LGBT Counselling

In most cases, whatever your sexual orientation, if you are wondering if it is time to seek help, then it probably is! If you are struggling to accept your sexual orientation, or dealing with how other people react to it, or if you suffer from poor self-esteem, depression, or anxiety, or sometimes feel attracted to the idea of self-harming, then it is definitely a good idea to see a therapist, ideally someone who has some training and experience in working with clients from the LGBT community.

Conversion Therapy (CT) is an ideologically-driven, clinically disproven “treatment” that is intended to negate same-sex attraction and replace it with opposite-sex attraction, which is represented as being the only moral option. In years gone by, and to this day in certain cultural environments in which same-sex attraction is widely viewed as morally wrong, some practitioners – often from conservative religious backgrounds – suggest that conversion therapy may be a way forward and that it can actually transform unhappy same-sex attracted people into happy heterosexual people.

However, no reputable therapist will provide treatments of this sort, and in fact conversion therapy is actually banned in many jurisdictions. Research shows that CT generally has extremely negative mental health outcomes for those involved, including decreased overall sex drive, feelings of shame, fear and guilt, exacerbated low self-esteem, and raised levels of depression and anxiety. Responsible therapy for the same-sex attracted does not, and would never, attempt to persuade someone that their same-sex attraction is “wrong” and can be changed, so CT is definitely an approach to be avoided.

Accepting the need for therapy is a brave step. For everyone, but perhaps for LGBT people most of all, it is very important to find a therapist whose philosophy and beliefs are in alignment with yours. While people from the LGBT community have higher than average levels of mental ill-health (according to some estimates, up to three or four times higher), research indicates that many of those who feel that they would benefit from therapy struggle to identify therapists who are experienced in working with sexual minorities, and also do so in an affirmative manner.

A good therapist for you does not need to be same-sex attracted themselves, but does need to view same-sex attraction positively, and to be able to interact with you from a place of understanding. Unsurprisingly, the research shows that outcomes are much better for LGBT clients who feel that their therapist understands them and views them, including their sexuality, in a positive light. In researching potential therapists, you should feel comfortable asking them about their views on same-sex relationships, and whether or not they have experience of working with LGBT clients.

Responsible therapists meet LGBT clients in a positive space. In other words, the starting point of therapy is accepting that there is nothing wrong with being same-sex attracted, or with being attracted to both sexes. In this context, the goal of therapy is to help clients to accept their sexual orientation without shame, because it is not shameful, and to work towards developing a healthy, functional approach to life that will serve as the foundation for a happy, productive outlook.

Therapists often suggest using an approach such as Cognitive Behavioural Therapy (CBT). They will use this approach to work with the client to identify the triggers to negative feelings and thoughts, and to promote healthier, more useful ways of responding to those triggers. Other approaches that are often useful in these circumstances include:

• Dialectical Behavioural Therapy (DBT), which focuses on acceptance and emotional regulation, including building skills to help manage upsetting or challenging situations and emotions.
• Rational Emotive Behaviour Therapy (REBT). REBT focuses on working with clients to challenge any irrational beliefs they may hold that are contributing to emotional distress or other issues. As these irrational beliefs are replaced with more rational ones, your level of well-being will grow.
• Acceptance and Commitment Therapy (ACT). ACT, a form of CBT, is focused on mindfulness. It allows you to accept negative emotions relating to your sexuality, your relationships with others, or any other topic, rather than trying to suppress them, while at the same time it encourages you to learn how to move on from these unhelpful thoughts and feelings and to gradually replace them with more positive ones.

One of the hardest things for many people is a lack of support from their family and loved ones, or fear of coming out in case a lack of support is forthcoming. This can be especially hard for people who have grown up in conservative families, particularly families whose religious traditions remain hostile to same-sex attraction.

If you are lesbian, gay, or bisexual you may have found it difficult to tell your family and other loved ones, or perhaps you did tell them, and their response was not what you hoped for. You might be feeling disappointed, let down, or even guilty. If their response was extremely negative, you may also be cut off from your usual sources of emotional support. It can be a very difficult time.

There is no one right way to feel, think, or behave in these situations. Sometimes people are so angry and disappointed they want to cut themselves off from their families completely and do not want to contemplate a future in which bridges might be constructed. Or they might be hopeful that, with time, their loved ones will get used to the idea of their not being heterosexual and become more accepting of it. Either way, a few sessions with a suitably qualified therapist will provide you with the space you need to talk things over, discuss your priorities, and find your way towards a fulfilling future, with or without your family on board.

Things can be more complicated in the case of adults who are already married or in relationships, possibly with young children, who realise that they are same-sex attracted, or that their same-sex attraction is more important to them than they realised, and that they want to leave their previous relationship. In these situations, their former spouses or partners can be – understandably – very hurt. The role of the therapist – perhaps in parallel with work carried out with a mediator who may be able to assist with legal matters including the division of assets and custody arrangements – is to find a way for this former couple to separate as amicably as possible and, if they have children, to find a way to coparent effectively and respectfully.

While family therapy is not always possible – usually because of negative reactions to someone coming out as gay, lesbian, or bisexual – when it is an option, it can be a very useful therapeutic modality. Depending on the situation at hand, you might attend therapy with members of your family of origin, such as parents and siblings, or with your partner or former partner and children.

While it is understandably hurtful when your family and loved ones are not immediately receptive to understanding your sexual orientation, it is also okay for them to have complex feelings that might benefit from exploration in a therapeutic context. Guided by an empathy-focused therapist, family therapy can provide a safe space in which these feelings are discussed in a productive, supportive manner.

Therapy can help parents to accept their son or daughter’s sexual orientation. In the process, everyone’s mental health improves, as the levels of stress and the number of negative emotions in the family decrease. Similarly, in the case of former spouses or partners of the opposite sex, family therapy can help them to come to terms with the end or reconfiguration of a relationship that they had probably expected to be in forever.

Group therapy can be a useful approach for many people from the LGBT community who are seeking help, as not only will they engage with a therapist in a safe and supportive setting, but they will also have the opportunity to meet others who have had similar experiences to themselves. Highly destructive feelings such as shame and guilt are common among this group, and can contribute not only to stress and anxiety, but also to an array of destructive behaviours, including substance abuse and self-harm of various sorts. In a group therapeutic setting, being among other people who are having similar experiences can be therapeutic in and of itself, while working with the therapist can help the group members to learn new ways to experience their sexuality and feelings of romantic attraction, as well as how to identify the triggers for destructive thoughts, feelings, and behaviours.

Finding a suitable therapist can sometimes be a little more complicated for people from the LGBT community, but awareness and understanding of the issues they face is growing quickly among psychotherapists and psychologists, and today it is easier than ever before to find a therapist who provides or facilitates therapy from a positive, affirmational point of view. While life can still present sexual minorities with additional challenges, there is no reason people who are same-sex attracted or bisexual cannot enjoy the fulfilling, happy lives they have every right to experience. Starting therapy may be the first big step that you take towards a much brighter future, in which you find it easier to accept and love yourself as you are.

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