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Thank you Dr. Friedman for presenting this case to us and thereby giving us the opportunity not only to discuss some of the issues that are at center stage in the field of psychoanalysis and psychoanalytically oriented psychotherapy: namely the therapist's own motivations, feelings, actions, nonactions and the role that they play in the therapy, but also for opening the closet door and allowing for a discussion of sexual orientation in a nonprejudicial way.
Your case of a gay male therapist treating a gay male client raises many of these complicated and interesting issues. One of the issues is, “How can a gay or lesbian client feel welcomed in the analytic–therapeutic situation, and enter into a trusting relationship?” For so long people of “other” sexual orientations (gay, lesbian, bisexual and transgendered) have been hesitant to enter treatment not only because the field of mental health has pathologized them but because they may not feel comfortable with the power dynamics of the traditional therapeutic relationship. The very nature of the traditional analytic situation is one in which the patient (1) does not know much about the analyst's life, opinions, beliefs, prejudices; (2) does not even have the face-to-face opportunity to view the analyst's nonverbal reactions and possibly see any positive regard; and (3) then, to add insult to injury, has to take the passive, disempowered position on the couch, with the authority figure at one's back, out of sight! For populations who have been oppressed, disenfranchised, persecuted, and alienated from society, this may have been intolerable.