Christian Counseling and the LGBTQ Community

I recently attended a workshop sponsored by the Human Empathy Project, in which the specific topic was on the therapeutic complexities regarding faith issues and the LGBTQ community.  Within this multidimensional discussion several different perspectives were considered.

Much of the focus of that discussion was about how a Christian therapist with traditional values and teachings comes to terms with working with an LGBTQ client. A significant challenge for many therapists of faith is to recognize the spiritual or theological value in affirming persons of alternative sexual orientations, due to Biblical passages that are perceived by some to condemn such behaviors. Passages from scripture such as, “Love one another as I have loved you,” and “Judge not, as you are not judged,” are offered as suggested guidance toward greater grace in this regard.

It was pointed out that until recently, best practices indicated that therapists who felt uncomfortable or ill-equipped not work with clients who presented outside of the scope of the therapists’ expertise. However, while it may apply to working with specific mental health issues like eating disorders or gambling addiction, there have been several significant changes in the code of ethics across governing boards in this profession. The emerging best practice is to become more culturally proficient, thereby less biased toward any specific culture or sub-group be it about gender identity, race, disability or religious values and so on, in order to provide fair and just mental health services to everyone.

The complicated history of the relationship between the disciplines of psychology and religion on the issue of homosexuality in particular has led to pathologizing and demonizing of this portion of humanity over decades, if not centuries. This has resulted in harmful practices in our field, such as “conversion therapy,” based on incorrect information. It is imperative to understand that this is not a psychological disorder, but is biologically based, making gender identification not a choice that can or should be reversed, but something to be gracefully accepted and affirmed.

This position of being life affirming to all people, regardless of individual differences, is very much in keeping with Respect-Focused Therapy.  From within this framework, therapists are able to move forward the deeper conceptualization of respect as a function of keen understanding and a healing force. It is a process of due diligence to stay open and curious to new possibilities and greater understanding of the larger human experience.

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

 

We’re All a Little Crazy

The other day I came across a blog post about a national mental health awareness movement called “We’re All a Little Crazy.” Numerous celebrities in sports and the performing arts lead this movement. Many stories are shared about personal experiences with mental illness, from bipolar disorder to PTSD through #SameHere and a sign language gesture which points one’s thumb towards oneself and the pinky toward another.

The concept behind this movement is to disarm the stigma of mental illness as being something foreign, weird, or outside of a “normal” existence. In fact, many, if not most of us, have at one time or another experienced some level of depression, anxiety, trauma, or loss that would put us, at least temporarily, somewhere on the continuum between mental health and mental illness. The emotional distress within that continuum obviously varies in intensity and manifestation, but to be not mentally well at some point within one’s lifetime is arguably a part of the human condition.

As mental health professionals, it should be especially incumbent upon us to be acutely aware of the additional burdens and pain caused by the stigmas placed on people with mental illness, particularly those that invite bullying or estrangement. Most importantly, we need to be in continuous check on ourselves as we may also fall into the elusive cracks of stigmatization (even if unintentional) of a person diagnosed as borderline, Schizoid-affective, or with Bipolar disorder who come with great vulnerability into our space for assistance and healing. By honoring their stories of struggles and accomplishments as significant and as ordinary as our own, we are welcoming them down a path to healing and recovery. After all, we’re all “a little crazy!”

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

When Is Love Healthy? Attachment, Vulnerability, and Respect on GoodTherapy.org

I am excited to announce I have become a topic expert for GoodTherapy.com.

My first article, “When Is Love Healthy? Attachment, Vulnerability, and Respect”, discusses a topic that has long been a source of marvel and mystery for human beings. What is the meaning of love? And what, exactly, does healthy love look like?

Read the full article.

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

 

Helping Clients Cope with Love Expectations

Therapists consider the winter holidays as being the roughest time for our clients. This includes Valentine’s Day. The heavy commercial marketing creates expectations, that if not met, can cause self-doubt and even deeper depression for those already troubled by these issues. There is a real possibility that these feelings could manifest for some clients, and therapists should be prepared with strategies to discuss difficult questions about love and companionship that clients might ask, either out loud or to themselves.

• How do I/we define love and how does that compare to personal experience?

This question might not be phrased in this way, but it’s often lurking in the back of clients’ minds. To help the client[s] organize their thoughts and fears around this question, gives them the opportunity to consider the dissonance they experience around this issue and define for themselves what real love looks and feels like to them. For so many with attachment issues and trauma, this kind of discussion is imperative to repair damaged thoughts and beliefs about love.

• How do I/we practice a loving relationship?

What are your clients doing in their love lives, or pursuit of them, that is serving them well or isn’t? This is topic a little tricky because it is not meant to create more angst for them, but to help them to have a clearer understanding about what they’re bringing to the table in loving relationships. As they begin looking more deeply at this, it’s wise to encourage them to acknowledge all the positive traits they offer as well as those they want to approve upon.

• How and where am I/we aware of being loved?

This is such an important question to highlight with clients. So many times, the focus in therapy is on the lack of love in their lives, often for good reason, but the reminder that somewhere in their lives there likely is at least one other individual who has shown them love. Whether it’s a grandparent, teacher, a child, or even a pet, someone has love for them.

• How do I/we show love to ourselves?

This is the most critical question in terms of personal growth and resilience. Therapists need to frame this as being fluid, but something to be built upon—foundational to emotional strength and endurance. Exploring ways to express genuine self-love will provide discussion about the differences between vulnerability and shame.

• How do we navigate in the love world without getting deeply hurt?

Again, this is all about gaining self-appreciation and respect that allows the client to set appropriate boundaries protecting him/herself from legitimate harm. Yet they should also able to more freely give love to others without unrealistic expectations that set up an emotional let-down.

All of these questions have the potential of leading clients toward genuine healing and growth. They also have the potential for deepening wounds and despair if they are handled without intentional care and respect. Therapists should remain diligent in keeping respect (the core component of real love) present and available for our clients to hold on to and grow into.

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Tapping into Therapeutic Creativity

Many times, we as therapists can feel “stuck” in the process of doing therapy, either with a particular client or more generally with a certain population. It may be an adolescent not wanting to be in therapy, a very depressed older individual or a couple so entrenched in a non-stop pattern of arguing you feel a need for a megaphone just to interject some redirection.

In most, if not all, of these cases we need some moments of calm and self-clarity to be sure, but it might also be helpful to “think outside of the box” as well. Try introducing creative interventions such as art (music, visual arts, poetry or prose).

We could certainly draw from our own experiences by offering stories, metaphors or pieces of music, but I have found it to be much more profound when tapping into the creativity of the clients themselves. Their own storytelling, poetry, artwork, music, etc. can be much more compelling, meaningful and healing if they are left untouched in a respectful manner. That is, we don’t interpret or judge in any way, but instead encourage growth by allowing clients’ creative outlets to portray whatever meaning and purpose they are attempting to express.

A word of caution: those of us who are not specifically trained or certified in expressive art therapies should use these modalities carefully and only adjunctively to the work we are trained in. However, creativity in all its wonderful forms, used with care, can be transformative in moving the therapeutic process forward.

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

Preparing for Difficult Clients

Working with clients productively isn’t always an easy road. Clinicians frequently run into clients who are challenging, frustrating, maddening or otherwise pushing our emotional buttons in some fashion.

For example, there are clients who have their own anger issues and come in ready to pick a fight. They simply want to argue with us, and question our knowledge or expertise. There are clients who are passive-aggressive, are in denial of their addictions or simply don’t engage in therapy the way we would like in order to make the progress we wish for them. Then there are clients we just don’t like for some reason; they don’t share our values and don’t respect our time or our boundaries.

Often, the rule of wisdom is to refer such clients out so that they can find a better fit and get better care. But before you do that, I have a few suggestions for preparing yourself for your next session.

To begin with, check yourself. How are you feeling? Tired? Anxious? Hungry? Already dreading this appointment or preoccupied with something you’d rather be doing? What buttons are being pushed inside of you by this client? Spend some time slowing down and acknowledging your feelings. Breathe and try divesting yourself from feeling graded (even pass-fail) on the outcome of this session. This is your client’s session, not yours.

Then spend some time thinking about where your client is emotionally and cognitively. As I frequently say to interns, try going behind the curtain of the stage your client occupies to see the stagehands at work. What’s going on behind the behavior or attitudes you’re seeing and experiencing? Behind the anger is there fear or doubt? Behind the bluster is there insecurity or sadness? Is there a traumatized child puppeteer behind the puppet you see?

As you go into your session, attempt to drop all negative pre-conceptions, judgments and expectations into the trash can. Work with the person in front of you who is scared, sad, lonely or vulnerable from a place of authentic respect.

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.

The Blame and Shame Game

When working with couples, I often run into a repeating pattern of behavior I call

“The blame and shame game.” It goes something like this:

They came in initially because they were arguing too much—at least every other day, they reported—about money, sex and children. Maryanne was concerned that hundreds of dollars had gone missing over the past six months and John pled innocence, claiming that she was “trying to pin everything on him.” He, in turn, accused Maryanne of having a secret affair with her ex-husband, which she also denied. Accusations continued to be thrown. They both began yelling and pointing fingers at one another. They were blaming one another for various unrelated incidents from the past and upping the level of each other’s transgressions in rapid succession, overlapping their voices such that the volume increased so significantly no one voice could be heard.

This pattern seems to be prevalent among couples that have not had good parental modeling for problem-solving or conflict resolution. It is within this framework that winning supersedes resolution. The result is predictably that they both hop on this treadmill that takes them nowhere, except deeper and deeper pain.

The interventions to this cycle are multidimensional in nature. That is, they overlap; they work together. In Respect-Focused Therapy, the specific needs of each individual or couple supersedes any formulated model or technique. This approach rather suggests that all known evidenced-based and reliable techniques, etc. to a therapist be utilized as best serves the needs of each client’s situation.

For example, in the case sited above, I was deeply aware that I need to gently interrupt the pattern of “blame and shame,” but I also knew that such a pattern was deeply entrenched in their style of communication over the long span of their relationship as well as the pattern each had grown up experiencing with their respective parents. This could and would not be an easy fix; to assume so would be to disregard these two people who sat in front of me. For me to assist them in effectively, I had to first acknowledge and positively regard/respect their perspectives on how and why they communicated in the fashion they did.

By asking more questions about how each had grown up, I found out that competing and never losing face in the process was a highly held value in both homes. This being particularly true in John’s home, unfortunately also meant “win no mater what the cost.” This included attacking his wife with a charge of adultery, which later it was found out he didn’t believe, in order to cover his gambling addiction.

In order to get a foothold into any meaningful resolution, I had to openly state my awareness of how much raw pain they each endured every day and how much energy and stamina that must require.

Once it was established that I truly understood how exhausting and frustrating it was for both always needing to win and yet no one ever winning, then I was able to begin offering some tools such as active listening and non-violent communication to slowly break up the long-standing pattern. Eventually, with months of trust-building, we were able to reconsider and reevaluate the value of winning an argument vs. the value of resolving conflict.

 

Respect-Focused Therapy (RFT) is a foundation on which all modalities and techniques used in therapy can be strongly grounded, in order to produce sound, effective outcomes. This approach offers clients the opportunity to gain experiential understanding of being respected, possibly for the first time, from the therapeutic relationship and then be able to heal old wounds by creating more respect for self and others in the therapeutic process.