Choosing a Therapist I

James Roberts

I tested positive for HIV in January 1991. I was 26 years old and had been living 
in New York for over two years. Someone I had slept with a few times called me
 and told me he was positive. We had not practised safe sex. I did not have the
 money for private medicine and so had go to a public health centre, which in New
 York is exclusively for the poor. Facilities are basic and the service rudimentary.
 Staff are suspicious, bored and defensive. They don’t use your name, so when the
 nurse came over to me personally and gently asked me to see the doctor I knew
 what to expect. He asked if I understood what HIV positive meant and that was it.
 The next few months were a blur. At that time being HIV+ meant you were about 
to get AIDS and then die. The ravages of this disease were all too evident on the 
streets of New York; men in their thirties weighing seven stone, and looking as if 
they were sixty, were a regular sight in the West Village, and now this was going 
to be me. In my brief stay in this city I had already met people who had died. It 
is so odd to be confronted with mortality when you feel your life has only just
 begun. I struggled to contemplate the implications of my new health status and 
after a few months of stumbling through life I left New York. I had yet to speak to
 anyone professional about my illness.

It was April 1992 when I first sat in my therapist’s office. Fifteen months of
 struggling with denial, fear, sorrow and grief in an increasingly isolated and lonely
 world had left me depressed and lacking any self-esteem. Superficially strong and 
having relocated to London, I was having increasing difficulty suppressing the
 huge emotional turmoil within me. My doctor suggested that I see a counsellor.

The woman who assessed me took me on as her patient. I didn’t choose her, but it 
was essential for me to have a female counsellor. As a gay man I have always had
 difficulty relating to heterosexual men, particularly emotionally. I have always 
regarded them as threatening and difficult to communicate with and therefore feel
 alienated from them. I see no common ground. I have never had a close 
relationship with any straight man and indeed I avoid them. Obviously, I know and
 like many straight men, but I am always aware of an underlying tension, however 
subtle. I think this is based on the fact that I perceive all relationships with men 
from a sexual perspective, be they straight or gay. I would never allow myself to
 find a straight man sexually attractive i.e. to experience “unrequited Love”.
 Consequently I felt very strongly about the gender of my counsellor. I would have
 felt in a supine position with a straight man and believed that he would not have 
understood my emotions. I would certainly have found it difficult to express or
 show my emotions to him. In contrast I perceive women to be emotional,
 perceptive, caring and tender; qualities I do not associate with men.

A gay male counsellor was something I also wanted to avoid as I felt that there
 would be a sexual attraction, either mutual or one sided. This again exposed my 
belief that all male relationships are sexually based and hence my barren emotional
 relationships with straight men. I felt a gay male would be too close and subjective 
and again there would have been an element of not wishing to be emotional with

I formed a very close bond with my counsellor. I trusted her. She was calm,
 assured and professional yet I also felt that she really got to know me and who I
 really was. I also believe that she became very fond of me. I confided in her and
 told her feelings that I have expressed to no one else. She felt like an incredibly 
close friend, someone I admired and looked up to. I have huge respect for her. She
 was warm and friendly and yet reserved and controlled. Through her I was able to 
express deep-rooted feelings of great anger and sorrow, something I had never been 
able to do before. I spent many sessions constantly crying and often broke down 
completely. She would always wait patiently for me to recover, handing me tissues
 but never touching me or even comforting me, just encouraging me to release these 
terribly suppressed emotions. Because she was a woman I immediately felt at ease. 
Her manner and her appearance reinforced this feeling. It mattered to me how she
 looked – her clothes, jewellery, hairstyle and ever her voice. All this was part of
 my relationship with her. I will always remember her soft New Zealand accent.
 She was feminine, funny, intelligent and articulate. This was important to me. I 
remember I sent her a postcard from San Francisco. It was a 1930s photograph of
 three Japanese women in traditional costume posing as the three monkeys Speak,
 Hear and See No Evil. I thought it was vaguely relevant, in a funny sort of a way.
 She put it on her desk and that became such an important thing to me. I checked
 for it every time I went to see her and it was always there. I supposed I needed to
 feel that I mattered to her. I could never have done this with a man. Part of the
 reason the relationship worked was because I genuinely felt that she believed in me
 and had such faith in and hope for me, much more than I ever had for myself.

From the onset she set up a very warm and nurturing environment. She was always 
prepared, happy to see me and interested in what I had to say. She always
 remembered everything I had said, or appeared to do so. This made me feel
 important and relevant. I remember once when I arrived she appeared to have been 
crying and I felt protective of her and wanted to help her. I had a very strong
 emotional response to the idea of her being upset.

I don’t think I could have achieved the level of trust and thus set up my safe haven 
if my therapist had been a man. I don’t think she became a maternal figure for me,
 but because she was a woman I really felt I could trust her.

When I first started therapy I was very withheld emotionally. I felt it was wrong 
to be angry or sad. I became able to express these feelings and accept the sorrow 
in my life. I learnt how to deal with my illness, to talk about it and accept the
 reality of my situation.

I saw my therapist for about three years on a weekly basis and then, at her
 suggestion, intermittently for another two. When I first went to her I was confused 
and lost, full of sadness and unable to see a place for myself in this world. I had
 lost hope and was terrified at the prospect of a virus destroying my body. She
 brought about a great change in me and helped to find a strength within me that I 
never knew I had. Initially I so needed her and our sessions were exhausting and 
upsetting, but slowly over the years this changed and at the end I felt a different 
person. Eventually she left to do post graduate work. It was very difficult for me 
to accept that I would never see her again. The last time I saw her it was very
 upsetting – it was like losing my best friend. I couldn’t believe that she would not
 be there for me anymore. It was so strange. I know it was an “unreal” relationship. 
I knew nothing of her life, her hopes, fears and aspirations. I never saw her elated
 or depressed, excited or bored. She always supported me, believed in me and 
asked for nothing from me. Essentially I knew nothing about her and yet I felt such 
a strong bond. I miss her terribly and consider her to be one of the most important
 people that have been part of my life.