‘Where was my pride, in affirming to others who I truly am?’

It was a group exercise in training, to demonstrate the diversity of sexual attraction, behaviours and identity in my cohort. By taking part, I would 'come out' publicly for the very first time…

I stood on my own in the middle of the classroom, as the only member of the sexual minority within the cohort. The rest of the counselling psychology trainees were squeezed together on the 'heterosexual side' of the room. The physical distance between my classmates and myself represented something profound for me – my 'otherness'. I was 'sticking out' as a bisexual person. I recognised an acute stress reaction running through my body (Mate, 2019). I felt exposed, vulnerable and unsafe. I looked at the lecturer, an affirmed queer person. I wanted to catch her hand and hold it, to ground myself, to feel that I am not alone, that it is not just 'me' but 'we'.

On the way home I felt a mix of strong emotions: anger, fear and shame. They felt like a big wave, I was drowning in it. I blamed my lecturer for accidentally 'outing me' to my cohort. I felt terrified of what my classmates would think about me as a bisexual person. I subconsciously expected to be rejected by them. Moreover, I felt ashamed of my own response. Where was my pride, in affirming to others who I truly am? What happened to my 'congruence'? Why did I feel so threatened?

Upbringing

It took me a few weeks to feel I could ride that wave and see what was lurking in the depths. I started to critically reflect about my upbringing in Poland. I realised that the pervading heteronormative narrative present in Polish Catholic culture made me invisible and non-existent as a bisexual person (Balick, 2010). The dominant discourse operating in my life was that one could only be heterosexual, cisgender and monogamous. Any diversity within GSRD characteristics was deemed as 'abnormal' and morally 'wrong' as per the teachings of the Catholic Church.

Additionally, my gender expression as a woman had to reflect the emphasised femininity (nurturance, empathy, compliance) and subjugation. The power resided within the hands of men (hegemonic masculinity), who owned the privilege of authority, paid work and physical strength (Proctor, 2010). Thus, as a young bisexual woman in a largely homophobic country I was powerless, scared and secretly ashamed of my true identity.

It did not surprise me, then, that I labelled my first romantic relationship – a lesbian one – as 'friendship' and lesbian sex as sexual 'experiences'. When I was 'coming out' to people close to me I would often hear biphobic assumptions that my bisexuality was 'just a phase of confusion' or 'a sign that I was promiscuous' (Barker, 2019). Some people were also warning me against putting my true sexual orientation on job applications, in case 'the employer was homo / biphobic'. All these messages made me second-guess my sexual identity, undermining my trust in my own experiencing. For the sake of safety and sometimes out of sheer fear, I would hide behind the façade of heterosexuality for many years.

I did recognise that my shame about my true sexual identity was not a sign of my shortcomings, but my societal and cultural inheritance. As Matthew Todd writes: 'It isn't being gay but growing up in a society that marginalises anyone who is not heterosexual or gender-conforming that leaves a devastating impact' (2021, p.18). I internalised homophobia that was consistently present throughout my life (Baumann et al., 2020; Leo et al., 2014; Moore & Jenkins, 2012). I adopted the shame and sense of 'wrongness' about my bisexuality. I was scared to 'come out' as I assumed I would be met with prejudice and discrimination. In the same breath, I felt angry with myself that I was supressing the expression of my true identity (Leo et al., 2014).

Paraphrasing Paul Gilbert (2013), it was not my fault that I internalised homophobia, and held that strong internal conflict. But it was my personal and professional responsibility to confront it (British Psychological Society, 2019).

Therapeutic relationship

I understood that I would have not been congruent or able to work with clients around Gender, Sexual and Relationships Diversity in an affirmative manner (Baumann et al., 2020), had I not first reflected on and accepted my internalised homophobia and started my process of affirmation as a bisexual woman. Today, I feel grateful to the lecturer from that group exercise for facilitating this progression for me.

My process of sexual affirmation became an important part of my therapeutic relationship with a young gay man from a Catholic family. He had been suffering with pronounced symptoms of anxiety, depression and suicidal ideations since his primary school years. After a few sessions spent on the exploration of his life story, we collaboratively reflected that he internalised the homophobia and created high career and educational goals for himself to compensate for the 'defectiveness' of his homosexuality and feminine gender expression (Leo et al., 2014). He deemed himself as 'not worthy of acceptance and love' and he believed that he needed to fulfil many conditions in order to become lovable (Rogers, 1961). His belief was that he would never be able to be truly happy because his GSRD characteristics were disabling him from accessing the social script of a 'normal and happy life' – getting into a committed relationship and starting a family. Like me, growing up in a heteronormative society made him feel exposed and vulnerable when expressing his gender and sexual characteristics in public. He felt alone and 'sticking out' as the only gay person in a heterosexual community.

His experiencing triggered for me the vivid memories of the classroom exercise. Should I self-disclose my sexual orientation to this client, metaphorically holding his hand and letting him know that he was not alone?

I started to wonder about the value and aim of my self-disclosure. Would it be to satisfy my own need of affirming my sexuality, or would it be in the service of affirming the client's experiencing? Would my self-disclosure of our shared experience help the client to explore his experiencing more openly, or might it stop him speaking about experiences that could be divergent with mine? How would my decision regarding disclosing or not disclosing affect my congruence in the relationship with this client? (Rogers, 1961).

Positive effects

Without exception, the research evidence suggests that the therapists' self-disclosure about their sexual orientation has positive effects on the clients and the therapeutic relationship (Bashan, 2004; Baumann et al., 2020; Hanson, 2005; Leo et al., 2014; Mahalik et al., 2000; Moore & Jenkins, 2012). GSRD clients experienced an increased sense of safety and trust in the therapeutic relationship after their therapist disclosed to them their sexual orientation. Also, GSRD clients viewed therapists who made the disclosure more positively than therapists who did not (Bashan, 2004). The therapists who decided to self-disclose described similar experiences. They also noted that upon their disclosure, the therapeutic relationship with clients would deepen and strengthen (Moore & Jenkins, 2012). Baumann and her colleagues (2020) observed that when the therapist and the client were both sharing sexual and gender minority identity, the therapist's self-disclosure was part of an affirmative therapy and facilitating strong presence of evidence-based relationship variables – empathy, genuineness and congruence (Norcross & Lambert, 2019). They noted: 'When we [therapists] are willing to confront these aspects of ourselves and our pasts, we begin to create space to truly be with our patients' (Baumann et al., 2020, p.254).

Nonetheless, as Moore and Jenkins observed, the GSRD therapists were often hesitant and cautious about disclosing their sexual orientation to their clients, especially to those who were heterosexual. The GSRD therapists feared being rejected or hurt by their clients or losing the therapeutic relationship with them. They were afraid of repeating the wounding experience of not being accepted for who they were. Moreover, the source of the therapists' fear of 'coming out' to their clients was largely based in their own negative assumptions and prejudice about sexual and gender minority identities. As the researchers concluded, the therapists' internalised homophobia and shame was projected onto clients, creating a barrier to openness and congruence in the therapeutic relationship. These experiences resonated strongly with my own.

The present-day psychodynamic school suggests that lack of self-disclosure about own sexual orientation to the GSRD clients can be a sign of the therapist's internalised homophobia and colluding with the client's shame (Leo et al., 2014).  In line with this reasoning, the exercise of self-disclosure marks a commitment toward a shared goal of diminishing the client's anxiety and shame about their GSRD characteristics and shows appreciation of the holding nature of the therapeutic relationship. The person-centred approach also advocates for the therapist's authenticity and congruence in the therapeutic relationship to promote the client's trust, sense of intimacy and change (Rogers, 1961). The therapist's self-disclosure here is viewed as a vehicle for the client's therapeutic progress – it can help to normalise the client's experiencing, enable the client to use the therapist as a role model and equalise the power differential present in the therapeutic relationship (Knox & Hill, 2003). Consonant understanding has been produced within the feminist therapy school. The therapist's self-disclosure of their sexual orientation aims to address the power imbalance, foster sense of solidarity with the client, and allows the client to make an informed choice whether they would like to work with the therapist (Mahalik et al., 2000).

A healing moment

Once I had reviewed the research, I made an informed decision to self-disclose my sexual orientation to my gay client. The evidence fostered my confidence that 'coming out' to the client could be affirming for both of us, and it would disrupt the pattern of internalised homophobia present in our relationship.

We agreed to spend one session discussing the definitions and understanding of the gender and sexual identity and expression using Sam Killerman's Genderbread Person diagram. I chose this session as an appropriate time to disclose my bisexuality. The client's response was clearly positive. He asked me questions about how I negotiated the tension between being a person of sexual minority whilst living in a society that privileges heterosexuality and binary gender identity. Again, I shared with him how I constructed my own alternative definition of a 'normal and happy life' that was different to the mainstream one. This helped the client to challenge his assumption that, by default, his life as a gay man would be 'lacking' or 'worse' than a life of a heterosexual man. The client said this was the most healing moment of our therapy for him. Parallel to the process of affirming his queer identity, appreciating and validating the client's process of grieving his 'lost heterosexuality' was an equally important element of our work (Leo et al., 2014).

A remaining dilemma

I had self-disclosed to the client without first consulting my Supervisor about the appropriateness of this intervention. I understand that this was contradictory to the Health and Care Professions Council Guidance on conduct and ethics for students. I felt the need to bring this dilemma into my Supervision, but I observed an internal resistance to do so. I felt more ready to disclose my non-binary orientation to my queer client rather than to my heterosexual Supervisor.

I recognised that it was a threatening experience for me to 'come out' to my Supervisor, and an affirmative experience for me to self-disclose to my client. There was a power play between 'ingroup' and 'outgroup'; and as I was still in the process of affirming my sexual identity, I had to give myself time to let it unfold, just as I would support my clients to give themselves that time.

My Supervisor seemed surprised and not prepared for my disclosure; they assumed that I was heterosexual. It was a new, surprising element that I was introducing to our relationship, which could potentially put it into imbalance. They did not have the knowledge about the suitability of therapist self-disclosure of their sexual identity to the GSRD clients. I felt they were following my lead, formulating a clinical judgment based on my recall of the client's response.

As Baumann et al. stated: 'the counter/transferential content and supervisory needs, and therefore clinical issues, may differ among sexual minority trainees working with LGBTQ patients in comparison with their heterosexual peers working with the same population' (2020, p.247). Perhaps the Supervisory curriculum needs some extension in terms of working and supporting GSRD trainees and practitioners.

Katarzyna S. Adamczyk is a Counselling Psychologist in Training and a BACP registered therapist, running a private practice in Aberdeen. She got her Master's degree in psychology in Poland, where she lived for the first 23 years of her life. Last year she was named the winner of the Division of Counselling Psychology Trainee Prize: this article is adapted from the reflective report that won the prize.

Key sources

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Barker, M-J. (2019). Good practice across the counselling professions 001: Gender, sexual and relationship diversity (GSRD).

Bashan, F. (2004). Therapist self -disclosure of their sexual orientation: from a client's perspective. ProQuest Dissertations Publishing.

Baumann, E.F., Ryu, D. & Harney, P. (2020). Listening to identity. Practice Innovations, 5(3), 246–256.

British Psychological Society. (2019). Guidelines for psychologists working with gender, sexuality and relationship diversity.

Gilbert, P. (2013). The compassionate mind. Robinson. 

Hanson, J. (2005). Should your lips be zipped? How therapist self‐disclosure and non‐disclosure affects clients. Counselling and Psychotherapy Research, 5(2), 96–104.

Health and Care Professions Council. (2016). Guidance on conduct and ethics for students.

Knox, S. & Hill, C. E. (2003). Therapist self-disclosure: research-based suggestions for practitioners. Journal of Clinical Psychology, 59(4), 529–539.

Leo, J., Baker, M., Peck, P. & Forstein, M. (2014). Emerging from shame: sexual identity, countertransference, and self-disclosure in a long-term psychotherapy. Harvard Review of Psychiatry, 22(4), 231–240.

Mahalik, J.R., Van Ormer, E.A. & Simi, N.L. (2000). Ethical issues in using self-disclosure in feminist therapy. In M. M. Brabeck (Ed.), Practicing feminist ethics in psychology (pp. 189–201). American Psychological Association. 

Mate, G. (2019a). When the body says no. The cost of hidden stress. Vermilion.

Moore, J. & Jenkins, P. (2012). "Coming out" in therapy? Perceived risks and benefits of self‐disclosure of sexual orientation by gay and lesbian therapists to straight clients. Counselling and Psychotherapy Research, 12(4), 308–315.

Norcross, J.C. & Lambert, M.J. (2019). Psychotherapy relationships that work: evidence-based therapist contributions. Oxford University Press.

Proctor, G. (2010). Working with women. In C. Lago, B., Smith (Eds.), Anti-discriminatory practice in counselling & psychotherapy (2nd ed., pp. 53-62). Sage.

Rogers, C. (1961). On becoming a person. A therapist's view of psychotherapy. Constable.

Todd, M. (2021). When gay doesn't mean happy. Therapy Today, 32(5), 18–21.