The Closeted Client

The New York Times Magazine, June 19, 2011

Is it possible to be happy and remain in the closet? Most therapists would probably say, "no." Not all therapists agree. According to a front-page story appearing in the magazine section of yesterday's New York Times ("Living the Good Lie"), there is much debate within therapeutic circles as to whether it is ethical to support (and even encourage) a client to stay in the closet. Personally, the thought of telling one of my gay or lesbian clients they should stay in the closet runs counter to my clinical training and how I generally conceptualize sexuality. Much of the work I do with clients--be they gay or straight--is helping them identify and become more comfortable with the various aspects of their lives. But, what do you do if your client's religious beliefs run counter to their sexual orientation?

According to Mimi Swartz, the author of yesterday's New York Times piece, therapists such as myself are struggling with how to be affirming of our client's sexual identities, while remaining respectful of religious beliefs that sometimes deplore homosexuality. Its a conundrum, that some psychotherapists, such as Denis Flanigan, see as "intractable."

Flanigan and other like-minded therapists have attempted to find a third way. Their "client-centered" approach aims to embrace a client's sexual orientation without necessarily forcing that client to identify as being gay. It's a somewhat controversial stance and one that makes some therapists uncomfortable. The American Psychological Association has weighed in on the debate and has cautiously endorsed similar forms of client-centered therapy. In a report commissioned by the APA entitled Appropriate Therapeutic Responses to Sexual Orientation, the APA has concluded: "Acceptance of same-sex sexual attractions and sexual orientation may not mean the formation of an L.G.B. sexual-orientation identity; alternate identities may develop instead" (p. 59). Therapeutically, the results of such an approach can be unorthodox. Sometimes this might mean accepting a client's sexual orientation as gay, while acknowledging their sexual identity as being straight.

For those interested in learning more about this topic, visit APA's Appropriate Therapeutic Responses to Sexual Orientation here.

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Tyger Latham, Psy.D. is a licensed clinical psychologist practicing in Washington, DC. He counsels individuals and couples and has a particular interest in sexual trauma, gender development, and LGBT concerns. His blog, Therapy Matters, explores the art and science of psychotherapy.