Why choose LGBT supportive psychotherapy? (Rene Vazquez, DSW)

Why Choose LGBT Supportive Psychotherapy?
By René G. Vázquez del Valle, DSW

People often ask the question does a LGBT person really need a specific kind of therapy?   Standard psychotherapy is performed by mental health professionals who are trained in the helping process, but this does not mean that all therapist function similarly or that they perform gay supportive treatment just because they are mental health professionals.  If you are questioning the type of therapy offered and whether or not it is relevant to your lifestyle as a homosexual person, a few areas of concern need to be addressed   It would be of consequence to question if the treatment you are choosing is gay supportive in nature, and whether or not the therapist seen has knowledge regarding the bio-psycho-social issues related to treatment with the LGBT population.

Traditional psychotherapy was developed and historically focused on the mental health needs of the heterosexual client and how the heterosexual person functions in the world and in his or her emotional and sexual relationships. Historically, psychoanalysis described the bisexual nature of all human beings, as espoused by Sigmund Freud himself, but a conservative group among the psychoanalytic movement quickly overshadowed this.  With the homosexual client, traditional therapy had often focused on attempting to get the person to change their sexual orientation to heterosexual. This was the optimal goal, whether overt or covert, in many forms of traditional therapy.   Many traditional therapists, who are not aware of the specific focus of gay supportive psychotherapy, lack a framework other than the one provided by traditional therapy from which to work with.

Homophobia, the so called fear experienced by heterosexual persons towards anything homosexual in nature, was not examined by psychoanalyst until the early 1970’s when it was first coined. Social psychologists defined homophobia as the irrational dread, fear of homosexuality and homosexual people.   Unfortunately, the term homophobia does not accurately describe what the condition really is. Most homophobic individuals do not experience actually fear, but rather hate, dread and or loath homosexuality.  The misleading notion that heterosexuals only fear, not actually loath homosexuals, has caused confusion for therapist who are not familiar with the reality of the experience. Mistakenly, traditional therapists have focused on the fear that a heterosexual person may have of his own homosexuality, failing to see the pathology inherent in contempt of homosexuality.

Alternatively, gay supportive psychotherapy starts from the premise that homosexuality, bisexuality, transgender do not represent emotional disturbance in and of itself, but what is conflictual and problematic is the loathing and society’s bias against them. That societal bias or opprobrium towards homosexuality is what often causes emotional pain for the LGBT individual.  Gay supportive psychotherapy understands homophobia to be a dread and hate of homosexuals, which has traditionally existed in society.  This fear, dread and hate of homosexuality have existed since Biblical times and permeates all of our society and our societal beliefs and norms. Homosexuals raised in heterosexual society and who are socialized to be heterosexual in nature, are also raised with and subjected to these cultural beliefs about homosexuality.   Homosexuals who have experienced heterosexual socialization are keenly aware of the bias that society has against them and of the social pressure to conform to heterosexuality.    It is fairly easy to imagine the effect that societal contempt can have on a person’s sense of self and on the emotional development of a young adolescent homosexual who is struggling with a budding sense of self, especially if that sense of what it is he is, is so loathed by society. In gay supportive psychotherapy homophobia and society’s opprobrium is viewed as the major cause of the psychological distress experienced by the homosexual.   For most individuals, conformity to heterosexual standards results in societal acceptance, while differences, especially shame based or stigmatized divergences, cause alienation.  When a young homosexual wishes to fit in and be part of society he has to agree with the beliefs of the peer group and identify himself with them.  Identifying with peer group homophobic attitudes causes the homosexual to also believe and take in the belief as part of his being.  When this occurs it is referred to as internalized homophobia.  The homosexual who identifies with this bias is caught in an emotional dilemma when he /she attempts to counter those beliefs in him/herself and will struggle with attempting to overcome the societal beliefs, and or norms which were ingrained in him/her.  The homosexual, for example, who hates himself or who cannot accept their homosexuality is often suffering from internalized homophobia.

Since internalized homophobia works at both the conscious and unconscious level a skilled therapist must be able to identify the multiple manifestations of homophobia in a client’s life. When a gay person is himself homophobic, this leads to massive amounts of guilt and shame and a tendency to be punitive towards him-self and others. For example, the homosexual who experiences shame based feelings can often experience difficulties in his relationships, due to the projection of these unresolved feelings onto friends, partners and /or significant others.

For the homosexual, therapy should focus on developing a healthy identity by coming to terms with any denied, shame based or punishing aspects of the self; a therapy, which is self-loving, and which helps to reject and externalize any homophobic belief which the client may have accepted as part of his identity.

The ultimate objective of gay supportive psychotherapy is to provide the client with corrective emotional experiences that are geared towards ameliorating the emotionally negative effects of biased socialization, and overcoming internalized homophobia.

If you are attempting to decide what type of therapy or therapist you need it would be especially important to know if your treatment is gay supportive in nature, and if the therapist is trained in issues related to homophobia. If the therapist should try to convince you that the issues in therapy with gay people are no different than therapy with straight people, question how is that so and why aren’t they different?  The response may guide you in determining if that therapist is the right one for you.