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Caring is the term most often used for clinical concern, but the word passion better transmits the deep-running sense of interest and often outrage that must infuse difficult and persistent clinical efforts.
In 1907 Freud called psychoanalysis “a cure by love.” What did he mean? Where did sexual love fit into his formulation? If a patient “falls in love” with a therapist, are the feelings the patient experiences as “real” as the feelings experienced by a couple in an intimate relationship? What, then, of countertransference love? Do we speak of “caring” about a patient, a “kind of affection,” because we don't have the courage to call it love? Is there a place for genuine love on the therapist's part? These questions reflect central issues of concern to psychotherapists dating back to the earliest analytic relationships.
Except for the work of a few pioneers (Field, 1989; Samuels, 1985), until recently the professional literature has been remarkably silent on the subject of erotic countertransference feelings. Hate in the countertransference is much better understood than the feelings of love or eroticism that may emerge in treatment (Searles, 1959; Winnicott, 1965). Typically, when therapists have written about their own sexual feelings for patients, they echo the traditional advice to control the feelings, go back into analysis, and terminate the treatment if there is any possibility that the feelings might spiral out of control.
Recently, there has been an attempt to examine more thoughtfully the issues around love in the therapeutic setting. The 1992 annual conference of the American Psychoanalytic Association was focused on “Love in the Analytic Setting.” The following year there was a meeting on the same theme at the American Psychological