Female or Male Therapists for Women Patients: New Formulations

Abstract

This paper seeks to provide some perspective on the frequently asked question: "Should women patients be referred only to women therapists?" This question, put starkly, cannot help but be provocative. An affirmative answer suggests a position that would deprive many of a profession and a livelihood. A negative answer could intimate that the sex of the therapist is irrelevant to the flow of the therapeutic process. The question stirs personal and economic fears that lurk behind the more academic question of "gender influences in the process of therapy," for it potentially implies that the majority of practitioners (men) may be unqualified to treat the majority of patients (women). To advance the discussion of this issue, this paper will emphasize several points. First, the focus will be on the actions of the therapist, not on the decision-making process of the patient. No one theory can predict the individual situation; the final selection is an agreement between two specific persons, not between an abstract "woman" and an abstract "man." Second, given this switch from focus on patient to therapist, the question becomes not whether women or men offer the best therapy for women, but rather, "What therapeutic conditions are most likely to facilitate women's emotional growth, and how might these best be established in therapy?" Third, even if some of the conditions that maximize women's potential are more likely to be associated with therapists of one sex than with the other, this should be seen not as an end point which directs a patient's decision, but as a starting point which could inform the training and supervision of therapists. Thus, the question of therapist gender and its effect on therapy with women highlights an issue of therapist self-awareness and growth rather than one of the patient's selection process.

A Female Analyst's Use of Desire

“…More recently, female analysts have written a small number of articles investigating the female analyst/male patient dyad for the sexualized nature of the transference (Goldberger & Evans, 1985;Kaplan, 1985;Karme, 1979;Lester, 1985;Person, 1985). Most of these articles suggest that men do not express eroticized trans ferences with their female analysts for fear that they would be either engulfed by the voracious preoedipal mother or be pas sively identified with her.…”

“…The influence of the analyst's gender on treatment has received only limited attention in the psychoanalytic field (Goldberger & Evans, 1985;Kaplan, 1985;Karme, 1979;Lester, 1985;Person, 1985). The classical theoretical tendency has been to minimize the analyst's "real" gender attributes in favor of maximizing the power of the patient's repetitive, internally derived transferential projections.…”

Gender and race matching preferences for HIV post-test counselling in an African-American sample

“…In a mental health clinic with African-American clients, gender did not affect continuance in treatment (Terrell & Terrell, 1984). Older reviews of gender matching in mental health treatment also show conflicting results (Bilker, 1993) with therapist experience accounting for more variance than gender (Kaplan, 1985).…”

Conflicts in Treatment, Issues of Liberation, Connection, and Culture: Art Therapy for Women and Their Families

“…Therefore, if this problem is to be attended to, the philosophical stance of the therapist and his or her belief system are central to the comfort and therapeutic success of the female client (Walters, Carter, Papp, & Silverstein, 1988). Kaplan (1991) has this to say about gender differences influencing the practice of therapy:…”