Five reasons why gay men may benefit from therapy

gay men
Reading time: 9 minutes

It’s not uncommon for me to meet another gay man suffering from anxiety and depression who is either unaware, in denial, or unwilling to recognize and address it.

Some years ago, I had a falling out with my flatmates. At the time I was directing a major shoot at film school and was under immense pressure. Amid my mad scramble to find a new apartment, I decided to meet Samson*, a gay Phillipino man in his 20s who worked as an IT consultant. 

Having exchanged niceties, Samson quickly got down to brass tacks, advising me he wanted a flatmate willing to hang tea towels and stack dishwashers in a specific fashion.

As someone known for my somewhat OCD tendencies – I for example never allowed people to sit on my bed while wearing their “outside clothes” – I could to some degree relate. 

But Samson seemed to take things one step further. A health fanatic devoted to all-natural products, he told me I wouldn’t be allowed to clean with bleach, on the account he might be exposed to its fumes.

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Despite my reservations, I took the room. But from that first meeting onward, the stipulations piled up. One minute I was using too much fridge space, the next I was filling the kettle with “excess” water and wasting energy.

Samson even took to switching off the oven when he believed I was using it too long.

While he managed to bend some of his rules for me, I couldn’t shake the feeling that my presence in Samson’s home was not welcome. I could tell that while he wanted to save on rent, but also wanted to live alone. 

Worse still, whenever we happened to cross paths, Samson would complain. First, it was about his cutthroat colleagues at work. A week later it was the ex who seemed incapable of empathy, and the friends who failed to understand Samson’s very specific health choices. 

Samson told me he was against eating hydrogenated oils, on account of them being carcinogenic. For him, discovering that a meal contained even a trace of such was enough to ruin an entire night out.

Listening to Samson, I felt torn. Some of his complaints were understandable, and yet I knew I was being used as a sounding board for his discontent.

I tried to bring empathy and some perspective to the issues Samson raised, and yet nothing I said or did made any difference. Samson was trapped in a cycle of negative thinking, focused only on assigning blame to others.

So long as he continued to see the apparent failures of others as a reflection of their respect for him – and by implication Samson’s worth as a person – this would likely continue.

Samson’s paradigm was clearly at fault here, but I became convinced that it was serving double duty as a smokescreen for Samson’s inability to manage his own distress. 

By pretending it was not there, he would never have to confront it. Yet this unwillingness to accept and recognize his covert depression was precisely what was keeping him stuck. Rather than practicing introspection, Samson searched for scapegoats. 

Once or twice I broached the subject of seeing a therapist. Each time, Samson produced a readymade excuse.

The few therapists Samson had approached would not take his health insurance. The nature of Samson’s job meant he was often on the road with short notice, making it difficult for him to plan therapy sessions in advance.

Then there was the question of trust: Samson didn’t want to open up to just anyone

These were legitimate friction points, ones faced by many gay men looking to undertake therapy. But they were also excuses. As per the old maxim, if you really want to do something, you’ll find a way.

1. Gay men often suffer from depression

An inability or unwillingness to acknowledge one’s own mental health struggles is usually a product of self-denial; of alienation from one’s own authentic feelings.

Like a majority of men, we as gay men are programmed to go at it alone. Masculinity is popularly defined as self-reliance, an idea more widely echoed in our culture’s embrace of rugged individualism, i.e. the “I don’t need help from anyone” mentality (see my earlier article on embracing your authentic gay identity).

Gay men tend to be more emotionally expressive than their straight counterparts. Gender-atypical tendencies like this often lead to us being singled out and persecuted. Any wonder then we should be especially challenged when it comes to asking for help.

But forcing ourselves to repress our emotions and to cut ourselves off from the help of others leaves us prone to covert depression. This depression is often the reason many of us should seek help…and yet it can also serve as a major source of resistance.

Depression sufferers know all too well how we can become trapped in the stasis field of negative thoughts and “automatic”, self-perpetuating cognitive distortions.

In his book Feeling Good, David D. Burns notes that these distortions lead in turn to procrastination and “do-nothingism”. That is, we found ourselves restrained by the very same inertia we are seeking to escape. 

Thus the depressive, lacking the motivation to change, surrenders to the comforting familiarity of their unhappiness.

Another reason it is difficult to take action is that covert depression operates as a kind of background presence that evades easy detection, or may be put down to just a passing “mood”.

Similarly, anxiety – depression’s fraternal sibling – may also be dismissed as an inevitable feature of modern life. It may even be regarded as a helpful crutch that gives the sufferer a motivational edge; a willingness to go the extra mile that is recognized and rewarded by employers.

2. We may have attachment difficulties

Caregivers play a crucial role not just in early development but our future wellbeing. They comfort us during times of distress, fostering a sense of security through healthy attachment. That attachment serves as a template for future relationships, shaping whether we are able to form close bonds with others. 

Attachment also provides children with an internal working model of self-worth. It defines whether we see the world as a safe or nurturing place, or one full of pain, uncertainty, and anguish. It provides the primary reference point for our lived experience

Ruptured attachment is the result of either active trauma, which typically involves a boundary violation such as physical or sexual abuse, or passive trauma, which involves some form of physical or emotional lack, such as neglect. Ruptured attachment can occur at any point during childhood or teenagehood.

Gay men experience both active and passive trauma when a parent rejects, neglects or attacks them over their sexuality, an experience which is all too common.

During early attachment, trauma is preverbal, making our suffering literally beyond words. As such, it can be difficult to “re-cognize” the experience and come to grips with its effect on us as adults.

Without the help of a trained practitioner, we will continue to live unknowingly in the shadow of our trauma, afflicted with mental health conditions like depression.

3. We may be unable to self-soothe

Ruptured attachment results in an inability to self-soothe. When our caregivers fail to properly “attune” to us and provide the correct behavioral modeling, we fail to develop this vital skill. 

Self-soothing means being able to realize we are hurting, to give ourselves the comfort we need, and to seek it from others when we can’t

Without self-soothing, we may find ourselves prone to “fight, flight, or freeze” in times of stress. 

That is, we engage in one of three coping strategies: coming out guns blazing, running from danger, or shutting down. We don’t seek the support we so desperately need, leaving us beholden to depression and anxiety.

In an attempt to pacify our troubled minds and hearts, we may turn to the Band-Aid fixes of grandiosity or process addictions.

4. Gay men are debilitated by shame

For gay men, depression is often compounded by longstanding shame. The distinction between guilt and shame, as pointed out by Brené Brown, is that guilt involves believing “I did something bad”, while shame involves assigning a permanent negative quality to yourself, like “I am bad”.

We come by shame firstly through socialization. Society teaches us our sexuality is abnormal, perverse, and even morally wrong. When this view is adopted by our caregivers, it may not necessarily lead to outright rejection, but rather words or deeds that are invalidating.

Invalidations, no matter how small they may seem, can inflict profound psychic wounds, Alice Miller says. If the only people in the world duty-bound to love you unconditionally mock or belittle you because of your sexuality, you may come to believe you are inherently unlovable.

The child with a devastating belief in his own unworthiness is likely to carry it into adulthood. If left unaddressed, this belief can leave us relationally impaired, resulting in an insecure attachment style.

Attached authors Amir Levine and Rachel Heller estimate about half of the adult population suffer from insecure attachment styles. In the case of gay men, this figure may arguably be even higher.

gay men therapy

How a therapist can help

Therapy is one way we can identify the impact ruptured attachment or invalidation has had upon us. It offers avenues for reconnecting with aspects of ourselves we may have become alienated from as a result of parental and social rejection and invalidation. 

And it is through this connection that we develop self-awareness, what Daniel Goleman calls “emotional intelligence”, and thus the ability to self-soothe.

A relationship with a therapist ideally is reparative. They model the unconditional acceptance of an ideal caregiver, creating an accepting space in which clients can vent to thoughts and feelings they have been forced to repress, often as a matter of survival. 

A good therapist uses compassion and insight to help their patients reintegrate alienated parts of the self. Through their guidance, gay men can come to terms with the loss and anguish they have suffered.

Therapy requires that we go to places we have been avoiding. After a lifetime spent mastering the art of emotional concealment, gay men undergoing therapy are asked to forgo their craft and expose their wounds and weak spots.

Embracing vulnerability in this fashion allows us to ultimately regain our long-lost ability to be emotionally authentic.

As Buddhist Pema Chödrön points out:

Without realizing it we continually shield ourselves from this pain because it scares us. We put up protective walls made of opinions, prejudices, and strategies, barriers that are built on a deep fear of being hurt… Finding the courage to go to the places that scare us cannot happen without compassionate inquiry into the workings of ego… Either we question our beliefs – or we don’t. Either we accept our fixed versions of reality – or we begin to challenge them. 

Choosing a therapist

Making the decision to undergo therapy sometimes feels like half the struggle. Then you have to deal with the deadly triad: money, scheduling, and what Samson called trust, but which I like to think of as compatibility

You can’t put a price on your mental wellbeing, so don’t let the cost alone thwart your efforts. If you don’t have a mental health care-inclusive health care plan, consider finding a therapist who offers sliding scale fees. If you need to take time out during working hours, negotiate with your manager or HR department.

When choosing a therapist, we all need an assurance that we are in safe hands. We are, after all, seeking the unconditional acceptance we were once denied. Our chosen confidant, therefore, needs to show they will honor this responsibility. 

Bessel van der Kolk suggests three criteria by which you can gauge this: comfort, curiosity, and collaboration. To that list, I would also add proactivity and accountability:

  • Comfort: Do you feel comfortable and safe in the presence of this therapist? Do they seem comfortable with you? In the words of van der Kolk: “Someone who is stern, judgmental, agitated, or harsh is likely to leave you feeling scared, abandoned, and humiliated, and that won’t help you resolve your traumatic stress”.
  • Curiosity: Does the therapist seem interested in you as a person? Or do they see you as just another patient to be handed a rote list of advice and instructions? Do they actually listen to you? Are they comfortable sitting with your distress? Or do they immediately leap into diagnosis and prescription?
  • Collaboration: Is the therapist demonstrating a genuine desire to work with you, to explore your issues in-depth and to formulate a treatment plan?
  • Proactivity: Some therapists tend to take a nondirective role. As a result, you may feel you have to overcompensate. Sessions may become endless talk marathons, broken only by you prompting your therapist for participation. There is great value in a sympathetic ear, and venting is definitely part of the process. But given for example depression’s tendency to keep us trapped in automatic thoughts, we are never going to make the necessary shifts in our thinking without the help of someone willing to interrupt, redirect and even challenge, where necessary.
  • Accountability: Does your therapist honor their appointments with you? Do they cancel or reschedule on short notice? A therapist who is unpredictable or inconsistent can’t provide you with the security and caregiver-like “containment” you need. This also works in reverse. Do they help keep you accountable? Set tasks and homework? Without proper follow through on your behalf, your recovery may be hindered.

Remember: you are not locked into any therapist relationship. Treat the first session and those that follow like you would a date. You may be seeking immediate relief, but your objective should be to assess compatibility. 

In the end, there is no use building a relationship with someone who isn’t capable of giving you the support you need. Be willing to shop around until you find the right fit. And if it isn’t working, be prepared to move on. 

As with any endeavor, you will face setbacks. Sometimes these setbacks may simply come down to lack of motivation. If this is the case, break the task of finding a therapist into baby steps and try to complete one step a day.

The act of unlearning maladaptive behaviors and patterns can take months, if not years. Your recovery ultimately comes down to your being patient with the journey, flexible in your approach, and perhaps most importantly, remaining committed to your wellbeing,

Creating a new self unburdened by the injustices of your past first requires that you choose to break with the old.

“When I let go of what I am,” says Chinese philosopher Laozi, “I become what I might be”.

For advice on finding a therapist, check out this handy post by the American Psychological Association.

Takeaways

  • Acknowledge you may have depression.
  • Consider how your attachment history and feelings of shame might be playing a role.
  • Fight motivational inertia! Take it one baby step at a time.
  • Stay committed. You're in this for the long haul.

Have self-care tips of your own you’d like to share? Comment below, or send me a message.

* Names and identifying details have been changed to protect the privacy of all individuals discussed in this article.

© Ehsan Knopf. Any views or opinions represented in this blog are personal and belong solely to the blog owner and do not represent those of people, institutions or organizations that the owner may or may not be associated with in professional or personal capacity, unless explicitly stated. All content found on the TheThoughtfulGay.com website and affiliated social media accounts were created for informational purposes only and should not be treated as a substitute for the advice of qualified medical or mental health professionals. Always follow the advice of your designated provider.

10 self-help books to read during the coronavirus lockdown

coronavirus lockdown gay books velvet rage
Reading time: 8 minutes

The coronavirus lockdown may have given us time aplenty to stew and fret, and yet that time can just as easily be used to play “life catch up”.

With the world deep in the midst of its own crisis, there is arguably no better time for personal reckonings and insights.

Here are 10 self-help books that you may find infinitely helpful in your own quest for answers as a gay man.

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Understanding the gay struggle

“Something about growing up gay forced us to learn how to hide ugly realities behind a finely crafted façade. Why is this so? We hid because we learned that hiding is a means to survival.”
– Alan Downs, The Velvet Rage

Even as an out and proud gay man, I felt like I was still living a life of subterfuge. Only now it wasn’t my sexuality that I was hiding but my vulnerability

My dating experiences revealed I wasn’t the only one struggling with an entrenched sense of self-loathing and shame. More than a few of us had been left emotionally crippled by our experiences.

Not only were we incapable of building robust relationships – we were also prone to seeking relief through substance and process (behavior) addictions.

The Velvet Rage argues however that there is cause for hope. Author Alan Downs charts the journey gay men must take from self-loathing to self-acceptance before concluding with a raft of invaluable suggestions for how we can live happier and healthier lives.

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Transforming your life through vulnerability

“Vulnerability is not weakness, and the uncertainty, risk, and emotional exposure we face every day are not optional. Our only choice is a question of engagement. Our willingness to own and engage with our vulnerability determines the depth of our courage and the clarity of our purpose.”
Brené Brown, Daring Greatly

When I came out as gay, I was searching for connection and a sense of belonging. I was, in a way, looking for a replacement family for the one from which I had become alienated.

Initially I looked for it at gay venues, like bars and clubs. I quickly learned that it was sex, not vulnerability, that many of the men I met were looking for.

These individuals might claim to have achieved self-acceptance, and yet their aversion to vulnerability was so total, the denial of shame so complete, that our relationships remained mired in superficiality.

Any invitation to be emotionally authentic was met with bewilderment, resistance, and even scorn. To those I encountered, being vulnerable was at best weak, at worst dangerous.

Daring Greatly author Brené Brown argues that this need not be our fate. “Shame,” she writes, “derives its power from being unspeakable. Shame keeps us small, resentful, and afraid”.

Her solution? Recognize it for what it is, understand its triggers, strive for critical awareness, and be willing to reach out to others and speak out about our shared experience of shame.

You can watch Brown’s TED talk on vulnerability here.

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Recognizing the influence of trauma

“Traumatized people are terrified to feel deeply. They are afraid to experience their emotions, because emotions lead to loss of control… Being traumatized is not just an issue of being stuck in the past; it is just as much a problem of not being fully alive in the present.”
– Bessel van der Kolk, The Body Keeps the Score

I was 12 when my family began to fall apart. My older brother’s daily battles with my parents, his drug use and random acts of violence, lying, and thievery reduced our household to a warzone.

My parents eventually buckled under the strain of it all, withdrawing emotionally and giving my brother free reign to bully me. 

The experience left me stricken with an unrelenting sense of loneliness and worthlessness.

Trauma was a word I exclusively associated with veterans or victims of extreme abuse. But as I came to later learn, trauma can be entirely passive, like emotional neglect.

Trauma for gay children is an all too common experience. We face it when we are rejected, assaulted and even cast out for our sexuality.

Bessel van der Kolk’s comprehensive The Body Keeps the Score is a deep-dive into the manifestations and mechanics of trauma.

Readers will come away from it with new insights not only into their own experiences with trauma, but possible treatments as well.

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Adopting optimistic thinking

“An optimistic explanatory style stops helplessness, whereas a pessimistic explanatory style spreads helplessness. Your way of explaining events to yourself determines how helpless you can become, or how energized, when you encounter the everyday setbacks as well as momentous defeats.”
– Martin Seligman, Learned Optimism

While my family was disintegrating, I was also being bullied at school due to a then-undiagnosed disability, Asperger syndrome.

My resulting depression and anxiety led to what Learned Optimism author Martin Seligman calls a “pessimistic explanatory style”. 

In moments of difficulty I would resort to self-blame, telling myself I was unlovable and entirely deserving of my misfortune. These explanations came at great cost to my mental wellbeing.

Learned Optimism argues that we can correct this chain of thinking by identifying the adversity we’ve experienced, the existing beliefs they trigger, and their consequences. By disputing these beliefs, we can alter the impact they have on us.

You can discover your own explanatory style with the help of this quiz devised by Seligman.

coronavirus pandemic gay books self compassion

Being kinder to yourself

“Self-compassion provides an island of calm, a refuge from the stormy seas of endless positive and negative self-judgment so that we can finally stop asking, ‘Am I as good as they are? Am I good enough?’”
– Kristin Neff, Self-Compassion

Previously I’ve discussed the burden of “grandiosity”, a defense used by gay men against feelings of inferiority or covert depression.

The one thing I’ve found key to my recovery as a grandiose workaholic perfectionist is the very thing I’ve denied myself: self-compassion.

When our attachment as children to our primary caregivers is disrupted (more on this below), we fail to develop critical self-soothing skills.

This may cause us to neglect our own needs during times of stress or suffering. We may even seek distraction in grandiose or self-destructive behaviors, like addiction.

Self-Compassion author Kristin Neff offers a third alternative: practicing self-soothing through mindfulness, being aware of our emotional states, and responding appropriately to them with words and acts of compassion.

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Adopting a ‘growth’ mindset

“Believing that your qualities are carved in stone – the fixed mindset – creates an urgency to prove yourself over and over… Every situation is evaluated: Will I succeed or fail? Will I look smart or dumb? Will I be accepted or rejected? Will I feel like a winner or a loser?”
– Carol S. Dweck, Mindset

Those fixed in their thinking, like grandiose gay men, are stricken by a fear of failure and imperfection. 

As such, they seek success in the place of growth, superiority rather than self-acceptance.

But, as in the words of Mindset author Carol S. Dweck: “If you’re somebody when you’re successful, what are you when you’re unsuccessful?” The fall from such heights can be devastating. 

The opposite of a fixed mindset is the growth mindset, which calls for us to suspend constant judgment of ourselves and others, in favor of personal change and development.

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Setting clear boundaries

“Setting boundaries inevitably involves taking responsibility for your choices. You are the one who makes them. You are the one who must live with their consequences.”
– Henry Cloud and John Townsend, Boundaries

Boundaries are crucial for all gay men because our right to choose how we live is one that often comes under the scrutiny and judgment of others, especially our own families.

As a gay man who enjoys a close relationship with my mother, I can safely say that it was one arrived at through continual negotiation, and a willingness to defend my personal boundaries. 

My transition to independent adulthood was predictably rough. My mother, for reasons that were perfectly logical to her at the time, would insist on trying to control or judge aspects of my life even after I left home. 

My decision to get a mini-mohawk, for example, would result in the silent treatment. Piercing my ears resulted in her nagging for me to “take them out”.

In moments of weakness I would kowtow to her will, at the cost of mutual respect.

Renegotiating boundaries with our parents can be a particularly thorny process, yet it is critical to the longevity of your relationship as well as those that follow.

While the non-religious may struggle with Boundaries’ numerous Biblical references, Henry Cloud and John Townsend’s classic remains a vital guide to establishing better relations with our loved ones.

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Understanding your relationship needs better 

“People have very different capacities for intimacy. And when one person’s need for closeness is met with another person’s need for independence and distance, a lot of unhappiness ensues.”  
– Amir Levine and Rachel Heller, Attached

Dating for me has historically been an uneven game of push-pull; a mismatch of varying needs and expectations.

It was only when a friend introduced to me the concept of attachment styles that the cause was at last brought into focus.

Our relationships with our primary caregivers from our childhood onward serve as a template for how secure we feel in the world. It also forms the basis for how we “attach” to others. 

Attachment falls into three categories: secure, anxious, or avoidant. Anxious people seek closeness and affirmation, avoidants seek distance and independence. 

Secures typically have no difficulty bonding with either type and thus serve as an ideal partner for anxious and avoidants.

While this all sounds rather formulaic, being able to recognize your own needs as well as that of your romantic partner is a guaranteed way to save both of you a lot of difficulty – and heartache – down the road.

Those interested in identifying their’s or other’s attachment styles can try this brief quiz by authors Amir Levine and Rachel Heller.

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Learning to meditate

“Mindfulness is moment-to-moment non-judgmental awareness. It is cultivated by purposefully paying attention to things we ordinarily never give a moment’s thought to. It is a systematic approach to developing new kinds of agency, control, and wisdom in our lives, based on our inner capacity for paying attention and on the awareness, insight, and compassion that naturally arise from paying attention in specific ways.” – Jon Kabat-Zinn, Full Catastrophe Living

Fight or flight is an automatic, unconscious reaction to stress. Stress in life is unavoidable; our choice merely comes down to how we choose to deal with it. 

The traumatic experiences of my childhood had become hardcoded into the behavioral circuitry of my brain. Later conflicts would invariably trigger them and I found myself resorting to fight or flight, to the detriment of my relationships.

In Full Catastrophe Living, author Jon Kabat-Zinn explains that by escaping the constraints of constantly judging and reacting, we discover not only self-awareness, but inner “realms of well-being, calmness, clarity, and insight”. 

Using exercises like diaphragmatic breathing and meditation, we learn to be present with our experience; to be aware of our feelings, rather than controlled by them. 

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Improving emotional intelligence

“People with well-developed emotional skills are also more likely to be content and effective in their lives, mastering the habits of mind that foster their own productivity; people who cannot marshal some control over their emotional life fight inner battles that sabotage their ability for focused work and clear thought.”
– Daniel Goleman, Emotional Intelligence

The skills described above – self-awareness (knowing one’s own emotions) and self-compassion (managing those emotions), as well as self-motivation, empathy and relationship management – are all critical to what Daniel Goleman calls “emotional intelligence”.

Emotional intelligence is a meta-ability that governs how successful we are in all aspects of our lives, from relationships, to our wellbeing, to personal effectiveness and productivity.

My discovery of Daniel Goleman’s seminal work served in this sense as a catalyst for confronting my own trauma and seeking a fresh perspective on my struggles.

I accomplished this with the help of therapy, reading self-help and psychology books, opening up dialogues with others, and yes, undertaking meditation.

While some sections and theoretical discussions may not be relevant to all readers, Emotional Intelligence is an inspiring essential read for all thoughtful gay men on the path of self-improvement.

Have self-care tips of your own you’d like to share? Comment below, or send me a message.

© Ehsan Knopf. Any views or opinions represented in this blog are personal and belong solely to the blog owner and do not represent those of people, institutions or organizations that the owner may or may not be associated with in professional or personal capacity, unless explicitly stated. All content found on the TheThoughtfulGay.com website and affiliated social media accounts were created for informational purposes only and should not be treated as a substitute for the advice of qualified medical or mental health professionals. Always follow the advice of your designated provider.