Clinical Handbook of Couple Therapy

By Alan S. Gurman; Neil S. Jacobson | Go to book overview

Chapter 21

Gay and Lesbian Couples in Therapy:
Homophobia, Relational Ambiguity,
and Social Support
ROBERT-JAY GREEN
VALORY MITCHELLImagine that you are invited to write a chapter on the topic of “therapy with heterosexual couples” for the newest Clinical Handbook of Couple Therapy. Where to begin? At the very least, this invitation requires you to make broad generalizations about the population of heterosexual couples in North America, if not the world. This is no small challenge.A request for such a chapter also implies that other chapters in the handbook will not deal sufficiently with heterosexual couples in therapy. It is your job alone to explain how general theories of couple therapy need to be altered to fit the characteristics of heterosexual couples:
Are certain kinds of clinical problems more frequently found among heterosexual couples in therapy?
Does the status “legally married” (which is unique to heterosexual couples) increase or diminish their relationship problems?
What different goals are required in work with heterosexual couples?
What strategies would you suggest for building an effective therapist–client relationship when a couple is heterosexual?
Taking into account a couple's heterosexuality, what change-oriented techniques are especially suitable in therapy?
How might a couple's heterosexuality require special adaptations in the way particular approaches to couple therapy are practiced (e.g., cognitive-behavioral, structural–strategic, emotion-focused, psychodynamic, integrative, etc.)?
Given that so many married couples enter therapy in a crisis following the discovery of a spouse's affair, how can therapists help couples cope with this aspect of the heterosexual lifestyle?

As these questions illustrate, it is extremely difficult to make generalized statements about heterosexual couples in therapy. Answers to such questions are elusive, and the risk of stereotyping is high. Heterosexual couples are not generally viewed as a homogeneous cultural group based on their sexual orientation. Ordinarily, experts writing on the topic of couple therapy do not consider how heterosexual couples might stand out from the lesbian/gay crowd. Rather, being in the majority, heterosexual couples blend in; their curious ways go unnoticed, apparently not needing further dissection because they are so common.

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