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Dear Dr. Robert

I'm 26 with a hubby in his late 30s, and three, going on four, kids. My question is about my baby doctor, a man in his 40s, who I see on a monthly basis, then near the end of the pregnancy, every week. He is a brilliant ob-gyn, and is quite professional.

My issue is I am attracted to him. I have not mentioned this or acted toward him in any way. I am unsure if the feeling is mutual, but possibly. He says "your kids are cute, must get it from the mother", I always knew you were a strong person", "don't wait so long to come see me again," etc., which just sound like playful encouragement to me. He is an affectionate person in general, towards all of his patients, not lingering hugs or anything that would suggest more than friendship, just care.

I don't think anything would ever happen between us, as I tend to cower away when I suspect someone could be attracted to me. I just wonder why I feel this way. The feeling isn't an intense erotic feeling--more like puppy love. I'm excited when the appointment is coming up soon, happy to see him. The type of fantasy isn't so much sexual as--"close" (am I craving "closeness"?). I am not uncomfortable with the idea either, or guilty (maybe I know nothing would happen so it's "safe"?).

I haven't mentioned it to anyone. I just feel a bit foolish. I read your articles on transference, would this be a good example? Is it normal? Is there a chance something would develop if I ignore this? I would hate to change my ob-gyn, he delivered my last baby (I suppose that is an intimate thing, but I don't know if that triggered the feeling) and he's a terrific doctor.

I should probably also mention my husband and I weren't always on such good terms, in fact last year we were separated, for a year, and even though I got pregnant I didn't move in with him until after just before the baby was born (his baby, I remained loyal). Things have mostly been fine since then.

Thanks for your time Dr Robert!

-[name withheld]


ask dr-robert ask psychologist todos santos ask psychologist dr robert saltzman

Dear [name withheld]--

As you read in my articles, the term transference means a shift onto another person of feelings, desires, and ways of relating formerly experienced in connection with someone in the subject's past, often, but not always, a parent. In other words, transference is a phenomenon which involves projecting or displacing unresolved conflicts, dependencies, and aggressions onto a substitute--someone in your present adult life--as if that person were someone in your past. Now, being aware of the transference is an important part of doing psychotherapy, because by noticing and analyzing the transference, the therapist can gain immediate access and valuable insight into the rhythms and necessities of the patient's emotional life.

Let me give a brief example: suppose I believe that I am treating a patient of mine with the kindness and compassion typical of my work, but that person complains to me that I seem cold, mean, and emotionally stingy. Now first I must look carefully at my own feelings toward the patient to see if perhaps there is some stinginess there. If I look carefully and do not find any, then I must assume that the patient is not really seeing me, but displacing on to me feelings that he or she had about a mean and stingy parent or other important early figure. Once I know this, I can begin to explore more deeply the adjustment that the patient has made to having been raised by a mean, emotionally stingy parent.

I have chosen a simple case, but in practice things are not usually so clear cut. That is because all of our relations with others inevitably contain at least something of the transference. In other words, our emotional attitudes towards others are based, at least in part, on our emotional experiences with early caregivers, and we cannot help treating others, at least in part, as if they really were those early caregivers.

So, although psychologists like to talk about the patient's transference, better practitioners also become aware of their own transference onto the patient of their own early emotional needs, fears, desires, and other feelings. I point this out so that you will understand that the transference is a universal part of human interaction, not just something that happens to therapy patients. We focus on it in therapy, because a psychotherapist needs to understand the needs, fears, desires, and other feelings of the patient in order to do the best work, and examining the transference is a remarkably good way to collect information about this, but some transference takes place in all relationships to one extent or another.

That said, certain kinds of relationships are particularly favorable for the strong emergence of displaced feelings that we call transference. These are relationships in which one person is more in the role of parent or caregiver, while the other is more in the position of child or recipient of care. For example, a young man of twenty when meeting a man old enough to be his father probably already begins to "see" that man as his father, unconsciously probably, and so conditions are ripe for the young man to begin projecting attitudes about his father on to the older man. If the older man really is in the position of caregiver, then conditions are even riper. So, for example, it is normal for a student to transfer feelings for a parent onto the person of an older teacher. Not only is the teacher older like a parent, which favors the emergence of transference material, but the teacher also is in the position of "caregiver," being the experienced one who, like a parent, is doing the teaching and making allowances for the inexperience of the student.

If you get the flavor of this, you will understand that your relationship with your ob-gyn is classically ripe for a strong transference. Your doctor is older (like a parent), and takes care of you (like a parent). In that sense the relationship is very much one-sided since you do not take care of him (again, like a child with her father). Further, although he wears clothes when you are together, you are often, like a child, undressed in his presence, and, like a parent he sees, touches, and cares for your body intimately. Beyond this, your doctor is an expert and you go to him for help and advice just as a child approaches a parent for help. In short, the very structure of the doctor-patient relationship tends, by its very nature, to infantilize the patient, and so a noticeable transference often emerges in that kind of situation.

If we were doing therapy now, I would assume that your feelings for your doctor probably point to old feelings for your father, and I might begin to explore that with you by saying, for example, "Tell me about your father. What was he like?" Now, we aren't doing therapy, but you might like to sit down with a pencil and paper, write on the top, "What Was My Father Like?" and see where that takes you. If we were doing therapy, I would also like to explore your statement that, "I tend to cower away when I suspect someone could be attracted to me." The word "cower" is a strong one, and I would be wondering what that is about.

But all this is a bit theoretical since we are not doing therapy, so I should now try to address your immediate concerns. In my opinion, you do not need to stop seeing your ob-gyn. Since he has done a good job for you, and you trust him, it would be unwise to change unless you became much more troubled by your attraction to him, or by his for you (if he has one). At present, the attraction, on your part, seems not to be troubling you; in fact, you enjoy it. As for your wondering about his attraction to you, gynecologists often turn out to be men who like women, like women's bodies, and feel comfortable being with women. So his remarks may simply be the kind of words that he says to many of his patients--a generalized appreciation of femininity and the female body--but not an indication that he feels anything particularly powerful about you specifically. Or, he may like to, for his own enjoyment, indulge in a kind of mild flirtation with the women whose bodies he sees and touches, but not one intended to lead to anything physical. In this regard, it is useful to remember that the sex drive in humans, having evolved over countless eons as a powerful survival instinct, is intense and not at all monogamous. In other words, it is normal for a man and a woman to feel attracted on one level or another, and to express that attraction in various subtle ways, and there is nothing wrong with that in and of itself. In any case, at this point I see nothing especially threatening in the situation, particlarly since your doctor's words "just sound like playful encouragement . . . .[nothing] that would suggest more than friendship, just care." My advice would be simply to be glad that you have a competent doctor whom you like and trust.

If you are still worried about this, or if your own feelings become more urgent to the point at which you are actively fantasizing sex with your doctor, then I suggest that you consult a therapist to discuss your feelings, for I would feel concerned that something not really intended might complicate your marriage. In this kind of situation even one or two appointments with the right therapist might do the trick.

Be well.

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