I had [a therapist] that said being gay was “no big deal” to her. She was trying to comfort me that she wouldn’t be judgmental but when you’ve dealt with homophobia you also want it to be a big deal to your therapist. I was trying to talk about how it wrecked my life and I felt it was dismissive.

Once a respected person centred counsellor and teacher said to me that we didn’t need rainbow flags at our training organisation, “because that is just paying lip service, this can be better addressed by treating everybody equally and listening to everybody’s story as an individual and with unconditional positive regard (UPR).”  I had googled the course I was teaching on and organization I was teaching for and there were no indications of it being LGBT friendly. I was looking at it through the eyes of someone considering training with us as a therapist and imagining them considering, ‘will I be safe here?’ ‘will I be putting myself through unnecessary stress?’. These are important questions for all trainees and I thought that we could show that this was a safe place to train if you are a member of the LGBT community. The response I got seemed to be that going through the rainbow flags and Stonewall logo process was a bit excessive and unnecessary. That people would know when they met us that we were safe.

To be honest, my heart sank and I didn’t bother arguing. I had been shut down with the weight of the person centred creed. I knew however that this would put me, and many people, off and limit the diversity of the therapists being trained and perpetuate an exclusive cycle of recruitment and continued inaccessibility to therapy for a large section of the population. This article is my, better late than never, response.

We should listen, not take a straight person’s privileged perspective

I was unable to verbalise this to my  (straight) colleague, at the time. There are many deeper reasons for feeling silenced, but it is no small reason that the creed and ideology of person centred therapy is often seen as complete, effective and unquestionable.

UPR = therapy abbreviation for Unconditional Positive Regard, is a central tenet of Person Centered Therapy yet, I think some therapists use it as a lazy ‘covers all’ approach to intersectionality.

We have to question the training group’s replication of privilege in society

My initial therapy training was a three year counselling diploma in person centred therapy (with bereavement and loss as a specialist focus). I also undertook a four year training in gestalt therapy in the 80’s and 90’s. (postgraduate diploma); a Masters degree in humanistic psychotherapy, a two-year clinical supervision course and later a two-year certificate in psychosynthesis. In addition to this over the last 30 years I have been on additional CPD trainings and workshops in various therapeutic forms, much of it in body psychotherapy, but until I actively sought it out, none of my core training, which led to multiple accreditations, covered racism, sexism, or homophobia. As a trauma specialist, of course, much of my work was as the result of oppression, but it seems that some consider UPR to magically remove the oppression.

As a trauma specialist … much of my work was as the result of oppression

Offering unconditional positive regard (UPR) to clients is a central to person centred therapy, one of the three core conditions which if present in the relationship, create an environment for psychological change. By offering positive regard to all clients regardless of who they are, the therapist hopes to remove harmful “conditions of worth“ (ie all the ‘shoulds’ and ‘oughts’ that we are raised with that tell us how to be and that we are defective if we are other than these rules), and to allow the client simply to be their authentic self. Such simple theory is indeed, in my experience, undoubtedly powerful in its capacity to free the individual to become more at peace with themselves.

These groups … are predominantly white, heterosexual, middle-class people

I’ve seen many, many times, in my training groups and my client groups, profound healing from offering the core conditions. Just one thing though, these groups of people are predominantly white, heterosexual, middle-class people, while they will all have suffered threats to their authentic self and learned to adapt to others’ expectations, I have to consider, what is preventing others from training in therapy and accessing therapy? Is being accepting, enough? Surely we have to question the training group’s replication of privilege in society?
Unconditional positive regard does not go far enough, because equal is not the same. Because no matter how compassionate and unbiased the therapist is, both the client and the therapist come from a prejudiced world and an unequal society. The ideal of the therapy room being a space where society’s conditions of worth are left behind, is simply that, it is an ideal. Soceity comes into the training room and into the therapy room, the prejudice and assumptions are never fully left outside the door, because we would have to leave ourselves outside the door. Therapist and client are saturated with assumption and prejudice. Of course we are trained to leave that outside but it’s not possible to be conscious of all our bias. If we are fully compassionate and empathetic, therapists have to listen more closely to the experiences of oppressed minority groups that they do not understand.

Prejudice and assumptions are never fully left outside the door

I love person centred therapy, I see it as radical and as turning society on its head. But it is not enough to revere and follow the philosophy written by an old, dead, white man in the 1950s/1960s. Natalie Rogers wrote in Emerging Woman about her experience as a woman, and the impact of sexist societal assumptions on her. She can show the limits of Rogerian theory due to the privilege of her father, and so can we.  As therapists we don’t have to, I don’t want to, toe the line or conform to a principle or a philosophy that may not have had the full facts or the full understanding when it was devised. There is a lot of controversy and infighting in the therapy world between people who are pure person centred counsellors and therapists; purism is sometimes worn as a badge of honour. I view any purist view with suspicion if it shuts down challenge. I don’t understand how following the party line can be person centred, how unwavering and unquestioning agreement can be authentic. To have such hierarchies about pure form and to stick to something inflexibly, is not the heart of person centred philosophy, nor is it therapeutic.

Therapists have to listen more closely to the experiences of oppressed minority groups that they do not understand

To not be proactive in getting oneself trained and well read in LGBT issues is like a therapist saying ‘I don’t see colour’ when working with black clients. To just ‘accept’ your client is gay is to completely and utterly MISS their experience. Being gay, is not a one off event, ‘I realised I’m gay and came out’, all sorted. Simply treating these clients ‘the same as everyone else’ doesn’t acknowledge the world we live in and the ongoing, daily process of being gay.

It’s not good enough to be not trained enough

When we don’t know, we are simply ignorant, not malicious. The number of mistakes I made in my own practice due to ignorance are shameful, and rightly so. It’s not good enough to be not trained enough. Therapy training is woefully inadequate, but it’s not an excuse. It is out there if you look. Assuming UPR is enough is offensive to people who suffer horrendously due to ignorance on a daily basis.
Because of this, and because of a complete lack of training in all those decades of training I took to become accredited and qualified, I have sourced my own training in working with LGBT clients and other minority/disadvantaged groups.
In 2016 I went to the WPP training Institute in Cardiff to attend a workshop on working with LGBT clients. This was run by Helen Rowlands as part of a wider scheme in association with Pink Therapy. As with all my training this was self sourced and self funded, no one ‘sent’ me, no one paid for me.
One of the training exercises that we used was a bit like the children’s game ‘Grandmother‘s Footsteps’. We all stood at one end of the room and were given an identity on a piece of paper, (gay, trans, straight, female, male, different ages and ethnicity). Helen stood at the other end of the room and read out statements. If we could agree with the statement we could take a step forward, towards the therapist at the other end of the room. If we couldn’t agree with the statement and we had to stay standing still.
The statements were various, along the lines of: ‘I have never had to worry about holding my partners hand in public’; ‘I have never had people at work use the wrong pronoun for me or for my partner’; ‘I have never felt I had to hide the gender of my partner’; ‘I have never been concerned that I may not get a promotion at work due to my sexuality or gender’; ‘I have never felt in physical danger due to my sexuality’; ‘I have never been ridiculed, misunderstood or isolated from people because of my sexuality’; ‘I have full and unconditional acceptance from my family for who I am’; ‘Most of the people I work with have the same sexuality as I do’; ‘I have never been in a country where my relationship is illegal or my marriage is not valid’ or ‘When I go to a new place I do not think about sexuality and whether it will disadvantage me’. You get the picture.
The exercise resulted in a very visual demonstration of accessibility to therapy. Some people with privilege could get there easily and others would probably never get there.

The … mistakes I made in my own practice due to ignorance are shameful

Here are a few experiences of mine, of friends, and of clients that I would like to share to explain why UPR, or perhaps empathy, does involve rainbow flags Stonewall logos and active inclusive practice.
Empathy has to extend to being proactive and informed to make extra effort to walk in the clients’ shoes. Reading these people’s stories is an opportunity to increase knowledge.

“Every time my job sends me to work in a new office, I feel wary, I have to think about whether to hide my sexuality. This is on top of the usual anxieties about starting in a new workplace. The last office I went to, my new manager had an LGBT ally rainbow poster up and there were pride flags, subtle but present, on desks and noticeboards. I heaved a big sigh of relief and relaxed, there was a lot I needed to learn but I now had one less thing to worry about.”

“I truly don’t know if there are straight therapists who really “get” the coming out process—not on that deep level.”

“I have a therapist who’s known me for 27 years. She is fantastic with the divorce, … helping me to survive a breakup, my burgeoning sexuality, my parenting and kid issues, but she doesn’t understand the intensity of lesbian relationships, the wearing down and frustration and “otherness” that sets in when you live among primarily straight people… she doesn’t understand that lesbian breakups are different.”

“I have had several women reach out for me for support because their therapist does not pay enough attention to their coming out. They are respectful and kind, but they simply do not understand the significance of this process.”

“I came out to my GP in an appointment, she listened and acted very supportive in the moment, and then gave me a referral to what she called a local support group for people going through what I was going through. I only realized after leaving the appt and doing an internet search on the group she recommended that it was actually “a ministry for convicted criminals looking to rehabilitate themselves and people looking to rid themselves on unwanted same sex attraction”. All it takes as an LGBT person is to have one experience with one bad seed in any segment of the medical community to make us extremely careful and cautious about any care provider we add to our team. In my case, at the time I had literally no gay friends, and I hadn’t come out to any of my family members, most of whom are quite religious. That feeling of being judged and alone is bad enough, but to also feel as though your caregivers may make your situation worse is even more personally threatening and isolating in my opinion.”

“Everyone at yoga just assumes because I have kids that my partner is a man. I’ve been going for a year but it’s just easier to nod when they use the wrong pronoun as I go there to relax not to go through another coming out process.”

“[my therapist] has saved my life … and helped me immensely … She doesn’t truly understand that homophobia, internal and external, is ever-present. I feel that she thinks being gay is one and done. Becoming gay is a process, and being gay is a life alteration.”

Examples from my own experience are scrolling through the list of therapists trying to work out from the photograph, their face, their clothes, if they are likely to be homophobic or not! As a therapist I have had clients who have told me their housemate is a friend and then spend the next six sessions wondering how when and if they should tell me that their friend is their partner. The mistakes and assumptions I have made over the years, were not a lack of empathy and unconditional positive regard, they were born of ignorance. And therapists can deal with their ignorance, this is extending empathy into activity outside the therapy session, working endlessly on exposing our own assumptions including our own internalised homophobia.

Many good naturedly accept it as ‘that’s just how it is’

When clients have to deal with kindly meant ignorance or homophobia at work, at the shops, at the dentist and the doctors, every single day, then having the resilience to find and then contact a therapist is not always easy. To find a therapist and then to be in the position of having to educate the therapist (far more than other people) into the particular issues they face adds insult to injury. Many good naturedly accept it as ‘that’s just how it is’, but is that good enough?

Therapists can deal with their ignorance

I don’t think it is. I want to urge therapists to be more actively accepting and confirming of clients who are having to make extra scary steps to even get into therapy. It’s too complacent to think of UPR exempting us from this task. Of course one person’s experience doesn’t inform us about the next person’s experience but if gay people say they relax and feel safer if there is evidence in the room of active LGBT support, then we should listen, not take a straight person’s privileged perspective that rainbow flags are unnecessary.

 
Increase your experience of your LGBT clients’ world through training and reading and listening. Decide to be not just ok with LGBT clients but affirming (I cannot express how different this feels but it removes a whole layer of danger) and put this in your promotional literature. When a client comes out to you, you don’t need to say you’re ok with it or it’s no big deal, just ask with warmth and kindness, ‘how do you feel that has affected you so far?’ That is enough for your client to know their sexuality IS important, and you know it’s significant. Let them tell you how it is for them, while knowing that you’re trained enough not to reinforce any distress or trauma caused by society’s homophobia.