Despite the growing popularity of queer theory in sociology, lesbian, gay and bisexual studies; literary and cultural studies; and its undoubted impact on the politics of sex, gender and sexuality; the academic and applied world of counselling, counselling/clinical psychology and psychotherapy (referred to as therapy from here on in) has been suspiciously silent about the matter. And, if we were to believe counsellors, counselling and clinical psychologists and psychotherapists, none of the clients who attend therapy has any queer concerns either. Therapy, it has to be said, has not been queered, despite there being much to query! And yet, because queer is an approach that combines theoretical innovation with reactionary tendencies, especially in relation to sex, sexuality and gender, it provides an ideal challenge to the conventions of therapeutic endeavours. In an effort to initiate a discourse that merges different strands of thinking in relation to therapy, I have brought together a number of authors from psychology, counselling and sociology who may be considered to be somewhat dissident in their opinions towards sex, gender and sexuality when compared to conventional views held by most therapists. However, as I see it, these authors are providing the foundation for crucial debates that need to be developed and researched within the realms of counselling, counselling/clinical psychology and psychotherapy as well as suggesting future directions in theory and research and for that reason they should be applauded for their ârisky behaviourâ.
The Noah's ark of therapy
From their inception, binary categories have been the centrepiece of modernity, separating men from women, male from female, black from white, homosexual from heterosexual, able bodies from disabled bodies. Ideologically, this form of thinking has underpinned therapeutic structures, constructing the various models into an enterprise that is remarkably consistent with binary configurations. Despite the rhetoric that suggests therapy promotes individual freedom, such freedoms are sanctioned and constrained by social discourses and regulatory practices when people present as truly âindividualâ in the eyes of the therapist. This is certainly the case where issues relating to sex, gender and sexuality are presented that fall outside of the conventional social markers for these configurations. This interrogates the notion of âfreedomâ for the âindividualâ extensively, because the unconventional individual poses a threat to established therapeutic discourse as well as challenging the meaning of freedom within the therapeutic space. An intersex person going to a therapist is likely to be faced with ignorance and questions while the therapist searches for the psychological condition of gender identity dysphoria (GID), where gender is primarily arranged as two diametrically opposed bodies, and all bodies are then compared against this construction. It is the therapist rather than the client who may be troubled by the shift and change of conventional to unconventional meanings, but it is the client rather than the therapist who may have to bear the consequences. As Hegarty points out (Chapter 9), it is important to realise that therapists are âvery ordinaryâ people âsituated within cultureâ and are open to the same prejudices and ignorance as lay people.
Even more troubling to therapy will be the âqueerâ client, who presents and represents âothernessâ, a sort of sexed, sexualised and gendered oddity whose body carries no fixed meaning in relation to sex, gender or sexuality. Instead, this client presents as multi-identity, the body carrying a plurality of meanings drawn from many different strands of identities in action. The therapist is unable to attach binary meanings to the client in the interaction and this will influence the narratives that emerge in the therapeutic working alliance as well as how these meanings interrogate therapeutic models. This book represents some of these new ways of thinking that will hopefully disrupt therapeutic ideology and provide a new therapeutic topography for practitioners and theoreticians to explore.
Queer solutions
All the chapters provide queer theoretical challenges a) to normative accounts of sex, gender and sexuality by challenging the generally held belief that these are biologically driven and ânaturallyâ organised and b) to the notable presence of heterosexual hegemony and how this is represented through the various therapeutic models that fail to take into account non-heterosexual discourses in relation to sex, sexuality and gender. Each chapter carries a theoretical and psychosocial perspective that with hope, readers will want to develop and research in relation to their work with clients. The overall purpose is to challenge our binary thinking, to prevent the either/or rhetoric that has been a purposeful tool of modernity, pervading most theoretical and applied social systems. These challenges are embodied within the chapters so that alongside new knowledge that may be applied to therapeutic issues via theory and/or practice this knowledge may also be extended, applied and employed to initiate new debates and disputes within therapeutic contexts e.g. training of students. Some ways of framing these debates include: a) the impact of ideology on the shaping of therapeutic models and how this reflects the much wider heterosexualised structural and social ordering of society; b) the meaning and negotiation of emotion and how this may be used as a system of regulation within therapeutic ideology and practice; c) how meanings for gender are imposed onto and into the body and how this remains configured through heterosexuality; d) meanings of sex, sexuality and gender for therapists when presented by clients who are assigned to ânon-normativeâ categories; e) HIV and how meanings for this are integrated socially as well as therapeutically for both client and therapist; f) the meanings of sex and sex roles when we interact within adult, consensual, sexual relationships; g) the way research may employ queer theory and what this means for research design and interpretation.
Each chapter aims to address the above debates through theoretical perspectives and complexities in relation to the cultural, encounter and personal narratives or scripts of the therapist and the client, and to show how these are negotiated within the therapeutic encounter. The chapters include theoretical perspectives in relation to power within the therapeutic encounter, coming out of heterosexuality, the negotiation of emotion within therapy, theory and applied work in relation to intersexuality, the meanings for transgender sexuality, working with HIV and the sexual negotiation of bondage and discipline, domination and submission, and sadomasochism (BDSM) within sexualised interactions.
In Chapter Two, Ian Hodges clearly sets out what queer theory is, how it emerged and the implications for power and practice in the therapeutic setting. Ian raises a number of interesting questions for the reader to consider. Should we resist identity labels? How does Social Constructionism deal with the illusion of therapeutic discourse as fluid and interchangeable? Is queer theory really helpful for clients in therapeutic settings? What of clients who can only function with an âidentityâ and for whom a major achievement may be to announce to one other person âI am gayâ. Central to all this is Ianâs work on âpowerâ (understood as âthe discursive production of truthâ) that highlights the dilemmas operating in the therapeutic space. Ian uses the works of Foucault and Judith Butler to highlight how power âgets inside our bodies, our âheartsâ and our headsâ through the use of discourse. In many ways this chapter links to the later chapter by Hegarty (Chapter Nine) who presents the experiments of Zimbardo and Milgram, because it shows how power can be used to subordinate non-heterosexualities and may even explain why and how those who worked within the psy disciplines took such brutal steps to eradicate âhomosexualityâ in the past. It would be interesting to deconstruct the meanings of Milgramâs experiment when applied to the past history of sexuality where scientists giving electric shocks to homosexuals were doing so âin the name of scienceâ and ultimately the removal of homosexuality.
In Chapter Three, Darren Langdridge explores contemporary meanings of identity models. For Darren, traditional lesbian and gay identity models render them as fixed, linear examples of modernityâs quest for order and rationality. Although identity provides meaning, it can also be used to limit the endless possibilities of identity if reduced to a psychological dichotomy. Rather than earning identity bit by bit through developmental stages, Darren suggests that we should always be constructing and reconstructing identity so that, in effect, it is made useless as a binary product. At a cultural level, identity models have acted as instructional guides, telling us how we should arrange everyday social and sexual life into recognisable categories. Darren asks us to break with this idea. Introducing his own work, Darren introduces the reader to âa radical hermeneutics of suspicionâ where it is possible to work with the client beyond the apparent and challenge the clientâs perspective on the world by encouraging them to challenge the existing order of things. Darren provides an example of his work with a client that shows how binary positions in relation to sex, gender and sexuality may be shifted by searching out alternative examples from a range of culturally available discourses and re-positioning the self in light of these new discoveries.
In Chapter Four, I focus on the role of emotion and the way emotions, as cultural representations, are assigned onto and into the body of lesbian and gay clients by heterosexual, lesbian and gay male therapists. In this chapter, rather than emotions being understood as a natural product of the body, they are considered to be a socially organised set of meanings that act as a regulatory system, producing and reproducing binarisms that act to structure subordinate (to heterosexuality) sexualities.
Myra Hird in Chapter Five, focuses on the role of intersex, and Myra uses Freudian theory to show how conventional meanings of sexuality and gender may be disrupted through a re-reading of Freudâs work. She asks us to consider how the origin of identification and desire lies in âbisexualityâ and that the process of identification relies upon âreality through deprivationsâ that enact the individualâs gender recognition. Masculinity and femininity as âidentityâ are a form of compromise, reached through âdenial of the otherâ, so there is always resistance to identity. Challenging the limited dichotomy of gender, she pursues the notion that far from the individual being unhappy with a given morphology, instead it is worth considering the role of doctors and therapists who impose this belief onto their subjects when in fact, it is the doctors and therapists themselves who find the body in need of surgical (usually) regulation. Myra takes up this challenge, introduces Freudâs theory as a way out of the dilemma, and asks therapists to reconsider their own understanding of the intersexed body prior to working with clients. Using studies that are often cited as arguments for an âessentialâ gender, where the reassigned gender for a child is later rejected once that child is old enough to make a choice (thus suggesting that there is a ârealâ gender the individual wants to be according to medical interpretations), Hird suggests the selection of this alternative gender is also based on choice so that configuring an alternative gender does not necessarily mean the individual has a ânaturalâ gender after all.
Tam Sanger in Chapter Six, focuses on the experience of those who define as trans and the problem of assuming a binary identity fits all approach from those within the medical industry. She traces the history of trans people, questions the increasing desire to categorise and pathologise despite the instability of gender and sexuality, and suggests that practitioners think in a much broader way about their work with trans people and how it impacts on family and partners. Tam presents a series of interesting and challenging case studies that will surely provide those who are training students with a series of challenges to standard, carefully constructed, case examples.
Chapter Seven is by Catherine Butler and Angela Byrne who work as clinical psychologists in HIV and sexual health services. They take from their work with clients to suggest a queer reading of what is considered as ânormalâ, âhealthyâ and âdesirableâ behaviour. Using extensive case studies, they illustrate how therapists need to shift their ideas in order that they may work more effectively with all client groups. With this in mind they quote from their own research that shows therapists need more input in relation to sex, sexuality and gender, and they provide an outline of what training needs are required if therapists are to work effectively as well as ethically with various client populations.
Meg Barker, Alessandra Iantaffi and Camel Gupta, in Chapter Eight, focus on what seems to be taken as a form of the body in sexual theatre, where social actors may dress up, rehearse sexual scripts and endure pleasure through pain in a consensual, adult manner. They write in relation to bondage and discipline, domination and submission, and sadomasochism (BDSM) and the role of therapy and therapists when challenged by these queer sexualities. They advise of the current legal status of BDSM, why BDSM may be perceived as threatening and explore the extent to which BDSM can be constructed as a queer sexuality that challenges heteronormativity.
Finally, in Chapter Nine, Peter Hegarty presents a chapter that considers queer methodologies. Peter draws from experimental science, exploring the historical and methodological issues posed by quantitative approaches within the social sciences. However, rather than disavow the role of quantitative approaches, Peter uses these studies to present alternative ways of using their procedures and outcomes. This is particularly relevant to the works of Milgram and Zimbardo. He analyses how results are (and could be) interpreted and estimates their impact for both researchers and researched when assigned to a heteronormative framework. Peter provides evidence suggesting that before conducting research, the language, position and differences of those conducting the research in comparison to those being researched needs to be interrogated.
The overwhelming message of the book is really aimed at therapists who, it must be concluded, need to integrate a thoroughly psychosocial perspective into their approaches. Lingering in the time worn archetypes, therapists seem afraid of really challenging traditional discourses established when the world had far different ideas about sex, sexuality and gender. Each chapter provides a substantive area that asks readers for a queer perspective whereby the old rhetoric of either/or is disregarded (temporarily if not permanently), and the reader is asked to sit with the discomfort of change and new ideas. Admitting to this discomfort, to the fear of letting go of a familiar rhetoric, of stepping outside the safe boundary of sex, sexuality and gender will allow for a period of transition and a queer creativity. This project is not intended to be separatist but instead asks for a much larger social project that means radicalising therapy and providing a complete textual analysis of its very foundation that will propel it into the twenty-first century.
One final point. I have tried to let the voice of the different authors be heard throughout the chapters. Although I have edited the work, I would hope that I have not imposed myself into the chapters written by other authors. This is intentional because it is important that the plurality of ideas and identities are allowed to surface, adding to the uniqueness of queer narratives that are necessary to bring about a radicalising of therapeutic ideologies.
