by Kay Ferriter, Thérèse Hicks, and David Wyse
Recent research on counsellors, psychotherapists, and counselling psychologists (hereafter referred to as therapists) in Ireland indicates that up to one third of male therapists, and a quarter of female therapists exhibit homophobic attitudes (B. O’Connell. Pink Prejudice: An Exploratory Study of Correlates and Aspects of Homophobia Amongst Counsellors, Psychotherapists, and Counselling Pscychologists). As these results are from a self-reporting survey, it is quite possible that the situation is even more problematic. Further, it could be said that, assuming that homophobia is considered unacceptable in the profession, those reporting homophobic attitudes may not even be aware that their position is homophobic. Each of the authors, in our clinical work, has more than once met with clients who reported a negative experience in a previous therapy due to the therapist’s homophobia.
The specific roots of this problem lie in the severely homophobic position of the Christian denominations, particularly the Roman Catholic Church, and more generally in its highly dysfunctional approach to sex and sexuality in general. Given this context, it might be expected that training programmes would specifically address issues connected with sex and sexuality. However, this is almost universally not the case in Ireland.
The theoretical and diagnostic history of psychotherapy has not always been free from homophobic bias either. Reflecting the fears of the ‘feminine’ and sexuality which are rife in a patriarchal society, Freud certainly rejected homosexuality as normal and healthy; Jung was not specifically condemning of it, but seems to have been uncomfortable with the possibility. Up until the 1980s, both the DSM and ICD classified homosexuality as pathology and there are numerous horror stories of aversion therapy having been applied to gay men and lesbians to ‘cure’ them. Perhaps the simplest historical parallel relevant to homophobia is the belief about people who were left handed in the Middle Ages. They were said to be agents of the devil, and were often ostracized and even killed for being born this way. (In Latin, the word for ‘left’ is sinister, and even today it is still a negative term.) Homosexuality is not caused by anything, not by dysfunctional families nor sexual abuse. It is simply the way someone is born.
Thus, therapists have responded in significant numbers and with great enthusiasm to the Gay Men’s Health Project’s training entitled ‘Everything You Wanted to Know About Working With Gays, Lesbians, Bisexuals, and Transgendered, But Were Afraid to Ask’. There have been three offerings of this two-day training since November 2004, with over 50 participants completing the course. Ronan Waters and David Carroll (GMHP Outreach Workers) lead a homophobia workshop for the first half of the first day. This allows participants to explore the language of homophobia and heterosexism, and to look at the impact that this has on those who are not ‘straight’. (For the purposes of this article, the definition of homophobia is the fear and hatred of those who love and sexually desire those of the same sex. Heterosexism is the system of advantage bestowed on heterosexuals. It is the institutional response to homophobia that assumes that all people are or should be heterosexual and therefore excludes the needs, concerns and life experiences of lesbians and gays and bisexuals.) Giving permission for this language to be explored helps to take away its power. By exposing it to open scrutiny, its destructive nature can be candidly confronted. This also allows therapists to more empathically enter into the experience of an LGBT person and begin to look at what this does to their self esteem and sense of safety in the world.
Later in the morning we explore how and when each participant became aware of homosexuality, and what messages were embedded in the communication of this variation of being human. Homophobia so thoroughly saturates Western culture that it has been infrequent that someone in the training has responded with positive memories of their first learning about homosexuality. This, even more tragically, makes internalised homophobia almost inescapable. Internalised homophobia is the self-loathing and shame, which cripples LGBT people and leads to such difficult predicaments as married gay men, or lesbian women and gay men taking refuge in addiction, abusive relationships, and suicide.
In the afternoon, several presentations are on the agenda, one of them being a clinical examination of the phenomenon of married gay men. Quite a few men come forward currently for therapy, trying to come to grips with no longer being able to sustain a heterosexual marriage relationship. They slowly address the agony of having to deconstruct the world of spouse and children, grieving many years of having been untrue to themselves and to partners and families. Hopefully, as homophobia becomes less intense and acceptable, and as there is more support for men to be gay, the stream of broken lives will slowly abate.
An important new support for young gay people is BELONG TO, funded by the Dept. of Education under the City of Dublin Youth Services, and facilitated by Michael Barron and Almha Roche. It is a social support group for 14 to 23 year olds who are exploring their sexuality, or fairly sure that they are B L G TT (thus Belong To). Michael does a presentation, outlining their excellent work and projects. Also in the afternoon, Brendan O’Connell, a counselling psychologist, and former GMHP Outreach Worker, presents his research on homophobia amongst therapists. This is often an unsettling presentation for participants, unaware of the high prevalence of homophobia in the profession.
After a break of some weeks for participants to absorb and the first day’s input, a second day is held. The focus of that morning is to talk about working with lesbians while continuing to give the participants the opportunity to talk about sex and sexuality. Through an exercise in coming out, the participants are asked to talk about their own sexuality, specifically, any memories of their own emerging sexual identities. Because so many Irish training courses appear to do very little on sexuality as a social construction this is often a first for heterosexual participants. It has proved a very powerful experience, especially when it is juxtaposed with the fact that, for many gays and lesbians, it is a process they are continually negotiating. The feedback from the exercise consistently reflects two things: firstly, the all pervasiveness of heterosexism, and secondly, the usefulness of having a space to reflect on it. The second part of the morning is given over to presentation of a case. So far it has been on lesbians in, and coming out of, marriages, and lesbian parenting.
In the afternoon, we facilitate a process exploration on “talking sex and sexuality.” This module is designed to lift flagging energies in the afternoon through an experiential exercise based on “Speed Dating”. It also invites participants to focus on their skills, resistances and potential to concretely resource therapeutic relationships.
Few therapists report adequate training to resource explicit conversations on sex, intimate specifics of sexual acts, or exploration of sexual identity in the “here and now” conversations of the therapy room. For this reason, the group is facilitated to explore in a playful way, an immediate sense of ‘self’, both as client and therapist, through speed interviews with a succession of therapists and clients.
There is method to this madness! Whereas we break every rule in the book in terms of conditions appropriate to effective therapy, the exercise creates an experiential window on both client and therapist vulnerabilities when talking sex and sexuality. It underlines the value of skilfully ‘calling out’ and explicitly naming human sexual experience, which is often embodied as obstacle to both therapeutic alliance and self-healing. There is a discharge of high energy and laughter during this exercise. But at deeper levels there are insights and self-awareness that help participants to personally unfold their availability to process questions of sex, sexuality and identity.
On completion of the exercise we then make time in group to reflect and listen to the learning. We invite permissions to name and explore the limitations we bring to such intimate conversations allowing each other to attend to feelings of inadequacy. In this way there is also the discovery of the potential we each have to confidently encounter clients in these intimate experiences of self. In groups to date this reflection time has afforded permission for many participants to acknowledge ‘out loud’ their personal learning and insights regarding their own experience of sexual intimacy. An awareness of the unfolding nature of sexual identity is a place from which to become more available for attending to client experiences in the therapeutic alliance.
Rendering the experiential content of human sex and sexuality available to the counselling therapy relationship, both client and therapist take risks in their relationship by being real through naming experiences. Many of us find we are conditioned to block these conversations, both consciously and unconsciously, by our gestures and body language, and by what we say or omit to say in reflecting back with clients. We hope that this part of the day invites an ‘openness’ to appropriately making explicit what is held implicit in the therapeutic relationship. Thereby both client and therapist respectively embody their sexual identity and erotic potency as resources to a healing and integrating process.
The day finishes off with a presentation on spirituality. As noted above, patriarchal religion has been the driving force in articulating and enforcing homophobia. Spirituality is the way people make sense of living and dying, of grounding a cosmology, and of generally relating to the world around them. This presentation outlines how the traditional attitudes towards sex and sexuality evolved in the West and its total rejection of homosexuality. If one’s spirituality negates and shames one’s being, this has a profound effect on a person’s self-esteem and mental health. So it is important for therapists to become aware of this and to look at the need for revised or alternative approaches, which do not inherently vilify anyone.
The much valued feedback, on the sheets which participants kindly fill out at the finish of the training, highlights a number of aspects of the training. Perhaps most importantly is that therapists find a safe place to talk about a topic which they often feel very uninformed about, but which they need to discuss in detail. This helps them feel more confident about their ability to work with LGBT clients, both through being better informed as well as being more aware of their own biases and discomforts. ‘Gay’ is not a pathology and working with gay clients requires the same basic skills as working with anyone else. It is being aware of one’s own comfort (or lack of it) around sexuality that is perhaps the most crucial piece. We should note that a valid criticism of the training has emerged in that our emphasis to date on gay and lesbian client work more than trans-gendered clients leaves the workshop less than satisfactory for some. We are exploring how we might enhance the training to meet this need.
Also very important is participants’ discovery of Outhouse, the LGBT community centre on Capel St. It is a wonderful resource, and the home of the Gay Men’s Health Project’s Outreach and Counselling offices. People can drop into the café in the afternoon or evening, and pick up all kinds of literature relevant to the community, learn about specific meetings, or just make informal contacts. Participants in the training have also requested a follow-up to it, and the first such day is scheduled for September. Of importance to the GMHP Counselling service is the referral list which this training also generates. The counsellor for the Project has a waiting list of over a year. There is also a need therapists outside of Dublin, as we get inquiries from all over the country.
Kay Ferriter is a psychotherapist in private practice, and a co-founder of the Dublin Gestalt Centre.
Thérèse Hicks is a psychotherapist and the full time counsellor for the Gay Men’s Health Project.
David Wyse is a psychotherapist and a Senior Counsellor for the Drugs/AIDS Service and Gay Men’s Health Project of the HSE.