Thursday, April 4, 2019

"I'm gay and stressed. Will therapy work for me?"

rainbow heart

When it comes to stigma, having mental health issues and being LGBTQ are at the top of the list in South East Asia and the Middle East. 

While I'm seeing more and more young people practicing affirmation, many people still live in fear. False beliefs are a problem too. Plus, the majority of people here have never gone to a therapy session and don't know anyone who has. 

Because of this, there can be a lot of misunderstanding and confusion of who can go to therapy and how it works.

So one of the questions I'm asked fairly often is, "I'm gay. Will therapy work for me?"

I thought it would be useful to have a chat today about the philosophy and practice of therapy with some context for the LGBTQ community.

First, being LGBTQ is not a mental health problem. It doesn't need to be fixed. You are perfect as you are!

Second, like everyone on the planet, LGBTQ people suffer from anxiety, depression, stress, relationship issues and mental health problems just like everyone else.

So, what can you expect going into a therapy session with me?

There are more than 50 therapy approaches. You've probably heard of psychoanalysis that was made famous by Sigmund Freud, and person-centered therapy pioneered by Carl Rogers as these tend to be shown most often in films and TV.

While therapy approaches are all different from each other, they have this in common: they define how personality works, what exactly causes mental health issues, and how we should go about fixing these issues. They also suggest how therapists and clients should work together.

Once you tell me what you want to work on, my duty is to explain what therapy approaches will work best.

Although I use lots of different approaches, one of the most popular for dealing with false beliefs and other patterns that come with depression, stress and anxiety (my area) is cognitive behavioural therapy - called CBT for short.

Basically, it works like this.

How CBT practitioners see Human Personality
As we go through life, we experience and react to events. The events themselves don't determine our emotions and behaviour, they're just events. It's our beliefs, how we think about those events, that decide how we feel and react.

Example: suppose you see a wasp in the garden. That's an event. How do you react? If you believe all wasps sting, then you will feel frightened (emotion) and will run away (behaviour).  

Now, suppose you decide you want to stop being afraid and running off. You hire a CBT practitioner and you learn in therapy that wasps hunt pests that kill bees and ruin crops. This will change your beliefs from 'stinger' to 'helpful creature'. Plus, you do some exercises.

Then, next time you see a wasp in the garden, you will say, "Hello nature's helper! Aren't you pretty in your yellow and black jacket?" and you will feel happy and not run away.

I love CBT because this theory is very empowering! CBT practitioners believe that we can learn to manage and even change our beliefs, emotions and behaviour.  

Where do mental health issues come from? The CBT view
Faulty or unhelpful thinking is the root of emotional and behavioural problems. 

How do you go about addressing mental health issues? The CBT view
We deconstruct what's going on, figuring out what your current beliefs and behaviour are.
Then we decide on your goals, how you'd like to think and behave ideally.
Then, we either work on replacing your current beliefs with more positive thinking or we work on learning new behaviour. Sometimes, we'll do both.

How should practitioners and clients work together? The CBT view
It's very much a cooperative venture where the therapist and client work together to figure out exactly what's going on.

Then, it is the therapist's job to tell the client what studies and research apply. The therapist develops a personalised system that will help the client make effective change.

The client is then responsible for practicing and creating change. Yes, clients get homework!

Can we use CBT for everything?
CBT is great for certain things like overcoming recurring difficult thoughts as well as fears and phobias. But it's not good for everything. For example, I would not use it to understand or cope with abuse.

So, is there CBT for LGBTQ clients?
Nope. It's the same approach for working with men or women, different races, sexualities etc etc.  As far as I know, all therapy approaches are universal. We work with people, and as people are all different from each other, therapy approaches are big picture.

Do we talk about sexuality? Well, sometimes. If you think your sexuality is impacting on the issue you want to address in therapy, then we definitely talk about it.  Otherwise, it may come up as we talk about your relationships. 

I understand that this is a scary prospect if you live in a country where you are persecuted. 

Please know I promote the affirmation of LGBTQ rights. Also, whatever you say to me is secret. I don't tell anyone you're talking to me. You can read up on that here.

So, if you need some help, do reach out.

Image by Benedikt Geyer