Should men treat couples? Transference, countertransference, and sociopolitical considerations.

Abstract

While gender issues in the therapy process have recently received considerable attention, very little has been explored about the gender complications which arise in couples therapy. Couples therapy is seen here as a conversation and an experience which are significantly different for each member of the couple when the therapist is a male. Couples therapy differs profoundly from individual therapy in that couples therapy involves three people, two of whom will share the same gender, resulting in an inherent imbalance with important transference and countertransference consequences and dilemmas. This imbalance and the transference-countertransference constellations that result are explored. Recommendations concerning gendersensitivity are made to the therapist to promote appropriate treatment.How is it possible to conduct therapy with . . . couples in and out of marriage . . . without understanding how this process constructs many of the problems, relationships, and conflicts that we encounter in our offices? How can we make therapeutic interventions . . . and not be sensitive to the profoundly different meanings our words, tasks, and metaphors will have for men and for women as a result of their gender experiences? And how can we not but be aware that in a patriarchal culture life experience will be defined largely within a male frame of reference? M. Walters (1990)

"Okay, I'm here, but I'm not talking!" Psychotherapy with the reluctant male.

“…These templates have elsewhere been termed a priori transference (Shay, 1993). Similarly, therapists, male or female, meet the male client with preexisting templates about men which (using the totalistic definition of countertransference as including all of the therapist's affective experiences of and assumptions about the client) we refer to here as a priori countertransference (Shay, 1993). While the specific nature of these templates is not the subject of this article, certain common therapist reactions are worth noting.…”

“…In couples therapy, for example, the therapist must engage in a conversation and experience with two individuals arriving with differing levels of motivation, raised in markedly different sociocultural environments, and speaking different languages as suggested above. Moreover, only one of them shares the same gender as the therapist which may have profound transference and countertransference implications (Mintz & O’Neil, 1990; Shay, 1993).…”

“…While the concept of client transference has been avoided in the comments above, it will be obvious to many readers that each male client arrives at the therapist’s doorstep with preexisting gendered templates forged in his family-of-origin as well as by society at large. These templates have elsewhere been termed a priori transference (Shay, 1993). Similarly, therapists, male or female, meet the male client with preexisting templates about men which (using the totalistic definition of countertransference as including all of the therapist’s affective experiences of and assumptions about the client) we refer to here as a priori countertransference (Shay, 1993).…”

“…While not all men land so reluctantly on the therapist’s doorstep, many men experience therapy as foreign terrain. The currency of psychotherapy is communication, exposure, vulnerability, and intimate sharing, currency which men who have been socialized in this culture have limited experience with (Ettkin, 1981; Good, Dell, & Mintz, 1989; Krugman, 1995; Levant, 1995; Osherson & Krugman, 1990; Pollack, 1995; Shay, 1993; Tannen, 1990). As some therapists have written (Meth & Pasick, 1990), "For most men psychotherapy is the antithesis of masculinity" (p. 152).…”