Friday, November 14, 2008


The ancient Greeks described three different forms of love:

1) Eros -- sensual desire; attraction and appreciation of beauty; passion
--In describing eros we need not assume that it only refers to sexual passion; I think there is a component of the "erotic"-- in a broad metaphorical sense--in all moments of life, all motivations, all experiences of beauty in all its forms--

2) Philia -- virtuous, loyal, attachment between friends or family members; dispassionate but balanced, stable, reciprocal, equal.

3) Agape -- this term was adopted by early Christian theologians, referring to unconditional, giving, selfless love for all. In this type of theological view, agape was felt to be the feeling of the divine towards humankind. Psychiatrically I might say that agape was a projection of a feeling onto the projected character of "God" that fit with an idealized philosophy of life which was prescribed by religious leaders to the rest of the community.

I have to wonder if the "agape" idea was a bit of a defensive construct, since people with conservative religious beliefs or values might not want to be using a "love" term associated with eroticism or sexuality in their description of the divine, or in a prescription for ideal behaviour to espouse.

--since I am neither a scholar in Greek, nor well-versed in theological debate, I recognize that my above introduction may contain inaccuracies--

I do think love is one of the great joys of life, a requirement for happiness, a requirement for life itself to continue. A life without love can be intolerable.

But many of the experiences of love can lead to exquisite suffering. Love can be unrequited. Love can lead to obsession and despair. Love can fade and disappear. Love sometimes can throw off our judgment.

I do think that love is an ingredient of the psychotherapy experience. The struggle with "love problems" is one of the most frequent themes bringing people to psychotherapy.

If love occurs between patient & therapist, this love exists within the boundary of the therapeutic frame. Actions associated with this love--according to the rules of psychotherapy--take place through dialog. Actions outside of dialog (such as gift-giving, etc.) may or may not be allowed within the therapeutic frame, but if they do occur certainly would require careful attention or discussion through dialog. In many cases I feel that to reject a gift would be akin to rejecting a handshake--at times it could be humiliating--and that it may sometimes be part of the development of a healthy relationship to permit gifts in psychotherapy. I realize that many of my colleagues would disagree with me (all kinds of talk about boundaries would arise, I'm sure). I do realize that accepting gifts could give rise to a variety of problems in some cases (e.g. anger at generosity not perceived to be reciprocated, or gift-giving "getting out of hand" with more and more financial expense involved, etc.); in some cases I will gently let people know that their presence is a gift, and that other types of gifts can't be something I can accept. Gift-giving can be a much subtler theme, as many times patients may "try harder" in their therapy as a gift to the therapist, etc. Such gifts should not be rejected, yet of course it is important therapeutically to understand this motive, and to find ways to expand the range of motivations for "trying harder".

I affirm strongly that I have--and aspire to maintain-- a feeling of agape towards my work as a psychiatrist, and towards all of my patients.

I feel it is important to convey this positive feeling directly at times, and that it is often a fear of impropriety, or of boundary-crossing, etc. that prevents many therapists from openly pronouncing positive regard for their patients. As a community of therapists, I think this fear stems in part from recognition of many disturbing examples of boundary-crossing behaviour(e.g. therapists having affairs with patients, often with components of exploitativeness, and often causing complex harmful consequences for the patients). Or some therapists may have been taught to believe that the therapist should not "meet a patient's dependency need" but should rather interpret such a need, or help problem-solve around it, to help the patient meet that need outside of the therapy. Well, in many cases I feel that depriving a patient -- in this case, let's use totally frank language: depriving a patient of love -- is merely a tactic that keeps the therapy less personal, more frustrating, and less helpful. Also it fosters greater detachment in therapists, which I think fuels a broader phenomenon of therapists not really enjoying their work, leading to increased cynicism, less appreciation for the beauty and potential of their patients.

I believe all three types of love exist in every human dynamic, in some mixture. This is normal and healthy, a fact of life. This includes patient-therapist interaction. Yet these other varieties of love dynamics may only colour the dialog or the narrative in a therapy setting, they cannot cause the therapeutic frame to change.

Having said this, I think that in many cases, the patient-therapist relationship is much more distant. It can be like the relationship between "homeowner & electrician" or "shopper and retail clerk". This kind of distance may work just fine, the therapy itself doesn't have to be a specific setting to work out "love problems". The therapy may simply be about obtaining advice to relieve a symptom.

There are some cases -- such as in patients who have a history of dangerous interpersonal behaviour, or in cases of psychosis which may involve the therapist in a delusional system -- where the therapeutic relationship has to be much more distant. It is still not without agape though. A truly loveless relationship cannot be of much help; in situations like this it is often necessary to refer the patient to a different therapist.

In some cases, the therapy itself becomes a setting to "work through" love problems, and the love dynamics present in non-therapeutic life may show up in the therapy itself. In the psychoanalytic community, this would tend to be called "transference". The idea of transference is extremely important, since feelings or dynamics in a person's personal or past life may very well appear in the therapy, towards the therapist, and this phenomenon may epitomize a recurrent relational problem in the patient's life. Yet the term "transference" may also be part of a defensive language on the part of the therapist, to negate "true" feelings which may exist between patient and therapist. So I feel that both "transferential" and "non-transferential" feelings can be present, may be something to acknowledge--and sometimes to affirm--in the therapy, provided the boundaries are clear and consistent.

The world needs to devote more of its energy and resources to solving its "love problems", and to celebrating its many examples of powerful, healing, healthy love.


Anonymous said...

Just wanted to share a quick true life love story I came across involving two autistic individuals.
Their story has been told by the autistic society and by other pop culture media. (I have listed a few of the links here if anyone is interested.)

For those of you who are on the verge of giving up on love (myself included)...let us give ourselves a little more time and hope.

Anonymous said...


I came across a more thorough and updated classification of love.

I know there are many but I particularly like this one.

If is from Robert Sternberg.

He argues that love has three key components.
1)intimacy, which includes feeling that promote closeness and connectedness

2) passion, which includes a feeling of intense longing for union with the other person, including sexual union.

3) commitment to a particular other, often over a long period of time.

(When these 3 components are combined in all possible ways, you end up with seven subvarieties of love.)

Seven types:

2-Empty Love:



5-Companionate Love:

6-Romantic Love:

7-Fatuous Love:

8-Consummate Love:

Sterberg's theory suggests that the characteristics of the emotional bond that holds a couple together influence the unique pattern of interaction that develops in each intimate relationship.

In terms of a therapeutic relationship I would most likely describe it as either, Companionate Love, Liking, or Empty love (although I don't the term empty love).

And probably the best therapeutic results occur when companionate love is achieved.

I don't think the passionate component really fits into therapy unless the definition of therapy or passionate love are redefined somewhat.

Lastly, I have to wonder if it is "shared" love that makes therapy work or the illusion of love for the patient. I guess what I am saying is as long as the patient feels companionate love does it really matter what the therapist feels? I guess a highly skilled therapist would be able to portray this kind of love without genuinely feeling it?

(Or perhaps this is my general mis-trust of others coming through?)
Or maybe this is just an unsettling feeling of not being able to quantify or test for "LOVE."

But I guess in this sense "love" is like other non quantifiable object, idea, thought, force.

For example love would be like gravity. It exists. It is an invisible force and can be measured but only by it's observable effects on objects. In the great son quote "love can move mountains" is quite right here! However, gravity may not be the best example because it usually remains unchanged.

For an even better analogy I guess love would be more akin to the wind. An invisible force, that displaces/moves/powers/motors/can be harnessed, but yet constantly changes in in magnitude and direction.

In this sense love is a vector force..??

Hmmm... i feel new ideas spawning!


GK said...

Thanks for the comment.

The 3-component system you describe seems like a helpful way to think about love.

The subdivision into 7 categories, though, implies that either a component is entirely present, or entirely absent.

I think that the 3 components could be understood instead to each exist on a continuum, ranging from absent to strongly present. Furthermore, the components may each fluctuate to varying degrees over time (some more than others).

In this way we have an infinite number of varieties of love, just as there are an infinite number of hues and color saturations possible with three color receptors in the retina.

A typical close friendship might be characterized by 50% intensity on the intimacy component, 5% on the passion component (I think this is rarely zero in a successful friendship, but probably not too high so as to complicate matters), and 90-100% intensity on the commitment component.

But each friendship might be different, and the differences in the "love hue" might give each friendship a unique flavour.

Western traditions tend to require love relationships with a potential mate to be high on the passion component right from the beginning. In other cultures, the passion component may be quite low to begin with, but may grow over time.

So there are cultural variations in the types of love relationships, and the types of change over time which people might expect or accept.

Therapy relationships will have their own "hue", but regardless of what it is, I think that authenticity and genuineness strengthen the therapy, and increase the goodness of the relationship. An inauthentic masquerade on the part of the therapist is likely to render the therapy more superficial, limited, and fragile.