Countertransference issues in psychotherapy with lesbian and gay clients

Abstract

This article briefly reviews literature on responses towards same-sex (lesbian and gay) sexualities from psychoanalytic and 'lesbian and gay affirmative' psychotherapeutic perspectives. An analysis is presented of reports of countertransferential reactions to lesbian and gay clients, obtained from interviews with 14 psychotherapists who work in a lesbian and gay affirmative manner and 18 clients who had received affirmative psychotherapy. Data were subjected to grounded analysis. Participants consistently attended to the thoughts, feelings and values that therapists held in relation to lesbian and gay clients and how these affected the meanings and practices available to them. These were linked with the therapist's sexual identity among other factors. Negative countertransferential reactions were regarded as potentially occurring among heterosexual and lesbian and gay therapists and were seen as arising from therapists' conscious and unconscious fears about same-sex sexualities. These findings indicate a need to continue debating these issues more widely in the professional arena.

Exploring the clinical experiences of novice counsellors working with LGBT clients: Implications for training

“…Writers have highlighted the unique dilemmas faced by LGBT therapists in both therapy and supervision (Russell, 2006;Russell & Greenhouse, 1997;Satterly & Dyson, 2008). Grove (2009) has recorded the sense of challenge faced by student counsellors on learning about heterosexist oppression, and their acknowledgement that having LGBT friends and colleagues was an invaluable source of learning (see also Grove, 2003;Guth et al, 2005;Milton et al, 2005;Mohr, 2002). She has also observed that students' gayaffirmative skills and knowledge can remain relatively undeveloped during basic training, even when their expressed attitudes are highly affirmative (see also Mohr, 2002).…”

“…However, particularly in the early years of their clinical practice, many counsellors' ability to work with LGBT clients is likely to fall short of this ideal. They may lack sufficient life experience to: appreciate that the difficulties faced by LGBT clients; the coping strategies they use; reflect their experiences of living in a largely homophobic world (Dickey, 1997;Grove, 2003); acknowledge the damage that can be caused by making inadvertent heteronormative assumptions (DeBord, 2007;Walker & Prince, 2010); and be wary of the danger that they could collude with, and reinforce, established heterosexual values (Guth, Lopez, Rojas, Clements, & Tyler, 2005;Milton, Coyle, & Legg, 2005;Mohr, 2002;Mohr, Israel, & Sedlacek, 2001).…”

Lesbian and gay parenting: babes in arms or babes in the woods?

“…These models can often feel inappropriate and pathologising, as outlined in the main body of this paper, since same-sex couples often work with more flexible family models than their heterosexual counterparts. These findings are endorsed by research conducted in Britain (Annesley & Coyle, 1998;Milton, 1998) where, for example, one therapist, through her line of questioning, suggested that lesbianism was caused by the adverse reaction or violent sexual responses of men towards women, and other therapists struggled to accept the individuals sexual choice by questioning lesbians 'dislike of men' and gay men's 'dislike of women'. This, of course, immediately raises the question of when issues presented in therapy relate specifically to sexual orientation and when they do not.…”

Using the Generic Model of Psychotherapy to Develop a Culturally-Sensitive Approach to Psychotherapy With Sexual and Gender Minority Patients

“…Over the last decades, affirmative psychotherapy approaches for LGBT patients have been developed; however, they do not constitute a psychotherapeutic model in itself but instead advocate for the inclusion of specific attitudes into psychological intervention connected with acceptance and understanding of the nature and challenges posed by sexual and gender diversity ( Milton et al, 2002 ; Dillon et al, 2004 ; Kilgore et al, 2005 ; Bieschke et al, 2007 ; Martínez et al, 2018a ). Authors have described a number of affirmative interventions aimed at actively depathologizing sexual diversity and cementing its place as a positive dimension of identity ( Rock et al, 2010 ).…”