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Women Treating Men - Page 3

From many years of attention to men's language, attitudes, and needs, I've developed a specific approach to working with male clients. With a man, I introduce therapy as an educational experience, offering verbal and written descriptions of "what to expect in therapy." I use a variety of cognitive-behavioral techniques, including giving weekly homework assignments and using videotherapy and bibliotherapy. I find that structured assignments and role-playing exercises help men see the therapy process more as an educational experience and less as a pathologically-oriented excavation of their psyches.

I often rely on a sense of humor, down-to-earth language, and judicious self-disclosure to level the playing field between myself and my male clients. For example, I had a depressed male client a few years back who thought medication was "only for weak people." After trying every way I could think of to help him move out of this stance, I ended up sharing with him some of my own experiences with suffering, after which he looked relieved and said, "I don't feel so alone anymore. Maybe I'm not such a loser." He went on to take medication and improved dramatically.

I've found that terminating therapy typically is quite different with men. My female clients seem comfortable letting go of the relationship completely when they're ready and taking time to process their feelings with me about ending treatment. More often than not, my male clients end up arranging increasingly infrequent sessions, saying something like, "I want to schedule a session, but not now. I'm too busy." Then they call me in a few months (or even a few years), saying they want to run something by me. This strikes me as a way men have of maintaining control over the beginning and end of our connection—not really ever saying good-bye, but rather "see you later."

Special Challenges

A basic problem for women who treat men is that, no matter how empathic we may be, we haven't had the same socialization they've had. Occasionally male clients will confront me directly about my "ignorance" of what it means to be male—"You can't possibly understand what it's like to be a man. How can you possibly help me?" Over the years, I've learned not to be defensive when a man confronts me in this way. Instead, I'll say something like, "You're absolutely right. I haven't had your experience, but I'm interested in what you've gone through. Tell me more." Often I'm able to turn this into an advantage by putting myself in the student role and making my male client the tour guide to what David Wexler has called "Guy World."

In one session with Tom, a man who'd just gotten laid off from his job of 15 years, after I said something I thought was supportive ("Wow! That must be tough"), he turned to me with annoyance and said, "How would you know? You don't have to provide for your wife and children." I agreed and I asked him to tell me more about what it meant for him to feel like he had to be the main breadwinner. He told me it was a great burden, and that he didn't think his wife really understood how hard it was for him. We talked about the usefulness of having her join us for a session, and then I went on to explore what his dad had taught him about the responsibilities of being the breadwinner and the shoes he felt he needed to fill. Through asking questions, I let him know I truly wanted to learn about how he experienced the demands of being a man.

Male anger or verbal challenges to women's authority can be especially difficult to handle for female clinicians, particularly those who've had to deal with angry, patronizing, or dismissive men in their own lives. Even if that isn't the case, men's physical size and deep, booming voices can be intimidating. Take Fred, for example, an angry male client who was working through some issues about his ex-wife, with whom he'd had a nasty divorce. Usually my approach with angry men is to allow them space to vent their feelings, and to check my own countertransference at the door so that I can really hear them. I often say things like "Tell me more about your anger," even though sometimes I feel like changing the subject, withdrawing emotionally, or showing disapproval. When my male clients can express their anger without my resisting it or getting judgmental, they're better able to get underneath the anger to the sense of rejection and sadness that may underlie it.

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