In 2018, the decriminalization of homosexuality in India brought new hope but the prejudices, homophobia, and violence lingering around everyday discourses remain unchanged. Queer individuals encounter unique life stressors such as difficulties with self-acceptance in the face of social expectations and pressures, coming out, invisibility, harassment, discrimination, relationship issues, depression, anxiety, substance use, suicidal ideation, self-harm, bullying and victimization, social rejection, verbal and physical bullying, sexual assault, etc. Queer-affirmative therapy has turned out to be an armour for queer communities to live an unalienated life and resist oppressive frameworks.
Queering Mental Health
The shift from being queer-friendly to queer-affirmative is the need of the hour as it is essential to not merely acknowledge the existence of queer people but also actively get involved in supporting and helping them in their struggles in a society ridden by heteronormativity.
Queer affirmative knowledge draws from the politics and experiences of queer people, rather than discipline-based expertise. It can involve collective forms of care such as ‘Peer Counseling Practices’. The Queer affirmative therapist addresses the impact of social stigma towards an identity that does not fit within the normative. It includes understanding and combating queerphobia in clients as well as the self. The root of queer affirmative therapy lies in affirmative psychotherapy which considers the needs of marginalized people and takes an intersectional approach.
A true therapist ally carries not a burden to support queer lives out of pity or guilt, but an infinite responsibility to support by centring queer knowledges, to continue learning because we can never know it all, to affirm and join them in protesting the normative gaze, and to never forget the grit and the resilience with which lives on the margins are led.
– Shweta Srinivasan, (M.A., Adv.Dip.), queer affirmative mental health practitioner trained in Narrative Therapy.
Central Tenets to Becoming Queer Affirmative:
Acknowledging the history of bias and pathology, and educating oneself about queer history is crucial to disidentify with discourses of pathology, that undergird dominant approaches while doing an assessment, and working on treatment plans. It is imperative to become acquainted with the social and political aspects of queer movements and incorporate knowledge of queer people’s concerns and needs. Learning about lived experiences thereby takes place from the perspective of the margins and not from one’s place of privilege.
Reflecting on one’s upbringing, attitudes, and beliefs; acknowledging areas of privilege; recognizing bias stemming from living in a heteronormative and gender-binary society, addressing misinformation and misconceptions of clients, will enable one to tread on the path of becoming a “non-judgmental therapist”. This further involves being internally unprejudiced, and communicating verbally and nonverbally to the client that they can be their complete selves in the therapy room which is free from biases, moral labels, or judgments.
It’s paramount to remain cognizant of the fact that each person’s journey of “healing” is a unique and subjective one. Besides, emphasis should be on challenging the idea that the struggles of queer people come from them (blaming the victim), as well as questioning the rhetoric that symptoms are isolated or only play out at an interpersonal level but recognizing the external forces that influence them. Familiarizing oneself with inclusive language and terminology, which is complex and evolving, will help in supplying clients with queer affirmative language.
Questioning the idea of neutrality of a therapist becomes inevitable as issues of discrimination and marginalization are inherently political. Therapy is a political act because a therapist is unabashedly in favour of only one person- the client. If one believes in queer people’s right to exist and thrive, shying away from claiming this position - in public and personal spaces – is not an option. Being neutral is not at all affirmative and can be very damaging to the client.
By facilitating conversations about privilege and oppression, one can advocate for broader institutional and social transformation by learning about new policies and legislation that might impact the well-being of their queer clients. Connecting to different parts of the queer community in public spaces to hear their concerns, attending community meetings, and seeking out supervision from mentors who were queer affirmative can go a long way. Identifying resources strategically for clients that respect their queer identities, especially in one’s local community, and helping them engage with the community, while actively working to resist anti-queer sentiment among other providers would make a significant difference. Moreover, there’s a growing need for access to LGBTQ+ affirmative continuing education training and exploring certain parts of the spectrum that needs more attention and exploration, such as the trans and gender nonconforming experiences.
Self-disclosure and use of self by queer clinicians have also proven effective as using their identities aids in facilitating conversations about oppression based on their marginalized identities. Furthermore, this involves disclosing personal information to queer clients to normalize their experiences and encourage queer visibility and representation while avoiding assumptions and reflecting on traumas that might be triggered in the process.
Reimaging Therapy through the Queer Lens:
Mental health practitioners help clients resist marginalization and address the reproduction of dominant discourses. Queer affirmative space is also a space to celebrate queer identity where the client feels able to celebrate their identity.
A queer affirmative counselling psychologist, Srishti Banerjee opines:
An important aspect of being a queer affirmative mental health practitioner is recognising that you may be the only person who accepts your client for who they are – you and your space become important in their journey because they may not have anyone else who listens to them about their identity. Therapists must pick up, respond to, and ask about the client’s gender and sexuality if it has been brought up. This brings in the fostering of an environment where you can ensure that your client knows that you see them, you believe them, and they are valid.
The process involves challenging misinformation in clients as normative views on gender and sexuality are often internalized by queer folk, and a big part of sessions is to work with them through the misinformation. Besides, contributes to the fostering of a therapy that is responsive and affirming of the multidimensionality, fluidity, and intersectional experiences of queer people’s lives. Enabling a positive narrativization for the client’s story of gender and sexual identity and re-evaluation of how a safe space is created and communicated is necessary. Since safe space is felt when lived experiences are acknowledged and made visible deliberately.
The path to making healthier choices, rooting themselves in their intrinsic self-worth, finding social support, and achieving therapeutic goals can be tough. The therapist unpacks the origins of harmful survival resources and behaviours and replaces them with ones that allow one to thrive. Confidentiality is of absolute utmost importance, and the therapist actively helps to explore various interventions and their potential effects. Queer affirmative therapy may also involve working with family members.
Queer affirmative therapy is a much-needed breakthrough in which mental health practitioners, viz. psychologists, psychiatrists, social workers, and counsellors, can be put into service while working with queer-identified clients and their families. Nevertheless, what is required is to make consistent attempts to expand the ways we understand and value queer subjectivities.
References:
[i] Affirmative Therapy for LGBTQ+. (n.d.). Sandstone Care. Retrieved November 5, 2022, from https://www.sandstonecare.com/resource-library/mental-health-resources/affirmative-therapy-for-lgbtq-teens-and-young-adults/
[ii] Bisht, B. (2020, July 24). Understanding Queer Affirmative Therapy: Here’s Everything You Need to Know. SheThePeople TV. Retrieved November 5, 2022, from https://www.shethepeople.tv/home-top-video/unpacking-queer-affirmative-therapy-india/
[iii] Chakravarty, S. (2021, June 11). Why Mental Health Professionals Must Shift from Being Queer Friendly to Queer Affirmative. Scroll.in. Retrieved November 5, 2022, from https://scroll.in/article/997207/why-mental-health-professionals-must-shift-from-being-queer-friendly-to-queer-affirmative/
[iv] Collective, H. (2018, September 8). Center the Margins: Understanding Queer-affirmative Therapy. The Health Collective India. Retrieved November 5, 2022, from http://healthcollective.in/2018/09/understanding-queer-affirmative-therapy/
[v] Wandrekar, J., & Nigudkar, A. (2019). Learnings From SAAHAS — A Queer Affirmative CBT-Based Group Therapy Intervention for LGBTQIA+ Individuals in Mumbai, India. Journal of Psychosexual Health, 1(2), 164–173. https://doi.org/10.1177/2631831819862414
[vi] Voices. MHI. (n.d.). Retrieved November 5, 2022, from https://mhi.org.in/voice/details/professional-solidarity-what-queer-affirmative-counselling-practice-means-me-mental-health-practitioner/
[vii] Ramirez, Luis M. (2020). A Two-paper Exploration of Queer Affirmative Theory, Doctorate in Social Work (DSW) Dissertations, 143, https://repository.upenn.edu/edissertations_sp2/143
[viii] I would like to thank Srishti Banerjee (Queer-affirmative counselling psychologist) and Rashmi Jayashankar (Queer-affirmative consulting psychologist), and Charvi (Masters in Psychology student) for their inputs, comments and efforts towards improving the article.
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Aswathy B. Surendran is a student of Conflict Transformation and Peacebuilding (CTPB) at Lady Shri Ram College for Women (LSR), University of Delhi. Her interests lie in exploring policy issues and creative forms of protest.