Does Everybody Need to Differentiate?

Recently, I wrote a three-part series on differentiation of self. If you missed it, you can find it here: part one, part two, part three

After I wrapped up the series, I realized I still had more to say. In fact, I want to address an aspect of differentiation of self that is not often discussed: cultural considerations. 

Differentiation of self is very important to my work, and it is the lens through which I tend to approach relationships. Most of my clients get very excited when I talk about the three aspects of differentiation, and are very interested in building that skillset. They may not know how to get there, but they can see how their life and relationship would improve if they increased those skills. They’re on board. 

But what if you have a client who doesn’t actually want to differentiate, doesn’t believe in differentiation, or is very conflicted about it? Not everyone aspires to be seen and accepted as a unique individual. Some people, and some cultures, believe in upholding the family connection or carrying forward cultural norms, and hold those things as higher goals than individuality and unique expression. They may or may not want to shift to cultural values that include individuation. 

Additionally, there are some people who have discovered an aspect of their personal expression or identity that is in direct conflict with family or cultural belief systems. In that case, they will have to make some very hard choices. If they choose to differentiate, there will probably be significant losses associated with that choice. They may stand to lose family, friends, or an entire cultural identity. If they choose to stick with their cultural or family values and beliefs, they will have to let go of some dreams and desires, and possibly even some important parts of themselves. 

Rebellion is not for everyone, nor is it a higher form of being. Shifting cultures is a big deal. It’s not something we should assume is preferable, or push our clients towards. The world is a diverse place and there is a lot of room for differences between us. I don’t want to work at cross-purposes with my client’s values or belief systems, or set them up for family or cultural consequences that they don’t see coming and freely choose. Being differentiated ourselves, as therapists, requires us to recognize that our clients may make different choices than we would. 

I have often had clients who are wrestling with an internal dilemma: differentiate from family belief systems, or don’t. When this happens with an individual client, the first order of business is to resolve that impasse. When it happens with one partner in a relational therapy, the first order of business is to help each partner express their thoughts, feelings, and point of view so they can understand one another better, and ultimately come to a decision as a team. 

There is no one-size-fits-all rule book for life. Honoring diversity means upholding the right to differ. Supporting differentiation means deeply listening to and grasping the thoughts and feelings behind any point of view, not just the ones that are comfortable to hear. Our work in therapy is not to push our clients towards any one resolution, but to allow them to voice all sides of their impasse fully, so that they can make their decisions on their own terms. If, at the end of that process, they decide that they value their closeness with their family or their connection to their culture over expressing their individuality, that is a valid choice, and a good outcome for the therapy.

Reader Question: What Is Gender Fluidity? (Part 2)

My question has to do with gender fluidity. I understand that we all have male and female within. But somehow I’m finding this concept, when taken to dressing, acting out the parts, and expecting others to respond accordingly, as ridiculous. I feel as if I’m being really old fashioned and very judgmental.

(This is part 2 of a series–check out part 1 of What Is Gender Fluidity? here.)

Imagine being born intersex, with some combination of male and female body parts and/or chromosomes. This describes between .05 and 1.7 in 100 people, depending on how you assess. Your parents would probably have chosen your gender for you, arbitrarily, at birth, obviously without consulting you. You might have been subjected to surgery so your pelvic organs and genitalia more closely “matched” a  binary mold. Your hormones might have been adjusted in puberty to maintain the gendered outward presentation your parents chose.

When you imagine being in that situation, does it seem possible that your parents might have guessed wrong about how you would perceive your own gender? What if you aren’t born intersex, yet still the gender you were assigned at birth doesn’t match your own internal sense of knowing? Would you be likely to assimilate, or differentiate? And might you want a therapist who could help you work through the complexity of thoughts/feelings/beliefs with as little bias as possible?

Now imagine being a person who doesn’t have an internal sense of being male, or female. Or who identifies as all genders simultaneously. Or on some days one, and other days another. Or on some or all days somewhere in between. It might be difficult to find people who could relate, or be of support. You might get tired of explaining this potentially complicated and private aspect of yourself to people who don’t get it. You might get annoyed when people address you with binary pronouns like he and she, because it reminds you of just how invisible and culturally unacceptable your identity is. Gender neutral pronouns do a better job of honoring the authenticity of diverse identities, even though all pronouns will always fall short of the mark–there is a LOT of gender diversity.  

As a therapist, my work is helping my clients identify their internal sense of knowing, and then take steps to align their internal sense of themselves with their external actions and choices. There is a certain kind of authenticity that comes from congruency. From this standpoint, it is natural that I would work with gender diverse clients; to me it makes perfect sense that a person would strive for congruence between body, mind, internal sense of knowing, and external expression of gender. This is easy for some, but it’s not so easy for those who don’t congruently fit with the assigned mold, and are subject to marginalization for being different.

I was born in 1961. I didn’t know there were same sex couples, had no idea there was such a thing as dissonance between sex characteristics and internal understanding of gender, and certainly had no idea there was such a thing as non-binary gender identity or fluidity. I learned about same-sex attraction relatively early on. I learned there were trans people and identity perhaps two decades after that. I don’t know exactly when I became aware that not everyone felt congruent with a binary gender identity; it was relatively recent. Our culture, or at least my little sliver of it, has been blind to this aspect of diversity for a long time. So as I see it, we’re playing catch-up and things are moving fast. It isn’t comfortable, but I think I owe clients, friends, and family support for the development of their congruent selves, no matter what their path looks like.

Here are some suggestions for clinicians who work with a gender diverse population:

  • Don’t have checkboxes for male/female gender on your intake forms. Instead ask for gender and provide a write-in line. How a person self-identifies when given unlimited options is very important. Also, gender non-conforming people will feel seen.
  • Consider including a question about preferred pronouns on your intake form. Again with a write-in line. There are a lot of gender-neutral pronouns and a lot of ways to present gender so don’t guess. I have some clients who don’t have any idea what this question is about or how to answer it, but my gender non-conforming clients appreciate feeling seen. Knowing that, I think it’s important that I refer to them with the pronouns that are most comfortable for them. A person sometimes refers to themselves with different pronouns on different days, or changes pronouns during therapy. The client will let you know, or you can ask.
  • Get good at making a repair. When you work with marginalized populations, you are working with people who have been hurt many times. You obviously are trying hard not to add more hurt, yet nobody is perfect and I predict the occasional error. (Ask me how I know.) If you take a misstep, and you will, thank them for being brave enough to tell you, take the feedback gracefully, and make a sincere apology. Then go read a book or consult with someone who can help you understand anything you’re not clear on about that interaction.
  • Gracefully adopt and understand your clients’ evolving language. Language expressing gender diversity is evolving quickly; there is variation between communities, regions, and individuals. If I don’t understand a term, or think we might be thinking of two different things, I ask the client for their definition/meaning.

All Levels of Desire Are Normal

When therapists work with desire discrepancy, they sometimes fall into a counterproductive trap–identifying one partner as “high” or “low” desire, and trying to “fix” that partner’s desire level.

“High desire” and “low desire” are comparative terms. What standard are you comparing against? Is there such a thing as “normal desire” or “abnormal desire”?

I say no. Everyone’s level of desire is unique, and there is no reason to think a particular level of desire is “more correct” or “more healthy”.

As a therapist, you are in a uniquely powerful position to normalize any level of desire. The problem resides in the meaning each partner makes about their own desire level, or that of their partner, not in the level itself.

If a client were interested in shifting their own level of desire, it would only be possible in a very emotionally safe environment. Trying new things and stretching for challenging growth does not work when one feels pressured, pathologized, bad, wrong, or inadequate.

We would do better to celebrate difference in desire as expression of the uniqueness of each partner (that nonetheless can create tension), rather than pathologizing it.

Your clients probably have worked through desire issues in other areas of their lives. We all have desire differences in our relationships, whether they be about how much money to save, how clean to keep the house, or, in my house, how many cats is the right number. (When it comes to cats, I’m definitely the higher-desire partner.)

Making room for partners to hold the tension of being different from one another, and to find ways to work collaboratively with their unique differences, is both the work of couple therapy and the work of being in a long term relationship.

Here are some questions for your (and your clients’) consideration:  

  • What are your beliefs about desire? Do you believe there is a “right” amount of desire?
  • What does it mean, about you, and about your partner, that you are the higher or lower desire partner?
  • Where did you learn these beliefs about desire?
  • What other desire discrepancies have you and your partner worked through successfully?
  • What if you believed every level of desire is normal? How would that change things for you?


Desire is such a complicated issue because it has roots in every aspect of the relationship and of the self. That’s why treating desire discrepancy is so difficult. Reframing how you talk about desire discrepancy is a powerful first step towards freeing your clients from damaging habits and setting them on a path of personal growth.