Conversas sobre sentimentos sexuais na relação terapêutica

Abstract

Behavioral and cognitive behavioral psychotherapy have, in recent decades, evolved in the way they speak, understand and manage the therapist – client relationship. Three waves of behavioral psychotherapy mark this development, adding to clinical psychologys, interest in subjective and experiential aspects of the therapist – client relationship. The psychotherapeutic relationship can provide significant and change experiences both the patient and the therapist. Various feelings can arise during a session, including sexual feelings or romantic attraction to the patient by his psychotherapist. Psychotherapies describe how therapists should understand, use and manage feelings in the relationship with the patient. Contemporary behavioral psychotherapies invite psychotherapists to use their own person and their feelings as a therapeutic tool. This makes it is necessary to know how this requirement works for the professional person in daily office reality. This thesis seeks to clarify specifically what involves the sexual feelings of the patient in the therapeutic relationship and how therapists handle these feelings of the patient. The main objective is to clarify the impact and implications of sexual feelings of the patient, the therapeutic relationship in behavioral analytic and cognitive behavioral psychotherapy. The research is qualitative in nature, exploratory and interpretive, according to a contextual approach and inductive method, framed on grounded theory analyses. 28 therapists (27 female and 1 male) with at least two years of professional experience, were intervened about situations experienced in the clinical environment related to attempted sexual involvement and romantic approach by patients. The semistructured interviews were transcribed and subjected to analytical coding with the intention of allowing categories that describe the dynamics of sexual feelings of the patient in view of the therapist who is the object thereof. Patients try to break boundaries by commenting on the therapist physical characteristics, idealize and praise the therapist, report sexual fantasies in relation to the therapist, ask the therapist personal questions, ask the therapist out and try to obtain prolonged physical contact and intensity breaching the conventional patterns. The impact on the feelings of therapists are embarrassment, discomfort, guilt, discomfort and helplessness, bewilderment and shock, shame and feeling disrespected and void. Behavioral therapists try to manage alliance ruptures by making the relationships blocking patient problem behavior, seeking external support, or taking advantage of the sentiments expressed by the patient for the therapeutic process. As a result the some patients quit therapy, and others remain in treatment and experience benefits in term behavioral change.