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Michael Blumenfield, M.D. Headshot

Choosing a Psychotherapist: Should Gender Matter?

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CHOOSING A PSYCHOTHERAPIST

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.