Inkwell: Authors and Artists
just got a fistful of pink peppercorns (jillmaxi) Tue 26 Mar 02 02:51
hello all, and thank you for this opportunity to read and discuss michael's wonderful book. i'm about halfway through, and as i read, i keep thinking...this is a great book for those who are considering psychotherapy. i was thinking it would be addressing therapy aficionados or practitioners, but it really is the 101 for those overwhelmed by, or uninformed about, the art of psychotherapy. i am guessing as the book progresses it will talk more about psychotherapy that's tweaked with gay consciousness and compassion. it's nicely written, especially the more challenging expository sections and the stories are pointed without being too obvious or gratuitous. michael, since i haven't read the entire thing, i won't ask if you plan to travel around teaching therapists to open their hearts and minds to queer clientele in a deeper way. do you think training -- from the outside -- can impact a therapist who is not doing the inside, soul-transforming work that creates the field of compassion necessary to be truly queer-affirming (assuming said therapist is not him/herself queer)?
Michael Bettinger (mcpsycle) Tue 26 Mar 02 06:52
To respond the the question just asked by (jillmaxi), I began my career as a high school teacher and soon moved to the counseling department. Deep in my heart, I am a teacher and believe people can and do learn. I have taught on and off for most of my career. I believe people can and do learn. There is a teaching component in all therapy. And, therapists, too, can learn. All is takes in a willingness and spending time doing the learning. I do not have any plans at this point to travel to teach, but I am always open to teaching opportunities in the Bay Area. One of the "problems" with being a therapist is that we get to listen a lot more then we get to talk. I like to talk, so teaching is a good forum for me. The kind of learning you speak of is difficult. It is "soul-transforming", and that requires a lot of motivation. If the person doesn't have that motivation in the first place, the learning goes a lot slower.
just got a fistful of pink peppercorns (jillmaxi) Tue 26 Mar 02 08:51
indeed, michael. i am about to begin the formal training...of some sort. to begin doing therapy after x many years in therapy and on the spiritual path. so this book is helpful to me as well. i feel like sending it to people i know who resist therapy but are always first on line to ask questions.
Michael Bettinger (mcpsycle) Tue 26 Mar 02 17:59
Thanks, Jill for the kind words about the book. While the book is primarily aimed toward the consumer of mental health services, more than a few clinicians have given me feedback that the way I organized and approached the topics has helped them to understand more of what they are about as therapists, and as a result, they can tell potential clients more precisely what they offer and how they go about that.
C.L.Myers (clmyers) Wed 27 Mar 02 13:58
Michael, in your book, you go into some of the differences among different types of therapists in terms of style and the things they actually do in the room with clients. For example, you discuss the directive vs. non-directive style, etc. These distinctions are important, since many people will respond to one approach to therapy much better than they will another Can you talk a bit about the different "types" of therapy a potential client might consider?
just got a fistful of pink peppercorns (jillmaxi) Wed 27 Mar 02 14:05
good question. standing by.
Michael Bettinger (mcpsycle) Wed 27 Mar 02 18:24
The style of any therapist is based on his or her theoretical orientation and personality. I believe the personality is actually the more important determinant, and therapists with various kinds of personalities find theoretical orientations that suit their personalities. I would roughly divide therapists into two classes, those that do a considerable amount of talking during the hour, and those that dont. All therapists listen, but some will respond in a more active way, while others will take in what the client is saying and respond much less frequently. Innumerable times I have had clients come to see me and when I ask them about any former therapy they have had, they often comment that they were in therapy at one point, but the therapist didnt say much. To me this almost always means that the therapist is doing therapy form a psychodynamic/psychoanalytic perspective, and not making that clear to the client. These therapists believe that the most important thing they can do for the client is to remain a blank slate, and let the client transfer onto the therapist any number of ideas. Since the therapist has not shared much with the client, the therapist believes these ideas are mostly about the client and not the therapist, and the client most likely does roughly the same with other people in their lives. By working on the transference, the client gets to understand how he or she gets him or herself into trouble with others, and can use that information to help him or herself with whatever issues they are bringing into therapy. The problem, as I alluded to, is that psychoanalytic therapists rarely if ever make this well understood to their clients. The clients are often confused as to why the therapist says little. Psychoanalytic psychotherapists would do themselves a great service by making this clear to clients near the beginning of the therapy process. That would enable the clients to decide whether they want to continue with this type of therapy, and if they do, they will understand why the therapist says little. The other half of my equation is therapists who talk a lot more. This comprises many different kinds of therapy. In this case, (as in the former case) it is not just how much the therapist talks, but what he or she is responding to. In any conversation, a person says a lot. The other person can respond to any number of different parts of the content of what someone said, or something in how they say it (their process). Humanistic psychotherapists respond to the existential question in a person life, the meaning of life, death, etc. Behavioral psychotherapist respond to symptoms and how they can be relieved through actions. Cognitive therapist respond to a persons thinking process. Transpersonal psychotherapist respond to spiritual questions. Family systems psychotherapist respond to interactive patterns in families (this is not to be construed narrowly, many family systems therapist are aware of queer alternative family arrangements. There is no one best form of psychotherapy. All have about the same success and failure rate (depending on how you measure such things). When someone asks me what kind of therapy I do, I tell them I am an active therapist and will share my thoughts, feelings, ideas, experiences and intuition when appropriate. I happen to work from a humanistic and family systems perspective, so I will respond in a way consistent with that orientation.
just got a fistful of pink peppercorns (jillmaxi) Wed 27 Mar 02 21:22
a very useful explanation. i now have names for those things.
june (june) Wed 27 Mar 02 21:50
I want to comment on "directive" versus "nondirective," using bare definitions of those terms. I decided the style of my first ever therapist was sort of neo-Freudian, even though I didn't ask him. I wondered if he hated me but, again, didn't ask. Um hmm um hmm um hmm, he said. I saw him for 12 years and never found out anything about him. Yet somehow I became more self-aware. Maybe that guy was subtle. He was certainly very nondirective. In simple terms, as a psychotherapist myself now, I'm more directive with some clients and much less or not at all with others, depending on the approach that seems to fit where they are. Sometimes clients ask for specific guidance and I offer it. Others want to figure things out more on their own with me there for support. In both styles a goal is to help the client develop insight. One new client told me he was having some difficulties at work and stated that he needed a "strong directive" therapist. I wondered. When he complained about how rigid his work environment was, I backed off from telling him what to do, opting to explore with him instead. Figuring out how much to say and how to say it are part of the therapist's art, and we take both direct and indirect cues from the client.
C.L.Myers (clmyers) Wed 27 Mar 02 22:36
Your post makes me also want to make the distinction between being "directive" as a therapist and being "engaged". I believe there are certain types of therapy and certain conditions that call for "directiveness" -- e.g., suggestions, "homework", coaching, etc. Many models of family therapy are very directive. Cognitive and behavioral therapies also have a strong directive element. These types of therapies seem to be useful for things like depression, anxiety and obsessive- compulsive-type disorders (for example). Of course -- as Michael points out in his book -- you will get differences of opinion (depending on a therapist's own theoretical orientation -- which I agree says volumes about their worldview) as to whether certain conditions (e.g., depression) are best treated in short-term vs. long-term therapy and with insight-oriented vs. behavior-oriented therapy and so forth. But a more generic word for a therapist's "style" might be "engaged" vs. "not-so-engaged" (very few therapists are truly "disengaged" -- although some may appear to be!). I was definitely an interactive therapist. I also prided myself on knowing when to shut up -- although I made my share of errors in that dept. Also some therapists rely more heavily on "reflection" (mirroring back what the client has expressed without loading much/any interpretation into it), whereas others are more "probative" (questioning, exploring) whereas still others are more "analytical" (interpretting, reframing).
Michael Bettinger (mcpsycle) Thu 28 Mar 02 07:10
I would describe my style as conversational. At times I find myself being directive, at other times I find myself being non directive. Much of this is related to whatever the client is seeking. For those who most want me to be a witness to their lives, I tend to be quite non directive. I often ask questions to clarify or to help me to understand what is being said, but I refrain from giving directions. That is not why the client is seeing me. Other people come to me for both my opinions and advice. Sometimes I give it, sometimes not. It depends again on why a client is seeing me. However, short of telling a suicidal client not to kill him or herself, I rarely tell a client directly what to do. I do make suggestions and ask clients to consider those as suggestions. An example of how I might be directive is that I often ask clients to investigate the Enneagram. This is a method of typing personalities that uses non psychological jargon and is easy for most people to understand. I find that if a person understands their Enneagram type, they can often accept and normalize parts of their personality that they dont like but are also parts of the personality that tend to be enduring. If a client resists my suggestion, I generally dont press it. Being directive can be tricky. More than a few clients ask for directions so they can resist those directions. Under it all, I believe they are attempting to regain their sense of themselves that was taken away by highly directive parents insisting the child do as the parent wants. They come to the therapy asking for the same kind of directions they had and hated, but unconsciously they are attempting to set up a similar situation to what they grew up with in order to gain mastery over that situation and regain self worth, self esteem and a sense of being able to be themselves that wasnt possible as children.
just got a fistful of pink peppercorns (jillmaxi) Thu 28 Mar 02 09:58
what a great conversation this is. i hope you don't mind if i do a lot of listening...trying to get a grip on which way to go in terms of training. my therapist of many years never told me what to do. i really came away with knowing i am my own healer. i'm trying to remember if she asked a lot of questions.
Michael Bettinger (mcpsycle) Thu 28 Mar 02 10:59
One of my primary rules in life is that there is no one way for almost anything. So many ways we do things are merely just one was that is effective. I believe we choose to do things in a certain way because deep inside of us that makes sense. That includes therapy. There is no one way to do psychotherapy. Many avenues to lead to the same destination. My choices, based on Humanism and systems theory suits my personality. And, I find I need to attract clients who my approach suites them well. Others need to find other therapists. Unfortunately, many people choose the first therapist to whom they are referred (I believe people do the same with lawyers, accountants, plumbers, etc). But therapy is such a great committment that it would be worth a person's while to get the kind of therapy that suits them best. I hope the book helps people to do that.
C.L.Myers (clmyers) Thu 28 Mar 02 11:30
Michael, you just reminded me of one of my mental post-it notes from earlier in the conversation! BECAUSE of the point you just raised (it's worth it for a person to really investigate the different types of therapy available, etc.), your book has particular relevance for queer clients. Because -- as you say -- queer is different. Not only is being queer different than being straight/not-queer -- it is also different than being an ethnic or other kind of minority we typically think of. Some of these differences involve what we are likely to experience in our families and the world around us. Some of these differences are in the dynamics of our relationships. Some are in our internal phenomenological experiences of ourselves. And some just seem to be in our wiring. Can you talk more, Michael, about your thoughts on this?
just got a fistful of pink peppercorns (jillmaxi) Thu 28 Mar 02 13:18
i also appreciate how together the author is about therapy in general and about doing it. this isn't an angry "they don't get us" rant. one of the great strengths of this book is that i think it serves anyone wanting to understand therapy - not just queer folks.
Michael Bettinger (mcpsycle) Thu 28 Mar 02 13:30
I believe queer people are different in many ways from non queer people. Our differentness is not merely about our sexual orientation, but encompasses much more than that. Proving that statistically is a different thing. For a long time the emphasis was on proving that queers were no different than any other folks. Most of that had to do with depathologizing queer people. Initial studies in this area showed that queer people could not be identified as such by scores on standardized tests of mental or emotional functioning. The we are all the same mentality was assumed to cross over into other areas, such as cultural areas. We are now beginning to understand that queer people not only form a unique culture, as does every other group, but that in some ways we are different going into all this. One small way we have been able to identify is that queer people are more likely to be androgynous than non queer people. Androgyny means having the personality characteristics that are usually associated with both genders. It is more likely that a queer man will have some personality characteristics associated with women, and the opposite is true for queer women when compared with non queer people. (Being transgender is a whole other topic). This does not mean that queer men are really women or visa versa. Queer women are still mostly female in their characteristics, just as queer men are more like men than women. But as a group we tend to have more of the characteristics of the other gender than do non queer people. This has an impact on a lot of queer life; our relationships, our friendships, the work we choose, and the culture we create. More research is needed here. But the experience of being queer is not only shaped by the society, but also by how queer people are different, in all the ways we can or cant identify.
C.L.Myers (clmyers) Thu 28 Mar 02 15:16
There have been some interesting ideas to come out of research done in the past 10 - 15 years or so that busts open a lot of myths and stereotypes people have about queers. For example, you might remember the old notion (based on some study) that gay men are more likely to come from families with a distant father and an overprotective mother. Some researchers, I believe they were out of Minnesota, have since speculated that this is not a "cause" or a "precursor" to male homosexuality, but rather AN EFFECT OF IT within a family. Which is to say the parents behavior didn't cause the boy's homosexuality -- it's more the other way around! Another interesting area of research involves couple and relationship dynamics. Of course we good old lesbians still lead the pack on most enmeshed (or intimate -- depending on how you frame it!) relationships. But there's long been an assumption that gay men's relationships are the more disengaged than lesbians or straight couples. Michael, I believe you've found something that challenges this assumption as well, yes? What have you found, in your studies and clinical experience, about the uniqueness of queer relationships? And -- alongside that question -- here's a sub-question: are there any interesting, noteworthy patterns that have emerged among bisexual persons in relationships with persons of the opposite gender?
Michael Bettinger (mcpsycle) Thu 28 Mar 02 21:51
Cindy - You raise some interesting points that I have given much thought to. One of them is the overly protective mother/distant father syndrome that Freud and others believed caused homosexuality. While research dismissed that a long time ago, it couldnt be validated in controlled studies, it may have some validity, and your notion that it is a result is probably right on. And the reason is simple. Straight men do not like being the sex objects of other males, including their own sons. I believe that some of these men realize their very young sons look at them with sexual eyes; they are their sons first love object and they react with panic. When humans are afraid, they either get aggressive, or run away. From the stories we hear from many adult gay men, that is how their fathers reacted to them, and this was quite different from the reaction these fathers had to their heterosexual sons. Regarding the relationships that lesbians and gay men create, we are unique in some ways. Years ago, as part of my doctoral dissertation I investigated the dynamics of closeness and flexibility among gay man while a fellow student, Ellie Zacks of Sacramento did a similar study of lesbians. We found some seminal information about queer couples. Lesbians, as expected, were the most enmeshed couples. Less enmeshed than lesbians, but still considerably enmeshed were the gay male couples. And, the least enmeshed couples, the ones who did the least together, had the least friends in common, were the married heterosexual couples. The reason for this is not clear but this research has been duplicated and the results were the same. Queer couples are the closest couples that there are in America. We are different as couples in other ways. We are the most flexible of all couples. There are no rules going into queer couples as to who will do the dishes, who will take out the garbage, who will fix the car. All these things have to be determined by the couple. Sometimes a member of the couple will gravitate toward an activity; sometimes it is negotiated. But queer couples change these roles considerably more often than do non queer couples. I am not aware of the present research into couples where one or both are bisexual, but I am sure we will find some interesting results.
just got a fistful of pink peppercorns (jillmaxi) Fri 29 Mar 02 09:09
do you think this can be said across the board, or does class have anything to do with it? in my recent experience, i have found self-described "edgy" lesbians who come from privileged backgrounds to be suprisingly rigid about boy/girl roles in lesbian dating rituals and coupleships. but this is the silly world of the gender police. i wonder about that stuff. this is why i think of myself as just plain queer.
le grenouille mange la pamplemousse (rhone) Fri 29 Mar 02 12:10
Just changed health insurance plans and had to arrange for a new therapist. When I called to make the appointment I requested someone who worked with gay men. (Under different insurance plans, I've even had people ask me if wanted a gay therapist.) The person I spoke to seemed to think this was the oddest question in the world. I'm not at all happy with the person they've assigned me to, and I suppose I will try to find someone else and pay out of pocket. Any suggestions on finding queer-positive therapists in San Francisco? I know this should be incredibly easy, but my web searches so far have not turned up very much. Thanks.
Michael Bettinger (mcpsycle) Fri 29 Mar 02 14:26
Finding a queer-affirmative psychotherapist in San Francisco is really easy. You can go one of two routes. 1. BUY MY BOOK! Shameless self promotion here. The book will not on ly help you to find a therapist, but it will give you a lot more information than just how to find a therapist. 2. Take the easy route - Call the GAYLESTA (Gay/lesbian therapist association) referral line at 888.869.4993. Depending on what insurance you have, they may have a list of therapists who are part of that insurance panel. Better yet, do both. Now a comment on the person at the insurance company with whom you spoke. She was completely out of line by saying your request was the oddest question in the world. She has something important to learn. This will only happen if someone like yourself reports this to the insurance companies. Insurance companies are in business to make money, and most of them have figured out by now that they will make more money by being queer sensitive. It is likely that you will get a good reception if you report the incident. Back to Jills comments on some lesbians being extremely rigid. Gee, I hadnt noticed that. :-^) Seriously, there are rigid people, and a lot of them within every group. Lesbians tend to be the most flexible of all couples by far. This is an average so individuals may appear quite different. And I do now know how much of this is class sensitive. Most of the research was done on middle class people or people with middle class values. I would suspect however, that in the upper and lower income scales, lesbian couples will still come out the most flexible when compared with other couples in that socio-economic group.
le grenouille mange la pamplemousse (rhone) Fri 29 Mar 02 14:42
Thanks for the information! >Now a comment on the person at the insurance company with whom you >spoke. She was completely out of line by saying your request >was the oddest question in the world. Well, I only said that she "seemed to think that." She didn't make any overt comments. Her reaction was just "huh, what? What do you mean?"
C.L.Myers (clmyers) Fri 29 Mar 02 14:52
Still, I think Michael's comment is on the money. Insurance companies rely on these folks to make a successful interface with their customers. Someone in her position who is not prepared to respond to a statement like yours is not performing up to par.
bitch slapped by the universe (sd) Fri 29 Mar 02 18:35
Thanks for a wonderful book Michael. I appreciated the teaching nature of your discussion of various forms of therapy. It had never occurred to me, for instance, that a support group was for folks dealing with a common condition and was not about changing as opposed to group therapy where members are working on changing themselves. Did I state that correctly? It seems obvious now that you describe it. I'm amazed at the way you say such simple things without speaking down to the reader. I'll bet you are a fine teacher. I wondered if you have any comment on drug and alcohol abuse and addiction in the queer community. It seems to be a common thought that the rate of such problems is disproportionatly high. I also have the same question about queerfolk and depression. Is depression a larger problem here than in the rest of the population? If so, do you credit anti-queer sentiment from the majority for any of these problems?
just got a fistful of pink peppercorns (jillmaxi) Sat 30 Mar 02 08:32
thanks for your reply michael. lesbian flexibility is news to me;)
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