inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #0 of 90: Linda Castellani (castle) Wed 20 Mar 02 09:43
    
 Michael Bettinger, Ph.D., MFT, is a queer, Jewish psychotherapist, 
 author, educator and biker.  Originally from Brooklyn, he has lived in San 
 Francisco for the past 26 years and works as a psychotherapist in private 
 practice.
 
 _It's Your hour: A guide to queer-affirmative psychotherapy_  is a 
 consumer guide to psychotherapy aimed toward the special needs of people 
 who are lesbian, gay, bisexual, transgender, queer or questioning.   It 
 would also help anyone else who has questions about psychotherapy.  The 
 book covers many topics including why a queer person may want to use 
 psychotherapy to help him or herself,  the different approaches to 
 psychotherapy practiced by clinicians, methods of finding and evaluating 
 an appropriate psychotherapist.  Also covered are subjects such as the 
 place of insurance, psychotropic medications (antidepressants, sedatives, 
 mood stabilizers, etc), confidentiality and client/therapist boundaries.  
 _It's Your Hour_ is the only book of its kind and is helpful both for 
 those who have never been in psychotherapy as well as those who wish to 
 evaluate the psychotherapy they have been receiving.
 
 Leading the discussion is Cindy Myers, a long-time WELL member, a 
 lesbian and a licensed psychotherapist with 25 years of experience in the 
 counseling field.  Her work in the areas of sexual minority concerns, gay 
 and lesbian couples and lesbian sexual concerns has been cited in 
 publications, such as the Family Therapy Networker and featured in 
 conferences and workshops throughout the San Francisco Bay Area.  She has 
 written and taught extensively on the subject of sensitizing therapists 
 to the issues faced by sexual minority clients.  Cindy is currently 
 writing her doctoral dissertation in Human and Organizational Systems and 
 brings a challenging, often provocative, social-justice-oriented 
 perspective to her professional interests.
 
 Please join me in welcoming Michael and Cindy to inkwell.vue!
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #1 of 90: C.L.Myers (clmyers) Wed 20 Mar 02 12:12
    
Thank you Linda for that warm welcome!  And hello Michael!  Thank you for
joining me in what I know will be a very thought-provoking conversation
about psychotherapy from a queer perspective.  (As an aside, you chose to
use the term "queer" deliberately in your book because of its inclusiveness,
yet its distinctiveness in identifying our culture.  For these reasons, and
for the sake of congruity, I will also adopt that term for our conversaton.)
I think the best place to begin here is at the beginning.  You have written
a very comprehensive, accessible-to-the-lay-person guide to the many aspects
of psychotherapy and the variety of issues that are unique to queer persons
as clients.  This is easily the most comprehensive consumer guide I have
seen on this subject, as well as one that is very rich in terms of
identifying some of the larger issues that bring queer people to therapy in
the first place.  We'll be touching on a number of these issues as we go
along here.

But first, can you tell us a bit about yourself and your work, Michael?
What led you to write this book and how do you hope it will be utilized by
its readers?
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #2 of 90: Michael Bettinger (mcpsycle) Wed 20 Mar 02 16:42
    
Thanks, Cindy, for getting this discussion going.   There is a story
to how I got to write this book and it begins in 1985.  In that year,
Marney Hall wrote a book entitled _The Lavender Couch_.  I saw it and
was chagrined.  This was the book I wanted to write.  It was a book I
had been thinking about writing for a couple of years.   And now it was
done.  I thought to myself I would need to write books or articles on
other subjects, which I did for the next decade.

In the mid 1990's, I was asked to write a chapter on finding a
psychotherapist for a book on gay men’s health issues.  In the course
of writing that chapter, I interviewed Marney Hall.  As a result of
that interview, Marney mentioned to me that she was under obligation to
write an updated version of _The Lavender Couch_.  She told me she had
other writing projects she was more interested in, and asked me if I
would consider writing the updated version of the book.  After some e
mails back and forth between myself and the editor at Alyson, I agreed
to write this book.

That is how it came to pass that I am the author of the book.  It was
a book I wanted to write, but thought I had missed my opportunity.  And
then I found I had a second chance!  That doesn’t happen too often in
life.  So I spent the next two years researching, thinking, and writing
a consumer’s guide to psychotherapy, aimed at people who happen to
identify as lesbian, gay, bisexual, transgender, queer or questioning. 
Because I believe that people who are l/g/b/t/q are different from
those who aren’t in many different ways, (not only in our sexual or
gender orientation), I prefer to use the term “queer”, as in
“different”.  We are different.  We have a different culture.  We form
different kinds of relationships.  We are a community, and I wanted
this book to validate that.

So now the book is out there and I am excited about it.  It is my
first book length manuscript.  
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #3 of 90: C.L.Myers (clmyers) Wed 20 Mar 02 23:18
    
Congratulations on producing an excellent first book!

I want to put a mental post-it note on this matter of "queer is different"
because I think there are a lot of ways that this is true.  I'd like to come
back to it and examine some of the ways you've identified, along with the
implications this can have for clients in therapy.

First though, let me ask you this.  Is there a particular message (or two or
three!) you hope will be the "take away" that readers will get from this
book?  What do you see as being the most important focal points?
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #4 of 90: Michael Bettinger (mcpsycle) Thu 21 Mar 02 06:12
    
Perhaps what I would most want people to take away from reading this
book is that psychotherapy is not shameful, but merely another tool
that may help a person to lead a happier life.  Most of us grew up with
the notion that there is something shameful about seeing a
psychotherapist, and thus there is great resistance to seeing a
psychotherapist.  Underlying this is the notion that unhappiness,
emotional problems, or “mental illness” is the result of a defect in
one’s personality, and that is something a person should be ashamed of.
 

The result of this is that there are a lot of unhappy people who are
resisting something that might help them.  Going to a psychotherapist
because one is anxious or depressed is no more shameful than going to
the dentist when one has a cavity.  Just about no one, in my
experience, feels shame about having a cavity. They may not want to go
to the dentist for a lot of other reasons, but shame is not usually one
of them.  I would hope after reading my book that the reader will come
away feeling psychotherapy is not shameful, but a tool they can use
when appropriate.

And I believe this is even more important when the person is queer. 
Queer people grow up for the most part being taught to be ashamed of
being queer, and also grow up isolated from other queer people and the
queer community.   Many of the emotional problems that queer people
experience are as a result of that shame and isolation, and talking to
someone about those problems often helps to resolve them just by
talking about them.  
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #5 of 90: Michael Bettinger (mcpsycle) Thu 21 Mar 02 10:16
    
There is one other thing of importance which I hope will be taken away
by the readers.  The mental health profession historically has not
understood sexual orientation or gender orientation.   While all the
major mental health professional organizations are now queer positive,
there are many clinicians who are still quite homophobic and subscribe
to old theories that have no basis in fact regarding sexual and gender
orientation.  These people are dangerous to the mental health of anyone
who is queer, and should be avoided at all costs.  The book helps to
identify who those clinicians are.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #6 of 90: C.L.Myers (clmyers) Thu 21 Mar 02 23:31
    
On behalf of all of us -- and our loved ones -- THANK YOU for making that
point so powerfully, both here and in your book.

In your book you refer to "queer affirmative" therapist/therapy -- and I
want to focus on that for a moment if we can.  I'm heartened by your choice
of terms here.  For so long, it seems, we've (those of us who are queer, and
who practice therapy and train psychotherapists) have simply been aiming at
having more therapists be "queer sensitive".

I have a sense from your writing that the concept of "queer affirmative"
goes well beyond this.  What can you tell us it means - in your opinion and
experience for a therapist to be queer affirmative?  And for therapy, as a
process, to be queer affirmative?
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #7 of 90: Michael Bettinger (mcpsycle) Fri 22 Mar 02 08:18
    
I believe the best way I can answer that question is to quote from
what I wrote in the book.  This quote begins on page 109.

“A queer-affirmative psychotherapist is not necessarily queer. He or
she is simply a person who has an orientation to life that says queer
is great. A queer-affirmative psychotherapist is a positive,
affirmative person who looks upon the ability to love another person as
something wonderful, regardless of gender.

A queer-affirmative psychotherapist understands that there are more
than two usually accepted romantic/sexual orientations: homosexuality
and heterosexuality. A queer-affirmative psychotherapist understands
that there is a romantic/sexual orientation in which people are to
varying degrees attracted in love and sexuality to members of both
genders. A queer-affirmative psychotherapist understands that people do
not always emotionally identify with their physical gender or the
roles usually associated with that gender, and that this phenomena can
be independent of the gender(s) of the people to which that person is
romantically or sexually attracted. A queer-affirmative psychotherapist
understands that a person's romantic and sexual orientation is always
changing and evolving. A queer-affirmative psychotherapist knows that
what is most important is not where a person's romantic and sexual
nature has been or where it is going. What matters is where it is now.
A queer-affirmative psychotherapist understands that queer people have
been taught to see themselves as sinful, criminal, or sick, and that
helping queer people to not see themselves in those ways is part of the
work to be done in therapy. A queer-affirmative psychotherapist is
knowledgeable about the culture of being queer and understands that
queer people form families different from the norm. A queer-affirmative
psychotherapist understands that it's not easy being queer in a
nonqueer world. 

A queer-affirmative psychotherapist is also someone who has done
introspective work to understand his or her own inevitable prejudices
about being queer. He or she understands that everyone internalizes at
least some of society's negative messages regarding queer people, and
actively works toward minimizing how those prejudices interfere with
the psychotherapeutic process.”

For the process of psychotherapy to be queer-affirmative, all the
values I mention here must present in the therapy room at all times. 
This does not mean they are always mentioned, but the therapy moves
forward within the context of these values.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #8 of 90: C.L.Myers (clmyers) Sat 23 Mar 02 12:46
    
This actually takes me back to something you talked about a couple of posts
ago: dispelling the notion that psychotherapy is only for the "sick" and is
shameful to be involved in.

When you speak here about queer-affirmative therapy, I immediately am
reminded of one of my biggest roles as a therapist in my clients' lives:
that of witness.  Because there is so much in our culture that negates us
and/or renders us invisible, I found a tremendous need (among my queer
therapy clients) for the simple human presence of a witness.  I'm talking
now about someone who listens and sees and offers accurate reflections back.
I have born witness to relationships beginning and ending, careers beginning
and changing, birth and death and sorts of life events.  (ACK!!  That should
say "borne witness" up there!)

In my personal life, I have felt the harsh effects of living in a world that
is too short on custom, ritual and affirmation.  I remember crying in the
lawyer's office when my (now former) partner and I signed durable powers of
attorney documents and wills back in 1989.  I realized this was the closest
thing to a wedding I was ever likely to have and I just lost it -- right
there in front of the legal secretary!

Can you expound on this at all?  I'm talking about the roles and functions
performed by psychotherapists for queer people in a queer-denying culture.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #9 of 90: Linda Castellani (castle) Sat 23 Mar 02 13:35
    
E-mail from William A. Henkin Ph.D.:

Good day. I'm one of the many people Michael invited into this
conversation, and while I don't log on much and will not be able to
follow this discussion through to its conclusion because of travel
plans, I did want to accept Michael's offer, and to comment on posts #s
4 and 7.

In light of Michael's topic, it is important to note how little sex
education psychotherapists are required to have before attaining
licensure. Even though Freud, the nominal father of talk therapy, had
fairly radical notions about sexuality for his time and place, most
contemporary psychotherapy licensing bodies require only a single course
in human sexuality. That course usually attends chiefly to the anatomy
and physiology of arousal, and -- as if they follow each other like
night and day -- the processes of gestation and birth. Sex therapy on
the behavioral model is ordinarily the topic of second emphasis.
Although other topics are touched upon, they rarely command much time,
hence they rarely command much attention.

Michael observes that "Many of the emotional problems that queer people
experience are as a result of that shame and isolation, and talking to
someone about those problems often helps to resolve them just by talking
about them." Certainly I concur; and I add that when someone has been
shamed and isolated as a consequence of her or his sexual or gender
orientation or identity, it can be extraordinarily valuable to have as a
confidant someone familiar, or at least acquainted, with sex and gender
options, and who understands the ways they may have different meanings
to different people.

Discussing queer-sensitive, queer-affirming therapists, Michael says, "A
queer-affirmative psychotherapist understands that it's not easy being
queer in a nonqueer world." This is really a cross-cultural assessment,
and I think very much on point. It is never easy living in a culture
that is significantly different than your own; it is harder still when
the differences concern core identity issues; and it is yet harder still
when the dominant culture imposes the kinds of hostility and negative
stereotyping on an individual's core identity issues in ways that can
lead to the shame and isolation Michael mentioned earlier. As a
profession we have begun to recognize how differences matter when
counseling people who come to us from nationalities, religions, and
other backgrounds that are substantially different than our own, so
perhaps we can also see how it is also true across the very complex
fields of sex, gender, orientation, and identity.

I hope some anthropologists will comment further.

William A. Henkin, Ph.D.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #10 of 90: Michael Bettinger (mcpsycle) Sat 23 Mar 02 17:49
    
Let me talk from my experience about being a witness to a person’s
life.  For my long term therapy clients, this is probably the most
important reason they see me.   They may have begun therapy because
they were unhappy, depressed, anxious, had a relationship or a family
problem or had another specific reason why they wanted to see a
psychotherapist.  But a funny thing happens to some of these people. 
They begin to talk about whatever problem brought them into therapy,
and then find they have someone with whom they can talk about anything.
 

The “boundaries” of psychotherapy makes this easy.   The hour is all
about the client, not the therapist.  What is said in the room stays in
the room because of the ethical standards regarding confidentiality
that all psychotherapists subscribe to.  The client can control the
relationship to a large degree.  He or she can often see the therapist
for a long or short time, depending on the desire of the client.

As a result, there are a number of client with whom I have been
working for 10-20 years, on and off.  For some it has been more
regular, others call me every year or two for a limited amount of
sessions.  Repeatedly, I have heard comments from client to the effect
that I am the only person that ever really knew them.  One former
partner never wanted to hear about certain aspects of their lives.  
Their parents could never deal with some other aspect.  The only place
they could be themselves is in the therapy office.  And for gay men who
have lost friends and partners to AIDS, I may be the only one left who
remembers them during all those periods in their life.

In our outside life, relationships are usually mutual; you get to talk
about yourself and then the other person gets to talk about him or
herself.  This actually inhibits some people from sharing.  Many people
do not have the time or desire to get to know someone else that well. 
But they still want to be known.  In the therapy office, it is all
about them.  They can be sure that at least one person in the world
knows them to the extent it is possible for them to share that
information.  And, as a byproduct of therapy, the person often gets to
know themselves better and share that information.

I also want to respond to William Henkin’s comments on the woeful
state of training for psychotherapist in human sexuality.  He is
correct when he states that there is very little training, and most of
that training has to do more with the mechanics of sex than with human
sexuality.  The record of the American mental health profession
regarding understanding the nature of human sexuality is poor.  As a
result, teachers cannot teach what they do not know.  It is even worse
when you consider that they are ignorant of this disconnect for the
most part.  They believe they know lot about human sexuality, but as
the record shows, their understanding of homosexuality, bisexuality and
being transgender is extremely poor.   It has improved in recent
years, but it remains poor for the most part.  

To make this point even further, many sexual practices that involve SM
or fetishes are considered to be pathological if the individual who is
attracted to that form of sexuality is feeling distressed about it. 
Who wouldn’t feel some distress initially considering all the negative
messages people have received about kinky sex.  It is almost
universally negative.  The American mental health profession still has
a lot to learn.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #11 of 90: june (june) Sat 23 Mar 02 21:33
    
All of the discussion I've read here resonates with me. As a
psychotherapist with a variety of clients, I agree that it's crucial
for people to have a safe, open, nonjudgmental place to discuss every
aspect of their lives.
And therapists themselves must be willing to look at the ways they 
unconsciously may project negative stereotypes. Also, some started
their psychotherapy practices decades ago during the age of ignorance
when being queer was still formally diagnosed as a disease.
In that respect, I'm glad I trained more recently in a more accepting
environment, yet I too was only required to sign up for just one class
in sexuality. What a blessing that the instructor for that class didn't
focus on mechanics but instead helped us students to practice talking
-- yes, out loud -- about sex. We all finished that class more
sensitive to sexual matters and to issues of sexual minorities.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #12 of 90: Jon Lebkowsky (jonl) Sun 24 Mar 02 05:08
    <scribbled by castle Mon 25 Mar 02 12:06>
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #13 of 90: Michael Bettinger (mcpsycle) Sun 24 Mar 02 07:32
    
june wrote in response #11  "And therapists themselves must be willing
to look at the ways they unconsciously may project negative
stereotypes."

To those outside of the psychotherapy profession, that is called
countertransference, the feelings a psychotherapist has in regards to
the client.  Psychotherapists are taught to look carefully at their own
countertransference.  But there is one problem here.  Most of the
psychotherapists about whom june writes are so unaware that they are
having a personal reaction that they never label it is as such.  They
either feel their negative reaction is "right", or they don't even
recognize they are having such a reaction.  For those who feel their
negative reactions are "right", there is hope.  They are acknowledgng
their reaction. And queer people can then avoid them.   For those who
are unaware they are having a countertransference reaction, the
prognosis is much poorer.  They can't contain their countertransference
if they don't even know it exists, and thus the damage continues.  
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #14 of 90: (fom) Sun 24 Mar 02 08:38
    
(Because it's a repeat of #8, could #12 be hidden or scribbled?)
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #15 of 90: june (june) Sun 24 Mar 02 12:55
    
Adding to Michael's post in #13 on the damage of negative reactions:
Some clients want to work with a therapist who is of the same sexual
orientation, and that is a legitimate preference.
The support that a client gets from such a therapist, however, may be
just one manifestation of the good qualities we've already touched on
in this discussion: a compatible therapist, regardless of orientation,
is positive and affirming, appreciates the client's unique issues, and
is willing to confront his or her own biases. 
Above all, a good therapist recognizes that -- while we all feel
"different" to some degree -- the shame or isolation of queer people
differs markedly from that of the so-called norm.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #16 of 90: Michael Bettinger (mcpsycle) Sun 24 Mar 02 20:10
    
june - thanks for making this point "while we all feel "different" to
some degree -- the shame or isolation of queer people differs markedly
from that of the so-called norm."  The experience of being queer in
this society is unique.  It may be compared to the experience of other
groups tat experience some of the same negative prejudices, but being
queer is different and unique.  We also face a unique set of challenges
and the queer-affirmative psychotherapist understands either through
experiences or their learning the nature of the unique experience and
challenges faced by those who are queer. 
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #17 of 90: june (june) Sun 24 Mar 02 23:40
    
So true. For instance, it's easy for the therapist to just assume that
an adult client who is gay or lesbian is familiar with issues that
affect sexual minorities, moves around easily in the alternative
community, has decided how to handle the question of coming out, and so
on. Actually, though, many who are queer have never had an adequate
opportunity to discuss feelings, resolve conflicts, confront
prejudices, and develop a sense of belonging.
Maybe Mom and Dad are accepting, for example, but what happens to the
parents' plans if they had specific dreams about, say, weddings and
grandchildren? This and many many other work, family, relationship, and
discrimination questions affect queer people every day. Therapy is one
place where it's essential for them to get all the support they ask
for.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #18 of 90: Michael Bettinger (mcpsycle) Mon 25 Mar 02 07:48
    
The particular challenge you mention, dealing with the parent's
reaction to a son or daughter queerness is one that is particularly
well suited to family therapy.  Just because the son or daughter is an
adult and no longer living in the same household as the parents does
not preclude family therapy being a tool that can help the entire
family.  There have been innumerable times over the years when I have
been working individually with a client, and at some point, the parents
are coming to visit.  These times present challenges for some clients,
and some of those challenges can be discussed in family therapy.  I
invited the client to invite his or her parents to come to one or more
sessions while they are in town to discuss the issues. 
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #19 of 90: june (june) Mon 25 Mar 02 09:32
    
That's great advice -- an opportunity for the family to talk together
in a therapeutic setting.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #20 of 90: Michael Bettinger (mcpsycle) Mon 25 Mar 02 10:24
    
One reason many people do not realize the scope of what is possible
through psychotherapy is the traditional understanding of
psychotherapy.  The traditional understanding of psychotherapy is that
one goes to a psychotherapist to have something “done” to them.  It is
actually more helpful if one conceives of a psychotherapist as a
consultant; someone with whom an individual, couple or a family goes to
for help in dealing with some problem.  If one has a tax problem, one
goes to an accountant.  If the problem is emotional or relational, then
one goes to a psychotherapist.  This takes the psychotherapist down a
notch to a place of equality with the client(s), and that is helpful.  
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #21 of 90: Queer Is As Queer Does (maya) Mon 25 Mar 02 10:50
    
I am reminded of the first therapist I ever went to in my early 20s. 
I wanted to confess.  I sat across from him and noticed that behind him
was a huge volume entitled _How To Cure Homosexuals_.  Have you read
that, I asked the guy.  Yes, he said, I have.  And do you agree with
it, I asked.  Much of it, yes, he said.  Then you can't be my
therapist, I said, and walked out.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #22 of 90: Queer Is As Queer Does (maya) Mon 25 Mar 02 10:53
    
Which is to say, that later during my scholarship with the Jung
Institute, one of the main things I learned was the double burden
created by an individual who, not only has to come to terms with his
personal shadows, but also come to terms with the shadows projected
upon him by the culture at large.  I hope that in the process of
"queer-affirmative" therapy, a time comes when the counseling and
guidance is not merely to counteract shame, but to teach celebration. 
To dive headfirst into the lifelong process of discovering what "queer"
means to the individual and practicing it with joy and vigor.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #23 of 90: C.L.Myers (clmyers) Mon 25 Mar 02 14:06
    
About the training, or lack thereof, in human sexuality, I suspect my
educational experience is similar to June's.  I had the obligatory one
course in sexuality counseling and it did teach me everything I needed to
know about how people get in and out of orgasms physiologically.  But the
emphasis was much heavier on learning how to communicate empathically with
clients about sexual concerns and to keep our powder dry while going through
some insense and specific depictions of sexual activity.  My clinical
experience has been that it VERY important to be able to speak frankly and
comfortably about sexual issues in whatever level of detail the client will
do.  I've also found it EQUALLY important (not more and not less) to have
a strong knowledge base about sexual functioning -- harkening back to a lot
of that physiological stuff we had to slog through! -- because a good number
of my queer clients  (more, I would say, than my straight clients) needed
accurate information about human sexual functioning and all of its
variations and how to understand themselves and their own experiences.

I really think the reason for this goes right back to the negating and
invisibility we're subjected to.  It's not easy in this society to find
someone frank, knowledgeable and empathic to talk about sex with.  It's even
harder to find that person when the kind of sex you want to talk about is
not the stock heterosexual fare.

Thus, I also am nodding in agreement with the point June made about not
assuming that clients, just because they're queer, have everything about
being queer sorted out for themselves. I would add to that the notion that
just because a therapist is queer, we can't assume that homophobic or
heterosexist biases will not exist with them.  One thing I appreciate so
much about Michael's book is that it really is speaking to clients as
CONSUMERS and encouraging people to approach their therapy experience with a
sense of knowing what they want and should be able to get from a good fit
with a therapist.

...Which leads me back to your last point, Michael.  Your analogy of
considering a therapist in a way similar to that with which you would
consider an accountant or other professional is an interesting one.  Part of
the issue here is that there is no more shame in conferring with a therapist
than with a tax professional.  Another issue, though, that you allude to in
your last sentence: the power therapists are presumed to hold.  We are
sometimes believed to be people who can read minds and change personalities
and perform all kinds of psychic feats through some mysterious process that
only we understand.

Can you say something, Michael, about this general misconception about
therapists and therapy?  Also -- what should clients reasonably expect from
consulting a professional therapist, as opposed to conferring with a friend
or family member?  Most of us (the ethical among us, at least!) do not
profess to read minds and remake personalities -- but there has to be SOME
added value to consulting a professional, in addition to what you've already
mentioned.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #24 of 90: b7 (bookworm7) Mon 25 Mar 02 18:08
    
hello! Michael, I thought your book was very thorough and will be
helpful to a wide range of seekers. 
I wonder if you could speak to the idea of queer therapists
over-identifying with queer clients. This concept doesn't seem to apply
to straight situations and I wondered if you had any thoughts.
I'm also wondering if there's been any research on perceived outcomes
of queer clients who have straight therapists versus queer clients with
queer therapists.
  
inkwell.vue.143 : Michael Bettinger - It's Your Hour: A Guide to Queer-Affirmative Psychotherapy
permalink #25 of 90: Michael Bettinger (mcpsycle) Mon 25 Mar 02 18:26
    
Maya wrote in post #22

“I hope that in the process of "queer-affirmative" therapy, a time
comes when the counseling and guidance is not merely to counteract
shame, but to teach celebration. To dive headfirst into the lifelong
process of discovering what "queer" means to the individual and
practicing it with joy and vigor.”

That is certainly the case in the psychotherapy I do.  In fact, many
people come to me having already done the work about lessening or
eliminating the issues of shame and isolation.  While many come to me
with other problems, to some degree they already have begun to
celebrate who they are.  

The “celebration”, I believe is of the utmost importance.  About ten
years ago, I was involved in a project with a number of other queer
family therapist in San Francisco.  We wanted to put on a conference
which would deal with the issues of queer families.  At first, we
decided  to call the conference “Creating Diversity”.  But midway
through the meeting, I objected.  I said we already had created the
diversity.  What this conference was about was celebrating the
diversity, so the name of the conference was changed to “Celebrating
Diversity”.

My personal values, which I believe get reflected in the therapy (I do
not believe there is value free therapy) is to celebrate life, and all
that is meaningful.  Being lesbian, gay, bisexual, transgender,
heterosexual, polyamorous or whatever other way someone goes about
loving others and creating a life for themselves is to be celebrated. 
We can do that in healthy or unhealthy ways, and that is where work on
oneself comes in, but our nature of loving is to be accepted and
celebrated.  

I would also like to respond to some comments made by Cindy in post
#23.  She wrote 

“We are sometimes believed to be people who can read minds and change
personalities.” and “Also -- what should clients reasonably expect from
consulting a professional therapist, as opposed to conferring with a
friend or family member?”

So let me talk a bit more about psychotherapists as consultants.  If
we are consultants, we had better have something to offer our client. 
What we have, or should have, is a very good knowledge about human
behavior, human functioning, human relationships, etc.  We are selling
our knowledge and expertise.  We do need to know about the mechanics of
sex, as well as knowledge of human sexuality.  So I tell my counseling
students when I get a chance to teach that it is their job to learn
about people, lots of different people, and understand what happen to
people inside of them, and when they interact with other human beings,
or anything else in the world.

As for changing personalities, that an easy one.  Psychotherapist do
not change personalities.  Personalities do not change.  What does
change is how well, or not well a person is functioning in this world. 
Personalities are set at an early age.  But people can grow (or
regress) within the nature of their personalities.  If we live to be
100 and spend the entire time in psychotherapy, we would still say we
were the person we were when we began, but hopefully we would be doing
a better job of functioning in this world.  

bookworm7 write in post 24

“I wonder if you could speak to the idea of queer therapists
over-identifying with queer clients. This concept doesn't seem to apply
to straight situations and I wondered if you had any thoughts.”

This actually does happen with all configurations of therapy, and is a
problem regardless of when it occurs.  The therapy is not about the
therapist, or what the therapist wants for the client.  It is all about
the client and what the client wants.  A therapist who is
over-identified with a client, any client, has a problem that he or she
needs to deal with.  This is one of the reasons psychotherapist
regularly consult with other therapist, to keep themselves clear, not
only on what is happening with the client, but on their reactions to
the client, positive or negative.  I remember a time my partner and I
were doing couples therapy and at one point I had to say to the
therapist that I believed he was too highly identified with my partner.
 By talking about this, we were able to get back on track.  But it is
the responsibility of the therapist to deal with his or her own feeling
and to minimize to the extent possible how those feeling might
negatively intrude on the work.

Bookworm7 also writes, 

“ I'm also wondering if there's been any research on perceived
outcomes of queer clients who have straight therapists versus queer
clients with queer therapists.”

I do not know if there has been research in this area?  Does anyone
else know?
  

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