Published in In The Family, V. 8, No. 3, Winter 2003
When I first met gay therapists David McWhirter and Drew Mattison, a few years after reading their pioneering book The Male Couple: How Relationships Develop, (Prentice Hall, 1984) I complimented them on formulating a stage theory for the development of male couples and urged them to write an additional volume focusing on techniques for clinical work with male couples. As busy clinicians, researchers, authors and activists, they never followed up on my suggestion, and no one else in the mental health field got around to writing it, either. Now, 19 years later, David Greenan and Gil Tunnel, have done it. Couple Therapy with Gay Men is an incredibly useful addition to the professional literature. The authors are both experienced, well-respected, openly gay family therapists who have benefitted from some of the best raining in the field of family therapy. Along with offering a rich lode of ideas o how to help male couple , their book is a marvelous introduction to structural family therapy, with concise descriptions of joining, enactment and unbalancing.
Salvador Minuchin, the therapist who invented the structural family therapy model, wrote the foreword to this book. In it, he describes his own journey as a clinician toward a more nuanced understanding of gender, and then his growing understanding of homophobia and its impact upon sexual minorities, couples and families. In his foreword, Minuchin credits the authors with helping him grow beyond the limits of his own traditional Argentine and Jewish cultural perspectives and expand his thinking about same sex couples. Like any therapist, Minuchin had to learn which issues are idiosyncratic to sexual minority couples while at the same time assessing the dynamics that are endemic to all types of couples.
Reading Couple Therapy with Gay Men reminded me that one of the mainstays of family therapy training used to be the one-way mirror. Although it's not as popular now as it was in the 1970s and 1980s, one-way mirrors were a training tool for fledgling family therapists, who would sit behind the mirror and observe the therapist working with clients (with the clients' knowledge and consent, of course). Tunnell and Greenan give us a kind of virtual one-way mirror by presenting an array of theoretical concepts on such issues as attachment, loss, structural family therapy, gender role theory and gay identity formation, and then following up with detailed case histories that let us see how they apply those theories in clinical practice. I appreciate the combination of practical, usefulness and sophisticated theory.
Many of the couples discussed in the book are in long-term monogamous relationships, but the authors also include cases of nonmonogamy , treating the issue with respect. Indeed, in my own practice with male couples, issues pertaining to sexual exclusivity or nonmonogamy are most often cited as part of the presenting problem for seeking therapy. Greenan and Tunnell are unambiguous in their assessment that while, for many male couples nonmonogamy is part of their relationship, they question the impact that this has in the long term on the sustained intimacy and sexual activity of the couple.
I read Couple Therapy with Gay Men because, as a gay clinician, I try to read as much as I can about helping my clients. I was impressed with how the authors used their own personal stories, striking the right tone by being open and vulnerable about their own clinical mistakes, impasses and readiness to seek supervision when necessary. This made their work seem credible and honest to me. I was also inspired by their act of trust in themselves and in the reader by being willing, as senior therapists, to disclose their own stories, even the unflattering ones. As I got into the book, I realized I was also reading Couple Therapy with Gay Men as a gay man in a committed relationship. It was impossible for me not to recognize my own issues and struggles to remain connected, empathic, autonomous, sexually interested and active, but most of all vulnerable with the man I love and with whom I share my life.
At one point the authors write, "What a revolutionary idea: helping two men take care of each other emotionally!" Even though I do this same work in my practice, when I read those words I got goose bumps. They also write, "Many of the unbalancing interventions discussed in this volume have this as their goal: for men to lay down their guns and begin to experiment with expressing loving, tender, and vulnerable feelings in the presence of another man, and for the other to respond supportively." You wouldn't think this would be such a radical notion in the 21st century, but it is, and I am grateful to Greenan and Tunnell for articulating so succinctly the goal of all my therapy work and personal work.
Many have argued that therapy is political, and especially therapy with oppressed minorities, because there are clear, undeniable connections between clients' symptoms and their life circumstances. Racism, sexism, homophobia and classism-- to name a few, create obstacles, leading to rage, self-blame, and other emotional traumas. Greenan and Tunnell bring this political awareness to their book. "We normalize -treat as normal- the men's needs for a sense of dependency, closeness and nurturance. Treatment in this respect is a political act, challenging societal norms that the heterosexual family is the preferred (if not the only) family constellation." Later they note that in several of the case studies presented in this book, at times they found themselves "taking the couples's relationship more seriously than the couple did. heir lack of respect toward their own relationship mirrors the culture's views toward same-sex relationships." They then emphasize: "When a therapist takes a male couple seriously by validating their relationship, the couple is started down a path toward having a corrective experience in how they feel about themselves."
I have two complaints about the book. One is the omission of any discussion of working with male couples who may need therapy to help them separate. While the authors do mention that in relationships where there is domestic violence or severe drug addiction, it may not be appropriate to help the couple stay together, I think that the book would have greatly benefitted from an in-depth discussion of work with couples who are either incompatible or have become so estranged that there is no hope for the relationship to be saved. I was also lukewarm about the structure of the book, which at times felt pedantic, impersonal. The text-book set-up of introduction, development and summary in each chapter did not match my experience of the warm and vibrant content. At times, the structure felt relentless and irritating, but, to be fair, once or twice I welcomed the chapter summary, especially after a lot of clinical theory had been presented.
This book is written with a remarkable combination of intellectual rigorousness and heart. The final case Greenan and
Tunnell discuss is one I am familiar with, having seen a videotape of the session they describe prior to reading the book.
Even so, I found myself moved to tears while reading the authors' description of the case. Greenan and Tunnell have
managed to write a book that itself accomplishes what the authors are attempting to teach, which is how to remain open,
vulnerable and disciplined all at the same time.
Key Words: Gay Men, homosexuality, male couples, couples counseling with gay men, couples therapy with gay men