Last year I began my Post Graduate Diploma in working with Gender, Sexuality and Relationship Diversity. Enrolling was based on my own experience that lived experience simply isnt enough when working with people in therapy. That might not sound like a radical statement, after all I advise that those looking for a therapist check qualifications and credentials, however all too often therapists who identify as LGBTQAI have used this as the sole basis for working with LGBTQAI people.
Now it is clear that often a shared experience or identity is important to building the therapeutic relationship. BME people often have such a gap between themselves and white therapists that the burden of education is placed solely on the clients shoulders (despite this not being considered best practice). It is a difficult balance, which aspect of our identity matters the most to us, which aspect are we happy to explain? As someone who has lived overseas, and had the unusual (for a white person) experience of illiteracy and othering – refusal to be rented to because the neighbors would object to the smell of our food was an actual thing which happened to me- I can understand to an extent the desire not to have to explain, to educate, to wish to be among those who understand.
I also belong under the GRSD umbrella myself, which is where lived experience resembles trains passing in opposite directions. I know the power of recognition, the importance of being in a space which says “you are home”. But, on the opposite track I know how those with one identity can often speak over, or even actively silence those with others.
With this in mind I concluded that whilst individual experience is vital, it is only one half of the equation. Training is also just as vital. Not only because we cannot know what we do not know, but because in working on ourselves, in the deep way good therapeutic training demands, we become better therapists.
So, what have I learnt so far? Quite honestly too much to cover even in a series of blog posts, although many posts have been inspired by the course, as have innovations such as my Personal Boundaries Statement. It feels useful however to give a brief overview of the units so far, both for personal reflection, and so others can see what the course actually entails (And perhaps why friends and family have grown used to hearing “sorry this weekend I am studying”).
The course began with a week-long residential. When I am running training courses building a group ethos, even in a morning, can make a huge difference. This was not just a chance to get to know my fellow students however, but an in-depth look at ourselves, our own journeys, and how we experienced being members of the communities we live and work in. I strongly believe that a therapist must have explored themselves before working with others. In the past this exploration has often sidestepped sex and sexuality, leading to the therapists own projections of fear shame and stigma onto the client. It was also an opportunity to learn from some of the leading thinkers and practitioners in area such as GSRD therapy, clinical sexology, relationship counselling with non traditional family structures
As I explored for LGBT History Month the history of therapeutic attitudes towards GSRD folk has been rife with prejudice and pathologisation, so it was very fitting that the first unit of the course was on Mental Health, and how it intersects with, and impacts on being members of the gender, sexuality and relationship diverse communities. As well as the history of the profession exploring issues such as minority stress, the impact of homo/bi/trans/aro/ace phobia on mental health and specific known adverse experiences gave me a theoretical underpinning missing from so many qualifications.
Therapist Disclosure of Sexual Orientation (TDSO) & Living and Working in Same Communities
Two interlinked areas rarely discussed, and even more rarely taught, often to the detriment of those coming to therapy from minority groups. As I say in my Personal Boundaries Statement (something we had to write for this unit, and which I found incredibly useful to consider)
As someone who physically lives in a small village, with all the benefits, and disadvantages that brings, I am very aware that at times the gender, sexuality and relationship diverse communities can themselves feel like a village. I hope this Personal Boundaries Statement goes towards ensuring it is a safe village to be in.
Rather than a “fingers crossed” attitude of hoping we never encounter a client outside of the therapy room I was challenged to consider how I would react, in different scenarios with authenticity and the best interests of the person coming to therapy always given prime consideration.
Disclosure of sexual orientations/gender identity has always been a thorny topic within the therapeutic professions. A process of othering of non allocishet people has meant even to reveal your identity has been framed as abusive, whilst for a client to assume you are cis/het/mono/allistic is seen as perfectly fine. Research has shown over and over that GRSD benefit from therapy with those who also belong to GSRD communities. Research also shows that non GSRD clients are in no way harmed by knowing that their therapist is not straight or cis. However many students are still unable to be out in college, so this was a very powerful, thought-provoking and useful unit to study.
Intersectionality is an analysis of how identities intersect, first proposed by Krenshaw to explore how black women in America were oppressed both by gender and race. In this unit we were asked to consider how each individuals each have multiple axis of oppression. This is very important in working with GSRD clients, often assumptions are made about what aspect of their identity matters, or brings them to therapy, erasing issues such as disability, race, age, migrant status and so forth. In many ways my thinking on this can be summed up by one of my favourite Audre Lorde quotes.
Working with Sexuality and Gender Conflicts
Conversion therapy has made the news with the signing of the Memorandum of Understanding and a commitment to affirmative approaches to LGB and finally T people. However no signature on documents can make people who feel distress at their gender or sexuality feel magically OK with themselves. All too often the only people offering to work with this distress are those offering conversion therapy, so this unit was is so important, and I believe should be mandatory for all therapists. Whilst I had already written a paper on the topic learning from an expert, Pamela Gawker Wright was invaluable.
Shame and Internalised Oppression
Shame is the worm which turns inside, often poisoning our chances at contentment and wholeness. In a heterosexist and cisgenderist world people absorb from birth messages about how it is acceptable, and how it is shameful to be. This unit was one of the most reflective, making us look at our own internalized shame and how it oppresses us.
Coming out is seen as the pivotal moment of a GSRD persons life, often by non GSRD people who reduce everything to a simple before and after narrative. Many queer theorists have questioned the very idea of coming out as a one time life event, and challenged who this narrative is meant to benefit. This unit explored what coming out means to us personally, to different communities, to individuals. I am writing a paper on how inviting in is far more attractive to many, and changed the narrative from one of deception to one of power and control .
We all, of course, have a gender identity, however some are more stigmatised, and pathologied than others. Trans and/or non binary people have a history of poor treatment by therapists, and being trans is often still seen as an indication of mental illness. It is therefore vital that better training be available. In this unit we looked at the historic treatment of trans people, the at times controversial debate around diagnosis and the different interventions available to people with gender dysphoria. An understanding of how transphobia impacts on people simply trying to be their authentic selves is so important in understanding the experiences of the gender diverse communities.
Dimensions of Sexuality.
The final unit of the first year brought us back to that vital reflection on ourselves. To work with sex is to work with one of the taboos which still permeates our culture. As well as the theory around issues such as compulsive sexual behaviour, fetishes, shame and stigma we were asked to consider our own blind spots. Without this work we often can collude in a silence around sexual issues, diverting clients away from the areas we find shadowy.
As part of this unit we were asked to consider how different sex acts are stigmatised. I believe there is a gendered element to this (as well as the impact of race, age, disability and other factors) I am currently writing a paper based on the diagram below.
So, my first year of the Post Grad Diploma is drawing to a close. I have learnt more about myself as a human being than I ever anticipated. I have learned so much from my fellow students, and benefited from a learning enviroment where it was possible to be completely open about myself (something many students are unable to be) and know I have become a better therapist. Roll on year 2!