THE FIGHT SOCAL'S LGBTQ MONTHLY MAGAZINE SEPTEMBER 2019

PSYCHOLOGICAL DISTRESS
According to a 2015 national survey conducted
by the Substance Abuse and Mental
Health Services Administration lesbian, gay
or bisexual adults have a much higher rate
of substance use and mental health issues
than the heterosexual population. One of their
findings, for example, was that 39.1 percent of
LGB adults used illicit drugs in the past year
when compared with 17.1 percent of the heterosexual
population. Also, 37.4 sexual minority
adults had any mental illness as compared
with 17.1 percent of the heterosexual adult
“YOU DESERVE TO
LEARN HEALTHIER
COPING STRATEGIES,
HEAL OLD WOUNDS,
LEARN MORE ABOUT
YOURSELF AND HOW
TO BETTER NAVIGATE
A SOMETIMES
HOSTILE WORLD.”
population. These numbers break out even
further as it relates to age, race and ethnicity.
Rates for mental health issues and addiction
are also staggering for the transgender community.
According to the 2015 US Transgender
Survey Report, 39% of respondents experienced
serious psychological distress in the
month before taking the survey with 40%
having attempted suicide in their lifetime, almost
nine times the rate of the US population.
Transgender women of color face the most
pervasive forms of discrimination that have a
direct impact on their health and well-being.
There are multiple reasons why there’s a
higher prevalence of substance use and addictions
in our LGBTQ Community. The obvious
overarching explanation is minority stress
experienced with being scapegoated by society
for our differences. We have been demeaned,
devalued, ridiculed, patronized, blamed, incessantly
criticized, and have also experience
cultural sexual shaming for our very beingness.
These are all qualities of an abusive relationship
that we’ve been forced to experience first-hand
or as a byproduct of being an oppressed minority.
Who wouldn’t feel depressed, anxious or
have a myriad of other mental health issues as
a result of being in a toxic relationship that you
can’t fully insulate yourself from and is ongoing?
When we want to feel relief, a sense of
belonging, pleasure, or confidence we can
turn to a temporary fix outside of ourselves,
drugs. Illegal and prescription drugs can be
used in ways that medicate and/or increase
our psychological/emotional distress. At their
best, they can give a temporary reprieve from
what ails us in order to look more deeply at
the underlying causes, to treat these. They can
show us a window into what’s possible so that
we can have this without them. At their worst,
they can become a nightmare that adds additional
shame, isolation and self-rejection.
TREATMENT APPROACHES
So what is the best treatment approach for
dual diagnosis in the LGBTQ Community?
One size definitely does NOT fit all when
it comes to our needs as a community.
There are several options when it comes to
treatment of addictions: support groups, outpatient
treatment, inpatient treatment, detox
and residential care. Which one will work
best really depends on finding the right fit
with where someone is at and the particular
treatment programs involved.
While the twelve-step recovery program
works great for many and certainly has the largest
amount of groups of any treatment program,
others find it further perpetuates their shame
or is overall unhelpful (some estimates of its
effectiveness are as low as 5%—8% of those
who participate). There are also other treatment
approaches that work better for some: like Harm
Reduction, SMART Recovery, LifeRing Secular
Recovery, and Moderation Management.
Similarly to recovery programs, there are
also many approaches to providing psychotherapy
including: Cognitive-Behavioral
Therapy (CBT), Psychodynamic Therapy,
Humanistic Therapy, Narrative Therapy and
Hakomi Therapy. However, the single most
important factor of effective psychotherapy is
not the treatment approach but the relationship
between therapist and client. This
transformational relationship can provide
the safety, support, validation and guidance
that’s too often missing for LGBTQ people.
Being a good consumer of mental health and
addiction services means doing your research.
Unfortunately, all too often I see conversion
therapists masquerading by “specializing with
the LGBTQ community,” but would rather
change the client to becoming cis-gender and
straight, something that has been deemed ineffective,
harmful and dangerous by mental health
and medical professional associations.
Lastly, finding a therapist and/or treatment
program requires these services to not only
be LGBTQ-friendly but actually knowledgable,
in order to get the most effective care.
It’s not your job to pay for a service but then
end up spending too much time educating
them about what it means to be LGBTQ. You
deserve to learn healthier coping strategies,
heal old wounds, learn more about yourself
and how to better navigate a sometimes
hostile world. You deserve to thrive, love and
enjoy your life more fully.
James Guay, Licensed Marriage
and Family Therapist (#39252), has
provided individual and couples
counseling in private practice
since 1999. A former elite Gymnast and life-long
lover of nature, he focuses his social justice
activism for the LGBTQ population. Digital
content available at: www.livingmorefully.com.
Instagram: @jamesguaylmft
SEPTEMBER 2019 | THE FIGHT 31