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Queer Ear for the Straight Clinician is a new feature I am including in my newsletter as I recieve an increasing number of clinicians subscribing to my newsletter. Alienation or Affirmation? 10 common mistakes straight clinicians make when working
with gays and lesbians
By Joe Kort, LMSW 1. Not disclosing your sexual orientation when asked Often gays and lesbians call a therapist for an initial appointment asking your sexual and romantic orientation. Many therapists believe that is a therapeutic question best left to the consulting room and do not answer. You will most likely lose the referral if you are not open about your own orientation. While this may be a therapeutic issue, clients who make initial calls still want to know who they are entering treatment with. 2. Denying your own homophobia and heterosexism We are all imprinted from childhood to be heterosexist and homophobic. To deny this is a form of covert homophobia. Checking your countertransference is imperative when working with gays and lesbians. Without doing so you will inadvertently collude with their internalized homophobia (IH). For example a gay client might say, “I don’t know why they all have to act that way” and you might say, “Yes I don’t know why either” rather than assessing the IH within your client. 3. Lacking local resources for gays and lesbians Every therapist working with gays and lesbians should have easy access to local resources for your clients. One of the most important tasks for these clients is homosocialization. Contact your local gay community center or get online to see what is in your area in terms of newsletters and local gay newspapers. 4. Using the wrong terminology Appropriate terminology to use with gay clients no longer includes sexual preference or alternative lifestyle. Preference implies that it is a choice--which it is not--and heterosexuality is the alternative lifestyle for gays and lesbians. The correct word is sexual and romantic orientation. Homosexual is as offensive as would be the words negro and colored would be to an African-American today or crippled once was used to described physically challenged individuals and would be offensive if used today. The correct word is gay and lesbian.
5. Lacking information about the stages of coming out
Knowing the stages of gay and lesbian identity development is essential for clinicians. Without this information therapists can misunderstand certain thoughts behaviors by a client. For example, stage five (identity pride) resembles an adolescent stage of development—so it is expected that short-term relationships with some sexual promiscuity would occur and be developmentally appropriate. In stages one and two clients prefer to be identified as homosexual and not gay or lesbian. The Cass Model of coming out is the most widely used in Gay Affirmative Therapy. 6. Misunderstanding Mixed Orientation Marriages (MOM) Countertransference is very high when it comes to working with
couples with one straight partner and the other gay. Therapists often rush in to support divorce and move on with their lives or stay together—particularly if children are involved. The reality is these couples need to decide what is right for them—not the therapist. Knowing the stages of coming out as a MOM couple is important. The stages are 1) Humiliation; 2) Honeymoon; 3) Rage; and 4) Resolution. 7. Being a blank screen Therapists who favor a more psychoanalytic approach by being a blank screen to their clients and using little to no self-disclosure can do more damage and wounding to these clients than good. Lesbian and gay clients walk in with existing wounds of feeling and/or being shut out by others in their lives because of their sexual orientation. They need relational models in therapy. Appropriate self-disclosure by the therapist is essential and therapeutic in assisting these clients. 8. Neglecting to recognize that gay adults were once gay
children I have a quote; “Would the small child you once were look up to the adult you have become?” Your lesbian and gay clients were once gay and lesbian children. This makes most people—including clinicians—uncomfortable as people do not like to think of children as being sexual. However, being gay does not equate to being only sexual. Heterosexual adults were once heterosexual children. While most gay and lesbian children did not self identify as gay or lesbian they will tell you they knew they were different. How they knew and what made them different is important in helping them with in the consulting room. 9. Leaving your waiting room void of gay and lesbian
literature and paperwork Waiting rooms say a lot to clients about you as a therapist and your work. Lacking lesbian and gay literature, magazines and newspapers communicates a heterosexist stance to your clients. Does your intake form as about sexual and romantic identity? Does it include partner and significant other in addition to married and spouse? If you worry that some straight clients might have a negative reaction to this check your own heterosexist attitudes and homophobia. 10. Believing that a “couple is a couple” So often I hear well-intended therapists say, “A couples is a couple” in an effort to show they are non-judgmental toward gay and lesbian couples. However, gay and lesbian couples are very different than straight couples. While there are similarities, there are very different dynamics that two men or two women bring to a relationship than a man and woman do. The “Doubling” factor refers to intensified traditional gender role conditioning of both partners. Male couples are often disengaged having magnified issues around restricted emotional expression, achievement, competitiveness and sexual expression. Female couples typically are too engaged and struggle with enmeshment, lacking differentiation, and lack of sexual expression. _____________________________________________________________________ Gay Affirmative Therapy for the Straight Clinician:
The Essential Guide In press from WW Norton Books by Joe in 2007* A book for helping straight clinicians work with Gays and Lesbians
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ As a psychotherapist, if you have gay and lesbian clients, It’s not enough to be gay-friendly. The fact is, even the best intentioned therapists have some level of homophobia to overcome. From birth, heterosexist culture imprints us to think that heterosexuality is primary,and that any other orientation is inferior. It’s not even enough to be gay yourself. Gay or straight, we’re taught the homonegative belief that the "alternate lifestyle" of being gay is a more difficult way to live. But the "alternative" of living heterosexually is actually harder for gay men and lesbians, and can lead only to depression and self-defeating, or even self-destructive behaviors. Learn the issues that gay men and lesbians face. They may surprise you! COMING From WW Norton Books by Joe Kort: "Gay Affirmative Therapy for the Straight Clinician: The Essential Guide" by Joe Kort, MSW, LMSW This book will offer skills and information to straight therapist working with gay, bisexual and lesbian clients. It is not enough to be gay friendly. It is crucial that therapists be armed with the facts and information to do effective work with their gay, lesbian and bisexual clients. It is based on my work with Gay and Lesbian clients, my own personal journey as a gay male and psychotherapist of 21 years, along with the information I teach at Wayne State University's School of Social Work on Lesbian and Gay Studies. Look for Joe's books "Gay Affirmative Therapy for the Straight Clinician: The Essential Guide to come from WW Norton Publishers Joe's library .
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