smile, shake my head and look around the room, denying acceptance of my own ridiculous reality.

Its OK, Lori says, grinning. We can talk about this in here.

I look again at her stark blue eyes, prevalent under dark brown bangs, the rest of her hair reaching the top of her chest, which is hugged nicely by a fitted white tee under an open button-down. She jogs often, Id come to find out, which explains her petite figure and ability to probably pull off just about any outfit of her choosing.

I still cant speak, so she takes over.

Do you think youre the first client thats been attracted to their therapist? she asks rhetorically. Ive had other clients openly discuss their feelings, even their sexual fantasies involving me.

What? I cackle, beginning to feel as though Ive moseyed onto the set of a porno.

Its true, she says, acknowledging her desk. Whats yours? Do you bend me over and take me from behind?

Nailed it.

If thats what youre thinking, its OK, she goes on, earnestly, explaining that shes discussed sexual scenarios with her clients before so as to normalize the behavior and not have them feel their own thoughts are unnatural. By showing the patient a level of acceptance, she hopes to facilitate a more comfortable atmosphere for the work her painfully accurate pseudonym for psychotherapy.

I take a second to let the red flow out of my face, and ponder what she said. Im a little unsure about this whole technique, but the more I think about it, the more it makes sense. So I go home, incredibly turned on and completely unashamed.

* * *

One of the great breakthroughs Ive had in the thirteen months since I began seeing Lori (who agreed to participate in this article, but requested that her full name not be published) is a new ability to accept the existence of dualities in life. For instance, Ive always had a tremendous sense of pride that, if it doesnt straddle the line of arrogance, certainly dives into that hemisphere from time to time. Im great at seeing flaws in others and propping myself up above them by smugly observing my character strengths. Ive never liked that about myself, but the harder concept to grasp is the fact that I can be so egotistical while also stricken with such vast quantities of insecurity.

In treatment I came to realize that all people have contradictions to their personalities. Theres the insanely smart guy who cant remotely begin to navigate a common social situation, the charitable girl who devotes all her time to helping strangers, but wont confront issues in her own personal relationships. In my case, my extreme sensitivity can make me feel fabulous about the aspects of myself that I somehow know are good (my artistic tastes) and cause deep hatred of those traits I happen to loathe (the thirty pounds I could stand to lose).

My next session with Lori is productive. We speak about relationships Ive formed with friends and lovers, and how my family may have informed those interactions. One constant is that I put crudely high expectations on others, mirroring those thrown upon me as a kid. Im angered when people dont meet those expectations, and absolutely devastated when I dont reach them. Lori points out that it must be exhausting trying to be so perfect all the time. I am much more comfortable than I was the week prior, and can feel myself being more candid. Im relieved that the whole being-attracted-to-my-therapist thing doesnt come up.

Then, a week later, Lori mentions it, and I become tense again.

I thought Id be able to move past it, I say, adding, We aired it out, and its fine.

As definitive as Im trying to sound, Lori is just as defiant.

Im glad you feel that way, she begins, but I think you owe yourself some kudos. This kind of therapy, she shares, isnt something just anyone can take on. Such honest discussion doesnt simply happen, it takes tremendous guts, and Lori can see that I am dealing with it relatively well, so I should praise my own efforts.

Shit, we both should be proud of ourselves, she says. Its not easy on the therapist either, you know.

Why not?

Because talking openly about sex is risky at any time, much less with a client. She explains that therapists are warned any semblance of intimacy can be easily misconstrued. We learn in our training to not personally disclose, for example, she says, but adds that, occasionally, transparency can be helpful.

Still, with you, she continues, until I raised the question, I didnt know for sure that you would go with it; for all I knew youd run out of here and never come back to risk being so uncomfortable again.

Shes building my confidence more, and Im learning that I play a much bigger role in how my life is conducted than I often realize. My treatment wouldnt be happening if I werent enabling it.

Then she says, And dont think its not nice for me to hear that a guy like you thinks Im beautiful.

Crippled by the eroticism of the moment, and combined with the prevailing notion that no woman this stunning could ever be romantically interested in me, I flounder through words that resemble, Waitwhat?

If we were somehow at a bar together, and you came over and talked to me, she says, then flips her palms up innocently, who knows?

I laugh again and tell her thered be almost no chance of me approaching her because Id never feel like I had a shot in hell.

Well, thats not the circumstances were in, she says. But you might. Who knows?

Im confused Is she really attracted to me or is this some psychotherapeutic ruse? Im frustrated I told her I didnt really want to talk about it. Shouldnt she be more sensitive to my wants here? Im angry Is she getting an ego boost out of this? Most of all, I dont know what the next step is Am I about to experience the hottest thing thats ever happened to a straight male since the vagina was invented?

There were two ways to find out:

1) Discontinue the therapy, wait for her outside her office every day, follow her to a hypothetical happy hour and ask her out, or

2) Keep going to therapy.

* * *

A week later, Im physically in the meeting room with Lori, but mentally I havent left the recesses of my mind.

Where are you today? she asks, probably noticing my eyes roving around the room.

I dont know.

Are you still grappling with the sexual tension between us?

Here we go again.

Yes, I say, with a bit of an edge in my voice, and I dont know what to do about it.

Lori, ever intently, peers into my eyes, wrinkles her mouth and slightly shakes her head.

Do you want to have sex with me? she asks.

We both know the answer to that question. All I can do is stare back.

Lets have sex, she announces. Right here, right now.

What? I respond, flustered.

Lets go! she says a little louder, opening up her arms and looking around as if to say the office is now our playground, and, oh, the rollicking fun wed have mixing bodily fluids.

No, I tell her, You dont mean that.

What if I do? she shoots back. Would you have sex with me, now, in this office?

Of course not.

Why of course not? How do I know for sure that you wont take me if I offer myself to you?

I wouldnt do that.

Thats what I thought, she says, and tension in the room decomposes. Mike, I dont feel that you would do something that you think is truly not in our best interest, which is exactly why I just gave you the choice.

Her offer was a lesson in empowerment, helping me prove that I have an innate ability to make the right choices, even if Id so desperately prefer to make the wrong one.

I see what she means. Im awfully proud of myself, and its OK to be in this instance. Im gaining trust in myself, and confidence to boot. But, as the dualities of life dictate, Im successfully doing the work with a daring therapist, while at the same time not entirely convinced she isnt in need of an ethical scrubbing.

* * *

I dont have another session with Lori for nearly three months, because she tooka personal leave from her place of employment. When our sessions finally resumed, I could not wait to tell her about my budding relationship with Shauna.

Ten minutes into my first date with Shauna right about the time she got up from her bar stool and said she was going to the can I knew she would, at the very least, be someone I was going to invest significant time in. She was as easy to talk to as any girl Id ever been with, and I found myself at ease. Plans happened magically without anxiety-inducing, twenty-four-hour waits between texts. Her quick wit kept me entertained, and I could tell by the way she so seriously spoke about dancing, her chosen profession, that she is passionate about the art form and mighty talented too. Shauna is beautiful, with flawless hazel eyes and straight dark hair, spunky bangs and a bob that matches her always-upbeat character. She is a snazzy dresser and enjoys a glass of whiskey with a side of fried pickles and good conversation as much as I do.

Things escalated quickly, but very comfortably, and since wed both been in our fair share of relationships, we knew the true power of honesty and openness. So upon the precipice of my return to therapy I told Shauna about Lori, and admitted to having mixed feelings about what I was getting back into. I told her I was at least moderately uncertain if my mental health was Loris number-one concern since she always seemed to find the time to mention my attraction to her.

The first two sessions of my therapeutic reboot had gone great. Lori appeared genuinely thrilled that I was dating Shauna and could see how happy I was. I wasnt overwhelmed with sexual tension in the new meeting room, though it wasnt actually spoken about, and in the back of my mind I knew it was just a matter of time before it would start to affect my ability to disclose my thoughts to Lori again.

Then, while attempting to ingratiate myself with my new girlfriends cat by spooning food onto his tiny dish on the kitchen floor, I hear my phone ding from inside the living room.

You got a text, babe, Shauna says. Its from Lori.

Im so impressed with you and the work youre doing Shauna reads off my phone from inside the living room, inquisitively, and not happily. I stuff the cat food back into the Tupperware and toss it into the refrigerator. I make my way into the living room, angry at myself for not changing the settings on my new iPhone to disallow text previews on the locked screen. Shaunas walking too, and we meet near the kitchen door. Whats this? she says, holding up the phone. Your therapist texts you?

I take the phone from Shauna and say the most obvious, clich-sounding thing: Its not what it seems.

As I text back a curt thanks, Shauna tells me shes going to ask her sister, a therapist herself, if its OK to text patients.

Dont do that. I say, a little more emphatically. I promise, this is nothing to be worried about. Were not doing anything wrong. I explain that Loris just trying to build my self-esteem.

The only reason Im even bringing this up is because you said you werent sure about her in the first place, Shauna reminds me. I can tell she regrets looking at my phone without my permission, but I completely understand her feelings.

At my next session I tell Lori that Shauna saw her text and wasnt thrilled about it.

She probably feels cheated on to some degree, Lori says. A relationship between a therapist and a patient can oftentimes seem much more intimate than the one between a romantic couple.

Lori goes on to point out that the reason she feels we can exchange texts, blurring the lines between patient/doctor boundaries a hot topic in the psychotherapy world these days is because she trusts that Ill respect her space and privacy. Youve proven that much to me, she says.

On my walk home, instead of being angry at Lori, I understand her thinking behind the text. But Im also nervous about how Lori and Shauna can ever coexist in my life.

Isnt therapy supposed to ameliorate my anxiety?

* * *

A week later, Lori begins our session by handing me a printout explaining the psychotherapeutic term erotic transference written by Raymond Lloyd Richmond, PhD. It says that erotic transference is the patients sense that love is being exchanged between him or herself and the therapist the exact sensation I was experiencing with Lori, of which she was astutely aware.

According to Richmond, one of the primary reasons people seek therapy is because something was lacking in their childhood family life, perhaps unconditional nurturing guidance and protection. Upon feeling noticed and understood by a qualified therapist, sometimes a patient can be intoxicated by their therapists approval of them. A patient may in turn contemplate that a love is blossoming between them, and, in fact, it sort of is.

From an ethical standpoint, Richmond argues all therapists are bound to love their patients, for therapists are committed to willing the good of all clients by ensuring that all actions within psychotherapy serve the clients need to overcome the symptoms which brought them into treatment. This takes genuine care and acceptance on their part. However, a patient can easily confuse the love they feel with simple desire. Theyre not quite in love with their therapist, so much as they yearn for acceptance from someone, and in those sessions they just happen to be receiving it from their doctor.

Lori tells me that, all along, she has been working with what I gave her and that because I flirted with her a bit, she used that to her advantage in the treatment. In employing countertransference indicating that she had feelings for me she was keeping me from feeling rejected and despising my own thoughts and urges.

Theres two people alone in a room together, and if theyre two attractive people, why wouldnt they be attracted to each other? says Dr. Galit Atlas. A psychoanalyst whos had her own private practice for fifteen years, Dr. Atlas has an upcoming book titled The Enigma of Desire: Sex, Longing and Belonging in Psychoanalysis, and I sought her as an independent source for this essay to help me understand Loris therapeutic strategies.

Dr. Atlas explains that there are certain boundaries that cannot be crossed between therapist and patient under any circumstances like having sex with them, obviously. But many other relationship borders can be mapped out depending on the comfort level of the therapist, as long as they stay within the scope of the professions ethics, which complicates the discussion surrounding erotic transference.

As a therapist, I have a role, Dr. Atlas says. My role is to protect you. She says it is incumbent on the therapist to not exploit the patient for the therapists own good, but admits that the presence of erotic transference in therapy brings about many challenges. [Attraction] is part of the human condition, she observes. In therapy, the question then is: What do you do with that? Do you deny it? Do you talk about it? How do you talk about it without seducing the patient and with keeping your professional ability to think and to reflect?

I ask her about the benefits of exploring intimacy in therapy, and Dr. Atlas quickly points out that emotional intimacy though not necessarily that of the sexual brand is almost inevitable and required. An intimate relationship with a therapist can [be] a reparative experience repairing childhood wounds but mostly its about helping the patient to experience and tolerate emotional intimacy, analyzing the clients anxieties about being vulnerable and every mechanism one uses in order to avoid being exposed.

Dr. Atlas says this topic speaks to every facet of the therapeutic relationship, regardless of gender or even sexual orientation, because intimacy reveals emotional baggage that both the patient and therapist carry with them into the session. But this isnt a symmetrical relationship, and the therapist is the one who holds the responsibility.

Freud said that a healthy person should be able to work and to love, she says. In some ways therapy practices both, and in order to change the patient will have to be known by the therapist. That is intimacy. In order to be able to be vulnerable, both parties have to feel safe.

After I briefly explain all that has gone on between me and Lori, Dr. Atlas steadfastly says she does not want to judge too harshly why and how everything came to pass in my therapy. I dont know your therapist, and I dont know your history, she says. But she offers that I should explore the possibility that I might have created and admitted my sexual adoration of Lori because one of my fears is to be ignored, not noticed.

Then I offer: Maybe this essay is being written for the same reason.

Exactly.

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