Gay and Lesbian clients must contend with an extra "twist" on top of what potential emotional and psychological problems the general population may encounter. Rejection and discrimination by families, friends, employers, religious groups and society in general can be a serious threat to emotional stability. Thus, many gay men and lesbians struggle with establishing a positive self-identity.
Coming Out
One of the more critical, challenging, yet exciting time periods in the life of any gay or lesbian person is referred to as the "Coming-Out." (of "the closet") period. Not conforming to the norms established in society (not being heterosexual) may be overly challenging and confusing. During this ongoing journey of self-actualization, problems such as internalized disapproval, self-loathing, depression, anxiety and substance abuse may arise. In some severe cases, suicide may be contemplated.
Internal conflict can surround the natural urge to engage in same-sex relationships, Negative reinforcement from family members and the community are frequently prevalent. Sometimes they are covert reminders, like the "don't ask, don't tell" policy. This implies that the fact that an individual is gay is "understood" (by family, employers, military, etc) however, they don't want to know anything more about it. In some cases it is more than not wanting to know about it- they better not know about it or else. This passive-aggressive philosophy (you're okay but you're really not okay), naturally elicits a passive-aggressive response. A mixed message that you are both accepted and not accepted is confusing and abusive and could be very stifling to your growth. This type of conditioning can serve to repress positive self-identity and foster depression.
Other times the disapproval is more overt and can manifest as continual verbal shaming and degradation or even physical abuse. Worse yet, a person who is gay can face complete denouncement and alienation from established social norms such as family, employment, and religious environments.
Repressed Feelings
Processing feelings is a critical part of living. Therapy addresses interruptions in the even flow of emotions. Most gay people contend that they knew they were gay at an early age, but repressed those feelings for one reason or another. You may have struggled personally to believe or accept that you might be gay and perhaps you knew or felt that your family, friends, school, etc might not accept you. So what might a young gay person do in order to survive? Many gay and lesbian youngsters repress their gay identities in order to fit in. They often feel as if they are living a lie out of environmental necessity. Anger, rage, hurt, fear, depression, despair, and self-loathing are the byproducts of repression. Repression can stunt and mollify normal healthy thoughts and feelings including yet not limited to sexual desire for intimacy with same sex partners.
Feelings can only be repressed for so long. They can remain dormant well into adulthood. People who seek out therapy for concerns about sexuality may be limited in their capacity to deal with related issues in a healthy constructive manner. Many people, at some point in their lives, are inclined to repress feelings to a greater or lesser degree. In order to effectively realize progress in life, these feelings must be brought to the surface for exploration and understanding. Many gay men and lesbians who suffer from repression have difficulty with functional intimate relationships. In addition, repression can foster alcoholism, addictions, depression, and other issues that can upset balance.
Reliance on substances, sexual compulsivity, overeating, or other forms of "acting out" can have a devastating impact upon emotional well-being. Unhealthy social and familial relationship patterns too have negative consequences. Psychotherapy is the ideal forum to explore the cause and effect of feelings and behaviors. Treatment focuses on replacing unhealthy behaviors, thoughts and choices with more functional, constructive, and satisfying ways of living.
Unconditional Self-Acceptance
It is quite an undertaking to accept yourself unconditionally, despite being judged, rejected or even hated by others. With the constant presence of various forms of negative reinforcement like discrimination, ignorance, rejection, and stereotypes, much work, time and perseverance is required to reverse internalized homophobia. Psychotherapy can help you to make small initial steps towards changing thinking patterns. The old tapes can be re-programmed, so that this negative self-talk can be eliminated. Therapy for Gays and Lesbians is basically just like therapy for anyone else; a place to explore and think about the way you relate to other people.
How does one accomplish unconditional self-acceptance? - While you can't change the limitations of others or force them to change their attitudes and prejudices, you can certainly change how you react to them.
