Should men treat women? Dilemmas for the male psychotherapist: psychoanalytic and developmental perspectives.

Abstract

A spate of sexual abuse cases predominantly involving male psychotherapists with female patients as their victims raises serious questions about the ethics of cross-gender therapeutic dyads. Although such abusive situations must be highlighted as ethically aberrant, they may well represent a type of intrusive harm or hostile neglect which ensues on a continuum in the psychotherapeutic treatment of many female patients by male clinicians. I argue that the difficulties for men in empathically understanding women stem not only from certain misconceptions about women's development but especially stem from a paucity of understanding concerning men's psychology, a dearth of gender-sensitive information about the differences between boy's and girl's/men's and women's development, and a consequent difficulty for male psychotherapists to engage in the type of productive self-analysis that would ameliorate this gender-biased myopia. Recent psychoanalytically oriented child development/family research and innovative revisions of psychoanalytic theory are used to highlight some of the often overlooked, yet salient aspects of men's development as it is differentiated from women's. Specifically addressed is the possibility of a male, gender-linked vulnerability for a normative traumatic abrogation of the early holding environment with predictable sequelae in later intimate relationships, including the psychotherapeutic encounter. As the "confusion of tongues" between men's and women's development comes to light, is translated, and is empathically understood, new hope may be found for male therapists and their patients. An opportunity for enhanced therapeutic efficacy within an ethical and genuinely caring depth psychology may then be generated.