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Gay
and Lesbian Mental Health (Part 2) Introduction
Even though Ralph Ellison was talking about
the Black experience in Why is homophobia such an important issue in counseling? As you’ll see in the last section of this paper, everyone suffers from the effects of fear and hatred, whether they are the victim or the perpetrator. The problem is compounded when the client presenting, for example, with depression, is Gay or Lesbian. It’s easy to treat for low self-esteem, for childhood trauma, or for neglect, for example. But to overlook the debilitating effects of homophobia does a great disservice to both client and counselor. Using Ellison’s articulate words as our window to the issue of hurting (homophobia) or helping (healing) ourselves, we see that Gays and Lesbians have both contributed to and been victims of the code of silence. We learn at a very young age not to tell our "secret" not only because we hear others say that being "that way" is bad but also because we convince ourselves of "their" truth about being "that way" and then live as if the lie were true, rather than questioning it and then rejecting it as the canard that it is. This paper looks at counseling issues in Gay and Lesbian mental health, including homophobia and its effect on the counselor, the client, and the emotional well-being of the whole population, including non-Gays. For it is within oneself, that the work begins: our own internalized homophobia. Healing ourselves will have a much more profound effect on healing institutional homophobia for the very reason that our own mental health is a reflection of and is reflected in the values around us. Narcissism
It is a part of American psychological lore that a distant father and an overprotective mother are at the root of homosexuality in males (one presumes but rarely hears the opposite about females and Lesbianism, and that is a significant omission). I discussed in a prior paper that other theories counter this distant-father-overprotective-mother idea with one that states that the parents might be reacting to some inborn feature of the child and that the distance might be because of the perceived differentness and not the cause of it. This is an important concept (the irrational fear of "otherness") and is a part of the root system of any phobia. And it’s important for a client to "get" that the phobic response that caused their injury was possibly a function of, say, fear, and not necessarily a function of any perceived internal damage. In either event (nature or nurture), the counselor’s job is to help clients see normality and perhaps even the gift of their homosexuality and overcome the internalized homophobia and its damaging effects. In this process, it is vital to keep a perspective that disallows either paranoia or narcissism. It would be a fairly easy leap from homophobia to paranoia, especially with today’s news headlines; and it would be easy for narcissism to prevail if the client became convinced that his or her homosexuality was the singly most important issue in his or her personal, social, and political life.
I can attest to the false self. It was, indeed, a defense I developed when I realized I wasn’t acceptable as a "homo," as we were called back in the 1950s. I also had other reasons for developing that false self, but the result was the same: I withdrew my real-time, emotionally engaged self from every day activity and substituted a persona that could accomplish many different tasks, take risks, even enter into pseudo intimate relationships. Alas, that persona was transparent to many people but never to myself. It took many rounds with different therapists, and a battle with bone cancer to get my attention in a way I could see and act upon. I wonder if that narcissism is what helped me take the risks (and I still take big risks): that I have to value my accomplishments extremely highly to compensate for my internalized homophobia. (Of course, it’s possible that I take the risks out of a genuine sense of adventure, too.) If I presented to myself as a client, however, complaining of general unhappiness (in light of some of the exciting things I’ve done in my life), I’d have, as a counselor, to look at narcissistic injury as well as homophobia, in addition to what probably is some form of Post Traumatic Stress Disorder. I would be the person who
When I went into therapy when I was 10 (I was caught stealing), my therapist had no knowledge of homophobia, sexual abuse in boys, or PTSD. Would that he had! Had I been diagnosed more thoroughly, there would have been a rather different outcome, I hope for the better. This is why I carry on about counselors (as well as clients, not to mention the general public--Gay and straight alike) learning about homophobia and Gay culture and Lesbian culture. One cannot counsel effectively without having been in the territory, at the very least through books. There must be an understanding of the pervasive and debilitating effects of homophobia, without which, a client might begin the healing process but never understand the underlying issues of the narcissism or low self-esteem (which is not to say that homophobia is the only cause of those conditions.) Another reason this condition is difficult to diagnose is that we (Gays and Lesbians) usually tend to be fairly high functioning:
For a Gay-affirmative counselor (whether he or she is Gay or Lesbian or not), the issue in this circumstance should be fairly plain, though perhaps difficult to diagnose. The unhappiness or low self-esteem could easily be chalked up to the homosexuality itself. And the narcissism could be attributed to self-aggrandizement, unless the perspicacious counselor sees it as "a focus on the self...as the individual looks within to formulate his own view of self compared to what he senses from others" (Alexander, 1996, p. 10). What this meant for me is that I had to create another person besides my "real" self to cope with what I experienced as a hostile environment. At least part of that fear was internalized homophobia. I tried to formulate my view of myself (through others) and came up with "a sick homo." "Homos" can’t be anything but "sick," I thought, and yet I’m one of them, and yet didn’t feel sick, and I didn’t act "that way." There being no psychological support for my "condition," I created another me as a way of seeing myself the way others wished I was. As Ellison said, I told everyone what they wanted to hear to protect myself from what was surely going to be harmful to me, and nearly killed myself in the process. It was not easy to live the charade and I longed for someone, anyone, to see through it and help me extricate myself from the emotional Hell in which I lived.
Relationships & Intimacy The general rule in the U.S. around relationships is that we grow up, fall in love with a person of the opposite sex (even the toothpaste ads make that point clearly), have kids and a house and a job and live happily after (and while this isn’t always true in the world today (or even in America), many still hold the dream up as an ideal that, once again achieved, would bring happiness, contentment, and, miraculously, and end to social problems). Gays and Lesbians are also socialized for that vision while being told unequivocally that same-sex unions are not only illegal but are also sick and are not viable. While problems in any relationship are legion, they are especially difficult when two Gay men or two Lesbians get together. This is mainly because women are socialized to be cooperative, supportive, and nurturing, where men are socialized to be independent, strong, and decisive. Put two women together and there’s the potential for merging without separation or individuation; put two men together and there’s the inability to be intimate and the fear of expressing real feelings, although this is a vast oversimplification of the process. And it is up to the astute counselor to be aware of these possibilities, keeping in mind the overlay of homophobia that pervades almost any counseling. In previous papers I have discussed the dangers of merging in Lesbian relationships. In this paper, I take a different approach and look at women’s socialization as another way for a counselor to be of help in couples counseling.
While it is important to work on separation and rescuing issues, it is also important to recognize the sexism that accompanies the roots of the merging. If women were not willy-nilly cast in the role of nurturers and peacemakers and raised as equal persons in the human process, healthy merging (without loss of self) could more readily takes place in an intimate relationship. And this is how homophobia plays into the picture: were it not for the almost single-minded concentration of the Religious Political Extremists (RPEs) on the evils which homosexuals bring to society, the real focus could be discovered (recovered?), and that is the inequality of treatment of anyone who is different--in this case different from white, straight, "God-fearing" Americans who cherish the ever elusive concept of family values. But more of that later. With men, homophobia is prominent in their fear of intimacy.
The issue for a counselor, should a couple or individual present with relationship problems, is to help the couple understand the homophobia that may have been responsible for some of the intimacy problems, and also the socialization trap into which they probably have fallen. The fears around intimacy are just that--fears--and with that realization and some deep processing (or, perhaps, some cognitive-behavioral assistance, or any other workable modality), and some bibliotherapy, the work can progress. I feel, however, that it is important for a counselor to be aware of the internal as well as societal processes involved. It is not enough to assume that being Gay or Lesbian is the problem, or even that homophobia alone is. We are very much the product of the society in which we dwell, regardless of whether we’re "perfect children" or rebellious teenagers, or destructive adults. As Buddhists say, "You become what you resist."
Naturally, homophobia isn’t the only factor in a relationship where intimacy is the issue. There are myriad causes. My point is that the aware, Gay-affirmative counselor will delve into the issues of homophobia and socialization rather than remain ignorant of them, or worse, pretend they’re not an important component of the therapy. Latinos I cannot cover all cultures, but attempt here to include some information about Latinos as part of counseling awareness. There is, of course, a considerable cultural difference between African-Americans, Latino/as, Asians, American Indians, Alaska Native groups (Tlingit, Tsimshian, Haida, Athabascan, Inupiaq, Inuit, Aleuts, and so on), Russians, Deaf people--the list goes on. There are many subgroups within the larger cultural identities, and many different perceptions about homosexuality within all groups. There are, likewise, major differences a counselor would take in approaching the subject with these different groups. As an example, some American Indian Gays consider it quite all right to "cheat" outside the relationship as long as it’s with women; some American Indian tribes consider a two-spirit person to be more of a union between the male and female parts of our souls (a real and whole person) and less of a sexual identity; some African Americans consider themselves Gay only if they’re the "bottom" (person being penetrated). For a counselor to be sensitive to a Latino/a client, the best option is to be Latino/a. Barring that, and the client willing, mutual education would seem in order.
For a Gay-affirmative counselor, when working with Latino/as (in addition to considering familismo, personalismo, and simpatía (discussed in previous papers)), the double issue of homophobia and racism is important to add to the psychological mix. Again, it would be easy to diagnose depression and treat for it without delving into homophobia or racism. More than likely, the depression, if that is the diagnosis, would be strongly mitigated by internalized as well as institutional homophobia. If that factor isn’t addressed in counseling, a great gap in treatment will occur and leave the client only partly healed. One antidote for the sometime dilemma of "do I live as a Latino/a or as a Gay/Lesbian?" is socializing in a familiar milieu:
Other factors a counselor might keep in mind (and many of these issues would apply to non-Latino clients, as well) deal with generational differences. A first generation immigrant will see his or her sexuality very differently from second- or third-generation men and women reared in the U.S. (Alexander, 1996, p. 153). As has been discussed in previous papers, there is a difference in pre- and post-Stonewall Gays and Lesbians: attitudes about what being Gay or Lesbian is, as an identity, can be quite different. A Gay-affirmative counselor would want to be alert to those subtleties. And there might be more or less need in some men and women to reclaim their Latino/a identity. If the client has been Anglicized, there might even be serious transference if the counselor is Latino/a, and the client perceives it as a threat to his or her non-alignment with the culture (Alexander, 1996, p. 153). Spirituality The history of spirituality in the Gay and Lesbian communities has been, at best, spotty. Most mainstream religions reject outright openly Gay or Lesbian parishioners, and only two or three national churches welcome Gays and Lesbians with open arms. As has been mentioned in previous papers, there are several Gay and Lesbian churches that were started by Gays and Lesbians, and there are also groups that have spun off from the mainstream churches to form their own sub-group of that religion (one example is Dignity for Gay and Lesbian Catholics). In counseling, it may be as much a matter of reclaiming a spirituality that was lost during the discovery and coming out process as it might be to reinvent a new and more accommodating spirituality.
It seems worthwhile to explore spirituality with a client, even if the form isn’t necessarily recognizable as "mainstream" worship. Whether the exploration of one’s spirituality comes in the form of yoga, hiking in the wilderness, meditation, journaling, volunteering in a homeless shelter, or getting involved in a talking circle, the point is to connect with other people and through other people connect with some sort of higher power or heightened awareness. While some clients may not care to explore this area, others will find solace in a direct connection to their "higher selves." To me, the idea of spirituality is not so much a matter of giving up one’s responsibilities and thoughtfulness to the care of some omnipotent and omniscient father figure in the sky as it is to build a direct connection from one’s heart to the very source of life, which could include anything from a god or goddess, to the environment, to a talking circle, to the hearts of other people, to a sense of connectedness of all people and things in the universe. That awareness can help lift us out of an egocentric view of life and provide a perspective that can change the way we act toward ourselves and others.
The very homophobia that forces us out of most of our churches and synagogues can be mitigated and transformed into an intense spirituality. The counseling imperative, I believe, is to help a client to see themselves as children of the universe and not as freaks of nature. Violence Lesbian and Gay domestic violence is probably vastly under-reported, most likely due to anticipated homophobia and ridicule on the part of the authorities who might be notified. It is, nonetheless, a problem, and in my practice, I have seen at least one couple that regularly beat each other up.
I don’t wish to delve into a detailed account of Gay and Lesbian domestic violence and the methods of dealing with it. My intent is to talk briefly about several issues that might be addressed in counseling--homophobia, sexism, and racism among them. In the case I referred to in footnote #2, there was a considerable power imbalance. The partner with the most actual power (the part-Native man) didn’t realize he had it and assumed the other had the real power; the (White) partner who thought he held the power actually didn’t. The issue became more complex when the partner who is part-Native denigrated himself because of his racial and cultural heritage. Both partners were physically (though probably not sexually) and emotionally abused as boys and young men. The issues are more complex than I’m presenting here, but I want to talk about my experience with them. I saw the sexism in their expression of inequality in the relationship. They both believed that one had to be in control, and the White partner felt if he weren’t in control both physically and emotionally, he would literally go crazy and have to be institutionalized (a member of his family had been institutionalized and he was threatened with this fact as a child). The provenance of his view of how a man was supposed to act and maintain control was from his father, who regularly yelled and two-fisted his way through most every event in his life. He never understood sharing, cooperation, and compassion. Only physical abuse. The boy was forced to endlessly repeat jobs his father had assigned and deemed not well enough executed. The mother was docile and the father always in rage, frequently beating the boy who was not allowed to even raise a hand in self-protection while being beaten up. I would have counseled him through exercises designed to share power in a safe way so that he might learn that sharing power doesn’t have to be about relinquishing control. There would also have been massive amounts of PTSD counseling. The part-Native partner saw himself as deficient because of his Native heritage. Additionally, his self-esteem (as was his partner’s) was extremely low: he stated on many occasions that he didn’t see how I could like him, and frequently interpreted my hugs and expressions of happiness when I saw him as false and unfounded. His internalized racism was clear though his internalized homophobia was more subtle. He was not supported by his family around being Gay (nor was the White partner), and was uncomfortable in non-Gay social milieus if the subject came up. He wasn’t as closeted as his partner but still saw being Gay as a problem. The issues are extremely complex and there is much more to the psychological story than I am revealing here. I want to mention, however, that in counseling, while I would eventually have taken up many different issues, during the short time I worked with them, we worked mainly on anger management, self-esteem, and the balance of power and the roles they each thought they and the partner "ought" to portray. I saw the part-Native partner a year after they broke up and he was reeling from PTSD symptoms though I don’t think he was aware of it.
Personally, I’ve never dealt directly with the PTSD part of the abuse I suffered. It is true to this day that I have difficulty with emotional as well as sexual intimacy. I don’t presume to tie all of that to the sexual abuse, but I know it’s a part of my difficulties. In counseling, were I counseling myself, I would want to get into those aspects of the abuse and the aftermath. There is internalized homophobia left to deal with, that has had a profound effect on my development and growth and has never been discussed in any therapy I have had.
Anti-Gay violence (violence perpetrated against Lesbians and Gays by straights) is also a major concern. Generally, studies show that over half of all "socially active Gay men and Lesbians have experienced some form of physical anti-Gay violence. Men are victims more frequently than women" (Klinger, 1994, in Journal of Gay and Lesbian Psychotherapy, p. 127). The typical perpetrators are male and white and usually strangers to the victim. They are more likely to attack in groups and less likely to use weapons. In their "other lives" many are respected in their communities and schools. Among youth who are attacked, the larger percentage are attacked within the family (Klinger, 1994, in Journal of Gay and Lesbian Psychotherapy, pp. 127-128). In counseling, these issues must be seen both from the standpoint of homophobia and from individual suffering, meaning that a hate crime that is not necessarily a personal attack and is separate in some ways from how the client deals with the experience on a personal and internal basis. Among many other factors it is important to deal with issues of self-blame.
This discussion deserves more space and detailed consideration than I can provide here. It is meant as a start and an alert to counselors and therapists that the issue of violence and its strong homophobic component cannot be overlooked in treatment of Gay men and Lesbians (even though I haven’t covered Lesbian-bashing here). Most straight (or should I say most non-Gay-affirmative) counselors, I think, overlook the importance of many of these factors. Society Early in the Gay rights movement, I was told that as long as one person is oppressed in any way, we are all oppressed. Whether it is racism, sexism, homophobia, ageism, heterosexism, or religious zealotry, we all suffer. What this has to do with counseling is simply that we need to heal; and "society" is that "we" that needs to heal, both as individuals and as that collective consciousness. Healing begins with the individual, and healed individuals can make a difference in our social institutions and the healed social institutions can make a difference in national mental health, and by extension, world mental, physical, emotional, and spiritual health.
I think the implications for counseling are pretty clear. Here is an opportunity to take a person presenting, for example, with depression and anger about how the world is going to the dogs and it’s the homosexuals and liberals who are responsible, and look at the issue of homophobia in light of his or her projection. If even a small part of the problem can be relieved by alerting the client to the fact that this projection is little more than a self-examination avoidance pattern, the first step can be taken. The real issue is scapegoating, and it’s a national pastime, or so it seems: rather than taking personal responsibility, many people are willing to place blame (external focus versus internal focus). The subject becomes convoluted from the start, because blame is a complex issue and one that has to be resolved before moving on to what the client perceives as so bad that they must blame someone else for their woes, much less look into their own fears, motivations, feelings and prejudices. What is obvious to me is that homophobia draws an incredible amount of energy away from the core issues. It is easy to cast the blame and, consequently, not deal with one’s own issues, and issues of sexuality in America seem to draw vast amounts of energy far out of proportion to the issue itself. It becomes a self-perpetuating smoke-screen.
Again, from a counseling standpoint, I posit that displacement is as great a danger as blame. I would want to work with a client to help him or her see the danger of putting the responsibility for his or her unhappiness on others, especially Gays and Lesbians. In that projection is the kernel of avoidance that says I cannot bear to look into my own soul, my own hurts, or my own fears, and discover the core me because I’m afraid that there won’t be anyone there, or worse, I’ll hate what I discover. All of which is a patterned response to some hurt or trauma, perceived or real.
As an openly Gay counselor, I feel I can be of tremendous influence in helping people past the damaging effects of what I’ll call homophobic blame. Whether they come to me for counseling (I won’t hold my breath), or I go to them as a speaker or workshop facilitator doesn’t matter as much as counselors in general becoming aware of this issue. How Homophobia Hurts Everyone I’d like to conclude this paper with a brief homophobia checklist (Blumenfeld, 1992) and some of the counseling alternatives they suggest to me. The list is not exhaustive, nor are the suggestions meant to be all-encompassing. This is more of a brainstorming list than a complete exposition.
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