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Book Reviews   |    
Psychotherapy With Gay Men and Lesbians: Contemporary Dynamic Approaches
Reviewed by Ski Hunter, Ph.D.
Psychiatric Services 2004; doi: 10.1176/appi.ps.55.9.1073
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edited by Jack Drescher, Ann D'Ercole, and Erica Schoenberg; New York, Harrington Park Press, 2003, 258 pages, $24.95 softcover

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The chapters in this book, previously published in the Journal of Gay and Lesbian Psychotherapy, address practice with lesbian, gay, and bisexual clients. In addition to an introduction by the editors, the book has four sections: "Gay Patient-Gay Therapist," "Erotic Transference/ Countertransference," "Gender Identity and Creativity," and "Two Cases of Psychotherapy With People with HIV/AIDS." The contributors include faculty members in universities or institutes, members of editorial boards of journals, and private practitioners. The focal interest of all the contributors is psychotherapy and psychoanalysis.

Key themes of Psychotherapy With Gay Men and Lesbians: Contemporary Dynamic Approaches include whether there is a lesbian, gay, and bisexual therapy; whether a therapist's sexual orientation makes for a type of therapist; changing views of categories such as lesbian and gay (what do they really mean in changing cultural contexts?); gender and sexuality (are we passing for a certain gender or sexual orientation?); essentialism and constructionism; postmodernism (for example, subjectivity, such as one's values and attitudes, is part of the therapeutic process); the interpretative subjects of therapist and client; whether the therapist should take the same risks asked of clients, such as discussing with clients one's emotions and feelings; relational psychotherapy; countertransference; negative transference; erotic transference in same-sex therapeutic dyads; self-disclosure by therapists (for example, sexual orientation and experiencing sexual feelings for clients); and other boundary issues.

This book essentially represents contemporary and developing views of psychoanalysis versus the old or traditional views, which, for example, were moralistic and judgmental of lesbian, gay, and bisexual clients. Other examples include subjectivity (versus objectivity) and transference-countertransference (versus being seen as neurotic). These phenomena are now seen as having a legitimate place in the foreground of therapy. A theme present throughout the chapters is what is happening to the therapist during therapy. Sexual issues are particularly grappled with, such as whether a therapist should disclose his or her sexual reactions to a client. One of the case studies involving a client with AIDS raises another boundary issue in the context of a client who is seriously ill and hospitalized. Should the therapist visit the client? There is also the provocation when working with these clients for a therapist in terms of his or her own mortality, potential future illnesses, and losses. Are these issues to be kept in the background, or disclosed to the client?

The editors' purpose was to have the book's contributors discuss contemporary issues in psychotherapy with lesbian, gay, and bisexual clients. The book looks at the relationship going on in therapy between the therapist and the client and the complicated issues that occur. In addition, thinking outside the box is evident on many topics, including gender, sexual orientation, subjectivity, and countertransference. The book's value lies in the discussions and critiques of how these and other issues get played out in therapy. Many of the issues are contentious and thus are not settled. Agreements and disagreements are evident.

Dr. Hunter is affiliated with the School of Social Work at the University of Texas at Arlington.




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