June 3, 2009

male or female therapist?

I am often asked by someone who has decided to seek out therapy whether to select a male or female psychologist. Psychologists discuss this very question among themselves because professional opinions vary.

My answer is typically that it's really up to the preferences of the individual. It's a very personal decision. Some people think they would feel more comfortable with one gender or the other.

Women often tell me they prefer to see another woman. They think they would feel more comfortable sharing the frank details of their lives with a woman, particularly when sexual issues or a history of sexual victimization are involved.

Choosing a psychologist or therapist is not unlike choosing an ob-gyn. Some prefer a doctor of the same sex believing she will be more understanding and knowledgeable because she's been there.

Or like choosing a massage therapist. Some people want to avoid any semblance of a sexual vibe. Whether that points to a male or female therapist depends on you and your inclinations.

Many guys prefer female therapists. They find it easier to open up to a woman. There aren't many settings where men allow themselves to be emotionally vulnerable in front of other men. They don't want to start on the couch.  Or maybe that is exactly what they are after.  The ability to relate on a more emotional level with another man.  

Sometimes the preference depends on experiences growing up. I recall one friend who had a particularly critical father. She decided to go with a female psychologist. She didn't want to start out fearing or assuming negative judgements.

Other times our adult experiences shape our preference. An abusive female boss may lead a patient to choose a male therapist. Again, to avoid feeling judged. This is often referred to as "negative transference." When we make assumptions about or react to a therapist in a negative way because she reminds us of someone we don't like.

Sometimes it makes sense to choose a psychologist who is the same gender as the abusive or critical parent. Give yourself a chance to feel accepted, to feel comfortable with and understood by someone of the same gender as the critical parent. Therapy, for many, is often, in part, a re-parenting experience. Where the parent figure, this time around, accepts us for who we are and the decisions we have made.

I've been in the position of conducting psychological evaluations for children in need of therapeutic intervention and asked whether the child should see a male or female therapist. I recall one boy who had repeated negative experiences with various males in his life. I suggested a male therapist to help the child gain a positive, nuturing experience with an adult male. To help undo.

So it really just depends on the preferences and experiences of the patient. Of course, one of the most important considerations in is the expertise of the therapist. How experienced and expert they are at therapy. Feeling comfortable with the therapist is another. Does it feel like a "good fit?" Do we seem to "click" when we're in session? And no one will be a better judge of this than you.

Sandy Andrews, PhD  is a Clinical Psychologist / Therapist who provides CBT in Austin, Texas  

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