After being in individual therapy for over a year, Scott, a 34-year old man, was hospitalized for a suicidal level of depression. During a predischarge session, he confided that, since entering treatment with me he had been lying about out an important aspect of his life: he had always lived at home with his parents, and not on his own, as he had led me to believe. To complicate matters, his parents had bailed him out of severe debt. Scott (not his real name) admitted feeling very embarrassed and ashamed over his seeming inability to become independent if his parents, to leave the "safety'' of his parents' home. Despite the fact that he is a talented and successful professional, Scott complained of feeling like an emotional cripple.
Immediately following discharge from the hospital, a treatment planning session was held with the whole family (except Scott's brother, who lives out of state). Scott's mother arrived wearing a portable electrocardiogram machine, she had developed sudden chest pains the day Scott was released from the hospital. The chest pains proved to have no physical cause, but were instead part of an overall manipulative pattern that had induced feelings of guilt in Scott for wanting to move into his own apartment So our first session focused on having both parents verbally support Scott in his stated goal of moving out in the immediate future. Within two months Scott had moved out on his own.
The above example illustrates how one consultation with this man's entire family system, as distinguished from simply the biological family, helped save hours of individual treatment because both the therapist and client were able to see clearly see how ell meaning parents, thinking they were being helpful, in fact were infantilizing their adult son. Another reason this one session with the family was so crucial to Scott's treatment was that it provided an opportunity for the validation, in a way that was not threatening to his parents, of certain feelings that he had been expressing to the therapist. It was important for Scott to learn the his inability to move out was not simply the result of some lack of maturity on his part .
Almost everyone thinks he or she knows what individual therapy is about. If not from films like Now Voyager or The Three Faces of Eve, then from a friend who has been in therapy. Television's "Bob Newhart Show" popularized the concept of group psychotherapy. But still relatively obscure is a radical new form of psychotherapy that began to flourish in the 1960s, the decade that spawned hippies, the sexual revolution and the Stonewall Rebellion. This new form of treatment is known as "family therapy."
In family therapy, the individual who has been labeled disturbed, or who is viewed as having problems, is still seen by the therapist, but in conjunction with his significant others. However, the"problem'' becomes redefined as a family issue, thus removing much of the burden and stigma from the one person who happens to be showing symptoms. An important concept in family therapy is to avoid branding any person in the group as "wrong'' or "bad'' but instead to help each member of the family system become more aware of the ways in which they affect the family as an organizational structure, and how this system influences them and the other family members.
At first glance one might think that family therapy would not apply to any lesbians and gay men. Quite the contrary: gay people all were born into and raised by one type of family or another. Some have created legal families )f their own by marrying and having children. Others have had children through artificial insemination, adoption, or foster parenting programs. Many lesbians and gay men are in committed relationships with lovers. Groups of friends and other support systems fulfill many needs for gays that were formerly thought to be satisfied only by blood relations or by legal marriage.
Working with lesbians and gay men in a family context is almost without precedent. One of the few pioneers in this area is Bernice Goodman, a social worker in private practice in Manhattan. "Most therapists ignore the impact the family and society has on a lesbian or gay individual when working with him or her,'' Goodman says, explaining the need to expand the traditional definition of 'family.'' A person's family is not solely those who are related by birth or marriage," Goodman says, "but anybody one chooses to live with, build meaningful relationships with, and share her or his life with.''
It can not be stressed too much how important it is for gay people to be consciously aware of how we are redefining the meaning of family in contemporary America. Cases in point: the skyrocketing numbers of same-sex household, many of which are based on a primary love relationship. Numerous same-sex house holds contain children being raised by a single gay man or lesbian or by a pair of lovers. Increasing numbers of men, many openly gay, are choosing to raise children either on their own or in joint custody with ex-wives.
Like people in other societies throughout the world, gay men and lesbians need celebrations and rituals that we have customized to meet our needs. Being deprived of gay marriages, and very often failing to have lovers or anniversaries recognized by our nuclear families or by society at large-these serve as examples of why it is incumbent on us to take it upon ourselves to establish practices and ceremonies that are meaningful specifically to us. (One small way of accomplishing this is to celebrate holidays--Christmas, Passover, Halloween, Gay Pride Day-perhaps with family-style dinners, with those who have functioned as family throughout the previous year.)
Family therapy provides a means of helping friendships and other romantic emotional, or sexual relationships over those rough stretches that occur in all human interactions. Family therapy can also help people focus in on what is strong, positive, and nurturing in a relationship or group of friends.
A major goal of therapy is to help the individual learn how to create satisfying relationships with other people. In order to accomplish this, it is imperative to gain an understanding of' the ways in which being a member of a minority and a counterculture adds additional stress t already tense relationships. The resulting feelings of self-doubt and isolation are very powerful forces in shaping the personalities of lesbians and gay men. Some clients must learn to feel complete despite the efforts of a family that has been unsupportive or even hostile. At times, a person finds he must mourn the loss of the family he or she was born into even if they happen to still be alive.
However, family therapy generally attempts to teach other, positive method of resolving conflict. A number of specific problems respond well to family therapy. Bernice Goodman, for example has worked extensively with lesbian mother and their children, lovers, ax-husbands, and parents. Part of her work has been to act as an advocate for her clients as well as an expert witness in custody battles where sexual orientation is used to attempt to deny the mother's custody of, or even access to her own children.
A few examples of cases in which family therapy has been the treatment of choice will help illustrate how relevant this form of psychotherapy can be to gay people's lives.
Coming out to one's family almost always presents complex issues and problems, and when the person comma out is a parent, the difficulties are compounded.
Current research into alcoholism and other forms of chemical dependence suggests that an addicted person's recovery and continued alcohol or drug free life correlates directly to the level of involvement of the family in the treatment and recovery process.
For lesbians or gay men who are parents, family therapy may have little or nothing to do with issues of sexual orientation.
Family therapy remains the treatment of choice for lesbian and gay youth who still reside with their families, as well for those who have been thrown out of their family home. Under aged gay people who are "out" to their families and who are struggling with all of the inherent difficulties of adolescence, combined with the dilemma of creating a satisfying lesbian or gay identity, need and deserve adult support. However, when parents are paying for therapy and are unhappy about their child's sexual; orientation, they can and unfortunately too often do discontinue therapy with a gay sensitive therapist.
If you are thinking about beginning therapy, how can you know whether family therapy will help you? One way of determining the answer is to ask yourself whether the important others in your life are a regular source of unhappiness, problems or strife. If so, are they available and would they be willing to become involved in therapy with you?
It should come as no surprise to most gay people to learn that many of our problems result from having been viewed as different, and thus often labeled the "bad one." Often, even as adults, we harbor many of the same ill feelings we first experienced as children. Family therapy can provide a means of working through these uncomfortable feelings. If you suspect that family therapy or couples therapy may be helpful to you, ask prospective therapists if they are skilled in this area.
One thing is certain. As lesbians and gay men build more support systems that function as
families, the applications of family therapy will grow in importance to our community.
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