Conversations about Psychology and Sexual Orientation

Chapter 4: Who Do We Want You to Be? : A Commentary on Essentialist and Social Constructionist

Chapter 4 Who Do We Want You to Be? A Commentary on Essentialist and Social Constructionist Perspectives in Clinical Work Suzanne Iasenza As I read Glenda Russell and Janis Bohan’s compelling and thought-provoking chapter on essentialist and social constructionist perspectives in clinical work, I began to reflect on my twenty years of clinical experience, much of which involved working with issues of sexual orientation. I experience myself as a social constructionist and as an essentialist in the therapy room at different times, depending on the patient and where I am in my own professional and personal development. My reading thus sparked an interest in how my therapeutic stances change and according to what criteria. I ask different questions, as Bohan and Russell suggest, depending on the perspective I am using. They say that the essentialist asks, “Who are you?” and the social constructionist asks, “Who do you want to be?” So, for example, I may be the social constructionist with a confused adolescent who needs to explore possibilities without foreclosing on a particular identity. I would explore the “what ifs” of being with a man or woman, or both; of coming out or not; of impact on family, the prospect of having children, career choices—all part of who the client wants to be. Or, I may take a social constructionist position about the normality of fluidity and the multidimensionality of sexual orientation to help a heterosexual patient nonjudgmentally examine the homosexual parts of the self. 71 On the other hand, I may be the essentialist with a patient who is living a committed life with a same-sex partner but who is suffering from a homophobic family or social situation or from internalized homophobia . I would help such a person explore how to accept who he or she “really ” is, or, more accurately, how to identify, protect, and defend the vulnerable homosexual parts of the self. I often use an essentialist stance with parents of gay children. Parents can usually accept their children’s homosexuality more easily if they feel that their child had no choice, was born that way, and that they are not to blame for the way their child turned out. Sometimes I use essentialist and social constructionist approaches with the same patient in a stage-like manner akin to Vivian Cass’s coming -out model. I take an essentialist approach when the patient is first coming out to help the person overcome internalized homophobia and develop a healthy gay or lesbian identity. I use a social constructionist approach once the patient has the ego strength to feel safe and entitled to make choices about sexual orientation. Thus, I use the essentialist or social constructionist approaches strategically , depending on the patient’s developmental stage and goals. My approach also varies with the same patient presentation, depending on where I am in my own professional and personal development. When I was in training as a psychologist, most of my teachers avoided discussion of sexuality and sexual orientation, which left trainees feeling inadequately prepared to explore these issues. As a result, much of my early work dealing with sexuality issues lacked the flexibility I have described . I am still detoxifying from years of analytically oriented clinical supervision, which, paradoxically, in theory acknowledges the inherent bisexuality of individuals but in practice labels pathological anything other than opposite-sex desire and behavior. Despite my own years of self-education and my personal acceptance of my homosexual and heterosexual parts, I have had to diligently unpack my knapsack of subtle prejudices, the homophobias and heterosexisms of everyday life that exist inside and outside the therapy room. When I was less sure of my own lesbian identity, I once refused to work with a patient who wanted to explore changing her relationships from gay to heterosexual because I couldn’t even entertain a social constructionist approach, one that suggests that one can be who one wants to be, especially if one wants to change from gay to straight. I saw such a request as homophobic. Maybe in some cases it is. I wouldn’t refuse to 72 s u z a n n e i a s e n z a work with such a person now; I am no longer threatened by such a request . In my early years, due in equal parts to my own budding lesbian identity and to the lack of available training in...