The man I am trying to be is not me

ABSTRACT

This paper explores the therapeutic process between analyst and Josh, a trans man whose life had fallen apart after transition. Repetitive enactments involving hiding, deceiving and mystification constituted a prolonged therapeutic impasse. The analyst’s struggle with these binds and with countertransference confusion and anxiety, ultimately illuminated zones that had remained off-limits for a prolonged period of time. Where the couple had been snared in a bind structured by gender, they were now able to access a history of violation and to ask more profound questions about connection, aloneness, authenticity and loss.

L'auteur de cet article explore le processus thérapeutique entre l'analyste et Josh, un homme transsexuel dont la vie s'était brisée après son changement de sexe. La répétition de mises en acte – dissimulations, tromperies, mystifications – devait conduire à une impasse thérapeutique prolongée. La lutte de l'analyste contre de telles injonctions et contre un état de confusion et d'angoisse contre-transférentiel finit par illuminer des zones qui étaient demeurées interdites pendant longtemps. Là où les protagonistes du couple analytique avaient été pris au piège de contraintes structurées par le genre, ils étaient maintenant capables d'aborder une histoire de viols et d'interroger plus profondément ce qu'il en était des relations, de la solitude, de l'authenticité et de la perte.

Dieser Beitrag untersucht den therapeutischen Prozess eines Analytikers und Josh, einem transsexuellen Mann, dessen Leben nach dem Geschlechtswechsel völlig aus den Fugen geraten war. Sich wiederholendes Enactment, das mit Verbergen, Täuschungen und Verwirrungen einherging, begründete einen lange anhaltenden therapeutischen Stillstand. Das Ringen des Analytikers mit diesen Belastungen und mit Verwirrung und Angstgefühlen in der Gegenübertragung beleuchteten letztendlich Bereiche, die für einen langen Zeitraum tabu geblieben waren. War das Paar bisher in einer durch Gender strukturierten Klemme gefangen, so wurde beiden nun eine Geschichte der Verletzung zugänglich, und sie konnten sich mit tiefer gehenden Fragen zu Bindung, Alleinsein, Authentizität und Verlust befassen.

Il presente articolo esplora il processo terapeutico tra l'analista e Josh, un transessuale la cui vita era andata in pezzi a seguito della transizione. Dopo una lunga impasse terapeutica caratterizzata da ripetuti enactment focalizzati sui temi del nascondere, dell'inganno e della mistificazione, il confrontarsi dell'analista con queste difficoltà e con i relativi vissuti controtransferali di confusione e ansia ha portato infine a gettare luce su aree rimaste a lungo off-limits. Laddove in un primo tempo la coppia era rimasta intrappolata in un vicolo cieco basato sul tema dell'identità di genere, essa è stata a questo punto in grado di affrontare una storia di violazione, diventando anche capace di porsi domande più profonde riguardanti la connessione tra le persone, la solitudine, l'autenticità e la perdita.

El artículo explora el proceso terapéutico entre el analista y Josh, un hombre transexual cuya vida se vino abajo después de la transición. Los repetidos enactments que comportaban ocultamientos, engaños y falseamientos fueron un impase terapéutico prolongado. La lucha del analista con estas constricciones y con la confusión y la angustia en la contratransferencia, finalmente, iluminó, las áreas que se habían mantenido vedadas durante largo tiempo. Allí donde la pareja había estado atrapada en un vínculo estructurado por el género, ahora podía acceder a una historia de violación y hacer preguntas más profundas sobre la conexión, la soledad, la autenticidad y la pérdida.

KEYWORDS:

• Gender
• relational psychoanalysis
• intersubjectivity
• psychotherapy

Acknowledgement

The author thanks Drs Darlene Ehrenberg, Gerard Webster, and Ilene Philipson for their comments and feedback.

Notes

1 This analysis was conducted face to face, four times a week.

2 There is no convincing evidence that it is possible to have a male brain in a female body, or vice versa. Brain structure research instead suggests the brains of trans subjects consist of complex mixtures of masculine and feminine regions, similar to the brains of cis-gendered homosexual subjects, but different to the brains of cis-gendered heterosexual males and females (Guillamon, Junque, and Gomez-Gil 2016).

3 By referring to “femaleness” or “maleness”, I am not referring to an immutable “essence”, or to the sex of the body. I understand “femaleness” and “maleness” to be complex ways of experiencing the self that have particular, individualised meanings. They emerge in specific historical, relational and social contexts and can be “colonized” by experiences (historical or affective) belonging to another (Suchet 2011; Silverman 2015). Put more simply, gender is an emergent property of complex relational and social systems, best understood as a “a pattern in time” (Fausto-Sterling 2012).

4 A full discussion of sex and gender is beyond the scope of this paper, however the following highlights some of the key issues. Stoller (1968), who coined the term “gender identity”, understood sex to be a biological given, consisting of the morphology and physiology of the body. Gender, he argued, referred to the psychological aspects of femininity and masculinity, which are socially constructed. In the current discourse, this distinction has become increasingly blurred. Sex is seen by some as no more “real” or concrete than gender and it has become commonplace to refer to “sex assigned at birth” rather than “natal sex”. Judith Butler, one of the most influential gender theorists of our time, is perhaps best known for arguing that gender is “performative” and constituted by normative heterosexuality, ie. “gender is an act which has been rehearsed, much as a script survives the particular actors who make use of it, but which requires individual actors in order to be actualized and reproduced as reality once again” (Butler 1988, 526). Butler also extends this position to sex, arguing that the distinction between sex and gender is meaningless: “perhaps this construct called ‘sex’ is as culturally constructed as gender; indeed, perhaps it was always already gender with the consequence that the distinction between sex and gender turns out to be no distinction at all” (Butler 1990, 9).

5 See Hansbury (2017) who argues that this kind of countertransference is transphobic.

6 Regret post gender-reassignment is reported to be very rare, affecting only 2.2-3.8% (Landen et al. 1998; Dhejne et al. 2014). However, due to the serious methodological limitations of the research (Murad et al. 2010), it is actually not clear whether there is an under-recognised group of patients who do not have good outcomes post-gender-reassignment (D’Angelo 2018).

7 The Baranger and Baranger (1964, 9) articulate this difference:

If there is no complicity on the analyst’s part, then the patient’s bastion is just a difficulty for the analytic work or a “resistance”, but it is not a bastion in the field …  … However, when such complicity is present, communication is divided: a sector of the field crystallises, comprising the patient’s resistance and the analyst’s counter-resistance, unconsciously communicated and operating together, while on another separate level, an apparently normal communication goes on.

8 See Lemma (2018).