Mutual influence in the gay male therapist – heterosexual male client psychotherapy dyad: An exploratory qualitative analysis

This qualitative study explores ways in which the meeting of a gay male therapist and a heterosexual male client in psychotherapy may be influential and healing for both participants. Utilizing mutual influence as a lens, the study explores the unique dimensions of this psychotherapy dyad; particular focus is paid to the ways in which gendered socialization impacts gay men who become therapists and heterosexual men who present to therapy. There exists little literature on mutual influence within this specific psychotherapy dyad; an aim of the present study is to unify, deepen, and texture a broad body of literature in the fields of relational psychoanalysis, developmental theory, and gender and sexuality studies. Semi-structured interviews were conducted with ten gay male psychotherapists. Interviews focused on the relationship between participants’ identities as gay men and work as therapists broadly, and their reflections on psychotherapy relationships with heterosexual men specifically. A modified grounded theory approach (Corbin & Strauss, 1990; McCracken, 1988) was utilized to analyze the data. Multiple themes and sub-themes were identified and organized into the following categories: reflections on gay men as therapists; reflections on heterosexual men as patients; emergent phenomena within the dyad; and mutual influence. These themes were metabolized into a loose theoretical model: men of all sexual orientations are impacted by socially constructed masculine ideologies; gay men may renegotiate their relationship to masculine ideologies differently than their heterosexual male counterparts; adaptations related to this renegotiation may underlie a relational style for gay male therapists; gay male therapists may be in a unique position to work with heterosexual men in psychotherapy around issues related to the impact of masculine identity development; and, both parties stand to be influenced and changed by the psychotherapy interaction. Intimacy and connection between men was identified as a potential mechanism for change. The discussion section reviews ways these findings support, expand upon, and challenge aspects of an existing body of literature. Limitations of the present study, implications for training and practice, and directions for future research are discussed. This study adds to an emerging body of literature related to psychological practice with men.