Case Study - Page 2

Men in circumstances similar to Rob's frequently describe their experiences in therapy as confusing and polarizing; whether they see gay-identified therapists or heterosexual therapists, they face a strong bias toward full disclosure and divorce. Many men have shared with me their panic after initial sessions with well-meaning therapists who supported "authenticity" while not acknowledging the complexity of honoring multiple and complex identities. Like Rob, these men report loving their wives, loving their children, loving God, and being attracted to men—all at the same time. My work with gay and bisexual men over the past 10 years has taught me to see psychotherapy as a place to hold dynamic tensions without easy, premature resolutions. As a therapist, I saw my job in this case as conducting a careful conversation with Rob about how he viewed the incongruity of his identities, and through gentle challenging of his assumptions, helping him discover a way to live with greater clarity, which might conceivably include even greater ambiguity.

So after he'd finished his introduction, I simply said, "You sure have a lot to manage. To me, it seems that our challenge is to help you find a way to honor all these parts of yourself. So what might that mean for you?" Rob's breathing visibly slowed, he put his head back on the cushion of the couch, and exhaled. "I don't feel like I fit anywhere," he continued. "I don't feel straight' enough in the straight world, and I don't feel gay' enough in the gay world. I can't be all of who I am anywhere. I don't know what to do."

Our initial sessions began by simply acknowledging many conflicting desires: to be a good Roman Catholic, to be gay, and to stay married to his wife and live with his children. We focused on the fact that, whatever it meant for him, his sexual orientation might feel like a significant threat to others in his life, especially Mia, who unambiguously envisioned a traditional marriage with him. She, for her part, began seeing a female therapist, who encouraged her to be clear with Rob about her own needs, sadness, and grief—all of which, unsurprisingly, was difficult for him to hear and often left him feeling guiltier and more ashamed.

Whenever possible in cases like this, I try to see the couple together, and Rob's case was no exception. I'm very much aware of the contrasting dynamic of a partner who's questioning his sexual orientation being in therapy with me (a gay man) while the straight wife sees a heterosexually identified woman—usually the typical scenario when both partners seek separate therapists. Many gay or bisexual men seek out a gay-identified therapist, assuming they'll be understood and supported more fully than by a heterosexual therapist, while their straight spouses seek a heterosexual therapist for exactly the same reasons.

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