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EMDR Therapy with LGBTQ Populations

June 9, 2022
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Pride Month is a time to celebrate the wonderfully diverse ways we as humans can express ourselves, our sexuality, our gender, and our love for others. It is also a time to remember how many types of trauma someone who identifies as LGBTQ(IA+) may have experienced. LGBTQ populations are as much at risk as the rest of the population regarding trauma through natural disasters, loss of loved ones, occupational hazards like first responders and military members, and other traumas that can affect people. In addition, as the American Psychiatric Association points out, there are many ways that LGBTQ individuals specifically may experience trauma including harassment and discrimination in school and at work, medical care needs being unmet, internalized shame, family rejection, physical assault, sexual assault, and microaggressions.

What are ways to support people who identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, pansexual, non-binary, or genderqueer? If we are not familiar with the terms just mentioned, we can educate ourselves and get familiar with the gender spectrum at GenderSpectrum.org. Identity, attraction, sexuality, and personal expression are all aspects of the gender identity spectrum to be familiar with. We can use gender-affirming names and pronouns. We can serve as advocates, allies, and active bystanders. We can foster cultures of inclusivity and celebrate diversity. We can advocate that all people deserve to feel healthy, accepted, safe, and whole.

EMDR therapy heals trauma, so we can also advocate for EMDR as trauma treatment for LGBTQ individuals who have experienced it. Establishing a safe or calm place, grounding techniques, or developing internal resources during phase 2 of EMDR can be powerful for people who have experienced threatening messages from society.

Conversion therapy and other forms of sexual orientation change efforts have been shown to cause harm, including an attempted suicide rate twice as high as those who did not experience sexual orientation or gender identity conversion therapy. Sexual orientation change efforts have been largely abandoned by mainstream medical and mental health organizations, although there are still areas in the US that allow it. EMDR therapy can be used with LGBTQ populations, including LGBTQ youth subjected to conversion therapy or other trauma.

The EMDR International Association advocates for all identities and prohibits the use of EMDR therapy for sexual orientation change efforts by its Members, Certified Therapists, Approved Consultants, Credit Providers, and Approved Training Providers. View EMDRIA’s Sexual Orientation Change Efforts (SOCE) policy on our website here.

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Resources for EMDR Therapists:

We see a need for more resources regarding the use of EMDR therapy with people who identify as LGBTQ(IA+). We’ve listed a few below, and welcome any additions – just send them for review to info@emdria.org.

Peer-Reviewed Articles:

Balcom, D. (2008). Eye movement desensitization and reprocessing in the treatment of traumatized gay men. Journal of Gay & Lesbian Social Services, 12(1-2), 75-89. https://doi.org/10.1300/J041v12n01_04

Greene, D. C., & Britton, P. J. (2015). Predicting adult LGBTQ happiness: Impact of childhood affirmation, self-compassion, and personal mastery. Journal of LGBT Issues in Counseling, 9(3), 158-179. https://doi.org/10.1080/15538605.2015.1068143

Snyder, M. (1996). Intimate partners: A context for the intensification and healing of emotional pain. Women and Therapy, 19(3), 79-92. https://doi.org/10.1300/J015v19n03_08

Blogs/Other Articles:

Phelps, J. (2019, December 20). Moving past trauma: EMDR has helped LGBTQ patients overcome toxic feelings. OUTINSTL [Wellness blog]. Retrieved from: https://outinstl.com/moving-past-trauma-emdr-has-helped-lgbtq-patients-overcome-toxic-feelings/

Books/Chapters:

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.

  • “Transgender and gender nonconforming (TGNC) people have a gender identity that does not fully align with the sex they were assigned at birth. This chapter introduces the basic concepts and terms related to the experiences and lives of TGNC people. Common misconceptions are addressed in order to build a basic awareness of the needs of TGNC people. The chapter discusses the ways in which TGNC people are affected by transphobia or anti-trans bias, ranging from micro aggressions to overt acts of violence. It describes the various ways that eye movement desensitization and reprocessing (EMDR) therapy may be used to help provide affirmative care when working with TGNC people. Finally, a case vignette is used to illustrate the application of EMDR therapy and the use of a Resource Development and Installation (RDI) protocol to assist TGNC people in healing experiences of trauma.”

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.

  • “Understanding the variance across the sex/gender/affectional continua is a foundational part of clinical practice with gender-influenced client issues. All clients have biological developments that lead to sex/gender/affectional differentiation and variance. This chapter explains how positive treatment outcomes are improved by integrating a sex/gender/affectional continua and Eriksonian psychosocial development across all phases of eye movement desensitization and reprocessing (EMDR) therapy. It offers an explanation of sex/gender/affectional continua and Erik Erikson’s psychosocial stage of adolescence, ego identity versus role confusion. The chapter illustrates how to synthesize and apply the sex/gender/affectional developmental continua, developmental theory, and adaptive information processing (AIP) model throughout each phase of EMDR therapy of the concepts. The AIP model helps conceptualize cases and posits that past disturbing experiences feed current symptoms, issues, challenges, or problems. Conceptualizing these issues includes assessing the experiential effects that sex/gender/affectional congruence/incongruence have had on the person’s identity.”

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.

  • “This chapter reviews the unique elements of eye movement desensitization and reprocessing (EMDR) therapy with gays/lesbians/bisexuals. Lesbians and gay men are more likely than heterosexuals to present for mental health treatment and are more likely to experience trauma. Stigma/discrimination and deficits in social support likely increase the incidence of psychological disorders. The chapter outlines the experiences of oppression of sexual minorities and reviews how EMDR therapy might be used to help clients heal. Microaggressions are subtle insults that are delivered through dismissive looks, gestures, and tones that are often directed toward people of color. In the mid-1970s, homosexuality was removed as an official mental health diagnosis. Some gays/lesbians grow up in religions that are welcoming and affirming faith communities for sexual minorities. AIDS was initially known as gay-related immune deficiency (GRID) as it was first diagnosed in the United States among homosexual men.”

 

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Great Reading for Mental Health Professionals:

Chang, S., Singh, A. A., & dicky, l. m. (2018). A clinician’s guide to gender-affirming care: Working with transgender & gender nonconforming clients. Oakland, CA: New Harbinger Publications, Inc.

Dawson, J., & Levithan, D. (2015). This book is gay. Naperville, IL: Sourcebooks, Inc.

Gonzales, K., & Rayne, K. (2019). Trans+: Love, sex, romance, and being you. New York, NY: Magination Press.

Hawn, T. (2020). Cultural awareness in therapy with trans and gender non-conforming adults and older people: A practical guide. Philadelphia, PA: Jessica Kingsley Publishers.

Kort, J. (2018). LGBTQ clients in therapy: Clinical issues and treatment strategies. New York, NY: W. W. Norton & Co.

Schroeder, S., & Theophano, T. (Eds). (2019). Headcase: LGBTQ writers & artists on mental health and wellness. New York, NY: Oxford University Press.

Singh, A. (2018). The queer and transgender resilience workbook: Skills for navigating sexual orientation & gender expression. Oakland, CA: New Harbinger Publications, Inc.

Posted in EMDR In the News, Gender Identity, LGBTQ, Minority Mental Health, PTSD (Post Traumatic Stress Disorder), Public Resources, Race, Culture, Ethnicity Issues, Self Harm, Social Anxiety Disorder, Stress Management, Suicide, Trauma

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