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My Therapy Practice

© This BACP article was first published in Therapy Today, the journal of the British Association for Counselling and Psychotherapy (BACP) in June 2022.

My journey as a therapist and as a gay man developed somewhat side by side, and at times I feel I fell into my specialist area of working with Lesbian, Gay, Bisexual, Trans and Queer plus clients (LGBTQ+), it wasn’t the plan. That being said, I couldn’t imagine my life not working with these clients now.


When I was growing up my sexuality was deep in the recesses of my mind. Denial, repression, and suppression among other things, were doing their job. One key ‘slap in the face’ was during my level 3 counselling course, my tutor (who still to this day I see as someone who changed my life) said to the class ‘sometimes people don’t truly know they are gay’, and I thought ‘shit’ … long story short I eventually started private therapy and began to figure out who I was. My therapist was the first person I had ever told I was gay, and it was the most freeing moment of my life. Thanks to my work with her, by the time I had started my level 4 diploma I had started the journey of acceptance.


Through my training not only was I learning how to offer person centred and psychodynamic therapy to clients, but I was continuing to have it myself and applying it to who I am, this really enabled me to figure myself out. Eventually, I got to a stage where I wanted to try and support other members of the LGBTQ+ communities, just to see what it was like. I managed to secure a placement with METRO charity, where my clients were members of the LGBTQ+ community. As soon as I started the placement it felt very different to other placements, there was a connection of knowing that although we have all experienced different lives there is a universal shared connection about being treated ‘other’. The look of relief on someone’s face when they didn’t have to explain to me what their identity meant, the smile when I was not confused by different terminologies, the deep breath of someone knowing they are truly safe. I realised then that although still relatively early in my journey, this was the work for me, and I loved it. I read everything I could about LGBTQ+ communities and by the time I had qualified I started to take on private clients adverting myself as working with LGBTQ+ clients.


As time went on, through client work and regular CPD I started to discover themes immerging with my clients. There were four common themes that jumped out at me. I was hearing over and over again how many of my LGBTQ+ clients had experienced intense shame, rage, internalised phobias, and that all of these were compounded by the wider context (intersectionality). I called these ‘The four pillars of LGBTQ+ therapy’, I believe that that the four pillars don’t hold anyone up, but they prevent them from being grounded.


Where appropriate, I use the four pillars in my work with LGBTQ+ clients. For example, we discuss their ‘wider context’ considering how things such as their culture, religion, society, laws, age, gender, family dynamics etc have shaped beliefs about their identity. We discuss the power of shame, how it feeds on silence, further, exploring how and when that shame developed. We also allow rage and anger, if anything I encourage it, giving clients a space to discuss their rage about being constantly treated as ‘other’ and discriminated against. Then we explore internalised phobias, the mechanism where many LGBTQ+ clients have an internal fear / phobia of parts of themselves and their identity. I have found this way of working can support clients working towards client acceptance.


It is worth noting however that many of my LGBTQ+ clients don’t come to me to focus on acceptance of their identity. I don’t assume that their difficulties are connected to that either. For some they choose to work with me solely because they can feel more comfortable being in a space where they know they are working with someone who has a lived understanding of what it can be like being LGBTQ+.


A lot has changed since I started my training back in 2015, being a therapist and regular therapy helped me become myself. Training while working out who I was solidified my understanding about being a gay man and working with LGBTQ+ clients. Sure, it wasn’t the plan, but the fact that I have ended up being able to offer the space I once had to clients makes all the hard times worth it.  

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