HealthyGamerGG - How do I come out of the closet??

Episode Date: June 23, 2022

Today Dr. K talks about coming out of the closet, how it interacts with therapy, misconceptions of therapists, and talking about sexuality to your therapist. Support this podcast at — https://redcircle.com/healthygamergg/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy Learn more about your ad choices. Visit megaphone.fm/adchoices

The tricky thing is that sometimes in therapy is when we actually have to hide the most. How do I come out to my therapist? I live in a very not-so-accepting, heavily religious country, and I feel like I can't trust people with this information, even a therapist. I trust my therapist with a lot, but I'm still afraid that they're going to out me with my parents, and that is truly a terrifying thought. I've been wondering about it, and I think it would help my case, because I feel like a lot of my problems also stem from my sexuality. but I just don't know how to tell if I can trust them with this. So the trickiest thing about sometimes being in therapy is that therapy is a place where we have to be very careful what we say,

which is kind of silly because therapy is supposed to be the place where we can say whatever we want to without being burdened by the consequences. But I've seen this a lot as a psychiatrist where patients will, come into my office and will try really hard to tell me they're suicidal without telling me that they're suicidal. Because if they tell me I'm, if they tell me that they're suicidal, because of medical legal reasons, I'm going to have them hospitalized. Because a lot of therapists, we have protocols, right, where it's like, oh, like you have to assess for suicidal ideation. You have to assess for suicidal ideation. A lot of times providers, it's very hard to sit

with the possibility of suicidality. So that's something that we're trained to do. do, right? So like, you can't hospitalize everyone who has a suicidal thought. That's just not feasible. It's not helpful, by the way. So the criteria for hospitalization are things like imminent risk. Chronically elevated risk is a completely different thing. So there's nothing special about today. It's like if you've had suicidal thoughts every day for the last three years, like hospitalizing you today may not help at all. But as a patient, you're terrified, right? Because maybe that's happened to you in the past, where clinicians didn't pay attention. to what you were saying, and they just heard these magic words, which set them off on a track.

And then they stop listening to you. Right. And so, like, sometimes what you have to do in therapy is, like, hide from someone who's really good at seeing through BS and is, like, knows you really well. And sometimes you're in a situation like this where, like, your therapist, you're concerned that your privacy is not going to be kept safe. They may have values or religious beliefs that they'll project. upon you so you can't be yourself.

So the tricky thing is that sometimes in therapy is when we actually have to hide the most. We also see this sometimes. It's kind of sad. But sometimes people, patients, respect their therapists. And in turn, they want the respect of their therapists. Because my therapist is such a good person. They care about me so much. They try so hard to help me. And stupid old me can't be helped.

And I can't bear to see the disappointment. They try so hard. they've worked with me so much, and I'm just not getting better. And so I have to pretend to be better so as to not disappoint my therapist. I've seen that too. So it's tricky because sometimes, like, this one person that we're supposed to be able to trust with all of our secrets, all of our worries, all of our fears, can be the hardest person to confide in. So what do you do about it?

So this is where I'm going to give you all. So this is where, like, I could go the route of, I'm sorry, you're in this situation and be very, like, empathic and stuff. And I genuinely am. Like, I think it's really sad that we live in a world where we know that there are scientifically validated forms of helping another human being in terms of, like, emotionally and, like, helping them understand themselves. Like, we know this through research. And we have large parts of the world where, like, people don't do that, right? where cultural influences, religious influences, trump what we know to be clinically effective.

We know basically what a lot of the right answers are in terms of patient autonomy, meeting people where they're at. But sometimes we have people in our community who come from these places where we can sort of say, go see a therapist, right? I say at the beginning of every stream, if you have a concern or question,

but sometimes it's a therapist that you get. So what can you do about this as a patient? So there are a couple of things. They're basically going to revolve around asking your therapist about a couple of these things. So this is where if you're, let's say, gay and you're growing up in a place that has religious restrictions against that or judgments, how do you navigate telling this part of yourself to someone who may not accept it? So this is where, remember that coming out of the closet or even being gay. is not binary, right? So we sort of think about it as binary. Like, oh, are you in the closet or are you out of the closet? Like, they're just two modes. But the truth of the matter is that if you really look at people's experiences of coming out in terms of sharing their sexuality, like it doesn't happen in a binary way, right? First, you tell particular people, maybe you start with a romantic partner, right, obviously. And then like you tell your close friends, sometimes you come out to your family, you come out to your friends, you come out to your dog. And you tell particular people. You like whatever.

So it's actually a gradual process that has a lot more nuance to it. That's been my experience anyway in terms of working with people, is that you don't have to come out all at once. You can sort of like do it in a graded manner, right? So what I would do is in that way sort of ask the therapist a couple of questions. So you don't have to come out and say, hey, I'm gay. You can ask them questions like, you know, what is your understanding of, like, what do you think about like homosexuality or like homosexuality?

or like homosexual thoughts or whatever. Like, what do you think about being gay, being lesbian? How do you understand that, that phenomenon as a thing? So you can sort of just ask them what they think about it, right? So you don't have to, if you're afraid that they're going to tell your parents, you don't have to tell them that you're gay. You can just ask them what they think about. Now, they may start to ask you questions, like,

why are you asking so much about what I think about being gay? And that's where you can also, like, so that's like the first thing, because you can just ask them what they think about it. You could sort of get a sense of whether this is safe or not. next thing that you can do is you can share with them that you have particular thoughts, right? So if you're concerned about them labeling you as gay, treating you as a particular way, and, you know, as an acknowledgement, like, I think it's sad that you have to do this. I think it's, like, concerning that you have to worry about ethical violations and stuff like that.

That's really not okay. But the truth of the matter is that some of us are in situations that are not okay. And that situation is a reality. and sort of like shaking our fists at the world and saying, oh, like, this is so unfair. Like, yeah, it's unfair and it's sad that you're in that situation, but you've still got to, like, do something, right? Shaking your fist at the world and saying that, oh, I live in a country that's not accepting of gender fluidity or sexual fluidity is like, yeah, it's sad, but like we've got to help you figure out what you're actually going to do about it. So the next thing that you can do is even kind of point out to your therapist that sort of like sometimes you have these kinds of thoughts, like what do they think about that?

How can they, how do they understand why do people have these thoughts? And that's where like hopefully your therapist will say one of two things. I mean, hopefully they say one thing, but they could say one of two directions, right? One is that some people are gay and that's just how it is, it's completely okay. And if they say that, then you're good, hopefully. The other thing they'll say is, oh, yeah, it's like an abomination against God. And so those thoughts need to be dealt with. The interesting thing is that either way, you can even go one step further.

And you can say that I believe that a lot of my problems stem from these thoughts. I'm noticing, I'm wondering whether there's a relationship between some of the thoughts that I have and some of the problems that I have. And so you don't have to come out as gay. You don't even have to embrace it. you can just point out, as you've done, that some of my challenges come from having these thoughts. And then y'all can work through, hopefully, that without sort of like owning and coming out of the closet entirely if it's not safe to do. So that's where I would even hope that there's a way to, like, work on some of these problems, even without coming out entirely to your therapist. Now, that's going to feel bad in some ways. It's going to feel really sad, too.

It's unfortunate that that's, you have to do these shenanigans, right? Because you're supposed to be able to trust your therapist. But that's where, like, even as a therapist, if I, if I'm judging something and a client comes to me or patient comes to me and says, I want to work on this thing, I can still work on them without, I don't know, I say this, without, like, letting the judgment kind of get in the way. So if someone comes to me and, you know, has a particular problem that I judge, if they say that, hey, I think this is like a concern that I have and it's affecting my life in these ways, can we work on that? I'd say yes, right? It's like, that's what we're supposed to do as therapists. So I think there's even a way to frame it where if you kind of point out that I'm wondering whether these thoughts and I think that language can actually be really helpful. Because it doesn't actually involve coming out and expose you to that risk.

Now, it's super sad that you have to frame it that way instead of being able to own your identity. Like, that's really unfortunate. It's a tragedy. But if that's the world that you live in, I think survival first. Right? And like, so I'd say you can start by sort of asking your therapist, if you're concerned about your therapist judging you, you can ask them about the topic is not related to you. What do you think about this thing? Next thing that you can do is you can share with them that you're sort of like having some of these thoughts and like, what do they think about that?

How should we handle that? And third thing that you can do is if they're tied to particular other challenges that you face, which is very common, then can we work on the connection between these two things? and at least be able to talk about some aspects of sexuality as it relates to these problems without coming out to your therapist and exposing yourself to a bunch of risk. Because this is an issue of safety and vulnerability. The other simple questions that you can ask

is how confidential are these sessions? So is there any chance that, I mean, you sort of have to ask. You know, would you ever disclose anything to my parents? Have you disclosed anything? to my parents. Under what circumstances would you disclose things to my parents? And that's where hopefully they're honest with you and hopefully you trust them and they're kind of straightforward with you. But there are absolutely cases where, you know, therapists exist within a community, where they will violate confidentiality for the sake of like community stuff, which I think

is absolutely an ethical mistake. But it does happen. And you can't really, you know, if you're somewhat, I mean, it can be super challenging to be, you know, not. heterosexual in certain parts of the world. And so, like, I think you've got to behave in sort of a safe manner. And hopefully, these are a couple of things that you can sort of try to, like, test the waters with your therapist. And that's essentially what I would recommend is, like, you've got to see how they are. And then over time, you can also ask, you can find a different therapist.

It sounds like you trust this person a lot. So I'd start by actually having a conversation with them a little bit about some of these ideas. So hopefully that'll help.