Male patients/female therapists: Dilemmas arising from male patients' diametric definitions of masculinity

Janet Smith Weathers (2000)

This dissertation considers the tendency on the part of some men to divide human emotions, values, experiences, capabilities, and viewpoints into diametric categories of masculinity and femininity Such a division may result in splits in self and object representations. For those men who conceptualize masculinity as other-than-femininity, the awareness of emotions or experiences that they have relegated to the category of femininity will be split off, and the possible eruption of these emotions or awareness of these experiences may threaten their sense of themselves as men. In the female therapist-male patient dyad, this type of male patient may find it difficult to internalize or identify with aspects of the female therapist because doing so may pose a threat to his manhood. Using a framework that emphasizes acquired, rather than innate, characteristics of gender, the paper explores the contributions of intrapsychic and social forces to the development of the tendency to define masculinity diametrically. Intrapsychic development is viewed using Benjamin's (1990) elaboration of the rapprochement crisis (Mahler, Pine, & Bergman, 1975) and Fast's (1984) theories of gender differentiation. In traditional two-parent families, in which women provide the childcare and fathers are remote figures to their children, boys may come to identify with a concept of masculinity defined by its distance from mother, and the father may come to represent an escape from the loss and awareness of dependency that characterize the rapprochement crisis. Social mandates for masculine behavior may prohibit expressions of loss. sadness. or other attributes considered feminine and may influence parental expectations for and reinforcement of the child's behavior. The mandates also may predispose male patients to excessive sensitivity to shame. Finally, the paper discusses ways to integrate splits in the self that result from the male patient's conceptualization of masculinity as other-than-femininity. Specifically, it addresses the need for the female therapist's own sense of subjectivity to facilitate the patient's internalization.