Most clinicians working with patients with EDs will see a limited number of male patients. Thus, most will need to make some adjustment to their standard approach to therapeutic engagement (Bunnell, 2010). A man's decision to seek treatment for his ED can reflect important attitudes about the need for assistance and support. The concerns about weakness and vulnerability that men often bring to therapy can be explored through careful and respectful examination of attitudes and beliefs about psychotherapy. Many therapists, male and female, are less likely to directly address relational issues with their male patients, in part because male patients may be less comfortable with direct explorations of the relationship. Englar-Calson (2006, p. 37) recommended an allied problem-solving stance with a focus on “action intimacy” because men may be more comfortable with directive techniques and may respond more favorably to cognitive-behavioral and similar therapies than female patients. Finally, therapists must also be willing to confront their own biases and gender stereotypes (see Bunnell, 2010, for further review). Countertransferential reactions to male patients may reflect clinicians' own biases about male vulnerability, also known as the “c'mon be a man” reaction. Do you as a clinician see men as less emotionally and relationally competent than your female patients? How do you as a therapist act differently with your male and female patients regarding issues of money, authority, psychological openness, self-disclosure, feelings of attraction, discussions about sex and intimacy, anger, flirtation, and power? Gender-competent therapists need to reflect on these questions and be mindful of their own blind spots and gender dynamics.
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