ABSTRACT
In this chapter, we explore the impact of therapist and patient affective processes, such as desire, disgust, and sexual attraction, as they are felt and/or enacted within the consulting room. These processes will be considered in relation to theories and cultural forces which underpin notions of good sex and bad sex. We will present our work as a dialogue between the two of us as qualified and experienced colleagues who have undertaken many years of personal therapy and who have attended an established supervision group together for ten or more years. This group has been a rich and stable resource for us over the years and is a place where we have the trust of our supervisor and the membership to lean into clinical issues which may interest or trouble us. We are both privileged as white, heterosexual male psychotherapists in private practice. We have also both been supported in dealing with complaints while working in statutory or voluntary agency settings in the past. We are interested in the contrast between this multidisciplinary work and the privacy, intensity, and potential isolation of private practice, where issues of vulnerability and power emerge in the asymmetrical relationship between therapist and patient. Our ultimate ethical consideration is for the well-being of our patients. We will describe past transgressive experiences and offer some reflections on what we consider with hindsight to be missed opportunities. We will also offer reflections on conditions that support atmosphere where clients can express and make meaning of what is in their minds and hearts.
