When the Erotic Enters the Room
From Panic to Backbone
8/22/20262 min read
Many moons ago, before I ever entered formal training, I was an Assistant Psychologist working with my first long-term patient. My supervisor was remarkably brave; when the standard CBT hammer proved ill-suited, she gave me the green light to work psychodynamically. I was already in once-weekly psychoanalytic psychotherapy myself, coming to 2 years in it at the time, and very eager to work deeply.
Then, raw erotic transference entered the room. And, human as it is, I began to feel something in counter-transference. Even worse - it was the first time something like that ever happened to me and to my patient!
I didn't respond with calm clinical poise. I panicked. I dissociated. Three separate times, I "chickened out" and avoided the topic completely. I felt mute, disconnected, and petrified - not just of that patient's body's reaction to me, but of how my own body was registering the moment. Terrified that feeling anything meant I was harming the patient or violating the boundary, I desperately searched for scaffolding - some kind of "word-cards" to think about what felt unthought. I would spend day and night researching the topics of "erotic transference" and "erotic countertransference" online.
That is when I found Andrea Celenza’s Erotic Revelations (alongside David Mann's work). Reading her book felt like a loud, echoing validation: this is normal. Celenza gave me the words to name what had felt dangerously taboo.
Armed with that relief, I brought it to my analyst, who offered his steadying refrain: "Nothing I've heard of today sounds unsafe to me. It actually sounded like something that happens daily in this line of work". That gave me the courage to disclose it to my supervisor, who proved immensely containing.
My fourth attempt to address it with the patient wasn't a polished clinical victory. I dissociated again, floating near the doorframe, watching myself deliver the right words with apparent calm, while the patient... flatly denied everything. Looking back, I don't blame them - I had unwittingly transmitted the message that this material was terrifying. I wasn't ready for this, so how could they be?
Celenza's work reminds us that psychoanalysis is locked in a constant battle against its own desexualisation. While, as female clinicians, we are often praised for empathy and receptivity, we equally need "penetrating insight" and clinical backbone to go where the patient fears to tread. Above all, we must break the isolated, shame-filled bubble through open consultation (or supervision, whatever name it may have where you practice).
Having attended some online seminars with Andrea Celenza, and leaned on her writing to save my clinical sanity (with a decent effect - after all, I decided to pursue this training later on, and I am a trainee now!), seeing Andrea Celenza deliver the keynote address in person feels like a profound full-circle moment.
She will be the keynote speaker at the British Psychoanalytic Council's flagship conference, Psychoanalytic Psychotherapy Now (PPNow 2026):
Theme: The Slippery Slope: Boundary Violations in the Consulting Room and in Our Institutions
Date: Saturday, 14 November 2026 (09:30 – 18:00)
Location: 10 Union Street, London Bridge (SE1) & Live Online Stream
If you have ever wrestled with the panic of erotic material, the fear of boundary transgressions, or the silence surrounding sexual dynamics in clinical practice, I warmly invite you to join us. Tickets are available for both in-person and online attendance, with subsidised rates for trainees.
Will I see you there? Let's break the silence together.