A friend approached me last week in regards to this article about things I learned at Transcending Boundaries, a wonderful conference I had the honor to attend whose purpose is to educate and provide a haven for people who are part of gender, sexual, and relationship minorities. While she told me she enjoyed the article, she expressed some concerns that she had about my “newness” to some of these issues. “If you’re writing that you just learned that BDSM isn’t scary,” she queried, “how can someone in the kink community feel comfortable coming to you for therapy?
I answered her with one of my favorite therapy stories. (The details have been changed to protect client confidentiality.)
A woman came into my office looking very nervous. She was coming to therapy to explore anxiety issues, and since starting therapy can be an anxiety-provoking experience, she was visibly shaking as she sat down on my couch.
I gave her my standard intake talk about office policies, confidentiality, late cancellations, and other routine matters, and then asked what had brought her to therapy. She began to talk about debilitating anxiety and some of the things it prevented her from doing in her daily life – things like grocery shopping, socializing, and engaging in hobbies. She told me about the support system she and her husband shared, and then paused nervously.
“I should tell you… yes, it’s going to come out eventually so I should just tell you. My husband and I are polyamorous.”
I smiled. “Thank you for sharing that with me. I have a lot of friends who are poly.” And the most amazing thing happened – her body visibly relaxed, and she was able to complete the remainder of the session with a much calmer, more natural demeanor.
I learned a lot from that experience about the importance of an open mind and a willingness to learn from clients about the way they live their lives. Just like I don’t need to be a tax attorney to do therapy with a tax attorney, just like I don’t need to have experienced terrible trauma to help someone who has, I also don’t need to have the same types of relationships my clients do in order to help them with their other problems.
Seeking therapy is scary for a lot of people, but for people in the GSRM (gender, sexual, and relationship minority) community, there’s another layer of difficulty. Unless they find someone who has a basic understanding of the way they live their lives, they could find themselves face to face with a therapist who wants to spend the first few months of therapy exploring how their polyamory is really just indicative of a fear of commitment, or how their interest in BDSM demonstrates that they must be repressing or reenacting a trauma history.
Being culturally competent means having a basic understanding of a community and a willingness to learn more from an individual – striking a balance between educating oneself about the way people live while also maintaining an understanding that each individual experiences things differently. Most people talking about cultural competence are referring to racial or ethnic groups, but there are a lot of different types of cultures outside of that definition. For example, I just read an article about being culturally competent to work with individuals in the military.
I would assert that cultural competence is also important in working with relationship minorities. I have a fundamental understanding that individuals who are polyamorous or kinky are not “broken” and I leave it to an individual to educate me about what their identity in that community means to them. I recognize that my polyamorous 3:00 client might “do” polyamory in a very different way than my polyamorous 4:00 client. I understand that if someone tells me they’re exploring kink, they might mean bondage, they might mean role playing, or they might mean something I’ve never even heard of. I may need people to clarify terms for me – to remind me that a “switch” is sometimes dominant and sometimes submissive, or to explain to me that a “metamour” is the romantic partner of your romantic partner. But at the end of the day, I have enough understanding to acknowledge the way my clients live their lives and to help them with whatever led them to seek therapy.
All of this is compatible with my own personal way of looking at mental health: “If you’re not hurting anyone else against their will and you don’t feel emotionally bad, you’re probably doing ok.”