Patti Geier, LCSW

Couple Therapy with Lesbians and Gay Men

When to seek treatment

I recently received a call from a woman who was interested in couple therapy. She and her partner were planning a wedding and thought it would be a good idea to have pre-marital counseling "to iron out a few problems." After a few months in treatment, they agreed that the work they accomplished benefited them as a couple and as individuals. They felt ready to begin the next chapter in their lives.

I offer this example because it is so different from what I usually see. In my work with couples I have found---whether they are lesbian, gay, or straight---that by the time the couple comes to treatment, they are unable to talk to each other without fighting. Communication has broken down and their relationship is tense, volatile, and destructive. It is rare for couples to reach out for treatment unless they are desperate, and therapy becomes a last ditch effort before breaking up.

It is difficult to move forward in a relationship when anger and resentment have built up to the degree where there are few conflict-free areas of discussion. Of course, it would be much more effective to seek counseling before reaching this point.

When you and/or your partner notice that you are fighting about the same thing over and over again without reaching a resolution, you may want to seriously consider couple therapy. If you begin to disagree on even the most banal topics and tension underlies every interaction, seeing a professional to help you talk to each other can be a very good idea.

What to look for in a therapist

The most important qualities in a couple therapist are the ability to listen, empathize with, and help the members of the couple communicate their feelings and needs to each other. Unlike individual therapy, a couple therapist needs to set ground rules so that each person has time to speak without interruption. The therapist needs to be active and skilled to keep the treatment from dissolving into the same kind of communication the couple has at home. This can be enormously helpful for people who don’t feel heard or tend to suppress their own feelings to avoid conflict.

The issue of whether to see a lesbian/gay therapist is something for each couple to decide. There are many gay-affirmative therapists to choose from, but if it is important for you and your partner to work with a lesbian or gay male therapist, ask the therapist that question directly.

While many of the problematic dynamics that exist between lesbian and gay male couples are not significantly different from their heterosexual counterparts, the issues can be quite unique. A few of these are:

1. Effects of internal and external homophobia.
2. Adoption and insemination: children, in general, bring up a variety of issues heterosexual couples do not share.
3. Coming out: there are inherent problems when one person is not out and the relationship is kept secret.
4. Family issues: parents, children, extended family, family of choice.
5. Differences regarding sex-roles in gay vs. heterosexual couples.
How couple therapy can help

Often, couples come to treatment with the unspoken hope that therapy will change their partner and, when that happens, their problems will disappear. However, since the only person any of us can change is ourselves, the work of couple therapy is to recognize our own part in the dysfunctional communication and take steps to improve it.

One of the important goals of couple therapy is to improve communication. Often, one person is so focused on what to say next that hearing the other person becomes impossible. The argument becomes more about proving that person wrong, than empathizing with the feelings underneath the words.

Shaming, blaming and criticizing rarely bring the desired result. Instead, it can leave one or both partners feeling demeaned, angry, and hurt. Couples who use character assassination when they fight chip away at their partner’s trust and self-esteem. Over time, this will destroy the relationship. In treatment, the couple can gain the tools that will help them communicate productively. Each member can begin to take an honest look at what she/he does to perpetuate problems in communication

It is very human to become defensive when we are criticized. Our natural instinct is to either withdraw or attack and it isn’t easy to change what feels natural. Having a third person to mediate breaks this cycle. A professional can intervene when the discussion becomes dysfunctional. She or he can facilitate productive communication and create a safer place in which to express feelings. By moving the focus away from "right" and "wrong" and back to the feelings underneath, the couple can gain the tools for effective communication. These tools will help build a stronger and healthier relationship.