Sex, Sexuality, Homosexuality: Is It Easy For Psychotherapists To Talk “about” With Clients?

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Talking to loved ones about problems in the sexual sphere, dissatisfaction, unusual fantasies is often difficult, unusual or inappropriate. It is not customary to address these questions to doctors and psychologists in our country, but in vain … What psychologists say about the topic of sexuality - in an interview with the French gestalt therapist, author of seminars about sexuality, Sylvia Schoch de Neuforn.

Sylvia, before diving into the topic of sexuality, I want to ask you how you see the peculiarities of the attitude to this topic in Russian society. I know that in Russia, in addition to long-term trauma programs in gestalt therapy, you conduct seminars on sexuality, and you also work in other countries. I'm interested in your observations about the differences. I think that in our country the topic of sexuality is quite taboo, and this probably affects the way psychologists work in this direction, and the freedom of our clients to deal with this topic

Based on my experience of participating in seminars in Europe, America and Russia, where I was a presenter or participant, there really is a difference. Americans, it seemed to me, talk about sex, about their attitude to this problem not so often, but at the same time quite calmly - they openly talk about their homosexual orientation, for example. The French easily talk about their sex life, tell intimate details.

If we are talking about the professional community, then the institutions of gestalt therapy for openness in this topic also differ. At the French Institute of Gestalt Therapy (IFGT), we practically do not talk about sexuality, and the Paris School of Gestalt Therapy by Serge Ginger (EPGT) is more free in this topic, we explore the topic of sex openly and, one might say, we talk about different things as they are, naturalistic. As an experiment, someone may be asked to visit a sex shop to get acquainted with the goods there, and those who are interested in swingers will easily get support to go to a specialized club and get this experience. Consequently, in these Gestalt therapy groups, participants can easily speak, for example, of sexual arousal towards another member of the group, while such open expression in seminars of other Gestalt communities would be unacceptable.

As for Russia, I notice more restraint and chastity when working with this topic in the study groups of the Gestalt community. It can be difficult to call a spade a spade, then I give a lot of lecture material about sexuality in the broadest sense of the word, for example, about seduction. When discussing this topic in a group, there is always a lot of energy, a lot of excitement, and you need to deal with it somehow. I began to suggest various experiments (where people, for example, approached each other, listened to themselves, shared their impressions), exercises (where people shared their fantasies in small groups), and they arouse lively interest, support the energy of the group.

In France, for example, some trainers may invite participants to share their fantasies in a large study or therapy group. Or as a milder option: invite everyone to write about what excites, on pieces of paper, put it in a common bag and offer to pull out and read someone's fantasy out loud. This is usually easier than voicing rather intimate details about yourself. The goal of this exercise for psychotherapists is to learn to accept themselves with their sexual fantasies, so that later they will feel comfortable when the client talks about what brings him pleasure during the session. In order to meet other people's revelations in this topic, you need to learn how to easily deal with your fantasies. If the therapist is embarrassed, the client will never be able to tell him intimate, intimate things, will not be able to work with his difficulties in the sexual sphere.

I think this exercise would be very useful to me. I remember the first encounters with the topic of difficulties in sex, peculiarities of sexuality - which clients spoke about in sessions at the beginning of my Gestalt therapy practice - were not easy for me. And I was quite embarrassed.

You are talking about the "chastity" of people in our country, I can assume that psychologists and leaders of therapeutic and educational groups have to make additional efforts to touch this topic and research it.

I would say you need to work more with shame. This is not about big efforts, but about ensuring the safety of the group members. Usually, when someone opens up and speaks to himself, then other participants can join, talk about their difficulties in the sexual sphere. But opening up first is always very scary, as there are fears of being rejected. The support of the trainer and the group is needed to raise this topic and start working with it. However, if a trainer, a psychotherapist does not quite clearly understand his sexuality, he will hardly work with a group on this topic, he will be confused himself, which will confuse his students or clients.

And even when I talked about groups in France, where everything goes lively and is described easily, in a naturalistic way, then, I must say, there are people who are rather closed, feel ashamed, - for them this way of dealing with the topic of sexuality is not suitable. A marker can be when people say they feel unfreedom or depressed.

Sylvia, when you lecture, conduct seminars on the topic of sexuality, what theoretical basis do you rely on? I mean this - sexuality, attraction, orgasm power, exciting objects - what does it all depend on? From biological foundations, from psychological characteristics, from upbringing, from the cultural, social environment? Or how do you think it all fits together?

I will try to classify it. First of all, there are biological factors that we can call "impulse force", what Gestalt therapists call the Id force. Different people are born with different vitality, libido, as psychoanalysts would say.

Further, in early childhood, attachment to parents, to a significant object is formed. It is important whether the child has managed to build a secure attachment at this age, whether he can fully surrender to this first relationship, whether he can feel safe. This is a very important factor in the formation of sexuality. It is also important the moment when the child first felt sexual impulses, his arousal, and how the environment reacted to this - parents or other people. Culture affects how it is perceived by others and, as a result, by the child himself.

And then family norms and taboos come into play. These can be explicit (manifested) rules and what the child implicitly receives from the behavior of the parents. During adolescence, it is important how parents handle growing up children. For example, how does a father react to his daughter becoming more feminine.

The formation of sexuality also depends on social norms. For example, when I was young, it was believed that you should marry a virgin. Consequently, the boys who supported this norm divided girls into those with whom they had sexual relations and those with whom they would marry. That is, you have to somehow relate to the norms, form your own norms, passing public standards through yourself. In France, the sexual revolution took place in the 60s, in Russia it happened later. This means that the norms have changed, adjusted, and now in France you can meet a fourteen-year-old teenager who is worried that he still has not had sex.

Also, there are taboos in society associated with religion. For example, the church condemned masturbation. There is also the influence of what is called a “consumer society”, where one person is viewed as an object of sexual consumption by another person. Such a society produces loneliness: it is impossible to just have a relationship, it is imperative to have a sexual relationship, even when you just want a relationship.

You are talking about the norms of society that affect how sexuality is formed, how a person experiences himself and his arousal, his sexual needs. It seems to me that the question of the norms on which a psychologist can rely when communicating with clients who have difficulties in the sexual sphere will be appropriate here. What should we, specialists, consider normal and what should not?

I will tell you how we see the norm in our country among psychologists. There is no norm when it comes to relationships that occur between consenting adults. I repeat - there are no norms and restrictions if it is agreed by two adults. And here it is important how two people who have different norms-introjects, that is, the rules, introjected, learned in the process of life, will treat them, overstep or violate them in joint sexual relations in order to get more excitement, more sexual pleasure. The main thing is that the law is not violated (incest, rape, of course, is not the norm).

I thought that it might be difficult for the therapist and the client to discuss the characteristics of the client's sexual life, for example, because their norms in some cases may differ significantly.

If we meet a client, the familiar and acceptable for whom shocks us, psychologists, it is important not to try to transfer the client to our coordinate system, to our ideas about the norm. And here it is precisely the Gestalt therapy position that allows us to explore the phenomena of contact with the client, studying the difficulty we find ourselves in, listening to his story, discovering what ways we (therapists) have to assimilate his experience without being judged. And we rather concentrate on what difficulties a person is experiencing than on how his desires correspond to our ideas about the right thing, how shocking they are for us. If we work with a couple, then the work is going on in order to help harmonize the desires of partners, to help them deal with their ideas so that their sex life improves. There is no task to bring someone to any norm.

It also happens that my standards as a therapist are broader, more tolerant than the client's, and then I have difficulty in the case when the client tells something shocking for himself, which personally seems to me quite normal. I could tell the client: “Hey, this is normal,” because I see that his subjective ideas about the norm make him suffer in some situation, however, this is his undeniable reality, which has developed in the process of living experience. There is a temptation to argue with his introjects, but I don't know how correct this seems to you.

In this case, the work will go rather to clarify the needs and ways to realize them, respecting the client's desire to correspond to his ideas about what is right, to fit into his own norms, but the therapist should strive to make sure to what extent the client can accept the nature of his sexuality, his attraction, his arousal, his bodily sensations. Often, for example, adolescents, having discovered in themselves attraction to people of the same gender, experience a crisis. They want to conform to the social norm, but their body tells them that their sexuality is different. Or, for example, people come to us who deny their sexuality, dissociated from the experience of their arousal - these are people who at some point refused to accept their manifestations. This can be, for example, people who are overweight, ignore sexual needs, but suffer from eating disorders. This or other symptoms, and the very suffering that brings clients into therapy, tends to make them more capable of revising and softening their own norms.

And with what questions about sexuality, in your experience, often come to psychologists. Or is it better to ask this: with what difficulties in the sexual sphere does it make sense to go to a psychologist?

In fact, with problems in the sexual sphere, you can go to a doctor, a sexologist and a psychologist. The difference is that a doctor will deal with physiology, a sexologist will help you deal with technical issues, and a psychologist will talk about sexual difficulties in conjunction with relationship problems. Often, to bring the problem of sexuality to the psychologist, clients “dress it up” or “dress it up” into something else. For example, men may say that they have a passionate desire only for women who are not available, but do not want a wife with whom the realization of sexuality would be possible. And it's still work about relationships in a couple.

Sylvia, in your opinion, how healthy can be considered the option when a person realizes his sexual needs without striving to build a long-term relationship. Frequent change of partners, sex without emotional closeness - I mean it. Intimacy and sexuality together and separately - variants of the norm or the separation of these processes in life - a sign of psychological problems?

It looks like we are returning to normal. Here the situation is the same: if this does not cause suffering for a person, then we may well consider any of his sexual behavior as the norm. If a person is traumatized by this situation, feels dissatisfied, wants to be better, then you can work to help him change his ways of building relationships. From my point of view, sexual relationships are more satisfying if they are supported by relationships in which there is emotional closeness, even though couples who have lived together for a long time complain about routine in their sex life. Sometimes one of the spouses chooses to revitalize the sexual sphere through sex with new partners and partners - in some cases this allows the marriage to survive, sometimes it ruins it. But here I am also not talking about the norm - it is important here what agreements the partners have and how they are observed.

Probably, I am influenced by the idea that sex without emotional intimacy can talk about attachment disorders, psychological problems coming from childhood.

Yes, of course, attachment disorders that arose in early childhood can manifest themselves like this. Also with adolescent children, when the parents did not feel very comfortable with the sexuality of the child, and the child had to split for himself the relationship of attachment and relationships in which there are sexual experiences. For example, a girl, finding that her growing up and sexuality embarrass her father and cause him to distance himself from her, concludes that when she is sexually attractive, she is unloved. Sexual addiction can be a consequence of sexual trauma - in order to avoid retraumatization, re-objectification, a person can deliberately bring a lot of sex into his life, initiate numerous contacts, only to avoid sex as violence.

With this answer, you supported me in the idea of being attentive and looking more closely behind the sexual behavior, in which there is little room for emotional intimacy, which the client or client tells me about. And be curious as to what the problem might be behind it.

Yes, you're right about that.

My next question arose in connection with one of my fields of activity, my work in the Resource center - this is a psychological center for the LGBT community. Some of my clients are homosexual and bisexual, and sometimes in our work we talk about identity, about the origins of orientation. We are discussing, and I myself am thinking about it, how the orientation is formed: in what proportion is the influence of biological, psychological and sociocultural factors. I know that there are no studies yet that could unequivocally answer this question, but something needs to be based on in the work right now. How do you define this for yourself?

I also do not have a clear answer, and everything that I have studied also does not give a clear answer. I adhere to the position that the original bisexuality of a person in certain circumstances unfolds in one direction or another. Freud spoke about the feminine and masculine parts in every person, Jung - about Anime and Animus, sometimes these principles are called Yin and Yang. Potentially, orienting tendencies are embedded in us, then they acquire a clearer form, attraction to a certain gender. I think that in the history of the development of each person (early childhood, adolescence), one can find key points, important experiences or avoidance of experiences that affect the future.

I like your approach. In our country, a pathologizing homosexuality approach is widespread, it can be simplified as follows: "Initially, everyone is heterosexual, but if something happened to a child in childhood, the educational process went wrong, society had a wrong effect, the child will become homosexual or bisexual." This is also common among specialists, - I think, under the influence of the fact that homosexuality was previously considered a mental disorder. Now doctors have recognized this approach as erroneous, but many ideas are quite rigid and difficult to change. This attitude is a kind of homophobia, making it difficult for people of non-heterosexual orientation to receive psychological help.

When homosexuality was introduced as a pathology in the DSM, psychologists in Europe treated it in a similar way, but this is no longer the case. I remember how there were rallies in France against same-sex marriage - this is such an evolutionary process, social norms are changing slowly. It is also difficult for me to agree with the idea of adopting children by homosexual couples, although professionally I am confident that children raised by such couples will grow up as ordinary children and will be happier than if they grew up in destructive heteropairs, where emotional and physical abuse is a part of life.

I believe that the evolution of ideas about orientation is the easier, the more smoothed out the gender roles in society - those responsibilities that are attributed in accordance with the cultural characteristics of society to men and women by gender. When the boundaries of these roles are blurred, when the differences are less, then the transformation of society is calmer. In Russia, in comparison with the countries of Western Europe, the gender gap, it seems to me, is very strong. I saw that your media write about sexism, I meet with the fact that there are communities, psychologists who support the idea of raising a "real man" and so on. In such conditions, the transformation will be slower.

And my last question, which is closely related to gender, is about transgender. In my opinion, transgender transitions just reinforce gender stereotypes, defining what exactly external attributes make a woman a woman and a man a man. At the same time, transitions do not help in the least in resolving internal psychological and external social conflicts. With the knowledge that the brain is not male or female, that gender standards are internalized in childhood (and then throughout life), and are not innate, it is impossible not to ask the question - what prevents you from accepting your gender, why make the transition. That is why I do not work with transgender people - I experience an invitation to a world where biological gender is replaced by gender attributes, as an invitation to an alternative reality, the basic foundations of which I do not understand. Are there transgender people in your practice, how do you perceive this phenomenon?

I think that the point here is that gender norms are interiorized in different ways, with varying degrees of success. When I first faced this question, I was also in great difficulty. I do not have so much experience in this topic, it can be difficult for me to perceive and understand the views of people when it comes to transgender. I had a lesbian patient who was in a permanent relationship with a woman, but she received satisfaction in a relationship with an unoperated transgender MtF (Male to Female, male → female). For her, this was not a difficulty and ambiguity, she called the additional participant in the relationship either "he", then "she", but it was not easy for me in this story. After that, I began to be more interested in this phenomenon and was touched by the difficulties these people have to go through.

What do you rely on in your work, what is your idea of how transgenderness is formed?

Perhaps any early experience of self-presentation can influence the future formation of self-perception, the idea of who we are. “My belief in who I am influences the way I behave and present to others,” I suppose that the image develops like this - not only in gender identity, but also in other issues. This is a difficult topic, I can recommend you a colleague from France who, like you, works with the LGBT community, so that you can discuss this topic.

Thank you for the recommendation and for the interview!

Nina Timoshenko and Sylvia Schoch de Neuforn