Many adherents to the various psychotherapeutic traditions agree that the therapeutic relationship is actively shaped by the personal identities and needs of patient and therapist. Invariably, during the course of psychotherapy, therapist and patient engage in an "intersubjective negotiation" based on their respective individualities.

In this series of creative scholarly essays arranged in eight "dialogues," leading clinicians wrestle with questions of race, culture, gender, and sexuality as they apply to the therapeutic relationship. Each dialogue begins with an original chapter contribution by a clinician that includes a detailed discussion of the psychotherapeutic process, especially with regard to the negotiation of complex and difficult interactions between patient and therapist. Scholars with differing personal and professional backgrounds then offer chapters that develop ideas presented in the opening chapter, and in a closing chapter, the clinician who initiated the dialogue provides some synthesis and elaboration in response.

Table of Contents


Positioning the Editor: An Introduction to Difference and Dialogue
—J. Christopher Muran

Dialogue 1: The Conundrum of Race

  • Toward the Acceptance of Human Similarity and Difference
    —Neil Altman
  • Commentary: Some Reflections on Racism and Psychology
    —Louis A. Sass
  • Commentary: Freud, Jung, or Fanon? The Racial Other on the Couch
    —Lillian Comas-Díaz
  • Reply: Multiple Perspectives on Prejudice
    —Neil Altman

Dialogue 2: Social Privilege, Disadvantage, and Multiple Identities

  • How Difference Makes a Difference
    —Beverly Greene
  • Commentary: Tapping the Multiplicity of Self–Other Relationships
    —Lewis Aron and Jenny Putnam
  • Commentary: Engaging the Plurality of Being
    —Adelbert H. Jenkins
  • Reply: Voices from the Margins—The Multiple Identities of Client, Therapist, and Theories
    —Beverly Greene

Dialogue 3: Treating Homosexual Clients

  • Homosexuality and Its Vicissitudes
    —Jack Drescher
  • Commentary: Homosexuality—Toward Affirmative Therapy
    —Marvin R. Goldfried and John E. Pachankis
  • Commentary: Holding the Tension Between Constructionist and Deconstructionist Perspectives in Psychoanalysis
    —Virginia Goldner
  • Reply: Parler Foucault Sans Le Savoir
    —Jack Drescher

Dialogue 4: Race and Gender in Psychotherapy With African American Men

  • Gender, Race, and Invisibility in Psychotherapy With African American Men
    —Anderson J. Franklin
  • Commentary: Making Invisibility Visible—Probing the Interface Between Race and Gender
    —Paul L. Wachtel
  • Commentary: Not Either, but Both—Race and Gender in Psychotherapy With African American Men
    —Lily D. McNair
  • Reply: Truth in Advertising—Therapeutic Competence Means Undoing Racism and Sexism
    —Anderson J. Franklin

Dialogue 5: Toward a Contextual Understanding of the Latino Identity in Psychotherapy

  • Bridging the Gap
    —Mabel E. Quiñones
  • Commentary: The Need to Explicate Culturally Competent Approaches With Latino Clients
    —Kurt C. Organista
  • Commentary: On Describing the Latino Experience
    —Rafael Art. Javier
  • Reply: Are We Bridging the Gap Yet? A Work in Progress
    —Mabel E. Quiñones

Dialogue 6: Attitudes and Stereotypes in Psychotherapy With Asian Americans

  • The Inscrutable Doctor Wu
    —Philip S. Wong
  • Commentary: Mending the Twain—Eastern Inscrutability and Psychoanalytic Neutrality
    —Alan Roland
  • Commentary: Cultural and Acculturative Inscrutability of Asian American Clients
    —Junko Tanaka-Matsumi
  • Reply: Kant, Confucius, and Doctor Wu—Integration or Coexistence?
    —Philip S. Wong

Dialogue 7: Multiple Perspectives on the Middle Eastern Identity in Psychotherapy

  • History, Custom, and the Twin Towers: Challenges in Adapting Psychotherapy to Middle Eastern Culture in the United States
    —Annabella Bushra, Ali Khadivi, and Souha Frewat-Nikowitz
  • Commentary: Negotiating Cultural Difference and the Therapeutic Alliance
    —Michael J. Constantino and Kelly R. Wilson
  • Commentary: A Strengths-Based Approach to Psychotherapy With Middle Eastern People
    —Pamela A. Hays
  • Reply: Parallel Journeys—The Anxiety of Foreignness
    —Annabella Bushra, Ali Khadivi, and Souha Frewat-Nikowitz

Dialogue 8: Defining Differences in Psychotherapy: Communication and Metacommunication

  • A Relational Turn on Thick Description
    —J. Christopher Muran
  • Commentary: Language, Self, and Diversity
    —Steven C. Hayes
  • Commentary: On Being in the Thick of It
    —Kimberlyn Leary
  • Reply: The Power of/in Language
    —J. Christopher Muran

Author Index

Subject Index

About the Editor

Editor Bio

J. Christopher Muran, PhD, is chief psychologist and director of the Brief Psychotherapy Research Program at Beth Israel Medical Center, where he maintains a private practice and is active in teaching and training. He is also associate professor of psychiatry at the Albert Einstein College of Medicine. He completed a postdoctoral fellowship in cognitive–behavioral therapy at the Clarke Institute of Psychiatry, University of Toronto, and psychoanalytic training in the New York University Postdoctoral Program.

Dr. Muran is the current president of the North American Chapter of the Society for Psychotherapy Research and a past recipient of its Early Career Award. He has published and presented on the topic of psychotherapy process, with particular attention to self-changes and the therapeutic relationship, and has served as associate editor of Psychotherapy Research and on the editorial boards of several professional journals. His research has been supported by grants from various funding agencies, including the National Institute of Mental Health. He is coeditor (with Jeremy Safran) of The Therapeutic Alliance in Brief Psychotherapy, coauthor (with Jeremy Safran) of Negotiating the Therapeutic Alliance: A Relational Treatment Guide, and editor of Self-Relations in the Psychotherapy Process.

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