Why Mindfulness is Key to Your Gay Male Clientèle
When a gay man comes for psychotherapy, his identified issue is almost always going to be nested in the fact that growing up gay is fraught with deep personal suffering. In a world that is largely unprepared to guide a gay boy, self-inhibition is a navigational tool that he is likely to develop very early. Thus, your gay male client has been editing himself since childhood — though you may not see it and he may not realize it. There are few people with whom he can be his true self, few environments in which he can feel fully at peace. A lifetime of negative messages from society at large and within the family cannot be undone by a gay-affirmative television show or the striking down of an antiquated marriage law. Gay men need to gain new experiences of safety in inhabiting the present fully; this is true of just about every gay man who walks into your therapy office.
As therapists, it is our responsibility to be educated about the people we see. Our waiting rooms do not discriminate, and it is very unlikely that any therapist will go through an entire career without opening the door to a gay male client. In my role as an educator, it is compelling when therapists are willing to admit that they don’t know everything they should about what it is to be gay or how to work with gay clients. It takes courage to admit this, especially in the new climate in which sexuality is front and center in the national conversation.
Now it is time to cultivate the ways in which health and happiness can be seeded across all dimensions of life for our gay male clients.
Let’s start with shame.
For gay men, shame is a birthright. It is the pervasive consequence of internalizing the negative reflections that come from family and society. These reflections have so many masks — fear, hatred, embarrassment, ignorance, judgment, mocking, belittling — and they lurk in every corner of the client’s life. You can bet that the avoidance of shame is the driving force for him.
Your client may not even be aware of it, compartmentalizing so successfully that he is hidden even from himself.
Part of the therapist’s creative task is finding a way to align with clients with these experiences. Ultimately, it is the client’s ability to acknowledge his pain and then to experience new comfort inside of his own body that will begin to convince him that well-being — truly being well — is within reach.
Even though the foliage on a tree may appear vibrant, it is the root system that provides nurturance. Long before he is even verbal, a gay male censors the truth to make sure he is loved and accepted. This is a reflex, automatic and unconscious, for survival. Therapists must always have this in mind as gay clients describe current challenges. The roots cannot be seen; they are underground. One component of psychotherapy with gay men is to appreciate the causes of damage to the root system. Then, the gift is to offer tangible ways to make repairs. It is never too late to restore the flow.
THE BODY MEANS BETRAYAL
Something to remember is that the body has meant betrayal for gay men as they were growing up and beyond. The body carries the memory of being different from other boys. Later, this body may not fit the media ideal promoted for men in general or the specific ideal gay male stereotype. And, certainly, the body is a traitor when it brings illness and sometimes death through its interactions.
Even after being out for years, many gay men continue to hide parts of themselves. They split off certain parts in an attempt to fit in. Gay men are unique in being a minority not only in the world but also in their own families. I call the need to conceal aspects of who one is “hiding in.” Gay men often take shelter deep inside a fortified place, separate from others.
But at what price? The fortified heart eventually becomes impenetrable, and most gay men continue to carry this way of being into adulthood. The trauma of being gay in an uncomprehending world is something a person doesn’t simply “get over”; decades later, hiding stills seems to be the way to stay safe. This kind of safety has a cost, which is manifested in various ways.
SAFE OUTSIDE BEGINS WITH SAFE INSIDE
Over the decades, I’ve developed a way to accompany my gay male clients as they move out of hiding. It begins with identifying resources my clients already have, with an acknowledgment of their resilience and faith in themselves. I point out I know that these things exist in my gay male clients, not because I am especially intuitive but because my clients are sitting across from me having survived and garnered enough resources to bring them to the present moment. Focusing gently in an informal way on the internal foundation my clients have already established, I take an opportunity to celebrate this accomplishment with them.
Mindfulness is an especially helpful perspective and practice for gay men, but it is scary at first. For a gay man, self-trust has in the past led him astray into discomfort and perhaps danger. From a very young age, he knew he was different, and he likely learned very quickly that his “difference” was unacceptable to family, to friends, to community, to God. Thus, dissociating from his instincts and from his difference became the compass and the map. After a lifetime of evidence to the contrary, he must be convinced that connecting to himself in the present is the more secure, healthier approach.
Mindfulness is key to well-being for gay men. Impulsiveness, bad habits, and self-destructiveness are all rooted in dissociation. The promise of mindfulness is in creating the circumstances from which thoughtful decisions, good practices, and constructive choices can emerge. Once your client experiences some of the strategies in this workbook, he will understand the essential place of mindfulness from the inside out. More than good advice, mindfulness invites him to experience himself as the wise and caring mentor on which he ultimately will be able to rely.
Now let’s introduce mindfulness to your client!
Simply begin with breath and a positive memory. A few quick questions about the positives in his life will help the client take the first steps toward being mindful: Perhaps he has a new job, takes care of a rescue dog, has finished a painting, has graduated from college, has learned to ski, visits his ailing father regularly, volunteers at the library, ran in a marathon . . . anything about which he feels good.
DIRECTIONS
Emphasize the following points in promoting the efficacy of mindfulness. You can ask your client to rate which of these apply to him, give examples of how other clients have incorporated mindfulness and how it helped them, or share your observations of how mindfulness will help him with his issues of concern.
Mindfulness helps people to:
- Cope with or reduce symptoms related to anxiety and depression.
- Manage physical discomfort, symptoms related to illness, or the manifestations of stress in the body.
- Calm the mind, as staying attuned to the present moment has a self-regulating effect.
- Open themselves to the totality of experience rather than numbing themselves to day-to-day experiences in an effort to cope.
- Make decisions by going inward and allowing the collective wisdom of body and mind to inform them about potential actions that are needed.
- Feel instead of using defenses as an avoidance technique.
- Connect with others in a meaningful, available manner.
So here’s a way to start:
The following exercise provides an introduction to mindfulness benefits. You can gently instruct your client to find a comfortable space and close his eyes. If closing his eyes is too threatening, simply have him focus on an object and soften his gaze. Practice this short mindfulness exercise as a way of introducing your client to mindfulness so he can have an experiential awareness of how it works.
“Find a comfortable space by allowing your body to get into a relaxing position. You can choose to sit or lie down, perhaps imagining yourself outdoors in nature where the scents or sounds may help you center yourself.
With your eyes closed, you begin to appreciate how your awareness shifts . . . further and further away from the moments or pressures of your day, closer and closer to your own abilities to observe and be present to what is happening inside of your body in this moment. Excellent.
As I count from one to five, simply allow each breath to be a little bit deeper than the last one, focusing on the inhale and the exhale, and while you do this, enjoy the ways in which you can go deeper and deeper inside: 1 . . . 2 . . . 3 . . . 4 . . . 5. That is right — the outside pressures of your day recede further and further away.”
[Pause a few moments.]
“And now as I count backward from 5 to 1, you can slowly orient yourself back into my office, feeling rested and refreshed, appreciating that even in a quick series of moments, you were able to experience a transformation that came to you rather easily.
When I finish counting back to 1, you may slowly and gently open your eyes and bring yourself back. 5 . . . 4 . . . 3 . . . 2 . . . 1.”
Mindfulness is an important tool in the therapist’s toolbox. Make sure you take full advantage of it!
