Managing Transference and Countertransference in the Treatment of Gay, Lesbian and Bisexual Survivors of Childhood Sexual Abuse

ABSTRACT

Gay, lesbian and bisexual (GLB) survivors of childhood sexual abuse must endure the detrimental intrapsychic and interpersonal effects of the traumatic abuse as well as societal intolerance and discrimination related to their core identity. The adverse psychological effects of the sexual abuse and specific developmental issues related to a homosexual orientation may be additive in terms of the deleterious impact on the survivor's interpersonal functioning. The relational difficulties these individuals experience will inevitably manifest themselves in the therapeutic relationship via the transference-countertransference matrix. Issues such as shame, trust, and boundaries are some of the clinical themes that may be particularly relevant with this population of survivors. The authors suggest some therapeutic intervention within the context of potential transference-countertransference paradigms.

KEYWORDS:

• Bisexual
• countertransference
• development
• enactments
• gay
• homosexuality
• lesbian
• psychotherapy
• sexual abuse
• sexual trauma
• transference

Notes

¹ Gartner (1997) writes that shame may make it difficult for the GGLB patient to disclose abuse or sexual orientation to the therapist—a person who holds perceived power and authority. Gill and Tutty (1997) suggest that gay or lesbian survivors may experience difficulty forming alliances with therapists, particularly straight therapists, due to fear that therapists will stereotype them in specific gender or social roles with which they do not identify.

² See Drescher (1998, 2002) for more detailed discussions of the meanings of etiological questions about homosexuality in psychotherapy with gay men.

³ Gay men who exhibit high levels of internalized homophobia may fear that others will perceive them as lacking masculinity or being sexually perverse. This is likely to be exacerbated in gay men who have survived sexual abuse.