How much to disclose: sexuality and other issues

Here are references relating to different types of therapeutic interventions we can offer and different types of mental health issues, developmental disorders and other presenting problems.
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miriam
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How much to disclose: sexuality and other issues

Post by miriam » Sat Apr 14, 2007 1:12 am

I think that you would have to have a good reason to tell a client anything that is personal, and it would have to be relevant to the issues the client had raised, and likely to have a positive impact on therapy.

For example, I often reveal that someone in my family is dyslexic when I'm talking about the pros and cons of diagnosing specific learning difficulties. I hope that it puts clients at ease and is normalising (particularly for the child, who might not know anyone else with a similar diagnosis and might be reassured that it is okay) and allows me to discuss issues with the benefit of personal experience. But of course if I admit that it is my husband who is dyslexic that inadvertently reveals my sexuality and marital status in a way that gay colleagues may not feel able to disclose their relationships. I suppose that this is easier given that I'm in the majority population group in this regard and am less likely to be the focus of a negative reaction when I share my traditional family construction.

However, I would avoid revealing anything controversial or overly personal. I think you have to be particularly careful with things like sex, religion, politics, drug-use, family issues, etc. For example, I'd discuss the pros and cons of cannabis, and if it was necessary I'd mention that I know people who have used it, but I wouldn't discuss whether or not I have ever used drugs unless there was an exceptionally good reason to do so. I'd happily talk about a client's religious or cultural beliefs, but I wouldn't talk about mine except if directly asked and if relevant.

WRT sexuality, I think there might be situations in which it would be fine to reveal your sexual orientation, and there should be no reason to feel that you are hiding it, but for the most part it just isn't relevant. There might be situations in which having contact with a person who is comfortable and open about being gay would be a very positive experience for a client, however in other situations it may tap into their prejudice or assumptions in an unhelpful way. I think that would be the same with gender, race, age and many other characteristics though.

I think it is possible to strike a balance between being honest and warm, without being too open. After all, you are there to discuss the client's situation, feelings and behaviour and not yours.

However, I think when you are on the receiving end of prejudice it is hard to ignore, and nor should you be expected to ignore it. I can well imagine that most people would be shocked to find that this kind of hostility still exists. We may have done much to challenge prejudice in our educated, elite little world of work, but it's going to take a lot more to change the narrow views of many ordinary people. The introspective and intellectually liberal world of the psychologists is not reflected in society as a whole. And that is something that we need to be aware of as psychologists..........that society in general is more hostile to diversity than we are.

The world tends to run on the assumption that being straight (and probably in a monogamous relationship) is the "normal" or at least preferred way or living your life, even when people are not actively homophobic. Of interest re heteronormative C. Butlers ‘Homoworld’ – see pp.15-17 of Clin Psych Forum, Apr ‘04. There are also more unexamined assumptions: 'White privilege'

When straight males are assumed to be gay

There is actually a growing body of evidence on the effects of being "demasculated" by being perceived as gay by your peer group whilst at school. Evidently it is not a problem for afro-carribean boys, or those who are into football, but quiet non-sporty boys seem to be plagued with bullying on the assumption they are homosexual, even when they are not (and presumably more "masculine" homosexual boys are freed from bullying by not fitting the steroetype?)

I researched it for a case where I was asked to write a report on the impact of such bullying, seemingly endorsed by teachers, on a particular young man. The case was particularly interesting as the young man had very good self-esteem in terms of his academic/work skills, his place in his family, and his personal qualities, but really struggled to believe peers could like or understand him. I was lucky to find measures that separated the factors out and made quite a strong case, although I don't know that it ever made court or gained him compensation.

It is an interesting topic, because it highlights the nature of the evolution of language, whereby labels are devalued by association with devalued population groups. In the same way that 'special needs' can now be said with a mocking tone, on the playgrounds (and in a surprisingly wide range of adult social settings) something that isn't liked or valued can be described as 'gay'. And qualities which are perceived as 'gay' are assumed to be negative, despite the fact that a lot of us might argue that less masculine qualities like compassion, empathy, warmth, desire to parent, are very positive and things we should be encouraging in young males. As with any other prejudiced or pejorative language, this is not a use we would accept on the forum, but it is interesting to consider the language that is being used in units and wards and to what extent this makes people feel that it is acceptable to have or disclose a non-straight sexual orientation.

A personal example from David89

I thought I would offer some of my experience in disclosing sexuality.

When I first started volunteering, one of the therapeutic workers actively encouraged me to disclose my sexuality, as she thought it might benefit service users by challenging attitudes/ perceptions. While I am perfectly comfortable with my sexuality and I am open about it without all aspects of my life... I felt slightly uncomfortable about this; replying if I was asked by a service user I would be comfortable disclosing this, but otherwise I did not see any benefit of shouting it from the rooftops!

This worker subsequently left the service and I had the opportunity to participate in group facilitating skills training. This training session spent quite a large amount of time focusing on boundaries. It was suggested to me that if a service user asked about my sexuality I should simply reply 'Why would that be important? Is this something you would like to discuss further?'

I've found this way of thinking very useful, as if service users ask you about an issue it can often be an indication they themselves would like to discuss it in more depth or get a bit of support?

I thought it might be helpful to share this for anyone else that is considering disclosing their sexuality. I really do believe there can be a benefit for individuals that are struggling with issues surrounding their sexuality, but it's something that would be have to be discussed at length with a supervisor as there is always the risk it could impact on relationships with other clients.

I'm aware I'm probably not the best person to have tackled this topic, so feel free to offer lots of suggestions for improvement! Thanks to Matt.Berlin and David89 for suggestions so far.


Addition by Workingmama: I agree with much of what is written above, but am aware that we can talk about 'disclosing sexual orientation' in a way that implies that talking about one's same sex partner/past partners is seen as 'disclosing' in a way that a conversation about family that is not explicit but is taken by the listener to mean that one is straight is not seen as 'disclosure'. For example, whilst many different types of family have children, I am aware that the knowledge that a worker has children leads many people to make an assumption about their family set up and sexual orientation that is not necessarily accurate. In this example a 'disclosure' of having children is not read as a disclosure of orientation because the unspoken assumption is that the worker is straight. There is a long and difficult history (and present!) for same-sex attracted people of having to negotiate conversations in ways that do not disclose orientation, and I'm aware that people 'pick up on' any implication that one is not straight in a way that they do not seem to react to implications of 'straightness'. Even in the educated elite that Miriam refers to there is still regular evidence of homophobia and heteronormativity and this inevitably is seen and impacts more upon people who are same-sex attracted. This is a difficult issue to negotiate in that, whilst our usual (and fully appropriate) way of work is to preserve therapeutic boundaries, it is important to acknowledge that this taps into a wider story in which same-sex attracted people are often required to police their language to avoid prejudice or discrimination. I think the idea that we ask service users what the question means for them is an important one, but also that we consider: if they asked do I have children, would I reply? If they asked where I come from, would I reply? If they ask about my sexual orientation, is my response different, and if so why? As ever, ripe discussion for supervision!

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Content checked by Workingmama on 26/6/19
Last modified by Workingmama on 26/6/19
Last edited by Borrowed Cone on Wed Feb 13, 2013 7:15 pm, edited 1 time in total.
Miriam

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