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In a seminal paper Blum (1973) differentiated between the erotic transference, which is ego-dystonic and which the patient realizes is not reasonable, and the erotized transference in which the patient is flooded with erotic preoccupations and fantasies about the analyst and hopes fervently that the analyst shares them. Pregenital factors may actually dominate but the patient resists interpretations and wishes to enact urgently the gratification of sexual desires with the analyst. Blum insists this phenomenon is not always pregenital or uninterpretable and he correctly points out that often there has been sexual seduction and overstimulation in the childhood of such patients. Erotized transferences have multiple determinants and a variable course.
In this article I will focus on the obverse of the erotized transference, which I will label the malignant eroticized countertransference. I am using the term “countertransference” in its most general sense, namely, to represent any sort of reaction that the analyst has to the patient, whether it is a reaction to the patient's transference or to any other aspects of the patient that stir up nuclear conflicts in the analyst. This sort of eroticized countertransference is malignant because it has the potential for destroying the therapy, harming the patient's life, and destroying the career and harming the life of the analyst. The terms “erotized” and “eroticized” are used interchangeably in the psychoanalytic literature, and I have chosen “eroticized” here to arbitrarily emphasize that this phenomenon is not primarily one of sexual lust but rather represents the sexualization of serious psychopathology in the analyst.
The mark of malignant eroticized countertransference, of