Reflections on working with LGBTQIA+ clients

Sonal Thakrar

Sonal Thakrar

UKCP psychotherapist Sonal Thakrar is an Integrative Psychotherapist, writer and visiting lecturer.

Several studies have determined that mental health problems are more common in the LGBTQIA+ community. Findings by Stonewall also show that poor mental health is higher among LGBTQIA+ people who are young, Black, Asian or minority ethnic, disabled or from a socio-economically deprived background.

I remember the first day of my five-year psychotherapy training. I had never talked about being gay in a group before, let alone being a gay woman of colour. My heart was pounding and I was hot. I now know this to be a deep feeling of internalised homophobia, shame and dysregulation. During this time, I was going through a process of ‘coming in’; a term that I use for when we are exploring our sexuality internally and may not feel safe or ready enough to be fully ‘out’. It enables a sense of empowerment, pace and focus on the self rather than the other. This to me is almost a pre-requisite for ‘coming out’ which is an inevitable part of living in a heteronormative society.   

I think about those of us on the LGBTQIA+ spectrum and what it feels like to sit in the therapist’s chair and the client’s chair. I imagine the space in between and what may emerge. I wonder if the space feels safe and inviting. I wonder if I will be able to get the words out to convey this to my client. These are perhaps some of the common things we experience. I also imagine what it is like to be a client who, consciously or unconsciously wants to explore their sexuality. I put myself in their shoes, drawing on my own experiences.

Here are some of the things that I have learned whilst working with clients who are exploring their place on the LGBTQIA+ spectrum:  

  • The client’s in-built safety radar will be active to protect against rejection, discrimination and annihilation.   
  • Like others, we need to be seen and be met, where we are and not where others believe we need to be.  
  • Empathy creates a space for us to confront shame and share our truth when we feel ready. 
  • A therapist who can bear witness to our experience of inequality creates hope for the future to be different. 
  • Strong internalised objects can dominate our views on sexuality; gentle curiosity can challenge our rigid beliefs and what belongs to whom. 
  • Trust enables us to step forward and experiment with alternative ways of being in relationships.  
  • Homophobia, internalised homophobia and subtle homophobia belong to all of us and run deep. Enactments give us a chance to heal our wounds. Acceptance without condition provides a new experience and paves the way for self-expression.
  • We are a work in progress, as always. 

It is more important now than ever for us to consider anti-oppressive practice, positive affirmation and improve therapy access for these clients.  

Psychotherapy can offer a safe space to explore your feeling, YOU CAN LOOK FOR AN ACCREDITED THERAPIST ON THE UKCP WEBSITE

You can also find support by contacting:

In an emergency, call: 999

NHS (England), call: 111

NHS Direct (Wales), call: 0845 46 47

The Samaritans 24 hour helpline, call: 116 123

Stonewall, call: 08000 50 20 20

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