October is Domestic Violence Awareness Month in the US, a time to acknowledge and create a listening space for victims and survivors. Domestic violence (DV), also known as intimate partner violence (IPV), occurs in all types of communities, identity intersections, social locations, and socio-economic standings. According to the National Coalition Against Domestic Violence, every minute 20 people in the US (about 10 million people) are physically abused by an intimate partner. The CDC defines intimate partner violence as “physical violence, sexual violence, stalking, and psychological aggression by a current or former intimate partner.” The effects of DV/IPV can be devastating for the family system as a whole, for each partner, and for the children who witness this type of violence. Trauma from DV/IPV can be experienced across generations. EMDR therapy has been an effective treatment for survivors of intimate partner violence (Schwartz et al., 2021). There is a great opportunity for EMDR therapists to help survivors of intimate partner violence.

This October DV Awareness Month, we are highlighting EMDRIA member Sue Genest’s article originally printed in the Spring 2023 issue of Go With That Magazine on “EMDR Therapy, Sexual Trauma, & Intimate Partner Violence.”

EMDR, 2SLGBTQPIA+ Community and Intimate Partner Violence

Go With That Article by Sue Genest

It is with great appreciation that I mention EMDR International Association (EMDRIA) inviting many speakers of varying social locations over the last few years to participate in presenting on multicultural and intersectionality as affirmative action toward inclusion and equity. These actions are impacting the lives of EMDR community members, like me, who experience discrimination as well as the lives we touch in our work in the world.

It would be impossible to speak to all social locations of the entire 2SLGBTQPIA+ community (rainbow community) in relation to intimate partner violence in this one article, but I will do my best to outline some basic tenets to contribute to awareness on the subject and make reference to authors and resources where further information can be obtained.

There are many layers of burden and oppression, varying social locations, and privilege across the rainbow community. Dr. Ashley (2021) refers to the oppressive matrix of varying privileges and disadvantages crossing over that impact lives daily. Minority stress models overlapping with research specifically on the rainbow community are beginning to highlight the needs and limitations of current research (APA, 2021; Harper, A. et al., 2009).

Research is still needed to fully understand the lived experience of members of the rainbow community and conduct unbiased explorations to effectively set in place affirmative healing action.

What is Sexualized Violence?

Intimate partner violence (IPV) includes all forms of abuse, such as sexual, physical, mental, emotional, financial, and spiritual. Sexualized violence includes IPV, but also societal and institutional violence on the grounds of gender, gender norms, roles, and expectations (APA 2021). Although this article is about IPV, I cannot separate the sexualized violence rainbow members experience daily within society that impacts and influences their experience and relationships. These include hate crimes, microaggressions, heterosexism, internalized heterosexism and binegativity, anticipation of stress and stigma, bullying; sexual harassment; racism, sexism, ageism, ableism, and classism. Rainbow members regularly feel compelled to conceal their identity to increase safety and lower anticipated violence (APA, 2021; APR 2021; Meyers 2015).

Additionally, the collective psychological injury of colonization, slavery, genocide, migration, and police murders along with racial, cultural, and institutional betrayal layer the burdens of the rainbow community and increase the risk of vulnerability to IPV and negative health impacts (APA 2021; Archer 2021; Brothers, G. 2021; Nickerson, M. 2021).

Societal and institutional violence playing a role in sexual violence contributes to the vulnerability of individuals and the community. The intersectionality of “interlocking systems of oppression” (APA 2021; Collins, et al. 2018), from societal discrimination and the lack of healthful representation in the world contributes to stress, disruptive development, isolation, and health challenges. The sexual minority stress model explains the need for community members to conceal their identity to reduce their stress while consecutively leading to poor health and identity-based disparities (Meyer 2003; Meyer 2015).

These disparities impact the daily lives of many and are reflected overall in societal institutions like correction populations with disproportionately marginalized communities incarcerated (Ahlin, et al., 2022). A parliamentary report in 2022 showed 50 percent of female inmates are indigenous in Canada with longer sentences and poorer outcomes, which is an increase from a decade ago. Compounding the problem is the lack of indigenous representation in staff and elders/grandparents (Steele, P. 2022). Black Canadians are also overrepresented in the correctional system (CNW 2022). “According to the U.S. Bureau of Justice Statistics, Black males accounted for 34 percent of the total male prison population, white males 29 percent, and Hispanic males 24 percent (USBJS 2018).”

More research is needed to capture the social location of the rainbow community, which changes over time, by age, gender, race, culture, ability, social class, and geography thus political and social actions around the world. Additionally, the historic marginalization and pathology by diagnostic and assessment systems, for example, pathologizing identity and sexual expression; no normed groups or community representation; limit what interpretations and generalisations can be made. Still intentional sampling is necessary and a sensitivity to the challenges in learning about the community and IPV is critical (ACA 2009; Harper, A. et al., 2009).

Lack of societal and institutional interest and heteronormative assumptions reduce funding, representation and visibility, and thus relevant publications and affirmative action. Stereotypes and bias leave gaps in the research, theory, and counseling practice. Rolle et al. (2018) noted that only three percent of IPV total research was focused on sexual minorities. No articles this author explored investigated age differences and IPV in the community. Specific searches on rainbow youth and IPV noted more research was needed while no articles mentioned the unique challenges of rainbow elders. Research limitations include male-focused studies, including that of animal research leading to theory and practice that have limited applicability, for example, identity development theories where participants are cisgender male (Banks, Hirschman, 2016; Collins et al., 2018; Collins, S., & Oxenbury, J. 2005; Collins 2005; Genest, (1) 2003).

Myth and stereotype harm true understanding and exploration of the rainbow community. Some of these include the belief that women don’t harm; IPV is mutual amongst cisgender male-to-male relationships; assuming no difference from the heterosexual community; a male’s nature is to overcome, be promiscuous, testosterone creates violence; and the inherent predatory behavior and perversion of the community. Myths could mean anticipation of violence as normative, for example, between cisgender male-to-male relationships or for transgender males taking hormones. These and other myths lead to conversion therapy and oppressive laws (BBC, 2021; Oxenbury, J. 2005; Rolle et al. 2018). Further, victims reaching out for help may be dismissed, have their reports minimized, or be harmed by professionals. The researcher’s gender expression and situational factors like geography (law, culture, etc.) may impact subject disclosure and thus outcome. Further, the invisibility of elders in all communities reduces their voice in research, and perhaps the assumption that youth may not experience IPV may also silence their experience (APA 2021; Human Rights Campaign, 2017; Genest & Oxenbury 2022; Oxenbury, J. 2005).

Other complications to research in this community include the need for members to “out” themselves or identify as part of the community to participate. Further, those experiencing IPV may be less inclined to “out” themselves to protect the reputation of the community in which they gain a sense of belonging and in light of the laws pertaining to the community in their geographic area (Rolle et al. 2018). Additionally, they may be isolated by the abuser due to rejection of family, church, or cultural community and in some geographic locations face punitive laws (Genest & Oxenbury 2022; Oxenbury, J. 2005). They may also fear retaliation from partners/community, additional violence from health professionals, loss of access to family or children, health necessities being withheld; health status being outed; lack of safe resources such as shelter or protective IPV laws (for example a restraining order disallowed); further isolation; and worsening conditions such as homelessness and being outed to family, employer, or other important cultural or spiritual communities (The Advocates 2013; Collins & Oxenbury, 2005). Additionally, internalized hate and shame lowers self-esteem and one’s ability to seek help (Meyer 2003, 2015). The National Coalition Against Domestic Violence reported that 45 percent of victims did not report due to the fears mentioned here, such as further victimization and denial of support (NCADV, 2018).

Although the rate of IPV in rainbow communities is between 25-33 percent and similar to cisgender heterosexual relationships, 29-33 percent, the oppressive intersectionality complicates access for couples seeking support and treatment. There are many similarities between how abusers control their victims across IPV relationships regardless of sexual preference (Center for American Progress, 2012). However, in rainbow relationships, batterers may use additional tactics, such as stealing their partner’s identity to access finances or assets; and threatening to “out” their victims to work colleagues, family, friends, significant cultural communities, and authorities. Additionally, risks such as losing access to one’s children may suppress a victim from reaching out for help (The Advocates 2013; NCADV, 2018; Peitzmeier, S., et al. 2020).

Social location further weighs on members who are BIPOC (highest physical violence); transgender (more IPV in public); and those on public assistance (highest IPV) (NCADV, 2018). Other community abuse includes name calling; assaulting body parts; and denying access to health care and prosthetics (Genest & Oxenbury 2022).

Min et al. (2021) reported same sex women-to-women IPV is predominantly verbal, emotional, and mental abuse—43 percent (18 percent experienced physical; 14 percent sexual). While same sex male IPV is predominantly emotional abuse—33 percent (17 percent physical; 9 percent sexual) (Badenes-Ribera et al., 2015; Rolle et al., 2018). Badenes-Ribera et al. (2015) completed a meta-analysis of same sex female IPV and found the mean victimization over the lifespan to be 48 percent. Rolle et al. (2018) noted that over 50 percent of men and 75 percent of women faced psychological IPV. Transgender and intersex rape was reported as 50 percent (Alderson & Oxenbury, 2015). NCADV estimates that 50 percent of transgender and bisexual women experienced sexual violence (CAP, 2012; NCADV, 2018; Peitzmeier, S. et al. 2020).

In 2020 in the Journal of Public Health Review, 85 articles were published with 74 unique data sets and 49,966 transgender individuals reported they had a likelihood of experiencing 2.2 times more IPV than other community members having experienced 37.5 percent of physical violence, 25 percent sexual violence. They were also at an increased risk of substance use, sex work, and mental health burden. Employment and housing discrimination, familial rejection, and conflict increased homelessness and sex work (CPA 2021; Rolle et al., 2018).

Jane Oxenbury’s research in 1990 suggested male-to-male IPV had a higher rate of physical violence while same sex women-to-women IPV was predominantly psychological. There is a possibility that the 30-year difference in the collection of data demonstrates age and culture differentials. No research this author reviewed noted the age groupings of research participants. Given the historical significance of oppression, hate crimes, and legal changes over the last thirty years, there is a necessity for further research to determine IPV differences amongst varying ages in the community (Genest & Oxenbury, 2022; Oxenbury, 2005).

Elders in the rainbow community may face further victimization and isolation due to limited safe and positive public gatherings; concealment of identity such as in auxiliary care or with helping professionals; and cultural beliefs during their development that compound internalized homo/bi/transphobia. Their isolation growing up and across their life span may increase their risk of bonding with the abuser, lower the chance of leaving, increase a sense of helplessness and shame, and lack of knowledge of safe resources. Further, their experiences of societal and institutional violence and invisibility limit their assurance that reaching out would provide affirmative support (CPA 2021; Genest & Oxenbury 2022; Rolle et al., 2018).

Another aspect with little reference in the literature is the phenomena of lateral violence. This term is often used in reference to indigenous communities. Other references noted nursing communities where dissatisfaction and frustration were aimed toward each other, self, and those less powerful (Falletta, 2017). Lateral violence may come from internalized heteronormativity, pathology, and the many other factors named in this article. The development of protective laws over time and societal views changing also change the subgroups targeted. Currently, transgender and bisexual individuals face the greatest violence in society and thus may also experience higher rates of lateral violence in the rainbow community. Elders or subgroups particularly at risk of lateral violence in their lived experience, may also be less likely to reach out for support when experiencing IPV.

Immigrants who have come from cultures and countries in which the rainbow community has been criminalized, persecuted, killed, and forced into severe forms of conversion therapy (electric shock, rape, dismemberment) (Taylor, 2018; Vickerman, K. A. & Margolin, G. 2009), may not trust authorities in their new country regardless of affirmative laws. Additionally, language barriers make seeking support, resources, and understanding the law difficult if not impossible. The risk of being outed to family or a cultural community may risk their lives even in an affirmative country. In 2021, a BBC article reported 69 countries still criminalize consensual same sex intimacy and 36 of the 53 commonwealth countries have laws that criminalize homosexuality. Several other countries apply the death penalty as the legally prescribed punishment (The Advocates 2013; BBC, 2021).

The impacts of IPV and cultural, societal, and institutional violence are significant. Bodily injury, life-threatening attacks, and death result when individuals are “othered,” labeled as perverse and expendable, and pathologized as non-normative (ACA 2009; APA 2021; Collins et al., 2018). Social violence and exclusion lead to a higher risk of mental health struggles such as depression, anxiety, PTSD, sleeping and eating disorders, internalized hatred, shame, and chronic pain. When IPV is added to this equation, rainbow members face significant challenges and increased health impacts.

Gary Brothers (2021) noted that chronic stress primes infection circuits and collapses dorsal vagal, which can lead to IBS, inflammatory, and pain-related disorders. He also noted that bisexual individuals have higher ACE scores leading to more health problems. Amy Banks, a senior scholar at Wellesley Centers for Women, noted that social exclusion leads to chronic stress and physical pain similar to that of a burn (Banks, 2011).

Addiction rates are higher in the rainbow community (9 percent of rainbow members reported opioid and 12.4 percent alcohol use versus 3 percent of heterosexuals using opioids and 10.1 percent using alcohol). There is an 8.4 times increased risk of suicide with family rejection. 98 percent of those experiencing four incidents of violence in the last year thought of suicide and 51 percent attempted (2018 National US survey). 85.2 percent of the community experienced verbal harassment; 90 percent of youth experienced bullying; 77 percent experienced hate crimes; and there was a reported 86 percent rise in hate crimes 2016-2017 (Center for American Progress, 2012; APR 2021; NCADV, 2018).

Affirmative action is critical within counseling communities and the EMDR community for the 2SLGBTQPIA+ community. Excellent resources for understanding affirmative action are:

Affirmative action needs to include supporting rainbow members toward affirming self. Marian Wright Edelman said, “It is difficult for children to be what they can’t see in the media and world” (Feder, 2020). The film “Disclosure” on Netflix illustrates how the poor representations of transgender individuals across film, for example, portraying them as sex workers, being murdered as the regular outcome, and being mentally ill, contribute to violence against them in society. The struggle to find the legitimacy of self in the world impacts self-esteem and vulnerability to IPV. Until the internet was widely accessible, rainbow members may not have seen themselves anywhere in the media, on film, or in their daily communities. The lack of visibility and language for one’s experience in the world inhibits one’s development (Feder, 2020).

Although many countries still lag in protective laws, Canada has made strides toward equity and protection of the rainbow community. In 1996, the Canadian Human Rights Act prohibited sexual orientation as grounds of discrimination. This inclusion was a clear declaration by Parliament that gay, lesbian, and bisexual Canadians are entitled to “an opportunity equal with other individuals to make for themselves the lives they are able and wish to have.” Further, in 2000, Parliament passed Bill C-23, giving same sex couples the same social and tax benefits as heterosexuals in common-law relationships. The enactment of the Civil Marriage Act in 2005 marked a milestone in sexual orientation equality rights, by allowing same sex couples to be married anywhere in Canada. In 2021, the Criminal Code of Canada (Criminal Code—Subsection 164) made conversion therapy a criminal offense, including removing a child from Canada to undergo conversion therapy. It also amends the Criminal Code to authorize courts to order advertisements for conversion therapy to be disposed of or deleted. Further action is needed to protect transgender individuals.

Governments must secure publicly funded resources, such as shelters, temporary transitional housing, allied lawyers, and restraining orders, to protect rainbow members experiencing IPV and isolation. Additionally, financial support to those who are rejected by families and who are facing homelessness is needed.

Ways to Implement Affirmative Action

Compiled by Sue Genest 2023. Resource: ACA. (2009). Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) www.counseling.org/docs/default-source/competencies/algbtic_competencies.pdf?sfvrsn=d8d3732f_12

  • Become informed: learn historical (marriage equality, legislation, etc.), biological, familial, cultural, socioeconomic, and psychosocial factors that influence the development of orientation and gender identity expressions. Learn APA Guidelines (2021), seek consultation, learn language, know resources, stay informed with current research, and then put knowledge into action (for example, affirm the full spectrum of gender identity expression/presentation).
  • Recognize your social location, power, privilege, and internalized heterosexism. Acknowledge institutional oppression and exclusion and its effect on theory and lived experience.
  • Understand the unique qualities of the 2SLGBTQPIA+ community: the coming out experience, ex-partners becoming family, and overlapping relationships in small communities of counselors and clients.
  • Make it known that you’re an ally with your actions. For example, use pronouns behind your name; using correct pronouns and name.
  • Advocate for social, political, and institutional change. Advocate for resources like shelter inclusion and facilitate access, challenge institutional barriers and discriminatory practices, and support positive public dialogue.
  • Educate and make policy statements for your organization, business, and employees. Utilize inclusive paperwork.  Don’t assume an individual’s orientation or pronouns. Use inclusive language. Have all staff informed vs. referring only to rainbow staff, recruit and retain rainbow staff. Train on macroaggressions and bias.
  • AIP and Cultural Orientation: Be sensitive to historical pathology of DSM, assessments, and speak openly about layers of burden/privilege and power as counselor.
  • Actively intervene in group treatment when homo/trans/bi phobia arises.  Screen group members for ex-partners especially if IPV was experienced.
  • Involve all participants in treatment plans and goals, exploration of identity, and policy development.
  • Explore all factors that might be bringing the client to counseling including asking about IPV, suicidal ideation, bullying, social exclusion, and internalized shame.
  • Explore clients’ challenges and social location and acknowledge past and current pathologies creating mistrust in the mental health community.

EMDR Application

As an EMDR counselor, understanding the unique challenges of the rainbow community informs our work and sensitivities in working with couples and individuals who have or are facing sexual violence. Dr. Francine Shapiro founded EMDR on the Adaptive Information Processing (AIP) model, which enhances our work in this community. These individuals need the non-pathologizing philosophy of EMDR work to heal from IPV and the societal and institutional violence they have experienced. Dr. Day-Vines (2022) referred to Hook’s 2016 article and noted in EMDRIA’s EMDR Trainer Day that 80 percent of marginalized clients had experienced microaggressions in therapy sessions.

The adjustments we can make in EMDR range across the eight phases. Understanding the important differences in the rainbow community allows counselors to hear the unique experiences and barriers instead of presuming their experience is identical or close enough to heterosexual couples to remain uninformed. Exploring our clients’ lived experiences and social location will build rapport and create appropriate therapeutic interventions. For example, safety planning includes rainbow community positive resources such as legal advice, financial aid, health resources, and options for shelter as well as seeking out and using appropriate assessments for the community, such as the Same Sex Danger Assessment (2017).

PHASE 1 & 2

The relational imperative in working with this community cannot be understated when in the past helping professionals have used assessments to pathologize and criminalize the community. The myth of the separate self has been discussed in counseling circles for decades by groups like the Wellesley Centers for Women and the Jean Baker Institute. We are “wired to connect” and infants co-regulate with their caregivers, which is critical for development (Banks, 2011; Banks et al. 2016). In my master thesis on “What Contributed to Healing and Transformation,” those who had identified as experiencing healing and transformation noted the Rogerian conditions for counseling and how critical it was to be given a safe space for self-discovery. The therapeutic container we create with our clients allows them to heal (Genest, (2/3) 2003).

EMDR counselors need to acknowledge humbly who they are in the room and their privilege as they would with any other marginalized client and those of different social locations from oneself. Using inclusive language and pronouns is critical to affirmative action as an ally. Providing space on your intake forms to express one’s identity, pronouns, and lived experience will begin a supportive exploration with clients within therapy. EMDRIA Annual Conference presentations, such as those of Dr. Ashley (2021) and Dr. Norma Day-Vines (2022), provide useful language to explore the social locations of our clients. For example, “I just want to start by acknowledging we have different lived experiences of varying privilege, oppression, and trauma. I am a white male cisgender therapist, which could create barriers for you to feel safe or comfortable. Do you have any thoughts about what I’ve said?” Dr. Ashley (2021). “It’s also okay to bring this up later in our therapy at any time” (Genest & Oxenbury, 2022).

Further, be conscious that many clients, due to cultural beliefs or experiences of violence may be unable to tell you that your language, microaggressions, beliefs, or lack of knowledge is creating harm or mistrust. It is critical that EMDR counselors seek knowledge and ways to explore the social location with their clients that create safety and thus understanding while not expecting a client to replace actively seeking knowledge or competencies yourself (Ashley, 2021; LGBTQ+ EMDRIA Panelists 2022; Godfrey 2022; Hayes, 2022; Day-Vines, 2022). “Supersede your own perspective to be present for and connect with someone else’s truth;” “Be acquisitive, curious, learning, and observing.” Be ready to apologize and hold space for your own discomfort and not knowing to better meet the needs of those clients who have experienced ongoing violence throughout their lives (Ashley, 2021; Day-Vines, 2022).

Affirmative action with marginalized communities goes beyond reading articles or even making space for clients to talk about their social locations. It also means voting for those who will do the same whether in our organizations, local municipalities, or federally. It also means advocating for funding to continue research that highlights the varying social locations so that counseling practice can be more informed and adjust healing practices. One example of the effects of advocating for sexual minorities was the reduction of suicide attempts by youth in the community when marriage equality laws came into effect in 2015 in the United States (APA 2021).

Acknowledge the strengths of those in the rainbow community and explore how they have had to deal with societal and institutional violence. Explore the positive aspects of being part of their community with clients (APA, 2021). Ask your clients what they see as the benefits and rewards of being part of the community to learn more about their particular lived experience. This may also inform the therapist of further resources that are of benefit to many in the community. One benefit I have discussed with my friends is that being required to challenge my socialization and pressures to conform to religious dogma around roles of women and sexuality, has provided the freedom to explore beyond stereotyped gender roles which is of benefit to everyone.

Factors to Examine in Phase 1 and 2 That Impact the 2SLGBTQPIA+ Community 

Compiled by Sue Genest 2023. Resource: ACA. (2009). Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) www.counseling.org/docs/default-source/competencies/algbtic_competencies.pdf?sfvrsn=d8d3732f_12

  • The 2SLGBTQPIA+ community is often pathologized in diagnostic manuals, through assessments, theory, developmental models, and language. There is a lack of representation/visibility and thus counseling practice which can create uninformed and inadequate training and interest, macroaggressions, misconceptions, myths, and conversion/reparative/reorientation therapy which is life-threatening.
  • Internalized phobias and hatred can impact development and impact areas of life including identity, shame, self-worth, sexuality, clarity, safety, mental and physical health, and academic and career success.
  • There may be layered burdens & privilege or intersecting identities that impact counselor and client such as gender identity, sexism, ageism, racism, ableism, religious discrimination, classism, trans/bi/homophobia, social exclusion, cultural values, beliefs, experiences of trauma, education, marginalization, lack of legal protections, limited resources, and health and career access.
  • Pay attention to dichotomies, gender binaries, limitations in language, and understanding of fluidity. Learn about heteronormative familial models and societal phobias that limit expression, development, adoption of language change over time, and affirmative action.
  • These clients may have experienced prejudice, phobia, institutional racism, systemic sexism, and colonialism pervading institutions fostering violence/hate crimes, pathology, and ongoing ignorance.
  • Typical developmental tasks may be complicated or compromised, delayed by social isolation; invisibility, lack of representation in media, unaddressed health concerns, family of origin rejection/conflicts, spiritual or religious beliefs, and conflicts, limited career options/discrimination, legal bias and lack of protection, increased daily stress, abuse, homelessness, prostitution, and/or STD/HIV infection.

SUGGESTED INCLUSIONS FOR INTAKE FORMS

  • Gender/Gender expression (optional)
  • Preferred Pronouns (optional)
  • Past IPV Partners (optional. You may name past partners who have been violent toward you to avoid being placed in a counseling group with them. Please discuss any concerns you have about this at any time)
  • What, if any, social discrimination, oppression, exclusion, marginalization, cultural or societal trauma have you experienced? (For example, racial or sexist oppression, homo/transphobia, microaggressions, social exclusion’s, etc.)
    • (If yes, please explain—optional). You may speak about this at any time in our therapy together
  • What did you like or not like about past experiences or techniques in counseling?
  • As you become comfortable with me, you are welcome to discuss what is working or not in our therapy together

PHASE 2

Preparation with this community may be similar to your other marginalized clients, where you explore and build their internal and external support systems. EMDR has been shown to help rainbow members to develop internal resources while addressing many of the unique distressing factors faced by the community (Balcom, D. 2000). Consider that in this community, they may have chosen a family that consists of former partners especially due to the isolating factors of social exclusion from cultural and religious communities and from family when they come out. Consider using April Steele’s (2023) imaginal exercises or Jean Shirley Schmidt’s DNMS Resource team (2020) as useful exercises for clients to consider who they admire in the rainbow community and their chosen families that can be supported throughout the EMDR therapy. Genest shared her nurturing, protective, wise figure pyramid in the 2022 EMDRIA presentation with the steps below to help clients with attachment exercises (Genest & Oxenbury 2022):

  1. List or collect pictures of those supportive in your life now
  2. List or collect pictures of those you know who have been supportive
  3. List or collect pictures of admired live figures that have impacted you
  4. List or collect pictures of historical, animal, and spiritual figures
  5. 5th layer: list or collect pictures of imaginary, mythical characters you resonate with

PHASE 1: TREATMENT PLANNING & PHASE 1-8

Once clients have a good foundation of preparation, then we can begin to target their experiences. Dolores Mosquera presented at the EMDRIA 2021 Annual Conference on domestic violence and suggested targeting memories of risk; helplessness; various forms of violence; intrusive thoughts and memories; and early childhood adverse experiences (Mosquera, 2021). It would also be imperative to explore with clients what abuse looks like in its various forms (physical, mental, verbal, emotional, psychological, sexual, spiritual, financial, and societal). Genest & Oxenbury (2022) EMDRIA presentation for “Manifestations of Interpersonal Partner Violence (IPV) /Abuse” handout by Genest, to help educate clients on the specifics of what constitutes abuse. See also NCADV, 2012. Consider targets related to coming out; being outed; having health status outed; risk of losing employment and family; etc., so that rainbow clients can identify with their counselor all the factors impacting their current lives and healing journey. As you explore treatment targets for EMDR, consider clusters such as relationship; social exclusion; ambivalence and internal conflict; internalized hatred; affect phobias; religious exclusion, and hatred. Additionally, target dysfunctional positive affect, for example, a rainbow person accepted by a partner and not by society which confounds the intensity of bonding as well as loyalty to the community.

PHASE 3 & 6

When working with transgender and gender non-conforming individuals, use discussion prompts about the assessment phase, particularly about their comfort with the body scan. Trauma is visceral and is held in the body as has been noted by many authors (Herman, 2015; Rothchild, 2003; Ogden, et al. 2006). Education about trauma and somatic experiences of trauma can help inform clients of their experience and EMDR processing. Collaboratively the counselor and client can determine how and when they will explore the somatic experiences.

PHASE 1-8; PHASE 4

Gary Brothers (2021) noted the importance of social engagement and a relational attachment approach to EMDR healing. He emphasized co-regulation, mirroring, attuning, and connection via gaze, voice, and intonation. Mark Nickerson (2021) noted the category of “Belonging” for cognitions and interweaves in EMDR. These are essential contributions to working with varying social locations in EMDR work with the rainbow communities. Relational interweaves founded on good rapport, and a culturally oriented EMDR counselor will be powerful, for example, “as you process, notice you are with someone safe who cares about you” (Brothers, 2021).

PHASE 3-6

When moving into desensitization and reprocessing consider using the term oppressive cognitions instead of negative or dysfunctional, as the terminology further reflects the pathologizing psychology has applied to the rainbow community in the past. Internalized inferiorities result in oppressive cognitions such as “I’m defective,” “I’m a freak,” etc. (Genest & Oxenbury, 2022). Additionally, there are truths to the violence the rainbow members have experienced, so individuals may have internalized society’s hatred, but they also may understand they are lovable, worthwhile, and deserve to be treated with respect. This author refers to beliefs that fit the situation and cultural reality rather than personal beliefs. For example: “I know I’m lovable, but I feel powerless in light of the new laws that prevent gender-affirming treatment.” Thus, the oppressive cognition is “I’m powerless.” Further, “I’m safe” is a present-time statement that may not be accurate in some geographic areas. Adapting it to “I’m safe now in this moment” may be all a client can believe. Refer to Genest & Oxenbury, 2022 presentation handouts for a list of 2SLGTBQ+ oppressive and positive cognitions. As rainbow clients see lists of common oppressive cognitions in the community and for belonging (Nickerson, 2021), they may be able to identify layers of belief such as believing “I’m defective” underlying a cognition of “I’m worthless.” These explorations require an affirmative relationship with the counselor.

Dr. Ashley (2021) noted that SUDs may not go below 4 for ongoing racial trauma. This may be the case for rainbow community members who find themselves in states or countries that hold discriminatory laws. For the validity of cognition (VOC), if it is not 7 I ask, “What is keeping it from going to 7?” Blocks, reality barriers, ongoing IPV, and cultural/societal violence may arise with this question. It is this author’s belief that accepting 6 for VOC may miss important discussions about the client’s concerns related to ongoing IPV, societal violence, or internalized shame and self-hatred.

Cognitive interweaves in EMDR are powerful with communities that experience stress on a daily basis. They may be critical to support desensitization. Many in the community have been exposed to religious and cultural bias and hatred disguised as morality. Internalized inferiorities may sound like: “I’m defective,” “I’m a sinner,” “I’m perverted,” “I’m satan’s child,” or “There’s something wrong with me,” (LGBTQ+ panel EMDRIA 2021). Educational interweaves might include references to websites and educational materials that directly challenge oppressive rhetoric, for example, ‘clobbering biblical gay bashing’ website (Sandlin, 2011). When a rainbow client is struggling with their identity or orientation, believe they deserve harm or have been told by a religious leader they are damned or going to hell, they may accept IPV as a form of punishment that they deserve or in which no support or aid would be offered if they did reach out for help. This author has found it helpful to use the educational interweaves as well as cultural stories that create dissonance, for example, “at one point in time in history, red-headed babies were considered witches, of the devil, or having no soul. It was much the same for left-handed people. Red-headed babies were left in the forest to die. Sometimes we get things very wrong in society, culture, and religion, and it takes time, education, and research for change to happen,” (add bilateral stimulation).

The future template in EMDR can include such things as:

  • Anticipated events before triggers
  • Confronting partner; court
  • Leaving the relationship
  • Running into IPV partner; shared custody
  • Seeing signs of batterer/narcissist again
  • Any future exclusions in life; ongoing exclusions
  • News stories of deaths or threats
  • Societal changes positive or negative
  • Times of feeling helpless or powerless
  • Events of other oppressed communities, for example, BIPOC person murdered etc.

Informed EMDR counselors can have profound impacts on helping the rainbow community to heal from daily and societal stressors and trauma they experience.

References

Ahlin, E., Mitchell, O., Atkin-Plunk, C. A. (2022). 1st Edition. Handbook on Inequalities in Sentencing and Corrections among Marginalized Populations. Routledge. New York, NY.

Alderson, K., & Oxenbury, J. (2015). Lesbian, gay, bisexual and intersex individuals. In, A. L. Sinacore & F. Ginsberg (Eds.), Canadian counselling and counselling psychology in the 21st century, (pp. 90 – 116). Montreal, QC: McGill-Queen’s University Press.

Human Rights Campaign (October 18, 2017). Common Myths about LGBTQ Domestic Violence www.hrc.org/news/common-myths-about-lgbtq-domesticviolence

Alexandria, VA (2009). ALGBTIC Competencies for Counseling Transgender Clients (2009)

Association for Lesbian, Gay, Bisexual, and Transgender Issues in Counseling (ALGBTIC) www.counseling.org/docs/default-source/com-petencies/algbtic_competencies.pdf?sfvrsn=d8d3732f_12

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American Psychological Association, APA Task Force on Psychological Practice with Sexual Minority Persons. (2021). Guidelines for Psychological Practice with Sexual Minority Persons. Retrieved from www.apa.org/about/policy/psychological-sexual-minority-persons.pdf

Arrow Passage Recovery (2021) Top Five Struggles of LGBTQ+ Community That Lead to Addiction. www.arrowpassage.com/top-five-struggles-lgbtq-community

Badenes-Ribera, L., et al. (2015). Intimate Partner Violence in Self-identified Lesbians: A Meta-Analysis of its Prevalence. Sexual Research and Social Policy, 12, 47-59. https://link.springer.com/article/10.1007/s13178-014-0164-7

Balcom, D. (2000, December). Eye movement desensitization and reprocessing in the treatment of traumatized gay men. Journal of Gay and Lesbian Social Services, 12(1/2), 75-89. doi:10.1300/J041v12n01_04 and www.tandfonline.com/doi/abs/10.1300/J041v12n01_04

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Banks, A—Social exclusion and Pain. Amy Banks: Wired for Connection

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Collins, S. E., Clifasefi, S. L., Stanton, J., The Leap Advisory Board, Straits, K., Gil- Kashiwabara, E., Rodriguez Espinosa, P., Nicasio, A. V., Andrasik, M. P., Hawes, S. M., Miller, K. A., Nelson, L. A., Orfaly, V. E., Duran, B. M., & Wallerstein, N. (2018). Community-based participatory research (CBPR): Towards equitable involvement of community in psychology research. American Psychologist, 73(7), 884–898. https://doi.org/10.1037/amp0000167

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Nickerson, M. (2016). Cultural Competence and Healing Culturally Based Trauma with EMDR Therapy: Innovative Strategies and Protocols. New York, NY: Springer Publishing.

Chapters in M. Nickerson’s book:

  • Chang, S. (2017). EMDR therapy as affirmative care for transgender and gender nonconforming clients. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy (pp. 177-194). New York, NY: Springer Publishing.
  • Grey, E. (2017). Sex assignment, gender assignment, and affectional orientation: Applying continua of congruence to dismantle dichotomies. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy (pp. 209-228). New York, NY: Springer Publishing.
  • O’Brien, J. M. (2017). EMDR therapy with lesbian/gay/bisexual clients. In M. Nickerson (Ed.), Cultural competence and healing culturally based trauma with EMDR therapy (pp. 195-208). New York, NY: Springer Publishing.

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Oxenbury, J. (2005). Domestic violence in lesbian relationships. In Family Violence: It’s Your Business, Community Resource Guide, Alberta Children’s Services, Edmonton AB.

Peitzmeier, S., Malik, M., Kattari, S., Marrow, E., Stephenson, R., Agenor, M., Reisner, S. (September 2020). Intimate Partner Violence in Transgender Populations: Systematic Review and Metaanalysis of Prevalence and Correlates. American Journal of Public Health (AJPH). https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2020.305774?journalCode=ajph

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Schmidt, S. (2020). Ego State Therapy Interventions to Prepare Attachment-Wounded Adults for EMDR. DNMS Institute, LLC. Gresham, Oregon.

Schmidt, Shirley—DNMS—Resource Team www.dnmsinstitute.com/developer www.dnmsinstitute.com/developer/#articles

Steele, A. (2023) Imaginal Nurturing Course. https://april-steele.ca/apr https://april-steele.ca/apr/product/training-program-imaginal-nurturing-ego-states-attachment-integrated-approach-early-deficits-download-version

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Taylor, D. (2018, July 21). Ulverston man who was given electric shocks to make him straight speaks out after PTSD therapy. The Mail. Retrieved from www.nwemail.co.uk/news/ulverston/Ulverston-man-who-was-given-electric-shocks-to-make-him-straight-speaks-out-after-PTSD-therapyed9d0ed7-dadf-4a42-9573-fd4e44633b17-ds7/21/2018

Tran, D., Sullivan, C., & Nicholas, L. (2022) Lateral Violence and Microaggressions in the LGBTQ+ Community: A Scoping Review. Journal of Homosexuality, Jan.(10), 1-15. doi: 10.1080/00918369.2021.2020543. https://pubmed.ncbi.nlm.nih.gov/35007475/

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EMDRIA Annual Conference Presentations

  • Archer, D. (EMDRIA 2021). Bound by our attachments: race, gender, and the trauma of violence. Session 321.
  • Ashley, W. (EMDRIA 2021). Contemporary JEDIs in EMDR Treatment. Session 101.
  • Brothers, G. (EMDRIA 2021). Integrating the attachment system and AIP model for chronic health syndromes. Session 414.
  • Genest, S. & Oxenbury, J. (EMDRIA 2022). 2SLGBTQPIA+ Community and Domestic Violence. Session 323.
  • Godfrey, D. (EMDRIA 2022). Providing EMDR to Transgender and Gender Diverse (TGD) Clients. Session 214.
  • Chabra, Roshni; Genest, Sue; Godfrey, Danielle; Hayes, Lisa; Marich, Jaime; Monette, Patrick. (EMDRIA 2021) LGBTQ and EMDR Experiences: A Panel Presentation. Session 16.
  • Chabra, Roshni; Genest, Sue; Godfrey, Danielle; Hayes, Lisa; Monette, Patrick. (EMDRIA 2022) LGBTQPIAS2+ EMDR Therapy Experiences: A Panel Discussion. Session 311.
  • Mosquera, D. (EMDRIA 2021). EMDR Therapy for victims of gender violence. Session 114.
  • Nickerson, M. (EMDRIA 2021). Connection and Belonging: A core human need and distinct category of NC/PC’s. Session 212.
  • Schmidt, S. (EMDRIA 2020). Ego-State therapy interventions to prepare dissociative clients for EMDR. Session 412.
  • Day-Vines, N. (EMDRIA 2022). Breaching the subjects of race, ethnicity, and culture with clients. Session 101

 

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Additional Resources

If you are a therapist interested in the EMDR training:

If you are EMDR trained:

If you are an EMDRIA Member:

Date
October 5, 2023

Topics
Abuse/Neglect

Client Population
Couples, LGBTQIA+

Audience
EMDR Therapists

Language
English

Content Type
Blog/Blog Post

Original Source
Focal Point Blog

Access Type
Open Access

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