It’s Your Hour

Michael Bettinger has written a book that he hopes will inform lesbian, gay, bisexual, and transgendered (LGBT) people about psychotherapy.  In many respects, Bettinger—himself a psychotherapist for 30 years—has succeeded.  It’s Your Hour is written for the neophyte client or would-be client in psychotherapy.  Therein lie its greatest strengths and a few weaknesses as well. 

Bettinger’s book is divided into four parts: the first introduces psychotherapy as a tool and describes the unique aspects of the intersection between psychotherapy and the experiences of LGBT people.  The second section of the book delves into models of mental health and different approaches to psychological treatment.  In the third part of his book, Bettinger discusses differences among clinicians and treatment settings, as well as financial aspects of psychotherapy.  The final section goes into the “nuts and bolts of psychotherapy,” covering initial contacts with a therapist, distinguishing dimensions of therapy (e.g., short- versus long-term therapy and feelings for the therapist), drug therapies, boundaries in therapy, and alternatives to psychotherapy.  Bettinger includes appendices reflecting a variety of topic areas, covering such issues as questions to ask the therapist and sample letters from psychotherapists in support of sexual reassignment surgery.  The book ends with several lists of resources, from a bibliography of readings to hotline information to contacts for professional mental health organizations.

In many ways, the author does a better job of addressing the topic of psychotherapy than he does of presenting the unique needs of queer clients.  He is at his best when discussing the nitty gritty of client-therapist interactions, with particularly strong sections on how to look for and interview a therapist, what happens in the first session, and the complexities underlying accidental meetings between therapists and their clients outside of sessions.  Bettinger makes a consistent effort at being inclusive of all members of queer communities, with the exception of not addressing the particular needs of queer youth.  While he offers case examples representing a broad slice of the queer community, some of his general background assumptions are notably imbedded in the author’s personal background and professional practice in a large city.  There is a lack of texture, for example, in his discussion of the manifestations of homophobia and heterosexism; this discussion fails to acknowledge important differences in how these dynamics are manifested in varying places where queer people are.

Bettinger speaks respectfully of mental health consumers and practitioners, and he also adds appropriate cautions about the potential for encountering practitioners who are unethical or incompetent.  The author’s discussion of different treatment approaches sometimes suffers from the hazards of writing about any complex matter for a general audience; his efforts to write accessibly occasionally slide into an overly simplistic exposition and generalizations that are far too broad.  Despite these shortcomings, the book offers a wealth of information to LGBT people who are considering psychotherapy.  A healthy consumer emphasis exists throughout the book but is especially prominent—and useful—in the section dealing with insurance payments and managed care.

It is perhaps an occupational hazard for those of us who practice psychotherapy that we focus on people’s troubles.  That focus is definitely found in It’s Your Hour.  While I acknowledge the necessity for dealing with troubles in a book about psychotherapy, I found myself wishing for an occasional nod to the expansive and creative potentials associated both with psychotherapy and with being queer.

© 2002 Glenda M. Russell

Glenda M. Russell, Ph.D. is a psychologist and activist and a member of the core faculty in clinical psychology at Antioch New England Graduate School in Keene, New Hampshire.  She is the author of Voted Out: The Psychological Consequences of Anti-Gay Politics and co-author of Conversations About Psychology and Sexual Orientation.