Between Gay and Straight: Honoring a Client's Multiple Identities

By Jeff Levy

Reprinted from Psychotherapy Networker, May/June, 2010.

http://www.psychotherapynetworker.org/magazine/currentissue/827-case-study

Rob rushed into his first session with me, gym bag on one shoulder, briefcase on the other, 10 minutes late and out of breath. He set his bags down, gently put his Blackberry on the table in front of him, and heaved himself onto the couch. He sighed and began: "OK, I'm gay, I'm married, I have three kids, and I'm not getting divorced." He'd shared some of this information with me in our phone conversation, but I was still struck by the sense of hopelessness in his tone. As he paused, awaiting my response, quite honestly, I was awaiting my response as well. I knew this was not Rob's first experience in therapy and that a lot was riding on what I was about to say.

Rob had been referred by a former client of mine he'd met in an Alcoholics Anonymous meeting. Just out of alcohol rehabilitation treatment, he'd begun attending AA meetings, where he'd shared parts of his story. He described a long struggle with his sexual orientation, growing up in a devoutly Roman Catholic family, where he learned that his sexual attraction to men was cause for eternal damnation. Perhaps to overcome his shame, he excelled academically, medicated himself with alcohol, and married a Roman Catholic woman his parents considered the perfect mate for him. After college, he became a lawyer, fathered three children (now 13, 15, and 18), and started his own law firm with a colleague. Outwardly, he was the epitome of success, admired and envied by his siblings as the star of the family; inwardly, he experienced himself as fraudulent, hopeless, and trapped. Finally, out of desperation, he told his wife, Mia, about his lifelong sexual attraction to men.

To Rob's surprise, Mia didn't reject him. To the contrary, she thanked him for his honesty and assured him they'd be able to "get through this together"-as long as Rob remained true to his faith and worked on their marriage. Mia consulted their priest, conducted extensive research on the Internet, and identified a reparative therapist to help him "overcome" his homosexual impulses. But after months of reparative therapy, he found himself even more depressed, drinking more heavily, unable to function at work, and still lying to Mia about his sexual attractions. He contacted a therapist in Chicago who identified as gay and, upon hearing Rob's story, took a decidedly different therapeutic tack: in his first session, he advised him to move out and begin the process of divorce. Rob panicked, drank to the point of passing out, and decided to enter alcohol rehab.

Men in circumstances similar to Rob's frequently describe their experiences in therapy as confusing and polarizing; whether they see gay-identified therapists or heterosexual therapists, they face a strong bias toward full disclosure and divorce. Many men have shared with me their panic after initial sessions with well-meaning therapists who supported "authenticity" while not acknowledging the complexity of honoring multiple and complex identities. Like Rob, these men report loving their wives, loving their children, loving God, and being attracted to men-all at the same time. My work with gay and bisexual men over the past 10 years has taught me to see psychotherapy as a place to hold dynamic tensions without easy, premature resolutions. As a therapist, I saw my job in this case as conducting a careful conversation with Rob about how he viewed the incongruity of his identities, and through gentle challenging of his assumptions, helping him discover a way to live with greater clarity, which might conceivably include even greater ambiguity.

So after he'd finished his introduction, I simply said, "You sure have a lot to manage. To me, it seems that our challenge is to help you find a way to honor all these parts of yourself. So what might that mean for you?" Rob's breathing visibly slowed, he put his head back on the cushion of the couch, and exhaled. "I don't feel like I fit anywhere," he continued. "I don't feel straight' enough in the straight world, and I don't feel gay' enough in the gay world. I can't be all of who I am anywhere. I don't know what to do."

Our initial sessions began by simply acknowledging many conflicting desires: to be a good Roman Catholic, to be gay, and to stay married to his wife and live with his children. We focused on the fact that, whatever it meant for him, his sexual orientation might feel like a significant threat to others in his life, especially Mia, who unambiguously envisioned a traditional marriage with him. She, for her part, began seeing a female therapist, who encouraged her to be clear with Rob about her own needs, sadness, and grief-all of which, unsurprisingly, was difficult for him to hear and often left him feeling guiltier and more ashamed.

Whenever possible in cases like this, I try to see the couple together, and Rob's case was no exception. I'm very much aware of the contrasting dynamic of a partner who's questioning his sexual orientation being in therapy with me (a gay man) while the straight wife sees a heterosexually identified woman-usually the typical scenario when both partners seek separate therapists. Many gay or bisexual men seek out a gay-identified therapist, assuming they'll be understood and supported more fully than by a heterosexual therapist, while their straight spouses seek a heterosexual therapist for exactly the same reasons.

Despite the invitation to couples therapy, Mia refused to join us, fearing that as a gay man, I'd be too aligned with Rob to be able to hear and support her. Several conversations with Mia's individual therapist (who advocated the couples work), along with my own efforts to reach out to Mia, failed to persuade her that couples work would be helpful. Rob responded to this with disappointment and anger, withdrawing further from his wife. At her therapist's suggestion, we explored the possibility that Rob might join his wife with her therapist, but Mia still resisted. She was becoming less willing to think about working with Rob, and was increasingly feeling the pressures from her family and friends to separate from him.

I've found there's a window of opportunity to engage the couple when my initial point of entry is the husband. When I've waited too long-when either or both members of the couple have moved too far away individually, or have separated too much, there's greater reluctance to see couples work as an option. In Rob's case, I feared I'd missed this opportunity.

While Rob and Mia still lived in the same home, they'd moved into separate bedrooms, explaining to their children that Rob's snoring was interfering with Mia's sleep. Not sleeping together enabled them to create some type of boundary while continuing to live together without unrealistic expectations of each other. Meanwhile, I provided Rob with as much information as possible about ways gay married men and their wives have chosen to restructure their contracts with each other. A particularly useful way of doing that, I find, is referring clients to the groups I facilitate for married and formerly married gay and bisexual men who are at various points in their lives and in their relationships with their families.

Some men in the groups have come out only to themselves and the group. Some are out to everyone, including their wives and children, while still cohabitating with their families. Some have chosen to divorce, and are either in the process of divorcing or have been divorced for a while. Those who remain married and still live with their families may have a mixed-orientation marriage (MOM)-a marriage of individuals whose sexual orientations differ.

The group gave Rob a chance to hear from men who'd managed to make such marriages work. Some talked of continuing to be sexual with their wives, but having an open relationship, in which each partner could engage in sexual relationships outside the marriage. Others talked about a variation of an open relationship-in which each partner could be sexual outside the relationship, but with only one other partner, who, ideally, was sexual with only one other partner also-known as a closed-loop relationship (CLR). I myself could have provided Rob with this information in individual or couples therapy, but hearing it from other men who were negotiating some of the same concerns as his allowed him to hear these options as realities, instead of theories. Meanwhile, Mia became involved in a chapter of the Straight Spouses Network, talking with others who were dealing with a gay, lesbian, or bisexual spouse.

Rob and Mia seemed to work out a don't-ask-don't-tell arrangement. For months, they continued to sleep separately, have meals together, engage in social events together, but not discuss whether or to what extent either of them was engaging in relationships outside their marriage. In Rob's individual therapy, he disclosed that he'd been dating men, and was scared to disclose this to Mia. While I didn't advise him to tell Mia, we talked about the ramifications of keeping this secret, and addressed reasonable concerns around safe sex and how, if he were to engage in sexual activity with Mia, he'd explain using a condom again (since they'd stopped using condoms years before).

After months of "don't ask, don't tell," Mia confronted Rob with her suspicions about his sexual activities. Having prepared for this in individual therapy, he was straightforward about them. She felt betrayed and angry. He felt guilty, apologized profusely, recommitted himself to their traditional marriage, and swore he wouldn't have sex with another partner again.

In our next session, Rob said, "I told her what I knew she wanted to hear, but I know I can't recommit to our marriage the way it was. I think we each deserve to be happy and feel desired. And even though divorce isn't consistent with my religious beliefs, having sex outside my marriage-even if Mia and I agreed to this-is even harder for me to fathom than divorce." This was the first time Rob had entertained the idea of ending his marriage. I checked this out with him. "It sounds like you're considering changing something much more fundamental in your relationship with Mia. Is that what you're saying?"

"I suppose I am," he responded. "I never thought I'd be in a place where I'd even consider not being married, but I'm not sure staying in this marriage is fair to Mia, me, or our kids. After dating, I don't think I'd even be satisfied in a mixed-orientation marriage or a closed-loop relationship. I need to talk to Mia about what our next steps should be."

For several sessions, Rob and I rehearsed this conversation with Mia-where he might have it, what her reaction(s) might be, and how he'd manage his reactions to hers. I encouraged him to clarify his thoughts by writing down what he wanted to say, and to write back to himself from Mia's perspective, to help him get the larger picture of what was going on for both of them. The conversation was difficult, but both were empathic with the other and honest about their own needs. In the same conversation, Mia shared that she'd decided months ago to seek a divorce.

Rob returned to therapy filled with relief, guilt, fear, and hope. He said he'd wanted to come out to his children when they'd shared the decision to divorce, and Mia and he had agreed to tell them about his sexual orientation and the divorce at the same time. Again, I encouraged him to write down what he wanted to say to his children and to share it with Mia, who helped him fine-tune what he'd say. He asked me for a referral to a family therapist that they could all see after he and Mia had told the children, in case they needed support in reconfiguring their family.

As Rob's divorce was being finalized, his dating turned into a serious relationship, but it soon ended. The feedback he received from his partner was that he was "too intense" and "moved too quickly." Rob desperately wanted a relationship, but now he wanted with a man what he'd had with Mia. He talked about how awkward dating was for what felt like the first time in his life. Not only was he dealing with what every divorced person deals with upon entering the world as a single person again, but he was entering the world as an available, out, gay man. He was in the process of reconciling his faith with his sexual orientation-which, for him, meant finding one man with whom to be monogamous. Gently, I encouraged him to look at his expectations about the speed with which he'd find a partner. I asked him what he'd say to his 15-year-old daughter if she told him she was looking for the person with whom she'd spend the rest of her life. I watched his face shift from confusion to acknowledgement. He answered: "I'd tell her she was too young to make a decision like that, and she needed to meet lots of people, slow down, and get her own life on track before she settled into a relationship or marriage."

I've seen Rob, on and off, for five years since he and Mia divorced. His co-parenting relationship with Mia has remained solid, though it's seen moments of strain when either or both of them have been dating someone more seriously. He's remained sober through these years, and continues to date with a greater sense of contentment and less pressure. He's found a Roman Catholic religious community that's accepting of his sexual orientation. Still, he sometimes grieves for the loss of how he used to view the concept of "family," and he struggles with reconciling his divorce and sexual orientation with his faith. We recently reminisced about our first meeting, and I reminded him of the first words he'd shared with me. "I'm so much less clear about who I am," he joked, "and that feels so good."

Case Commentary

By Jean Malpas

Jeff Levy's elegant work beautifully honors his client's "multiple and complex identities." Skillfully holding multiple perspectives, he attunes to Rob's dilemmas (while holding Mia and their children in mind) and supports him in the exploration of his life's incongruities without imposing his moral views or rushing to premature relational solutions. By supporting his client's journey (as complex as it might be) as his primary goal, Levy avoids the traps of biased clinical approaches, such as reparative therapy or a "gay-affirmative" divorce prescription. Instead he creates a safe context in which Rob's choices can slowly emerge out of what once appeared to be an irresolvable paradox.

I also appreciate Levy's attempt to engage the couple in conjoint work. In many contentious situations, therapeutic alliances with respective individual therapists can unintentionally reinforce the budding polarization of spouses. In this case, the risk was further increasing the split between the gay and straight worlds Rob and Mia were trying to negotiate. Although Mia's refusal indicates that the window of opportunity for such an invitation had probably closed, I wonder whether Levy suggested that the couple consult someone else, to find a more neutral space in which they could both feel comfortable and secure discussing their viewpoints and feelings. I wonder what would have happened if Mia and Rob could have negotiated the changing boundaries of their marriage. Could Mia have accepted a "mixed-orientation marriage" if she'd felt more in control of the therapeutic process? Would Rob still have chosen to leave Mia if he and his wife could have experimented with the freedom and security that a "closed-loop relationship" can potentially provide? As Levy mentioned, many couples with complex sexual bonds choose to stay together.

When working with open marriages (whether with a "mixed orientation" or not), I find it particularly important to explore the terms of the relational arrangement. In the long run, couples need to feel secure enough to open up their boundaries and to find a positive meaning in their actions. To achieve this, it's important to determine what each partner needs to feel safe enough to let the other have separate sexual experiences.

Some of the questions to explore in the process of helping couples determine their sexual boundaries are: How can letting a partner stay in the relationship yet act on desires for outside sex be perceived as an act of love and generosity? Can it be viewed as a testimony to the security of their bond, rather than an indictment of their intimacy? What are the rules about sharing details or maintaining secrecy regarding outside activities? What constitutes loyalty when one is in an open relationship? Can the outside sexual experiences be used as stimuli for the couple's ongoing sex life?

These are some of the many questions that continue to challenge our social constructions of love and couplehood, whether in heterosexual, gay, or mixed couples.

Author's Response

Working with couples around the possibility of opening the sexual boundaries of their relationship is complex, regardless of sexual orientation, as Jean Malpas comments. I'm grateful for his recognition that one of the unique vulnerabilities in helping clients negotiate mixed-orientation marriages is the tendency of clinicians to rush to prescriptive solutions that often impede, rather than expand, the possibilities for intimacy.

I agree with Malpas's assertion that in doing such work, it becomes essential to explore the terms of the relational arrangement. I regret that I wasn't able to do this with this couple because Rob's therapeutic alliance with me and Mia's therapeutic alliance with her therapist made couples work with either therapist impossible. In such situations, I've frequently referred couples to a third, hopefully "impartial," clinician, with whom the couple can explore the option of staying together in what they each perceive to be a more agenda-free space. Unfortunately, in this case, neither Rob nor Mia was willing to pursue this option. I still wonder whether I waited too long to offer it as a possibility.

I hope, nonetheless, as Malpas suggests, that we're beginning to challenge the social constructions of coupling, recognizing the influence of multiple, complex, and seemingly incongruous identities.

Jeff Levy, L.C.S.W., C.T.R.S., is cofounder and CEO of Live Oak, Inc., in Chicago. He's a part-time faculty member at the University of Chicago's School of Social Service Administration.

Jean Malpas, L.M.F.T., is a faculty member of the Ackerman Institute for the Family. His publications include "From Otherness to Alliance: Transgender Couples in Therapy" in Interventions with Families of Gay, Lesbian, Bisexual and Transgender People.