Trauma recovery begins when denial, repression, and dissociation end

Essy Knopf trauma recovery
Reading time: 4 minutes

The first proof of my trauma recovery was the return of memories once thought lost.

In the years after I started my therapy journey, I would find myself going about my business—walking my dog, showering, or driving to an appointment—only to be suddenly ambushed by recollection. 

Usually, these memories came to me in fragments: an odor, a feeling, a face, or a conversation.

I’d remember my excitement playing Link’s Awakening for the first time on my Gameboy Color. Or maybe I’d recall my late aunt’s tuxedo cat, Sylvester; the mockery of a snub-nosed boy in sixth grade.

Sometimes, I’d hark back to my first glimpse of the technicolor shells of iMac G3 in a school computer lab; the fantasies of collecting one of each “flavor”: Bondi Blue, Strawberry, Lime, and Tangerine. 

Other times, I’d wax nostalgic about the rain rattling the tin roof of the family home or the particular smell of the department stores my mother would like to spend hours wandering in search of sales.

Now and then, I’d think fondly of the moments spent loitering at the local newsagent, thumbing through copies of PC Powerplay and Nintendo Power magazines, dreaming about one day owning all the latest gaming consoles.

With each of these memories came emotions, often in a big jumble: longing and regret, as if for something lost, bittersweet joy, and sadness. 

A past rediscovered: the start of trauma recovery

When I think of time, I think of years, represented as a series of three-dimensional bar charts. Each bar represented a different month, arranged in a stair-like formation.

At the end of the month, I would imagine myself ascending a new bar, continuing until I had arrived in December, before moving on to the next chart behind it.

After my traumatic experiences, when I tried to peer back to the charts that had come before, my recall became hazy and my brain seemed to actively resist the effort.

If memories are like snapshots, all that was left to me were the countless throwaways that were returned to us when my family got our photos developed.

Always there were four or five shots that were to be out of focus. Sometimes a thumb was blocking the lens, or the flash of our disposable camera had blown out the image.

But the snapshots that now came to me, sealed for over 25 years inside some protective, internal vault, had all the vivid clarity of the present moment.

Puzzling as I was by this return, I was equally puzzled by the timing. The fragments were random and unconnected to my current circumstance. Just what was going on?

A sign of healing

For decades, trauma had strip-mined my consciousness of all evidence of my past; of memories both pleasant and painful.

Now, I was starting to amass a sizable collection. But having no idea what to do with them, I consigned them to a mental storehouse for later review.

Then, during one particularly humid summer—a summer that reminded me far too much of those of a childhood spent in the tropics—I was inundated by a wave of these memories, leaving me both bewildered and melancholic. 

“I just don’t understand,” I said during one therapy session. “Why am I remembering all of this?”

“It sounds like you’re healing,” my therapist replied, trying to normalize what to me felt painfully abnormal. 

“But why? What function does this serve?” I asked through my tears. “Why now? I just want to understand.” 

What I wanted was a cut-and-dry explanation for what is, for everyone, a messy and unpredictable recovery process. 

Therapists liked to call this behavior “intellectualizing”. In my case, I was trying to bypass an emotional experience by using my intellect. 

This “ego defense” was one I had depended upon for years to cope with my trauma. It was also one of the key obstacles to my healing. 

Reintegration: the beginning of trauma recovery

So rather than resisting the wave, I rode it, allowing the memories and emotions they conjured to come and go.

Soon after, I embarked upon a single-minded hunt for various articles from my childhood. 

This involved preparing a playlist containing every memorable song of the 90s and the early aughts. Next, I put together a book list containing every title my teen self had read. 

After this task had been completed, I hunted down scans of the magazines I’d once flipped through and the illustrated video game guides and manuals I’d once savored during long car trips.

Often, my searches did not culminate in any action; I didn’t always listen to the music or consume this reading material. 

Instead, I found a strange comfort in the fact I once more had possession of these formerly lost relics from my past.

This obsessive collecting on my part I realized was an outward expression of an internal process: reintegration.

The part of myself I had once cut off was returning piece by piece, and I was searching for props to help facilitate its assembly.

I was working, in my own way, towards a whole, coherent narrative of self and past.

Overcoming denial, repression, and dissociation

In the words of author Judith Huerman’s seminal work, Trauma and Recovery:

“The goal of recounting the trauma story is integration, not exorcism.”1

Herman goes on to explain:

Remembering and telling the truth about terrible events are prerequisites…for the healing of individual victims. The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. But far too often secrecy prevails, and the story of the traumatic event surfaces not as a verbal narrative but as a symptom. Denial, repression, and dissociation operate on a social as well as an individual level.

Undertaking therapy allowed me to finally release the taut knot of my trauma survivor psyche. And with that release had come recollection—not just of traumatic events, but everything in between.

Memories in turn triggered “floods of intense, overwhelming feeling”, which proved wholly alien to me after years spent dwelling in the “extremes of amnesia…and arid states of no feeling at all”.

I was not in crisis; I was in a state of trauma recovery. And in order to complete that recovery, I would have to let go of the three skills that had permitted my survival through alienation from my own self—denial, repression, and dissociation.

When one cannot escape a reality in which one feels threatened and powerless, one finds ways of adapting. 

I too had once acted as if nothing had happened, ignoring my emotions, burying memories, and mentally checking out when confronted by a frightening reality.

They had served an adaptive function. But maintained over time, they had caused the margins of my life to contract to a pinprick in which only survival is the only possibility, and never true flourishing.

This is a kind of living death; imprisonment in a psychological internment camp.

And now, finally, after years spent walking through a dim, gray limbo, I could see the possibility of a death revoked, and life renewed.

More to come in a follow-up post.

Social workers, here’s the practical guide to self-care you’ve been looking for

Essy Knopf social work self-care
Reading time: 5 minutes

Surviving the social work profession ultimately comes down to the self-care habits you establish in social work school.

The strongest habits reflect an understanding of priorities. Amid all the competing demands of school, you may ask yourself which to put first.

Is it school? Your placement? Your job? Your family? NOPE. 

Your number #1 priority is—and always should be—you. Because without health and wellbeing, you can’t properly attend other all the other priorities.

Many folk regard self-care as a nice “add-on” to their daily routine, such as a kind act towards one’s self, like taking a bath or getting a massage.

Such acts certainly matter, but self-care most importantly is ensuring you are getting the necessary sustenance for your body, mind, and spirit.

I’m someone who considers myself to be fairly well-versed in self-care principles. But even so, I still struggle to practice it.

What doesn’t help is that I, like most, have certain gaps in my knowledge of self-care principles. For example, it was only in my late 20s that I found out about sleep hygiene, a practice essential to getting a good night’s rest. 

For this reason, I’m going to start with a brief overview of the five fundamentals of good health (some of which I touched upon in my previous post on social work self-care).

The five fundamentals of self-care

1. Eating well. As social work students, we will often be so busy we end up relying on takeout. 

We can avoid this by meal planning and cooking in batches. Aim to get plenty of fresh plant-based nutrition

2. Getting sleep. While it’s not always possible, we should always strive to go to bed and get up at the same time each day. 

This is one part of practicing good sleep hygiene. Here are some other suggestions. Note that experts recommend getting seven to nine hours of sleep each night.

3. Exercising daily. All of us should aim for 30 minutes of “sweat-breaking” exercise every…single…day. Yep, you heard right!

If you’re short on time, consider doing a YouTube aerobic class. Failing that, try for a 20-minute walk around the block.

4. Staying social. It’s crucial that we dedicate time every week to enjoying the company of friends, family, peers, and partners. It’s all too easy otherwise to find ourselves caught up in an endless cycle of study.

5. Limiting intake. Sure, caffeine can help us shake off tiredness. And alcohol may help ease stress. But taken in excess, they may do us more harm than good

The same can be said of highly processed foods. When we’re strapped for time or low on funds, it’s all too easy to reach for a packet of potato chips or a can of soft drink.

Try to stock your pantry and bedroom with healthy snacks. The proximity of these snacks can help you with resisting the urge to splurge on junk food.

Enhancing mental resilience

Laying the foundations for good health has the added effect of supporting our mental health—a quality crucial to survival in this profession. 

Given some of us come to social work with a history of our own, stress can have the effect of triggering existing anxiety, depression, and/or emotional reactivity.

The good news is that these challenges can be addressed with time and daily effort. 

Here are some techniques that can help with maintaining your mental resilience. 

1. Meditation. This can be either guided or self-guided.

2. Breathwork. One example of this is the 4, 7, 8 technique

3. Grounding exercises. For instance, body scans.

4. Yoga. These days, yoga can be practiced from the comfort of your home, thanks to the variety of free classes available on YouTube.

5. Gratitude. A gratitude practice can include keeping a daily journal. Consider also writing down five things you’re grateful for on a regular basis, and/or sharing them with an accountability partner.

6. Affirmations. If you’re stuck on how to practice affirmation, consider using prompt cards.

7. Prayer. If you are spiritual or religious, know that prayer can have benefits similar to those granted by meditation.

8. Psychoeducation. Those of us with personal challenges such as anxiety and depression may find some benefit in self-education via bibliotherapy.

9. Therapy. Know that for many social work students, therapy services can be accessed for free through their school’s health center.

Coping with anxiety

Experiencing anxiety while attending school is perfectly normal. Taken to the extreme, however, it can be crippling. Understanding the mechanics of anxiety may go a little way to helping. 

Anxiety boils down to overestimating a threat and underestimating your safety and ability to cope. Of course, knowing this is one thing, but dealing with it is another matter altogether. 

For this reason, I would recommend revisiting the five fundamentals of good health discussed above. Are you fulfilling all of them? And if not, could this be contributing to your current stress?

After you’ve done this, ask yourself if exploring one or more of the practices I’ve suggested might help.

Failing this, know that you don’t deserve to suffer in silence. Ensure you seek support, whether from family, friends, your school, or community mental health services.

Self-education as self-care 

Above I suggested seeking psychoeducation about mental health challenges through bibliotherapy. Here are some books I have read and can personally vouch for.

1. The Anxiety & Worry Workbook by David A. Clark & Aaron T. Beck. This book contains worksheets that can help you with addressing your anxiety using Cognitive Behavioral Therapy (CBT).

2. The Happiness Trap by Russ Harris. This book offers exercises that draw upon some very useful Acceptance and Commitment Therapy (ACT) principles and skills.

3. Feeling Good and When Panic Attacks by David D. Burns. These books draw upon CBT to teach readers how to overcome depression and anxiety.

If you’re interested in exploring mindfulness and applying some of the principles to your life, there are three additional books you might want to investigate.

4. Full Catastrophe Living by Jon Kabat-Zinn.

5. The Places That Scare You by Pema Chödrön. 

6. When Things Fall Apart by Pema Chödrön.

Self-care and overcoming social work imposter syndrome

It seems that social work imposter syndrome is a rite of passage—but also a positive sign that you’re on the way to becoming a competent social work professional.

Imposter syndrome after all indicates self-doubt. And self-doubt reflects self-reflection, which is the first step to self-improvement. 

Still, when engulfed by these negative feelings, it’s helpful to remind yourself of the following advice by Judith S. Beck, from her book Cognitive Behavioral Therapy: Basics and Beyond:

My goal is not to cure this client today. No one expects me to. My goal is to establish a good relationship, to inspire hope, to identify what’s really important to the client, and perhaps to figure out a step the client can take this week toward achieving his or her goals.

What Beck is stressing here is that the only true measure of professional success in this profession boils down to a single factor. And this factor is our willingness and ability to meet our clients where they are at.

Wrap up

If you’ve found any of the self-care advice I’ve shared here useful, let me know in the comments. 

And if there’s anything you’d like me to cover, reach out and I’ll do my best to address it in a future blog post and video.

Please note that all of these tips and more are available in my free guide to surviving and thriving social work school.

Surviving in the social work field boils down to this single habit

Essy Knopf social work habit self care
Reading time: 4 minutes

What is your number one priority as a social worker? If self-care is not the answer, we need to have a chat.

Most Master of Social Work (MSW) programs will emphasize the importance of self-care upfront. It doesn’t take long, however, for this call-to-arms to butt up against reality. 

We as social workers must navigate many competing and conflicting priorities daily. This begins as early as school.

With so much to do during our relatively brief degree, our days are often dominated by assignments and course readings. 

Setting aside an extra hour for “you” time can come to resemble an unnecessary luxury. You may find yourself asking, “How can I afford to stop and relax when I have so much work left to do?” 

It’s a question I promise will continue to challenge you over the course of your career. For this reason, self-care is a habit you would be best served by building right now.

Here are some ways you can get started.

1. Make a commitment to self-care

If you can exercise enough discipline to study for multiple hours every day, you can certainly commit a minimum of one hour to self-care.

In strict cost-benefit analysis terms, your brain may try to argue with you about the necessity of relaxing.

It may feel good to have dedicated downtime. But time away from your desk may also put you behind in your work and feed your anxiety.

This can become a vicious circle: time anxiety persuades there is never enough, and while this might certainly feel like it’s the case, it’s not true.

The issue is not whether you have enough time to take care of your personal wellbeing. Rather, it’s your willingness to re-prioritize it. 

Let’s suppose you do. If you have time anxiety, this may worsen. But rest assured that over time, its death-grip on your psyche will weaken.

2. Block out downtime

Personally, I’ve found there are usually three windows each day in which most people can block out self-care time: 

  1. First thing, straight after waking up
  2. Midway during the day, such as during a lunch break
  3. Before bed, when one typically unwinds

The morning window works best for me (that is, supposing I get to bed early).

This period seems to afford me enough time to do a self-care activity such as meditation before my brain jumps aboard the “work ‘til you drop” train.

Another option is to dedicate a single day of the week such as Sunday to “you” time.

3. Permit yourself a personal life

Work is a hungry beast, and if we continue to encourage it, it will inevitably consume our personal lives. 

We may suspend social outings and quality time activities with our loved ones. Or we may sacrifice a hobby that previously enriched our lives.

Diligence and dedication in professional settings are admirable traits. But when taken to excess, they can lead to workaholism.

Having healthy boundaries quite simply means saying “yes” to all that is conducive to our welfare, and “no” to things that aren’t. And workaholism is definitely something that qualifies as the latter.

Don’t neglect your personal relationships for the sake of your calling. Refuse to become a martyr for your chosen social work cause. 

Instead, strive for a work-life balance. Schedule at least one social meetup a week. Revive that cherished hobby. 

Rather than constantly drawing from your well, take time out to replenish it.

Essy Knopf self-care social worker

4. Don’t go at it alone

Further to the last point, healthy relationships are like armored vans that can carry us through a warzone of difficult times. 

These relationships are thus crucial to our mental health and serve as an invaluable buffer during difficult times.

But they are only as helpful as we allow them to be. In times of need, don’t hesitate to reach out to coworkers, supervisors, partners, friends, and family members.

5. Self-care through the support of a therapist

None of us come to the social work field a clean slate. Each of us has a history, and the work we do can cause parts of it to resurface, both good and bad.

A therapist can help us with processing our experiences, as well as professional challenges like countertransference.

The insights of another professional can go a long way to supporting us in becoming better practitioners. 

6. Start meditating

Mindfulness-based strategies are an effective way to support mental resilience and ward off overwhelm and anxiety.

The most commonly known strategy is meditation.

Guided meditations can be found in person or online. UCLA Health for example has many recordings on its website, and there are subscription-based meditation apps such as Calm and Headspace.

An example of a self-guided meditation I use daily is breath counting. This is very simple to practice.

First, get into a meditation posture. A common one is sitting upright, with your feet planted on the floor, your hands resting on your lap, and your eyes either open or closed.

Next, count one, inhale, two exhale, three inhale, four exhale… Go right up to 10, before resetting to one. 

Every time your mind wanders or you become distracted, bring your attention back to the sensation of your breath and resume counting.

The breath counting meditation has the most beneficial effect for me when performed one to two times a day for 20 minutes at a time. 

If you are new to this kind of meditation, I would recommend beginning with a three-minute meditation, slowly work your way up to a longer session.

Whatever method you choose, know that finding your meditation groove can, at least, initially, be a struggle—especially if you’ve had no prior experience with mindfulness. 

For that reason, I would recommend starting with guided meditations or exploring free resources such as these five mindfulness-oriented phone apps.

7. Explore yoga or prayer as self-care

Another mindfulness-based strategy is yoga. If you can’t make it to a studio, try a virtual class. Many are available free to watch on YouTube.

Another mindfulness practice worth mentioning mention is prayer, which has been found to offer similar benefits to other forms of mindfulness. 

For these reasons, if you are spiritual or practice a religion, it may be worth incorporating a prayer practice into your daily self-care regimen.

Wrap up

If you’ve ever caught yourself saying “There is no way I can humanly do all of this,” know that you by far are not the first social worker to feel this way.

Feeling overwhelmed as we so often do in these instances is an opportunity to pause and check in with ourselves.

Are you getting enough time to recharge your batteries each day? If not, maybe it is time you carved out a slot in your daily schedule for a self-care activity.

Sure, it may not always seem practical. But let me ask you this: how much more practical is the alternative…professional burnout?

You can read more social work-related posts here.

Five reasons gay men should consider doing therapy

Essy Knopf gay men therapy
Reading time: 9 minutes

It’s not uncommon to meet fellow gay men suffering from anxiety and depression. It’s also not unusual that they are either unaware, in denial, or unwilling to recognize these challenges, or to take the steps necessary to address them.

Some years ago, I had a falling out with my flatmates. At the time I was directing a major shoot at film school and was under immense pressure. Amid my mad scramble to find a new apartment, I decided to meet Samson*, a gay man in his 20s who worked as an IT consultant. 

Having exchanged niceties, Samson quickly got down to brass tacks, advising me he wanted a flatmate willing to hang tea towels and stack dishwashers in a specific fashion.

As someone known for my somewhat OCD tendencies – I for example never allowed people to sit on my bed while wearing their “outside clothes” – I could to some degree relate. 

But Samson seemed to take things one step further. A health fanatic devoted to all-natural products, he told me I wouldn’t be allowed to clean with bleach, on the account he might be exposed to its fumes.

Despite my reservations, I took the room. But from that first meeting onward, the stipulations piled up. One minute I was using too much fridge space, the next I was filling the kettle with “excess” water and wasting energy.

Samson even took to switching off the oven when he believed I was using it too long.

While he managed to bend some of his rules for me, I couldn’t shake the feeling that my presence in Samson’s home was not welcome. I could tell that while he wanted to save on rent, but also wanted to live alone. 

Worse still, whenever we happened to cross paths, Samson would complain. First, it was about his cutthroat colleagues at work. A week later it was the ex who seemed incapable of empathy, and the friends who failed to understand Samson’s very specific health choices. 

Samson told me he was against eating hydrogenated oils, on account of them being carcinogenic. For him, discovering that a meal contained even a trace of such was enough to ruin an entire night out.

Listening to Samson, I felt torn. Some of his complaints were understandable, and yet I knew I was being used as a sounding board for his discontent.

I tried to bring empathy and some perspective to the issues Samson raised, and yet nothing I said or did made any difference. Samson was trapped in a cycle of negative thinking, focused only on assigning blame to others.

So long as he continued to see the apparent failures of others as a reflection of their respect for him – and by implication Samson’s worth as a person – this would likely continue.

Samson’s paradigm was clearly at fault here, but I became convinced that it was serving double duty as a smokescreen for Samson’s inability to manage his own distress. 

By pretending it was not there, he would never have to confront it. Yet this unwillingness to accept and recognize his covert depression was precisely what was keeping him stuck. Rather than practicing introspection, Samson searched for scapegoats. 

Once or twice I broached the subject of seeing a therapist. Each time, Samson produced a readymade excuse.

The few therapists Samson had approached would not take his health insurance. The nature of Samson’s job meant he was often on the road with short notice, making it difficult for him to plan therapy sessions in advance.

Then there was the question of trust: Samson didn’t want to open up to just anyone

These were legitimate friction points, ones faced by many gay men looking to undertake therapy. But they were also excuses. As per the old maxim, if you really want to do something, you’ll find a way.

1. Gay men often suffer from depression

An inability or unwillingness to acknowledge one’s own mental health struggles is usually a product of self-denial; of alienation from one’s own authentic feelings.

Like a majority of men, we as gay men often suffer interpersonal prejudice and discrimination over our identities. These minority stresses can leave us stricken with shame while placing us at greater risk of depression, anxiety, and suicide.

That risk is exacerbated by the fact that males are socially programmed to go at it alone. Masculinity is popularly coded as being self-reliant, an idea more widely echoed in our culture’s embrace of rugged individualism, i.e. the “I don’t need help from anyone” mentality (see my earlier article on embracing your authentic gay identity).

Gay men tend to be more emotionally expressive than their straight counterparts. Gender-atypical tendencies like this often lead to us being singled out and persecuted. Any wonder then we should be especially challenged when it comes to asking for help.

But forcing ourselves to repress our emotions and to cut ourselves off from the help of others leaves us prone to covert depression. This depression is often the reason many of us should seek help…and yet it can also serve as a major source of resistance.

Depression sufferers know all too well how we can become trapped in the stasis field of negative thoughts and “automatic”, self-perpetuating cognitive distortions.

In his book Feeling Good, David D. Burns notes that these distortions lead in turn to procrastination and “do-nothingism”. That is, we found ourselves restrained by the very same inertia we are seeking to escape. 

Thus the depressive, lacking the motivation to change, surrenders to the comforting familiarity of their unhappiness.

Another reason it is difficult to take action is that covert depression operates as a kind of background presence that evades easy detection, or may be put down to just a passing “mood”.

Similarly, anxiety – depression’s fraternal sibling – may also be dismissed as an inevitable feature of modern life. It may even be regarded as a helpful crutch that gives the sufferer a motivational edge; a willingness to go the extra mile that is recognized and rewarded by employers.

2. We may have attachment difficulties

Caregivers play a crucial role not just in early development but our future wellbeing. They comfort us during times of distress, fostering a sense of security through healthy attachment. That attachment serves as a template for future relationships, shaping whether we are able to form close bonds with others. 

Attachment also provides children with an internal working model of self-worth. It defines whether we see the world as a safe or nurturing place, or one full of pain, uncertainty, and anguish. It provides the primary reference point for our lived experience

Ruptured attachment is the result of either active trauma, which typically involves a boundary violation such as physical or sexual abuse, or passive trauma, which involves some form of physical or emotional lack, such as neglect. Ruptured attachment can occur at any point during childhood or teenagehood.

Gay men experience both active and passive trauma when a parent rejects, neglects or attacks them over their sexuality, an experience which is all too common.

During early attachment, trauma is preverbal, making our suffering literally beyond words. As such, it can be difficult to “re-cognize” the experience and come to grips with its effect on us as adults.

Without the help of a trained practitioner, we will continue to live unknowingly in the shadow of our trauma, afflicted with mental health conditions like depression.

3. We may be unable to self-soothe

Ruptured attachment results in an inability to self-soothe. When our caregivers fail to properly “attune” to us and provide the correct behavioral modeling, we fail to develop this vital skill. 

Self-soothing means being able to realize we are hurting, to give ourselves the comfort we need, and to seek it from others when we can’t

Without self-soothing, we may find ourselves prone to “fight, flight, or freeze” in times of stress. 

That is, we engage in one of three coping strategies: coming out guns blazing, running from danger, or shutting down. We don’t seek the support we so desperately need, leaving us beholden to depression and anxiety.

In an attempt to pacify our troubled minds and hearts, we may turn to the Band-Aid fixes of grandiosity or process addictions.

4. Gay men are debilitated by shame

For gay men, depression is often compounded by longstanding shame. The distinction between guilt and shame, as pointed out by Brené Brown, is that guilt involves believing “I did something bad”, while shame involves assigning a permanent negative quality to yourself, like “I am bad”.

We come by shame firstly through socialization. Society teaches us our sexuality is abnormal, perverse, and even morally wrong. When this view is adopted by our caregivers, it may not necessarily lead to outright rejection, but rather words or deeds that are invalidating.

Invalidations, no matter how small they may seem, can inflict profound psychic wounds, Alice Miller says. If the only people in the world duty-bound to love you unconditionally mock or belittle you because of your sexuality, you may come to believe you are inherently unlovable.

The child with a devastating belief in his own unworthiness is likely to carry it into adulthood. If left unaddressed, this belief can leave us relationally impaired, resulting in an insecure attachment style.

Attached authors Amir Levine and Rachel Heller estimate about half of the adult population suffer from insecure attachment styles. In the case of gay men, this figure may arguably be even higher.

essy knopf gay men therapy

How a therapist can help gay men

Therapy is one way we can identify the impact ruptured attachment or invalidation has had upon us. It offers avenues for reconnecting with aspects of ourselves we may have become alienated from as a result of parental and social rejection and invalidation. 

And it is through this connection that we develop self-awareness, what Daniel Goleman calls “emotional intelligence”, and thus the ability to self-soothe.

A relationship with a therapist ideally is reparative. They model the unconditional acceptance of an ideal caregiver, creating an accepting space in which clients can vent to thoughts and feelings they have been forced to repress, often as a matter of survival. 

A good therapist uses compassion and insight to help their patients reintegrate alienated parts of the self. Through their guidance, gay men can come to terms with the loss and anguish they have suffered.

Therapy requires that we go to places we have been avoiding. After a lifetime spent mastering the art of emotional concealment, gay men undergoing therapy are asked to forgo their craft and expose their wounds and weak spots.

Embracing vulnerability in this fashion allows us to ultimately regain our long-lost ability to be emotionally authentic.

As Buddhist Pema Chödrön points out:

Without realizing it we continually shield ourselves from this pain because it scares us. We put up protective walls made of opinions, prejudices, and strategies, barriers that are built on a deep fear of being hurt… Finding the courage to go to the places that scare us cannot happen without compassionate inquiry into the workings of ego… Either we question our beliefs – or we don’t. Either we accept our fixed versions of reality – or we begin to challenge them. 

Choosing a therapist

Making the decision to undergo therapy sometimes feels like half the struggle. Then you have to deal with the deadly triad: money, scheduling, and what Samson called trust, but which I like to think of as compatibility

You can’t put a price on your mental wellbeing, so don’t let the cost alone thwart your efforts. If you don’t have a mental health care-inclusive health care plan, consider finding a therapist who offers sliding scale fees. If you need to take time out during working hours, negotiate with your manager or HR department.

When choosing a therapist, we all need assurance that we are in safe hands. We are, after all, seeking the unconditional acceptance we were once denied. Our chosen confidant, therefore, needs to show they will honor this responsibility. 

Bessel van der Kolk suggests three criteria by which you can gauge this: comfort, curiosity, and collaboration. To that list, I would also add proactivity and accountability:

  • Comfort: Do you feel comfortable and safe in the presence of this therapist? Do they seem comfortable with you? In the words of van der Kolk: “Someone who is stern, judgmental, agitated, or harsh is likely to leave you feeling scared, abandoned, and humiliated, and that won’t help you resolve your traumatic stress”.
  • Curiosity: Does the therapist seem interested in you as a person? Or do they see you as just another patient to be handed a rote list of advice and instructions? Do they actually listen to you? Are they comfortable sitting with your distress? Or do they immediately leap into diagnosis and prescription?
  • Collaboration: Is the therapist demonstrating a genuine desire to work with you, to explore your issues in-depth and to formulate a treatment plan?
  • Proactivity: Some therapists tend to take a nondirective role. As a result, you may feel you have to overcompensate. Sessions may become endless talk marathons, broken only by you prompting your therapist for participation. There is great value in a sympathetic ear, and venting is definitely part of the process. But given for example depression’s tendency to keep us trapped in automatic thoughts, we are never going to make the necessary shifts in our thinking without the help of someone willing to interrupt, redirect and even challenge, where necessary.
  • Accountability: Does your therapist honor their appointments with you? Do they cancel or reschedule on short notice? A therapist who is unpredictable or inconsistent can’t provide you with the security and caregiver-like “containment” you need. This also works in reverse. Do they help keep you accountable? Set tasks and homework? Without proper follow through on your behalf, your recovery may be hindered.

Remember: you are not locked into any therapist relationship. Treat the first session and those that follow like you would a date. You may be seeking immediate relief, but your objective should be to assess compatibility. 

In the end, there is no use building a relationship with someone who isn’t capable of giving you the support you need. Be willing to shop around until you find the right fit. And if it isn’t working, be prepared to move on. 

As with any endeavor, you will face setbacks. Sometimes these setbacks may simply come down to lack of motivation. If this is the case, break the task of finding a therapist into baby steps and try to complete one step a day.

The act of unlearning maladaptive behaviors and patterns can take months, if not years. Your recovery ultimately comes down to your being patient with the journey, flexible in your approach, and perhaps most importantly, remaining committed to your wellbeing.

Creating a new self unburdened by the injustices of your past first requires that you choose to break with the old.

“When I let go of what I am,” says Chinese philosopher Laozi, “I become what I might be”.

For advice on finding a therapist, check out this handy post by the American Psychological Association.

Takeaways

  • Acknowledge you may have depression.
  • Consider how your attachment history and feelings of shame might be playing a role.
  • Fight motivational inertia! Take it one baby step at a time.
  • Stay committed. You're in this for the long haul.

* Names and identifying details have been changed to protect the privacy of all individuals discussed in this article.