There is a huge gender gap in the field of psychotherapy. At least 80% of psychotherapists in the US are women. So when a man pursues therapy, unless he specifically seeks out a man, he will most likely get a woman therapist. The dynamic of a male client with a female therapist can be both beneficial and problematic to the therapy. It can spark discussion over issues the client did not realize were there until working with a woman. It can replicate his relationship with another woman in his life. It also can reveal sexist beliefs.
I am a female therapist. One thing I’ve noticed since working in the field is that I encounter a ton of sexist comments in this work. Interestingly, while most of those comments come from male clients, not all do. Some of those comments are innocent and naïve, like when a client passively assumes I will stop working when I have children. Others are more direct, such as a man saying, “You’re pretty, but I’m not going to open up to you.” Some even try to scold me, saying things like: “Women shouldn’t say things like that to men,” when I use a more direct approach and suggest that a client be more honest with me (and themselves). The list can go on from subtle to aggressive forms of sexism in the therapy room.
What do we do about it?
It can be discouraging as a woman to still experience messages of inferiority, even while in a professional position. A clinician is an authoritative role to a client, yet it can be difficult to assert oneself when client beliefs about women get in the way.
Sexist comments require skill to navigate. Sometimes the best thing to do is ignore it. The client could be deflecting whatever is happening in their treatment, or may be simply trying to provoke a reaction. In this way it may not even truly be a gender issue — if I were a man, they would find something else to poke at. If it is not a blatant remark, it also may not be worth getting into. Is it even related to what they are addressing in treatment? I’m all about advocacy and girl power, but especially if rapport is not yet built, it can be best to let benign comments go when there are other things to address.
Rapport is always a work in progress. I’ve noticed that when there is somewhat of a foundation of rapport, and I react personally to a sexist comment, it can actually help strengthen the therapeutic relationship and earn respect. For example: “Wait, what was that? You do know I’m a woman, right? If I’m going to be your therapist, you can’t say stuff like that.”
It is our duty to help our clients be functioning members of society. The therapy room is a safe space where no topic should be off the table, and clients can process their thoughts and behaviors. If a therapist notices that a client has sexist attitudes or beliefs, and the client’s relationships with women appear to be suffering as a result, it should be the therapist’s duty to at least bring it to the client’s attention.
If you’re wondering…
My responses to the comments that were mentioned earlier:
[Musing about me being a stay-at-home mom once I have children.]
Ha! That sounds nice, but I’ve always envisioned my future self as a therapist too.
“You’re pretty, but I’m not going to open up to you.”
I appreciate your honesty. Do you feel uncomfortable opening up? You are in therapy, and in order for it to be successful, it kind of requires some opening up.
“Women shouldn’t say things like that to men.”
I’m sorry, are you a time traveler? Because this is 2018 where we treat each other as equals, and I have enough respect for you to not sugarcoat something that my job is to point out. (Clearly there was rapport built in this relationship.)