Does your therapist love you?

An essay on how therapeutic love shapes the healing process.

Alchemical print via source

Let’s imagine this scenario: you’re on a first date with someone and they’re asking all sorts of questions to get to know you. Where did you grow up? Do you like your job? Are you close to your parents? Do you prefer cats or dogs? Are you an introvert or extrovert? And then, they ask a question that completely stumps you:

Do you think your therapist loves you?

How do you respond? (tell me in the comments!) Do you change the subject? Do you ponder it for a while? Do you admit that you don’t really know–but that you long for your therapist’s love? Do you give a generic answer, like I’m sure therapists love all their clients in some way? Do you get defensive? Do you state that love is inappropriate in the therapeutic relationship? Do you puff up your chest and readily agree: how could they not, I’m an amazing client?!

Regardless of your response, I’m willing to bet that this question hasn’t left you indifferent–if you’re feeling a bit flustered, I get it. After all, is it possible that a stranger who knows all your deepest thoughts, regrets, and feelings, and whom you pay every week for it, truly loves you? And, most importantly, should love even be a part of psychotherapy?

The taboo of love

“The greatest need of a child is to obtain conclusive assurance
(a) that he is genuinely loved as a person by his parents, and (b) that his parents genuinely accept his love. […] Frustration of his desire to be loved as a person and to have his love accepted is the greatest trauma that a child can experience.”
Ronald Fairbairn

I’m not surprised when people feel uneasy when they hear about love in the therapeutic relationship. The Greeks famously have more than five words to differentiate the bonds they’re involved in–we only have one. We love our pets, we love our partner, we love our parents, we love pizza, we love our friends… but these loves are far from equal. We often say love when we mean attachment, sexual attraction, kinship, or just fondness. The absence of specificity can make us confused about our own feelings, as they’re all bundled up in one generic word: love.

Much of our confusion about love also comes from our mistaken understanding of it as a feeling-state, rather than a way of acting. But feeling love is not the same as loving someone, just as declarations of love are not equivalent to demonstrations of it. This distinction is particularly (and painfully) obvious in parent-child dynamics: parents who feel very loving towards their children can also abuse them greatly and fail to take responsibility for the dissonance between their inner feeling-state and the impact on the child.

And this brings us to our history of love. For many of us, our early experiences of loving and being loved also meant being engulfed, taken advantage of, abused, humiliated, neglected, abandoned, beaten up, or rejected. These betrayals of love often alternated with genuine warmth, which only made us more confused about love.

“A withholding parent, consciously sadistic or not, can go a long way toward bringing up a masochistic child, who would then have a strong chance of becoming an adult ‘looking for love in all the wrong places’—in constant search of recognition from others who cannot or will not provide it.”

(Daniel Shaw, Traumatic Narcissism: Relational Systems of Subjugation)

In some instances, love lacked completely. Those of us who grew up with narcissistic parents experienced our desire to love and be loved as “an unreasonable, selfish demand, and as an accusation by the child that the parent isn’t giving enough”. To preserving our attachments and the illusion that we’re loved, many of us had to give up parts of ourselves to appease parents who couldn’t accept us as we were.

To love and be loved means to lose oneself and to suffer greatly–so why would we want that from our therapist?!

What is love (in psychotherapy)?

So while it’s understandable why we may feel distrusting of love in the psychotherapeutic relationship, it’s interesting to consider that research consistently shows that the quality of the therapeutic relationship is the primary predictor of success in therapy–significantly more than technique, therapeutic modality, or any other factors.

What’s more, this finding is consistent even with modalities where the therapeutic relationship appears to be of secondary importance–for example, in psychedelic-assisted therapy. In the Psilocybin Assisted Therapy Trials for Depression, the strength of the relationship between client and therapist predicted “greater emotional-breakthrough and mystical-type experience”, with a direct impact on final depression scores, not mediated by the acute experience”. The weaker the alliance, the weaker the client’s improvement.

We really can’t deny it. Love is important in therapy–if not the most important part of it. It’s essential to our neurological, psychological, and emotional development in childhood and it’s just as important in our later development, in therapy. The quality of the therapeutic alliance, manifested as the quality of the therapist’s love for the client as felt by the client, is what heals us.

“No one can cure another if he has not a genuine desire to help him; and no one can have the desire to help unless he loves, in the deepest sense of the word.”

(Sasha Nacht in Traumatic Narcissism: Relational Systems of Subjugation)

After four years of intense therapy training and several more of personal therapy, I have to agree. Feeling loved by my therapist has been one of the most transformative parts of our work together, with immediate effects.

Even though our alliance has been built over years of weekly work, it eventually translated into a tangible increase of self-belief, more self-compassion, a sustained resilience to stress, and a greater capacity as a therapist. It gave me my first experience of being loved in a “clean” way–generously, without self-interest, and with plenty of space to be myself. It paved the way for better relationships and it raised the bar for who I allow in my life.

Regardless of how many books on love I’ve read, it was my therapists who taught me what love actually is.

And I can confirm this from the therapist’s chair too. As someone who has invested an enormous amount of energy in learning the newest, most effective therapeutic modalities, I’ve been surprised to find that the most transformative moments in my work with clients didn’t come from perfect technique (although that’s important), but from love: a genuine liking, acceptance, and enjoyment of the people sitting in front of me, even when they’re not particularly likeable, acceptable, or enjoyable.

Guidelines for therapeutic love

But how can one love be hurtful (or traumatising) and another one healing?

Well, the love I speak about is not romantic, sexual, or countertrasnferential (as in, projected from the therapist’s past experience onto the client). And it’s not only a feeling–it’s an ability to be with others, honed through many (!!!) years of working through my own muddled understanding of love, through lots of learning, and (yes) good technique. It’s a love that needs to be taken to supervision, broken apart, and truly investigated for any impurities that could pollute it. It’s a love that requires constant work and action. And, paradoxically, it’s a love that also comes naturally when all the other work is in place.

To further demystify the idea of therapeutic love, I will break down some of the key ideas behind a healing therapeutic relationship based on love. I hope it will help you see (and especially feel) your therapist’s love for you, if you are in therapy. If applied skilfully, these principles can make all relationships a healing experience for their participants, outside of the therapeutic realm–so feel free to take inspiration from them.

Empathy, congruence, and unconditional positive regard

Carl Rogers, the founder of humanistic (person-centered) psychotherapy, proposed that the positive relationship between therapist and client relies on the therapist’s ability to understand experience from the client’s perspective (empathy). This kind of empathy doesn’t happen by magic, but is a skill that requires an exchange between the two, with the aim of of “getting it”–that the client feels gotten. The therapist’s dedication to truly understand, rather than assume, is an act of love towards the client.

In addition, love happens via unconditional positive regard: the therapist’s non-judgemental attitude that accepts the client as they are, without the desire or need to change them. This attitude is particularly important (and more challenging) with clients who verbally attack the therapist or express their desire to harm others. In such cases, the ability to remain connected to the client, not withdraw empathy, and especially not punish or abandon the “difficult” client can be profoundly healing.

Finally, Rogers advocated for congruence, as the therapist’s commitment to act in accordance to their own beliefs and experience. This is similar to authenticity, which I’m explaining below.

Authenticity

Existentialists like Irvin Yalom would argue that a significant factor in the positive client-therapist relationship relies on the therapist’s willingness to be authentic. In his book The Gift of Therapy, he advises new therapists to let go of the blank screen agenda of psychoanalysis and be real: to express their genuine feelings in the moment and to self-disclose, cautiously and when appropriate. Done skilfully and consciously, self-disclosure (and answering client’s personal questions) can be an act of love that honours the humanity of both sides.

Mutual recognition and intersubjectivity

Psychoanalytic literature emphasises the importance of mutual recognition and reciprocity as the therapist’s ability to acknowledge, validate, and understand the client–not just intellectually, but through allowing herself to be influenced and moved by the client, sharing in the states of mind. Mutuality implies reciprocity, rather than a power dynamic of therapist-as-expert and client-as-patient.

More importantly, this kind of loving relationship demands intersubjectivity–that the therapist recognises and responds to the client as a subject, rather than an object. Intersubjectivity acknowledges others as separate beings with their own realities, feelings, gifts, hopes and dreams, and accepts that they may be different from ours without needing to change them. In itself, intersubjectivity is an act of love, as it presents as a genuine interest in the client and a recognition (even celebration) of their unique self and their gifts. This creates what Donald Winnicott, the famous British psychoanalyst, calls a facilitating environment: a safe place to grow and become oneself.

Its opposite, objectification, is the denial of someone’s subjective existence and their treatment as an object that has to match your reality, which is traumatising (and a common feature in narcissism).

Surviving hate and negative feelings towards the therapist

Drawing from his observations of mother-infant relationships, Winnicott offered some astute indications of what it means to be a good-enough therapist–especially when challenging feelings such as hatred arise.

Just as a mother needs to tolerate both her occasional hate towards the baby’s extreme dependence on her, as well as the baby’s hatred and rage at herself, so the therapist needs to recognise and tolerate the hate that sometimes arises in the therapeutic relationship. Allowing strong feelings like hate or a desire to destroy the therapist (without punishing, abandoning, or blaming the client) is a profound act of love that validates the client’s experience and offers them the space to work it through.

Psychoeducation and collaboration

Modern, trauma-informed approaches to psychotherapy emphasise the role of psychoeducation in treatment. While not explicitly framed as love, I believe this act of teaching to be a loving one–helping the client better understand themselves by sharing otherwise inaccessible insights.

For example, trauma modalities like Sensorimotor Psychotherapy rely on psychoeducation and collaboration to foster trust in the therapeutic relationship. This attitude places both the therapist and the client’s expertise as equally valid: one in the theory and practice of the therapy, the other in their own lived experience. In this sense, all interventions are done with the client’s explicit understanding and consent. This attitude is respectful of the client’s integrity and ability to know what’s best for them, even when the therapist may disagree.

Putting all theories aside

Finally, I find that the ultimate act of love is the therapist’s ability to remember that, at its origin, psychotherapy means “care of the soul” (in Ancient Greek psyche=breath, spirit, soul). This means that, occasionally, the therapist must be able to set theories aside and be willing to experience the client not as a set of diagnoses, treatment plans, or prognoses–but as something way more mysterious, impenetrable, and in many ways unknowable.

Letting go of the formulations of theory means being humble enough to admit that, no matter how knowledgeable we are as therapists, we can never know what soul demands of our clients. This non-rigid view lets go of ideas about what’s “normal” and assists clients in following their own paths, even when we couldn’t conceive of living such lives ourselves.

I find this love the most trying of all: letting go of trying to be a good therapist and trusting in the greater order of things. Such a transpersonal attitude requires serious humility and discernment and, most of all, that the love for the client is part of a greater love for all things. When therapists love consciousness (or the gods or existence itself), they stop trying to fix clients–and they love them, as they’re meant to be, instead.

“To decide when to apply the one or the other method rests with the analyst's skill and experience. Practical medicine is, and has always been an art, and the same is true of practical analysis. True art is creation, and creation is beyond all theories. That is why I say to any beginner: Learn your theories as well as you can, but put them aside when you touch the miracle of the living soul. Not theories, but your own creative individuality alone must decide.”

(CG Jung)

Too much love in the therapeutic relationship?

As you’ve seen, the concept of love in psychotherapy consistently proves to be the primary healing agent. However, this love is anything but simple. To facilitate healing, therapeutic love must be grounded in theory, ethics, and the therapist’s own personal development. In its essence, it shouldn’t feel like it’s about the therapist at all–“clean love” is not narcissistic.

But things aren’t always like that. Therapists who haven’t worked through enough of their own distortions of love can get confused when sitting with clients. This can lead to a myriad of experiences that, at their best stall growth, and at their worst retraumatise the client.

For example, love can often take on sexual undertones which, if not analysed, can lead to boundary violations and sexual misconduct. Therapists can feel envious. They can feel possessive of their clients, encouraging dependency. Like an anxious mother who doesn’t let her baby fall or explore, therapists can become too attached to clients and not allow them to make their own decisions or pursue relationships. Narcissistic therapists will likely make the therapy about them and use the client to prove how capable, loving, and talented they are in their roles. If need be, they will deny the client’s reality in order to maintain theirs–all in the name of love for the client.

I will be exploring these themes and the shadow of therapy in future essays on this newsletter. Meanwhile, I’d love to hear from you in the comments (and feel free to like and share this essay with others):

• Do you/did you ever feel loved by your therapist?

• What makes you feel loved in the therapeutic relationship? What did this teach you about how you need to feel loved in other relationships?

• How do you feel you’ve growth from this love?

• If you’re a therapist, (how) do you experience love for your clients? What was the most surprising part of loving your clients? How has this expanded you as a person?

“I hope that in an analysis I conduct, my patient and I will have been able to experience a full range of feelings for each other. Without having in any way avoided taking on sex and aggression, in the end, I would hope that our predominant feelings would include respect, understanding, acceptance, empathy, admiration, caring, the sincere wish for the other's happiness and fulfillment, and love. I hope the experience will have enriched both our lives in many ways, and that we will both be able to internalise the value and meaningfulness of the experience.”

(Daniel Shaw in Traumatic Narcissism: Relational Systems of Subjugation)