June Video of the Month
Timeless Presentations from Erickson Foundation Events
This ongoing series highlights keynotes, workshops, and dialogues from past Erickson Foundation conferences, showcasing influential voices in psychotherapy. These archival recordings offer more than historical interest; they hold lasting clinical value. Each session distills complex clinical ideas into lived examples, practical insight, and enduring therapeutic relevance.
In recognition of Pride Month, this month’s selection highlights the clinical importance of affirming care for LGBTQ relationships and families.
This month’s selection is…
✨ Shawn Giammattei, PhD
“Introduction To Gender Affirmative Couple Therapy with Transgender/Gender Expansive Couples”
Keynote | Couples Conference 2021, Online
This keynote brings attention to a topic many clinicians recognize as increasingly important but may not have received enough practical training to address: gender affirmative therapy with transgender and gender expansive couples. Throughout the presentation, Giammattei keeps the focus on the therapist’s assumptions, language, and clinical stance, and on how these can influence the care transgender and gender expansive couples receive.
Giammattei refuses to frame trans relationships primarily through pathology or crisis. Instead, he asks clinicians to recognize the “brilliance, creativity, and resilience” already present in these relationships, while also taking seriously the effects of minority stress, transphobia, grief, ambiguous loss, and rigid gender assumptions.
📌 About the Speaker
Shawn Giammattei, PhD, is a California-licensed clinical psychologist, clinical family psychologist, educator, researcher, author, and international speaker whose work centers on transgender, nonbinary, and gender-expansive clients, couples, youth, and families. He is the founder of Quest Family Therapy, the Gender Health Training Institute, and the TransFamily Alliance, and is known for bringing a systemic, relational perspective to gender-affirming care.
🧠 Session Highlights
Gender Affirmative Therapy as a Clinical Foundation
Giammattei opens by outlining the gender affirmative model, stressing that gender variations are not disorders and that gender diversity is a naturally occurring part of human experience. He distinguishes gender identity, gender expression, biological sex, and sexual orientation, helping clinicians avoid common conflations that can create confusion or harm in treatment. He gives clear language for thinking about gender while also reminding clinicians that the clients are the experts on their own gender.
The Therapist’s Own Gender Story
A central teaching point in the keynote is that gender affirmative therapy begins with the therapist. Giammattei asks clinicians to examine their own gender stories, biases, privileges, and assumptions about what is possible in relationships. He describes this as a process of “unlearning and relearning,” especially for therapists trained in models that may assume heterosexuality, cisgender identity, dyadic partnership, or binary gender roles. This emphasis makes the presentation especially useful for clinicians who want to move beyond surface-level cultural competence and consider how their own assumptions shape the questions they ask.
Seeing Transition as Relational and Developmental
Giammattei frames transition as a developmental and relational process. When one partner transitions, the couple, the family, and the surrounding support system also enter a period of change. His clinical example of “Maria and Janet” illustrates how love, fear, religious background, internalized transphobia, privilege, class, race, sexuality, and family structure can all intersect in the therapy room. This gives clinicians a more nuanced way to understand the couple’s distress without locating the problem inside the transgender partner’s identity.
Externalizing Transphobia and Minority Stress
Giammattei cautions therapists not to inadvertently blame clients for the effects of discrimination, trauma, or internalized cultural messages. When depression, anxiety, suicidality, mistrust, or relational conflict appear, he encourages clinicians to ask how repeated experiences of oppression and minority stress may have shaped the client’s expectations, fears, and protective strategies. This frame helps therapists stay compassionate and clinically precise at the same time.
Holding Grief Without Blame
Giammattei discusses the grief that can arise for partners or family members during transition. He does not dismiss that grief, but he also rejects making the transgender partner’s identity the cause of harm. Instead, he places the grief in a broader social context: the loss of expected roles, privileges, identity labels, family narratives, or assumptions about the future. This distinction is important because it allows therapists to support the non-transitioning partner’s emotional process without pathologizing or blaming the transitioning partner.
Expanding Couple Therapy Models
Giammattei also invites clinicians to examine the limitations of their preferred therapy models. He notes that many couple therapy frameworks were originally developed around heterosexual, cisgender, monogamous, dyadic couples. Those models may still be useful, but therapists must know when and how to adapt them. His discussion of mixed-orientation relationships, consensual non-monogamy, polyamorous relationships, and non-binary identity, challenges clinicians to widen their map of intimacy, commitment, sexuality, and family life.
✅ Notable Clinical Takeaways
Use the language the couple uses for gender, orientation, relationship structure, and identity.
Do not assume that being transgender is the presenting problem; ask about it, hold it in mind, and then follow the clients’ stated concerns.
Assess for minority stress, transphobia, internalized shame, trauma history, and the client’s experiences with medical, legal, and mental health systems.
Look for resilience as actively as you look for distress. Giammattei repeatedly reminds clinicians that survival, creativity, and commitment are often already present.
Give partners and family members room to process grief, but keep that grief contextualized so it does not become a rejection of the trans or gender expansive person.
Be willing to separate partners or family members temporarily when one person needs space to process fear or grief without harming the other.
Adapt couple therapy language and interventions so they do not unconsciously reinforce binary gender roles, cisnormativity, or heteronormative expectations.
🧩 Ericksonian Resonances
Although this keynote is not presented as an Ericksonian session, several Ericksonian overlaps are easy to recognize. Giammattei repeatedly privileges the client’s lived experience, treats identity as something to be understood from the inside rather than imposed from the outside, and searches for resources already present in the couple. His stance is also deeply contextual: symptoms and conflicts are understood in relation to culture, family, developmental history, and relational expectations rather than as isolated defects.
There is also an Ericksonian quality in his emphasis on possibility. Instead of asking whether a couple can fit an inherited model of what relationships are supposed to look like, he asks what kind of relationship this couple can create. That shift from pathology to resourcefulness, from rigid categories to individualized solutions, and from blame to contextual understanding aligns strongly with the Ericksonian tradition.
⏳ Why It Still Matters
This archival video remains valuable because it gives clinicians a practical and humane entry point into gender affirmative couple therapy. Giammattei does not offer a one-size-fits-all intervention. Instead, he teaches a clinical stance: be informed, be humble, ask better questions, examine your assumptions, and stay attentive to the social forces that shape intimate life.
For therapists working with couples, families, LGBTQ clients, adolescents, or anyone navigating identity and belonging, this keynote offers a useful reminder that competent care depends on more than acceptance. It requires careful listening, flexible models, and the willingness to meet clients inside the complexity of their actual lives.
Click here to watch the video.
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Integrative Therapy with Gay Men... The Gift of Presence
by Rick Miller
Type: eBook
Format: .epub
Empathetic, touching, and at times humorous, Rick Miller’s Unwrapped is both timely and unique in that the author’s own history echoes the universal history of many gay men. And from this perspective, Miller gently but boldly addresses the challenges and issues gay men face – and how therapists can rise to the occasion, healing not only the their clients, but evolving and changing themselves, becoming more in tune and more able to work with this minority. Childhood scars of having to “hide in” and remain secretive, strained relationships with parents and family, growing up in a religious environment, internalized and external societal homophobia, challenges with authority figures, pressures to conform to impossible gay ideals, working through loss and grief from the AIDS epidemic, sex and love in the gay world, sexual compulsion and addiction, the fear of aging – Miller leaves no stone unturned and discusses these topics relevant to gay men with honesty and integrity. He explains that gay men most often live from the “outside in” rather than the “inside out.” And although great strides have been made for gay men, there is still much to do in order to help them to live life wholly and fully.
Offering case examples intertwined with therapeutic hypnosis scripts, Miller presents real life clients and shares their progress and outcomes. Through pointed questions, he encourages therapists to carefully review their own motives, beliefs, and bias’ before working with gay men, and to then become prepared, informed, and willing to use their intuition and open their hearts.
Unwrapped is an excellent book and Rick Miller is the clear voice of a minority that has struggled so much for freedom and the right to live a peaceful, loving life. This is a must-read for all clinicians.
There is no other book like this. The author, a gay man, has created a most innovative, engaging, inspirational, and valuable resource for therapists who want to do mind body work with gay men. The techniques and stories offered in this book will be life-changing for their gay clients. The book is filled with HOPE.
— Ann Webster, PhD
Health Psychologist, Benson Henry Institute for Mind Body Medicine,
Massachusetts General Hospital
Instructor in Medicine, Harvard Medical School
With courage and sensitivity, Rick Miller draws our collective attention to the challenges gay men face on personal and interpersonal levels. The strength of his book, though, is in its emphasis on providing meaningful support and practical help when providing psychotherapy to gay men. Thoughtful readers will discover that Miller’s work has the potential to make an important contribution to clinical practice.
— Michael D. Yapko, PhD, Clinical Psychologist
Author of Essentials of Hypnosis (2nd ed.) and Depression Is Contagious
As we fight to secure equal rights for gay men, we still understand too little about the gay male psyche. Rick Miller’s Unwrapped is a significant and valuable step in that direction.
— Michael Cunningham
Author of The Hours
I can think of no better voice and no better book on psychotherapy with gay men for our time than Richard Miller’s UNWRAPPED-Integrative Therapy with Gay Men … the Gift of Presence. Rick Miller takes us into the world of the gay man and helps us understand both his unique and universal life difficulties. He shows how informed and caring psychotherapy can bring him to wholeness and healing. It is a “must read” for every therapist as well for the seriously interested.
—Claire Frederick, MD
Distinguished Consulting Faculty
Saybrook University, San Francisco
Co-author, Healing the Divided Self: Clinical and Ericksonian Hypnotherapy
for Post-Traumatic and Dissociative Conditions
A Teaching Seminar on Love's Hidden Symmetry
For those interested in learning how to apply Bert Hellinger’s family constellations method to their own work with couples and families. From a workshop given in San Francisco in 1999, this set shows how the family constellation approach works across a broad spectrum of issues. Part of the Professional Reference Series.
We have different sexual needs… We are afraid to express our needs… We simply can’t find time for each other. The real couples in Loving Sexuality reflect the very real issues that so many couples face after being together for months, years, or decades.
In this new video, Pat Love, author of the bestselling Hot Monogamy, offers a slew of great ideas on how to reignite the sexual dimension of your relationship. And dimension is key according to Dr. Love, who explains that a fulfilling sexual life — however it is defined — encompasses four essential ingredients: consciousness, chemistry, compatibility, and commitment.
Within each of the “4 C’s,” there are multiple levels of exploration and discovery, which are clarified through a series of thought-provoking — and feeling-provoking — activities. Dr. Love’s intention is to provide a safe place for couples to create positive change.
Loving Sexuality teaches essential skills for an enriched and enduring relationship. It looks at the delicate area of sexual interaction in a clear but gentle way, and provides practical strategies for partners to enhance their pleasure in each other across all dimensions.
How Love Works in Couple Relationships
by Bert Hellinger
Type: Softcover
In this expertly edited book, Johannes Neuhauser brings an artist’s eye to Bert Hellinger’s unique approach, and shows that beneath the surface of his often-startling work there is a gentle tenderness that calls — softly and steadily — to the truths that lay resting in our hearts. It is refreshing in this era of psychotherapeutic relativism to come across the work of a therapist who takes a quiet and clear-sighted stand for the centrality of love in human life. The power of the work that has emerged from Hellinger’s unwavering focus on the flow of love in relationships is remarkable; it will touch any who come into contact with it — professional and lay reader alike.
–Arthur Roberts, MA Editor and Co-Director, The GestaltPress.
When couples turn to therapy or to self-help, they are usually looking for a way to “fix” their “problem.” Common solutions might entail improving communication skills, identifying unproductive interaction patterns, or changing some specific behaviors.
When a couple steps into the work of Bert Hellinger, the partners are entering a realm of uncommon solution. Hellinger’s approach — family constellations and the underlying observations from which they take shape — taps into the deepest dynamics of a relationship. People begin to see just how unseen forces, including non-present family members and those of past generations, and the choices that were made long ago, affect the current partners’ connections with each other at many different levels.
Supporting Love presents verbatim transcripts of constellations with numerous couples, supplemented by questions, commentary, and discussion, to bring this multidimensional process into focus. Typically, a constellation moves through two stages. In the first, hidden — yet compelling — influences on the family are revealed. In the second phase, healing movements and statements are discovered — or recovered — and then tested within the constellation. The “psychic adjustment” that takes place, whether great or small, expands the couple’s vocabulary in creating solution.
Bert Hellinger’s voice is clear and strong on such topics as love, suffering, bonding, giving and taking, parenthood, childlessness, faithfulness, separation, and sexuality. Throughout the book, there are moments of exquisite clarity and moments of uneasy surprise: the resonance and discord of new insights into the ways we can support love — and the ways that love can support us.
