SEXUALITY COUNSELLING

  • The ‘coming out’ process 

  • LGBTI Counselling

  • Sex therapy and the mechanics of sex 

  • Fetishes 

 

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The ‘coming out’ process:

Coming out as LBGTI is a process that for many, is experienced in stages of change.  These steps are not necessarily mutually exclusive and can be experienced simultaneously. It is not uncommon for people go back and forth in their sexual identity development. 

  • Step One: Identity Confusion: “Who am I?” 

  • Step Two: Identity Comparison: “Maybe I am gay. Or maybe I’m bisexual.” 

  • Step Three: Identity Tolerance: Beginning to accept identifying the self as gay, lesbian or trans gendered or bisexual, 

  • Step Four: Identity Acceptance: Beginning to accept, rather than just tolerate your sexual identity, 

  • Step Five: Identity Pride: Feeling a sense of pride in your sexual orientation and feeling comfortable interacting in gay communities, 

  • Step Six: Identity Synthesis: Sexual orientation is integrated into your whole identity. 

“The coming out process is possibly one of the most difficult things to do in anyone’s life. I was born gay. It is my job to create a safe space for you to be able to express your feelings in a safe environment. I will hold you in a non-judgemental space and provide you with empathy as we explore your session. By sharing, you will find that a significant weight lifts off your shoulders. The parts of your body that hold these complex emotions then begin relaxing, then the mind has more space to be able to process everyday stuff.” 

The benefits for LGBTI (lesbian, gay, bisexual, transgender, intersex) counselling: 

  • Support with the difficult process of 'coming out' to friends and family 

  • Targets surrounding issues such as depression, anxiety, low self-esteem and addiction 

  • Confidential, non-judgemental environment in which to discuss your concerns, emotions and feelings 

  • Be able to explore private matters such as sex and relationship issues in safety. 

  • Tailor-made coping strategies to manage stressful/distressing situations




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LGBTI Counselling: 

“It has been made clear to me (from past sessions with my clients) that there is an issue surrounding the underlying stresses the LGBTI community cope with on a daily basis. For most, the issue of sex and gender does not seem to cause any significant long-term problems. This, however, is not the case for the LGBTI community. When a LGBTI client is presented to me, the surrounding issues of sex and gender are not usually the first thing spoken about. Fairly quickly, the conversation usually turns to this very aspect. My clients discuss issues surrounding societal negative attitude towards people of minority sexualities and the shame these clients have ‘learned’ to internalise. Many LGBTI clients will present themselves saying, “I am feeling more anxious than usual” or “I’m feeling quite depressed”. In other words, most LGBTI clients will present with the same range of everyday, chronic and acute, issues as other clients. LGBTI clients want to be able to talk freely about the totality of their lives. Accordingly, if it is relevant, they will want to talk about their current feelings around sex, sexuality and/or gender. Equally they may not want to talk about this at all, or until later in the process when a deeper level of trust has been established. 

As many LGBTI people have learned to live with the stresses of being different over long periods of time, they may not be aware of the toll that this experience of chronic low-level stress creates. So, you may enter therapy thinking that you do not need to talk about your sexuality, intersex difference or gender identity. Slowly both you and I may discover the residual effect of this stress is a big part of presenting a problem such as depression. Like any complex emotional issue, these sorts of discoveries occur in an open supportive therapeutic relationship where you lead the discovery.” 


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Sex therapy and the mechanics of sex: 

My sex therapy follows the PLISSIT (Permission, Limited Information, Specific Suggestions and Intensive Therapy) model, which involves four steps: 

  • Providing a safe space for clients to bring up issues around sex, 

  • Gathering information, 

  • Offering a diagnosis and suggestions for how to address the issue, 

  • Providing more intensive therapies, which may include making referrals to see other specialists. 

 

The areas that may be covered during sessions: 

  • Erectile dysfunction 

  • Painful intercourse 

  • Lagging libido 

  • Desire discrepancy (where couples have different libidos) 

  • Performance anxiety 

  • Sexual surrogates 

  • Sex addiction counselling 

  • Pornography addiction 

  • Sex avoidance 

  • Intimacy issues 

  • The active male’s orgasm (root chakra) versus the passive male’s internal orgasm (sacral chakra) 

  • Sex and narcissistic personalities 

  • The effects of childhood sexual trauma or physical abuse on sexual desire later in adulthood 

  • Fetishism 

  • Gender identity 

  • Safer sex counselling 

  • Avoiding STIs 

  • Living with HIV

 

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Fetishes: 

The term ‘fetishism’ was coined in the late 1800s. It originates from the Portuguese word feitico, which means ‘obsessive fascination’. The medical definition of a fetish is an object or bodily part whose real or fantasized presence is psychologically necessary for sexual gratification and that is an object of fixation to the extent that it may interfere with complete sexual expression. The chakra where this lies is the second or sacral chakra. The sacral chakra is all about emotions, feelings, relationships, expression of sexuality, feeling the outer and inner world, creativity and most importantly fantasies. The definition of a fantasy is an activity of imagining impossible or improbable things. When we put the two definitions of fetishism and fantasies together, a complex concept is borne. 

In dealing with fetishes, I pose the following questions: 

  • Is a fetish ever fully sexually gratifying? 

  • Does a body part actually need to be used during a fetish being played out? 

  • Does that body part need to be one of the sex organs? 

  • If a non-sex organ body part is ‘fetishised’, how does that body part become ‘sexualised’ in the mind? 

  • If a body part is not part of a fetish, how does a non-body part or ‘object’ become a fetish in the person’s mind and make it ‘sexual’? Or is the object simply an object where a fantasy has been attached, not necessarily of a sexual nature? (This may be linked to where memories are held in the body other than the brain) 

  • If the non-body part or ‘object’ of fixation interferes with complete sexual expression, how does this psychologically ‘sit’ in the fetisher’s mind? 

  • Is it ‘obsession’ that drives the fantasy never being fully realised? 

  • How much of the fetish is real or imagined?  

  • How much of the fetish remains a fetish once it has been played out? 

  • How much of the fantasy aspect remains once a particular fetish has been played out? Does this lead to the fetish wanting to be played out to a more extreme level each time, to preserve the ‘fantasy’ aspect necessary for the fetish to still exist in the mind of the individual?

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© MarcusNicholson - The Relationship And Sexuality Mentor

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