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How Therapists (Often Unintentionally) Stigmatize Polyamorous Clients

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This is the fourth in a series of articles about the intersections of polyamorous identities and psychotherapy, adapted from Rami Henrich and Cindy Trawinski’s article in Sexual and Relationship Therapy, “Social and therapeutic challenges facing polyamorous clients,” as well as supplemental materials that didn’t make it into the final research paper. In this installment, we identify three primary problems polyamorous clients face in therapeutic settings: lack of knowledge, client marginalization, and therapist bias.

Click here to access part 1 of this series. For part 2, click here . For part 3, click here .

Issues from the external social world can be complicated by issues specific to the therapeutic environment. Half of the respondents in Rami’s original research (unpublished 2011) reported unsatisfactory or negative experiences while working with therapists. Three participants with polyamory-aware therapists reported positive therapeutic experiences, especially regarding polyamorous relationship issues. Three participants did not seek therapy for polyamory issues.

Insufficient Knowledge

These excerpts demonstrate how therapists who are uninformed about polyamory are unprepared to serve polyam and consensually non-monogamous (CNM) clients adequately. Conversely, polyamorous clients can have positive and empowering therapeutic experiences with therapists who learn about polyamory, examine their biases and show compassionate support. Participants in the original study detailed what therapists needed to understand when working with polyamorous clients. For example, Helen asserted that therapists need to know:

… that you love more than one person… and to consider that the relationship problem is not that we are in love with other people. The problem is something else… Telling a polyam person not to be polyamorous doesn’t work. Therapists should allow that the norms for polyam relationships may be unique and distinct from what is considered typical for couples … [and] strive for sensitivity to the importance of communication of individual needs in polyam relationships … Therapists can learn to recognize the pluses and minuses that multiple partners bring to conflict and its resolution, decision-making, time management and communication.

Sue said she felt polyamorous clients have a range of unique needs to: explore and address commitment issues; be loved for their deepest selves rather than who they are supposed to be; develop and connect with their experiences of authenticity; and be transparent with regard to conforming or not conforming to societal dictates. Paul expressed his concerns about the potential for a therapist who is not educated about polyamory to get distracted by irrelevant issues and miss the real important things.

There is a strong focus on sex. If I am interested in having sex with someone outside my marriage, that is wrong. Get back in the box… [Sex outside of marriage] is viewed as betrayal, infidelity; it is an affair… wrong by definition. … If that judgment [about sex] could be lifted from a therapeutic relationship, that would be a great thing. It would behoove a therapist to look at the motives for why people choose polyamory.

Paul also acknowledged the importance of considering clients’ stages in the life cycle. A 40-year-old man with a wife and several children would have different issues with polyamory, Paul explained, than would an unmarried 20-year-old woman who was considering polyamory. Finally, Paul highlighted issues of jealousy, envy, and boundaries as important to polyamorous clients, as well as the challenge of pioneering new paths and broadening relationship structures

Similar to the experiences of other marginalized groups, like lesbian and gay clients,[1] stigma and judgment based on misunderstanding nonmonogamy as inherently negative often influence therapists’ treatment of polyamorous people.[2] This disadvantage is borne of a lack of cultural competency,[3] not an inherent problem with polyamory itself. There is a problem when therapists inappropriately (possibly inadvertently) stigmatize polyam and Cclients by misunderstanding polyamory as cheating or sex addiction while overlooking the non-polyam issues their clients identify.

Client Marginalization

These data (and our experiences) indicate that therapists frequently minimize, deny, or overlook polyamorous relationship issues and, instead, focus on consensual non-monogamy (CNM) as the client’s core issue. In our therapy practice, polyamory support groups, and Rami’s interviews, polyam clients reported repeated difficulties interacting with conventional therapists. Participants identified two primary reasons for negative experiences as therapists’ (1) biases towards monogamy, and (2) unfamiliarity with polyamorous relationships. Paul, married to Rita and partnered with Anna, explained his painful therapy experiences.

Twenty minutes into the interview… it was clear that… [The therapist did not believe] that I was interested and committed to staying in relationship with my wife. The therapist did not believe my wife [when she said], “I am OK that he has sex.” She stared down her nose at us, condescending almost… [and said] “I would be happy to take you as a couple, but no drug use, (there never was any) no physical abuse, (there never was any), and the affair has to stop!”

We went to see a second therapist, [and] I did not feel any judgment. I felt confusion from this person. She really didn’t understand what was going on. We had to do all this explaining and bringing her up to speed.

Sue’s childhood in a polyamorous family with parents who concealed the family structure influenced her views. In college, Sue sought therapy for anxiety and depression, and her experience with counseling center staff reinforced her shame and self-perception of abnormality.

I remember this reaction… when I was telling them about my family. They would be taking notes and kind of gasp “Oh, oh my!” Like that they didn’t quite know what to do with that… Even though they were compassionate, I think it reinforced … that there was something abnormal about this, it was shameful.

It is unlikely that Sue’s counselors had sufficient information about polyamory. Although basically supportive, their lack of familiarity and comfort with unconventional families was expressed as bewilderment. Such reactions can increase clients’ shame and distress and be counterproductive to therapeutic goals.

Therapist Bias

Therapist bias regarding CNM and polyamory stems from at least three sources: cultural conditioning that favors monogamy; lack of exposure to and/or knowledge of CNM; and issues with infidelity in therapists’ private lives. Most therapists in the US have been trained to favor conventional monogamy over other options.[4] Pepper Mint identified compulsory monogamy as a “structuring system of power” in which cultural representations idealize and enforce monogamy, making monogamy seem natural and inevitable. For Mint, monogamy only becomes problematic when “its ideology becomes hegemonic … when there is no real way to be something other than monogamous.”[5]

In a therapeutic setting, compulsory monogamy may appear as the therapist’s assumption that monogamy is the only healthy way for families to structure their relationships.[6] Paul reported concerns about therapist biases toward monogamy, and his desire for a non-judgmental therapist willing to help clients explore their motives for choosing polyamory.

Therapists will try to find ways of maneuvering, manipulating, shaming, doing whatever it takes to keep that [married] relationship functional… success is defined by keeping them legally married… [instead of] what would best serve them as individuals who will be in a relationship for the rest of their lives, married or not, is irrelevant.

When compulsory monogamy influences therapy, it makes all other forms of relationship appear inherently pathological. Pro-monogamy beliefs can be difficult for therapists to recognize or question because monogamy is deeply embedded in social mores, theoretical, and clinical assumptions and seems “natural”, rather than socially constructed. Similarly, anti-CNM sentiments can lurk unexamined in therapists’ minds and reflect polyamphobia,[7] or the unreasoned fear/hatred of polyamory.

Therapists’ unfamiliarity with CNM fosters a variety of reactions to clients’ desires for polyamory that belie therapists’ lack of sensitivity to issues confronting polyamorous clients. As these respondents indicate, clients note these reactions and may choose to leave therapy when the therapist’s attitudes and lack of knowledge are experienced as problematic.

Adding further complexity, therapists sometimes find non-monogamy personally threatening if it resonates with personal issues. Elisabeth Sheff found that people who experienced infidelity in their personal or family lives sometimes reacted negatively toward polyamory and CNM because “personal issues were inflamed by hearing about polyamory.”[8] Therapists with issues around a partner’s, a parent’s, or their own sexual infidelity are likely to have personal reactions toward polyamory and should pay special attention to their biases.

Providing therapy to polyamorous clients is often more complex than serving monogamous clients. Relationship conflicts among polyamamorists are multi-faceted events requiring something closer to family therapy or group facilitation than traditional couple therapy. Therapy with polyamorous clients can trigger therapists’ biases, tempt therapists to side with one person or group within a relationship against another, or diminish therapists’ ability to recognize client marginalization.

Bias against sexual minorities in a therapeutic setting is not new. Keely Kolmes, Wendy Stock, and Charles Moser found that over half of the self-identified bondage and discipline, dominance and submission, and sadism and masochism (BDSM) enthusiasts in their study experienced “biased care” such as being lectured about how “unhealthy” BDSM is, required to educate therapists, or discontinue kink activities as a condition of continued treatment.[9] Because BDSM and polyamory transgress many social agreements, serving polyam (and kinky) clients requires therapist deepen awareness of their biases, and develop sensitivity to clients and increase familiarity with issues associated with unconventional relationships.

Bibliography and Further Reading

Halpern, Ellen L. (1999). “If love is so wonderful, what’s so scary about MORE?” Journal of Lesbian Studies, 3, 157–164.

Kolmes, Keely, Wendy Stock, & Charles Moser. (2006). “Investigating bias in psychotherapy with BDSM clients.” Journal of Homosexuality, 50, 301–324.

Mint, Pepper. (2006). “Compulsory monogamy and sexual minorities.” Retrieved from http://www.pepperminty.com/writing/compulsorymonogamy.pdf

Sheff, Elisabeth. (2014). The polyamamorists next door: Inside multiple-partner relationships and families. Lanham, MD: Rowman & Littlefield.

Van Den Bergh, Nan, & Catherine Crisp (2004). “Defining culturally competent practice with sexual minorities: Implications for social work education and practice.” Journal of Social Work Education, 40, 221–238.

Weitzman, Geri. (2006). “Therapy with clients who are bisexual and polyamorous.” Journal of Bisexuality, 6, 137–164.

[1] Van Den Bergh & Crisp, 2004

[2] Weitzman, 2006

[3] Van Den Bergh & Crisp, 2004

[4] Van Den Bergh & Crisp, 2004

[5] Mint, 2006

[6] Weitzman, 2006

[7] Halpern, 1999

[8] Sheff, 2014, p. 127

[9] Kolmes, Stock, and Moser, 2006

About Rami Henrich, LCSW

Rami Henrich, LCSW, is a licensed clinical social worker and a Diplomate in Process-oriented Psychology (or Process Work), as well as a founding partner of LifeWorks Psychotherapy Center and North Shore Psychotherapy Associates. Rami has studied, taught and applied Process-oriented Psychology as developed by Arnold Mindell, Ph.D., for over 13 years. She has a special interest in working with relationship difficulties and those who identify as living an alternative lifestyle. Rami is a certified Imago Relationship Therapist as well as is a frequent speaker on topics including: Sex Positivity: Therapist Bias; Rank & Power; and Polyamory.

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