Introduction

R. Dennis Shelby

Some time ago at an analytic discussion group, I caused a bit of a stir when I offered my view that disclosing or revealing my orientation to a patient or anyone else, was not revealing a great deal about me as an individual. I was surprised at the reaction. The person leading the discussion (a heterosexual training analyst) was quite flustered and accused me of being glib. He emphatically stated that orientation was about everything: that it was about Libido! Several gay analysts reacted with alarm and anger. Yet no one could tell me why they disagreed, why orientation was about everything, or why they were so angry.

A common myth about gay and lesbian psychotherapists who specialize in working with gay and lesbian patients is that treatment is dominated by "sameness," "familiarity," or "mutual recognition." Like many observations and assumptions, it has some surface validity, but beyond readily recognizable characteristics, the idea of sameness begins to crumble. The human mind is far too complex, far too nuanced in its gross and subtle differences to assume that sameness dominates the clinical encounter when both parties are of the same orientation.

The following account of a clinical encounter illustrates the many levels of difference gay and lesbian therapists encounter in their daily work. Boris is an African-American gay man and a doctoral student. He comes from an enriched home life and has a law degree and an MSW from a prestigious university. His patient comes from a deprived, poverty-stricken family. She identifies herself as bi-sexual, is of mixed ethnic heritage, and was exposed to traumas in the course of her development that are far from Boris' life experience. But they still manage to make sense to each other. A useful transference develops and Boris accepts it and works with it.

The case write-up is a wonderful illustration of how very different the patient and therapist often are. This is often the case with the gay and lesbian clinician and their patients. Similarities are seemingly important, yet at times hard to observe. No matter how the patient and therapist identify themselves, they must still find common ground. That common ground goes deeper than social identification. But the question still remains: how important is the act of seeing a therapist of a similar orientation? It is very important for some patients, and many therapists make their living specializing in working with people of their own orientation. Despite this important degree of sameness, or alikeness, or recognition, differences remain that must be bridged. Perhaps it is the bridging function of the selfobject transferences that give each treatment its unique aspects. As usual I encourage people who agree or disagree to write, and offer their ideas to this endeavor.

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