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Michael Blumenfield, M.D.

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Choosing a Psychotherapist: Should Gender Matter?

Posted: 05/31/11 10:04 AM ET

On Monday, May 23, there was a front-page article in The New York Times titled, "Need Therapy? A Good Man Is Hard to Find," by Benedict Carey. The gist of the article is that women have taken over the field of psychology and counseling, and that many men who want therapy will have trouble finding a therapist who understands them. The reasons for this shift were described as economic and cultural. The article noted that managed care has taken a bite out of therapists' income, and that psychiatry, the most male-dominated corner of therapy, has increasingly turned to drug-based treatments. Additionally, as women entered the work force in greater numbers, they proved to be more drawn to talking-based treatments than men were. (It is a reasonable assumption that this article is directed toward psychotherapy, where there would be discussion and examination of feelings, thoughts, conflicts and interpersonal relationships.)

While the article mentioned that the impact of this gender switch on the value of therapy is negligible, it painted a picture that many men believe that only another man can help them (and I assume many women feel the same way regarding women therapists). It went on to mention that men are far less ashamed about affairs when speaking to another man: "A bar fight that sounds traumatic to a female therapist may be no more than a good night out for a man" (as if these differences, if they existed in various people, would interfere with therapy). It concludes with the suggestion that if men want to become therapists, they can write their own ticket (which doesn't even follow from the earlier assumptions about increasing number of female patients). It sites one study among 266 college male students at the University of Akron, which found that a man's willingness to seek therapy was directly related to how strongly he agreed with traditionally male assumptions such as "I can handle whatever comes my way." It concludes that therefore, such a man who happens to be on the fence about seeking therapy could be discouraged by the prospect of talking to woman (with no evidence that this assumption has any validity).

If this article were not on the front page of The New York Times, it wouldn't even be worth discussing. In addition to a poor understanding of how psychotherapy is conducted and how it works, there was no valid scientific foundation for the assumptions made. The article needs to be challenged, because it may discourage people from seeking therapy and may lead them to reject qualified therapists.

If it were true that in order to receive effective psychotherapy, the patient and the therapist must be of the same gender, it would follow that that they should be in the same age group, socioeconomic group, religion, race, occupation type, work ethic, sibling configuration, health status, life expectancy, marital status and political party and have the same experience with drugs and alcohol, military service, parenting, etc. This is an impossible task, and there is no established validity to the assumption that there must be some type of mirror image between the patient and the therapist.

There is no one simple experience of growing up as a man or woman (or growing up as a Catholic or Jew, or being a grandfather, or facing death, etc.) that must be shared by patient and therapist in order for the therapy to work. For the patient to assume that the therapist can only understand his or her experience if they somehow share some similarities (or for the therapist to assume the same thing) is a recipe for misunderstandings.

A well-trained therapist is a mature individual who has had training in human development, life cycle, psychodynamics, interpersonal relationships and techniques in psychotherapy. Psychiatrists are physicians who have also had training and experience in having personal discussions with people concerning their health and physical functioning at various life stages while they administer medical care. Very often, therapists from all disciplines have had their own personal treatment to could deal with their own issues, blindspots and conflicts. Therapists are trained in listening and helping their patients explain and elaborate their thoughts and experiences. As a therapist, you learn never to assume that you understand the meaning of a patient's experience until you have allowed the patient to look at it from various angles. Therapists are constantly aware of their own identifications with a patient, as they are about patients' assumptions and feelings about them. In fact, it is often through an examination of these issues that the most meaningful progress in therapy occurs.

Every person does have the right to choose their own therapist. No doubt some people will seek out therapists who have certain characteristics that are important to them. Hopefully this will be an issue that will be ultimately understood in the course of therapy. It is not easy to choose a therapist and know who is best qualified to treat you.

How to find a therapist is another topic that needs to be discussed in detail. Sometimes people go for consultation with somebody whom they have reason to trust, although he or she will not be able to treat them but will help choose a qualified person to treat them. It is important that the potential patient understand that a well-trained, qualified, empathic therapist does not have to be like them but only has to care about them.

 
On Monday, May 23, there was a front-page article in The New York Times titled, "Need Therapy? A Good Man Is Hard to Find," by Benedict Carey. The gist of the article is that women have taken over th...
On Monday, May 23, there was a front-page article in The New York Times titled, "Need Therapy? A Good Man Is Hard to Find," by Benedict Carey. The gist of the article is that women have taken over th...
 
 
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HUFFPOST SUPER USER
ignacio sanabria
Mirror synapses at work
09:41 PM on 05/31/2011
It would depend on the subject matter in question. If I am an addict, I would seek a male therapist. If I am an alcoholic, I would seek a female therapist. If I need marriage counseling I would prefer a female therapist. If I suffer from male erectile dysfunction I would prefer a male therapist, etc., etc.
Guest211
Stars Exploded to Make Me
09:16 PM on 05/31/2011
Having remembered an article I read last year.... it doesnt seem men have a problem with female therapists at all.

http://www.thedaily.com/page/2011/02/28/news-naked-therapy-1-2/
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french queen13
my beloved is mine and I am his
07:47 PM on 05/31/2011
Not sure if psychotherapist and psychologist are the same, but here's my two cents' worth. Some years ago I sought help for a stress/anxiety problem (how to cope with loud music that was making me physically sick). Finding a psychologist was a matter of finding someone within a reasonable distance of my home or work, since I don't drive. It then came down to a matter, not of their sex, but their background. I once had serious mistreatment from an overseas doctor based on her assumptions about Australian women - total cultural blindness - and I was not interested in going to see a psychologist whose name would suggest they too might be new to the country. Prejudiced? Unreasonable? No doubt, but wasn't a chance I was going to take. (On the practical side, I didn't want to have a talking cure with someone with an impenetrable accent.)

Anyway, I found an excellent psychologist, a man, and had a year's treatment (GP-recommended psychotherapy just having been added to the public health scheme).
04:00 PM on 05/31/2011
I agree with Dr. Blumenfield that it is not important that we be exactly the same as our patients or have had the same exact experiences. I am a female psychologist with a private practice in NYC , and at the moment my patients are 55% male and 45% female. I have worked with and helped people of a different gender, ethnic background, and sexual orientation, etc. than I am. It’s not that we have experienced the same circumstances but we have experienced the same feelings. We have all felt shame, humiliation, joy, despair, desperation, pride, etc. , and that’s the starting point of empathy. But even then, my experience of, let’s say, sadness is different than someone else’s and I still have to understand his or her experience of it and how it affected him or her. Also, I have had plenty of men discuss infidelity with me; providing a space where people safe from judgment about the choices they make has nothing to do with gender.
www.DrChristineFernanadez.com
03:25 PM on 05/31/2011
I think education is certainly important when trying to match therapeutic fit. As a counselor for men and couples in Phoenix, I wish that potential clients would research and investigate their potential picks for therapists. Often, it's a matter of which therapist is covered under insurance or who's less expensive. I try to help educate potential clients through intake, blogs, videos and introductory information, as well as promote the therapeutic connection early. It's critical to establish this connection. I agree with the author when he says, "It is not easy to choose a therapist and know who is best qualified to treat you." It's not. But, the original NYT article does have some validity: there are just certain topics that men will seek out male counselors for, such as infidelity, anger, and, often, couples counseling. Men already have a difficult time getting in the door for psychotherapy, and as a men's counselor, I have to meet them where they're at. When the author of this post writes, "The article needs to be challenged, because it may discourage people from seeking therapy and may lead them to reject qualified therapists," I think, in many ways, men are discouraged culturally from seeking therapy, so that's already an established issue. I think finding someone you can connect with, and if that therapist happens to be a male like myself, all the better.

See my blog at www.phoenixmenscounseling.com for more writings on men, mental health, and relationships. Thanks.
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jf12
When I saw her I marveled greatly.
02:13 PM on 05/31/2011
Ok, I have no problems with a female doctor, even a urologist for my kidney stone. But how many unmacho men in talky therapy do not have women issues as their primary problems?
01:02 PM on 05/31/2011
-Psychotherapist- have a huge disconnect between the clients everyday reality and the treatment plans that the psychotherapist offer no matter what there gender is? It all boils down to -Empathy- for the clients and which gender is more likely to use antipsychotic drugs as the main treatment method or use psychotherapy with little or no drugs? -Suicide- will result in most people with mental illness that have a lifetime of antipsychotic drugs versus somebody that is lucky enough to find a humanistic psychotherapist that has -Empathy- for the client???
12:58 PM on 05/31/2011
I'd pick a man.