Eye Movement Desensitization and Reprocessing in the Treatment of Traumatized Gay Men

Summary

Gay men suffering from traumatic experiences can benefit from Eye Movement Desensitization and Reprocessing treatment (EMDR). In the past decade the theory and practice of EMDR has expanded to address acute and chronic childhood and adult traumas, substance misuse or abuse, identity issues including shame and self-esteem, and health issues. Through a process of accelerated information processing, traumatic memories are desensitized and reprocessed, resulting in less distress for the client in the present and future. EMDR can also be useful for developing internal resources and for exploration of relevant themes for the client. Further attention is needed in exploring the use of EMDR for gay men traumatized by hate crimes, sexual issues resulting from traumatic experiences, and internalized homophobia.     

Relationships Among Internalized Homophobia,Sexual Identity Development,and Coping Resources of Lesbian and Bisexual Women

ABSTRACT

The purpose of this study was to explore the relationships among internalized homophobia, sexual identity development, and select coping resources (social ease, self-disclosure, social support, and financial freedom) for 182 lesbian and bisexual women. Bivariate analysis results demonstrated that internalized homophobia was significantly negatively correlated to social ease and self-disclosure. Sexual identity development was also found to be significantly correlated to social ease and self-disclosure. Regression analysis revealed that sexual identity, social ease, and self-disclosure accounted for 30% of the variance in internalized homophobia. Counseling implications, limitations of the study, and future research implications are presented.     

Acculturation Level and Internalized Homophobia of Asian American Lesbian and Bisexual Women

ABSTRACT

This is an exploratory study of the acculturation level and internalized homophobia of Asian American lesbian and bisexual women. Participants were 27 Asian American women self-disclosed as lesbian or bisexual. They completed a demographic sheet, the Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA; Suinn et al., 1987), and the Lesbian Internalized Homophobia Scale (LIHS; Szymanski & Chung, 2001). Results suggest that Asian-identified persons have lower levels of internalized homophobia than Western-identified persons. There were no significant differences in levels of internalized homophobia between bicultural persons and Asian or Western-identified persons. Counseling and psychological implications, future research directions, and limitations of the study are presented.     

Lesbians in Psychotherapy

SUMMARY

Using self-report measures, this study explored the relationship of attachment style and internalized shame among 100 self-identified lesbians. The participants were in the highest stage of lesbian identity integration (Cass's model, stage 6, synthesis) and were in ongoing interpersonal psychotherapy. Compared to earlier research on a non-clinical national sample of 317 self-identified lesbians, this sample of mid-life lesbians (predominantly European-American and college educated) reported higher levels of secure attachment and lower (non-clinical) levels of internalized shame. Collectively, scores of the four attachment styles predicted 43% of the variability in internalized shame. Secure attachment significantly predicted reduced shame. This article includes a discussion of theoretical and practical implications of the findings.     

Counselors as Social Advocates

ABSTRACT

The authors discuss the importance of social advocacy and empowerment models in working with lesbian clients. They also explore the multiple contexts that impact lesbian clients and their families. A case illustration involving a lesbian client facing issues of internalized homophobia, heterosexism, sexism, and legal issues is presented. Suggestions for applying a feminist and social advocacy approach are offered.     

Non-heterosexual women's experiences of informal social support: A qualitative metasynthesis

ABSTRACT

This metasynthesis explores how non-heterosexual women experience informal social support. A systematic literature search was conducted to identify papers for inclusion, following which Noblit and Hare's (1988) meta-ethnographic approach was adopted to synthesize the findings of 16 papers. Four themes were derived: (a) disconnection from family life, (b) the benefits of cross-sexual orientation friendships, (c) negotiating (internalized) homophobia and seeking a space for authenticity, and (d) the intimacy of friendships between women. The impact of heterosexism on the women's experiences of social support is discussed, implications for health and social care are explored, and future research avenues are proposed.     

Relationship satisfaction in lesbian couples: Review,methodological critique,and research agenda

ABSTRACT

There has been increased interest in and attention to understanding the characteristics associated with relationship satisfaction among same-sex couples. This review examines the individual, couple, and external factors associated with relationship satisfaction among contemporary lesbian couples, highlighting domains such as internalized homophobia, personality, communication, conflict, sex, stress, and social support. I discuss methodological concerns and future directions to advance research in this area.     

Chapter 14. Older Lesbian and Gay Caregivers

SUMMARY

This chapter will explore the experiences of older lesbian and gay men caregivers by examining the socio-historical times in which they have lived, the impact of a lifetime of adverse societal messages about homosexuality, family rejection, and internalized homophobia, as well as their development of resiliency and psychological well-being. Once the contextual issues have been identified, the research on older lesbian and gay caregivers for families of origin and families of choice will be explored.     

Pathogenic and Protective Relations in Alcoholic Families (II): Ritual Invasion,Shame, ACOA Traits,and Problem Drinking in Adult Offspring

ABSTRACT

This paper explores the relationship between the perception of ritual disruption by parental alcohol abuse in the family of origin and shame-based characteristics in adult offspring. The Ritual Invasion Scale was found to be related to self-reported depression, internalized shame, adult children of alcoholics traits, and problem drinking behavior.     

Residential group care workers' recognition of depression: Assessment of mental health literacy using clinical vignettes

BackgroundResidential group-care workers have a critical role to play in recognizing mental health problems amongst children in their care. However, little is known about the extent to which workers recognize and respond to mental health and behavioral concerns.MethodA sample of 124 residential group care workers completed an online survey in which vignettes of children experiencing either internalized or externalized symptoms of depression and ‘typical’ behavior were presented. In order to explore aspects of mental health literacy, workers were asked to rate each vignette for severity of a specific mental health concern (adolescent depression), portrayed as internalized or externalized behavior. Ratings of worker confidence and concern for the young person were also obtained.ResultsWorkers were able to recognize the existence of depression in these fictional vignettes. Depression in the presence of externalized behavior was rated as both more severe and more concerning than depression accompanied by internalized behaviors. Furthermore, workers had greater confidence in endorsing the presence of a mental health issue when accompanied by externalized behavior compared to an internalized presentation.ConclusionsResidential group-care workers are able to recognize the existence of depression amongst children in their care. Externalized presentation of mental health appears to be more easily recognized by workers and they are also more confident in identifying mental health concern when it is accompanied by externalized, compared with internalized behaviors. The implications for training and support of residential group care workers are discussed.     

Wellness in Adult Gay Males

Abstract

Adult gay males face significant social stigma, internalize negative societal messages related to their sexual orientation, and experience difficulties related to disclosing their sexual orientation to others, particularly to parents. Although the effects of these challenges in terms of pathology have been established, the relationship among internalized homophobia, self-disclosure, self-disclosure to parents, and wellness has not been examined. The results of a study of these variables among 217 gay males are presented and discussed.     

Filial Bereavement

Summary

Loss of parents for midlife lesbians is discussed in the context of continued development in middle age. From an intersubjective point of view, comprehension of externality, the capacity for mutual recognition, the disruption and repair of recognition and affirmation of subjectivity and the agenic “I” color relationships with parents throughout life. In filial bereavement, there can be a resurgence of intersubjective development along with an easing of internalized homophobia. In recovery from loss, there are opportunities to make loving identifications that more fully acknowledge externality and difference.     

Impact of mental health on perception of relationship satisfaction and quality among female same-sex couples

Using data from both partners in female same-sex couples, individual and dyadic (individual/actor-partner) level analyses were conducted to determine the associations between couple members' global mental health, internalized homophobia, and perceptions of relationship qualities and satisfaction (N = 90). Findings at the dyadic level indicated that an individual's global mental health was uniquely associated with her partner's assessment of relationship satisfaction and qualities, beyond the effects of the individual's own mental health and internalized homophobia. Implications for further research on the strengths and challenges within female same-sex couple relationships are discussed.     

Shame,Internalized Homonegativity,and Religiosity: A Comparison of the Stigmatization Associated with Minority Stress with Gay Men in Australia and Malaysia

ABSTRACT

In this study we explore aspects of minority stress by comparing Malaysian (n = 234) and Australian (n = 123) gay men on internalized homonegativity (IH) and internalized shame (IS) in a 2 × 2 multivariate analysis (country × relationship status). Religious motivation (RM) was also included as a variable because of the importance of religion in Malaysia as compared to Australia. Malaysian gay men scored higher on IH, IS, and RM. Single men reported higher levels of IS than did those in relationships. These results are discussed in terms of the minority stress model (Meyer, 2003).     

Preparing College Health Professionals to Deliver Gay-Affirmative Services

Abstract

On every campus, there may be many gay students, faculty, and staff who might benefit from medical and mental health services sensitively developed as an integral part of the range of health services provided to the total campus. It is crucial to develop a cadre of providers from different disciplines who have a knowledge of gay lifestyles, developmental issues, and societal pressures. Staff must develop or heighten sometimes painful self-awareness engendered by empathic identification with a stigmatized minority. They must also conceptualize homosexuality as a relationship preference or lifestyle choice and appreciate the importance of same-sex attachments in normal development.

This paper reviews common presenting themes of gay patients and clients who rarely come for help to change their preference. The effects of homophobia on staff practices and attitudes are reviewed in the context of learned negative stereotyping in the larger culture. Heterophobic expectations of potential gay consumers are explored, including those of being diagnosed as deviant, mentally ill, or arrested libidinally. Suggestions are offered for the design and marketing of collaborative gay-nongay services and for service to older hidden populations. Individuals are encouraged to examine their own relationships to homosexuality and to experience new learning through enriched encounters with gays.     

Midlife and Older Gay Men Living with HIV/AIDS: The Influence of Resiliency and Psychosocial Stress Factors on Health Needs

HIV/AIDS research has mostly focused on younger gay men. This cross-sectional study originated from a larger study of 316 respondents to include a subsample of 38 midlife and older gay men living with HIV/AIDS. The study explores physical and mental health utilization rates, including physical and mental health status. Resiliency, internal health locus of control beliefs, and psychosocial stressors of age and sexual orientation discrimination, stigma, and internalized homophobia were also examined. A total of 65.8% of the HIV/AIDS participants received no mental health services the past year, despite reporting higher mental health distress. Of those reporting an HIV status, 10.5% indicated having no health visits in the preceding year and more delays in seeking care when needed and unmet health needs for which services were not sought. Participants reporting higher resiliency indicated less mental health distress and better health access indicators. Stigma and internalized homophobia negatively affected resiliency. Implications for practitioners working with midlife and older gay men are provided.     

The Role of Self-Conscious Emotions in the Sexual Health of Gay and Bisexual Men: Psychometric Properties and Theoretical Validation of the Sexual Shame and Pride Scale

Researchers have theorized about the role of sexual shame as a mechanism through which sexual minority stress manifests into mental health difficulties, such as sexual compulsivity for gay and bisexual men (GBM), and about the resilience-promoting effects of sexual pride. However, no validated measures to date have directly tapped into these constructs rather than using proxies for them, such as internalized homonegativity. We developed the Sexual Shame and Pride Scale (SSPS) and conducted a psychometric evaluation of it using a sample of 260 highly sexually active GBM. The scale had the expected structure in factor analysis and showed evidence of internal consistency and test–retest reliability. Correlational analyses demonstrated the convergent validity of sexual shame and sexual pride with relevant constructs. Regression analyses demonstrated the predictive validity of sexual shame in relation to sexual compulsivity, accounting for unique variability even after adjusting for previously demonstrated etiological factors, and the predictive validity of both shame and pride, which interacted to consistently predict four sexual behavior outcomes. Findings suggest the SSPS is a psychometrically valid and reliable measure that may be useful in future empirical work and highlight preliminary evidence for the role of these constructs in the sexual health of GBM.     

Mental Health of Lesbian,Gay, and Bisexual Youth and Young Adults: Differential Effects of Age,Gender, Religiosity,and Sexual Orientation

Drawing on minority stress theory, this study examined the mental health effects of the added burden of disadvantaged social status in an Israeli sample of 461 self‐identified lesbian, gay, and bisexual (LGB) youths. Bisexuality was associated with lower levels of well‐being, and, at a younger age, with higher levels of mental distress. In bisexuals, this relationship was fully mediated by family support and acceptance, internalized homophobia, and LGB social contact. Religiosity was associated with low levels of family and friends’ support and acceptance, and high levels of internalized homophobia. These findings highlight the mental vulnerability of LGB adolescents and bisexuals, as well as the social vulnerability of sexual minorities in the religious sector, and the importance of social support to increase mental health.     

Exploring Dimensions of Racism,Homophobia, and Social Network As Concomitant Predictors of Condom Use in a Sample of Black MSM

With a convenience sample of 148 Black men who have sex with men (MSM) who primarily resided in the Washington, District of Columbia, metropolitan Area, the purpose of this research was to concomitantly use dimensions of racism, homophobia, and social network constructs in a regression model to predict condom use. In the model, analysis indicated that condom nonusers versus consistent users experienced more conversations with friends regarding salient topics (i.e., HIV status) (odds ratio [OR] = .86, p < .01) and fewer discussions with sexual partners about salient topics (OR = .77, p = .02). Furthermore, inconsistent condom users versus consistent users experienced higher levels of internalized homophobia (OR = 1.12, p = .04) and less racism associated with physical characteristics (OR = .89, p = .04). Notably, all of the racism dimensions identified in this research were nonsignificant as positive predictors of condom use. Overall, based on the findings, internalized homophobia may need to be isolated or targeted as an HIV-risk factor when implementing individual- and group-level HIV-prevention strategies for Black MSM. Moreover, improved communication skills among Black MSM pertaining to discussing salient topics (i.e., HIV status) with their sexual partners could also be used as a possible HIV-prevention strategy.     

Affective Mediation of Homophobic Reactions to Homosexual Males

Abstract

In a test of the assumed dissimilarity/revulsion (AD/R) model of homophobia, 58 heterosexual males who differed in homophobia participated in an acquaintanceship exercise with a male partner who self-disclosed, midway through the exercise, that his sexual orientation was homosexual or heterosexual. As predicted by the AD/R model, (1) participants high in homophobia became less emotionally invested in their self-disclosures after learning of a homosexual partner's sexual orientation, whereas those low in homophobia disclosed with more emotion over time; (2) participants high in homophobia interacting with a homosexual partner reported more negative affect stemming from the acquaintanceship exercise, evaluated their partner less favorably and indicated greater desired and actual social distancing from their partner than did participants in the remaining three conditions; and (3) the relatively negative behavioral/evaluative responses of participants high in homophobia to homosexual (but not heterosexual) partners were mediated by their affective reactions to the acquaintanceship exercise.