I entered the addictions field as a chaplain in an adolescent
substance abuse unit. When I first conducted 4th and 5th
Steps I made the mistake of assuming Roman Catholic patients
had an advantage of understanding how the 5th Step worked.
After all, they were familiar with confession. Wasn’t that a freeing
experience?
After hearing horror stories from
many of those clients regarding their
experience with confession, along with today’s media coverage
of sexual abuse by priests, I have learned not to assume that
people have had positive histories with their religions of origin.
Working in that adolescent unit prepared me for my later
work with gay, lesbian, bisexual and transgender (GLBT)
clients. I formed an understanding of what I call “spiritual
abuse.” Spiritual abuse occurs when a person’s spirit, or ways a
person practices spirituality, has been attacked.
Many of my early substance abusers refused to go to 12-
Step meetings because of the “God” talk. They would start
reading the steps on the wall and see “God as we understood
him” in Step 3, “Admitted before God” in Step 5 and then say,
“I’m out of here” before getting to “Asked God to remove” in
Step 6! They would argue that they had such terrible memories
of Sunday School, church, or other religious activities that
there was no way they would subject themselves to that kind
of negativity again.
I quickly learned that we needed to distinguish between
religion and spirituality. When conducting groups, I place
these two words up on the white board: RELIGION/SPIRITUALITY.
I then ask the group members to yell out what comes
to mind when they hear each of those words. Typically, they
start with words associated with religion: rituals, money, rules,
Pope, priests, nuns, ministers, rabbis, confirmation, confession,
abuse, obligation, homophobia.
Eventually, someone starts yelling out words for spirituality,
such as peace, serenity, nature, hope, trust, acceptance,
unconditional love, individual, personal, fulfilling.We discuss
attaching a positive or negative to the lists and everyone agrees
that the words on the spirituality side are more positive than
those on the religion side. I emphasize that if they are able to
see the difference between the two, they are more able to work
a program of spirituality.
Those who have such negative feelings about religion mayhave to go about the process of healing from spiritual abuse in
order to work a 12-Step progHealing from
‘Spiritual Abuse’ Assisting Gay and Lesbian Clientsram. To ignore spiritual abuse is
the same as ignoring sexual, physical or emotional abuse as a
part of the healing process. Most of us who are experienced in
this field recognize that unless we work on the whole self,
including physical, sexual and emotional, a
person cannot stay sober. I believe we need
to add “spiritual” to that list. A person with
a damaged soul cannot be a healthy whole person.

I began applying the principles of what we know about
sexual and physical abuse to spiritual abuse. First of all,we have
to name it: spiritual abuse. I invite clients who have had negative
experiences with their religion of origin to consider what
happened as spiritual abuse. Next, name the abuser: the name
of the denomination, the local church, clergyperson, parents,
whoever it was for them.

Depending on the severity of the abuse, clients may need
assistance in working through the anger and hurt of what happened
— before the healing process and rebuilding of a spiritual
program can begin. I remind clients of the program cliché,
“Take what you can use and leave the rest.”
There may be aspects of that religion of origin you can use in
your new spirituality, but you don’t have to believe it all. As an
example, I had a group of gay men come to my office when I
was directing a GLBT inpatient program. “We appreciate that
you offer to take us to the various gay churches in town on
Sunday morning. Many of us happen to be Roman Catholic.We
know what the Vatican teaches about homosexuality, but we
still find aspects of the Mass meaningful: particularly the rituals
and Eucharist.” I arranged for them to attend a GLBT-affirming
Catholic church.
Clients’ vulnerability
GLBT clients are especially vulnerable to spiritual abuse.
When they hear comments such as “homosexuality is a sin, an
abomination; sodomizers are condemned to hell” coming
from the pulpit, they experience spiritual abuse.
Who someone is at the core of their existence is their spirit.
Being gay, lesbian, bisexual or transgender is at the core of
someone’s existence. These struggling recovering persons
know that sexual orientation is not a choice. If it were, they
would have taken the easier way long ago.
They have struggled with their identity, and often thatstruggle is what has led them to addictive patterns and behaviors.
The shame of not being what their family and religion of
origin told them they should be has caused them to hide
behind alcohol, drugs, sex, gambling, spending, workaholism,
or other compulsive behaviors.
We cannot expect persons who have been so brutally
wounded in spirit to welcome a 12-Step program based upon
spirituality with open arms! We need to recognize the effects
of spiritual abuse, help the people we serve name it, and assist
them in finding a spirituality that works for them. For some,
they will be able to “take what they can use and leave the rest”
by going back to their religion of origin. For others, they will
need to explore other forms of spirituality and will need our
assistance in finding those resources.
For those GLBT clients who desire to stick with their religion
of origin, I offer information on local groups that have
identified themselves as welcoming of GLBT folks without
judgment and in full participation. Many mainline denominations
have national programs that local churches may use to
identify themselves. Examples are the Open and Affirming
Churches (United Church of Christ and Disciples), More Light
Churches (Presbyterian),Welcoming and Affirming (American
Baptist), Reconciling Congregations (United Methodist),
Reconciled in Christ (Lutheran), Supportive (Brethren and
Mennonite), Oasis (Episcopal), Affirming (United Church of
Canada), Inclusive (Great Britain), and Welcoming
Congregations (Unitarian-Universalist).
For those who do not have welcoming churches in their
denomination or who just want the experience of going to a
predominantly GLBT church, I recommend looking in the GLBT
newspapers for the GLBT-identified churches. The largest GLBT
denomination is the Universal Fellowship of Metropolitan
Community Churches. MCCs are found in just about every metropolitan
area in the United States and many other places,
including Russia, South America and Australia. There also are a
growing number of non-denominational GLBT churches.
Sometimes I give my clients the assignment of attending
one of these churches just so they have the experience of being
in a predominantly gay environment that is not a bar! GLBT
clients are apt to tell their counselors, “But the only place I can
meet people like me is at a bar.” When I give them the assignment
to go to an MCC or other predominantly GLBT congregation,
they often say, “But I’m not religious.” I tell them I wantthem to go and experience a large group of GLBT people who
are there to celebrate who they are (their spirits). They don’t
have to sing the hymns or pray the prayers. Just sit and take it in.
Alternative spiritualities
For those who want alternatives to traditional Judeo-
Christian congregations, there are growing options as well.The
Radical Fairy Movement in the GLBT community has its roots
in paganism. Paganism is an ancient religion often confused
with Satanism. Paganism is a positive spirituality that appeals to
those clients who want a program based upon nature.
Again, Pagan groups can often be found in the alternative
newspapers of a community or through more traditional
groups such as the Unitarian-Universalist Fellowships.
Challenge your clients to look in newspapers or online to find
a group that matches their needs or expectations for a spiritual
program.
Ancient Native American spirituality has risen in popularity
among some GLBT folks in the last two decades.The attraction
is the way most Native American tribes incorporated what
we would call GLBT persons into “normal” tribal life. They
were often honored for their unique talents and skills. For
example, in some tribes, what we call a GLBT person may be
referred to as a “two-spirited person,” meaning they have special
insight into both male and female spirits. For that reason,
they were often chosen as the medicine man or woman, or
shaman. Imagine that! Instead of being treated as the outcast
for being different, they were chosen as leaders because of
their special gifts.
I have worked with clients who have found serenity in
their spiritual quest by turning to Buddhism, Zen,Tao, and The
Church of Self Actualization, just to name a few others. I tell
them it’s not necessary to be religious to work a program of
spirituality, but it certainly doesn’t hurt to have a supportive
community to combat the isolation of addiction. It’s also
important to have some kind of program or support for your
own spiritual program.
In summary, it is important to recognize that GLBT clients
may have experienced spiritual abuse. They may need help in
identifying such action as abuse in order to find ways to heal
and work a spiritual-based program. Even my clients who are
not in 12-Step based programs benefit from working through
these issues. I always ask during my intake questions, “In whatreligion were you brought up?” I then ask, “Are you active in any religion/spirituality now?” Their responses to these questions assist in developing treatment plans on these issues. Assisting clients in finding a healthy spirituality is an important component
to full recovery. ■
Joseph M. Amico is executive director of the
National Association of Lesbian and Gay Addiction
Professionals and a member of the Addiction
Professional editorial advisory board.
Resources
Conover, P (2002). Transgender Good News,
New Wineskins Press
Helminiak, D (2000). What the Bible
Really Says About Homosexuality, Alamo
Square Press
Larkin, J (1998). Glad Day: Daily
Meditations for Gay, Lesbian, Bisexual and
Transgender People, Hazelden
McCall Tigert, L. & Brown,T (2001).
Coming Out Young and Faithful, Pilgrim
Press
McNeill, J (1988). Taking a Chance on God:
Liberating Theology for Gays, Lesbians, and
Their Lovers, Families, and Friends, Beacon
Press
Neisen, J (1993). Healing from cultural
victimization: Recovery from shame
due to heterosexism. Journal of Gay and
Lesbian Psychotherapy, 6 (2)
O’Neil, C & Ritter, K (1992). Coming Out
Within: Stages of Spiritual Awakening for
Lesbians and Gay Men, Harper Collins
Picucci, W (1998). Journey Toward Complete
Recovery: Reclaiming Your Emotional, Spiritual
& Sexual Wholeness, North Atlantic
Books
Roscoe,W (1998). Changing Ones:Third
and Fourth Genders in Native North America,
Palgrave
Roscoe,W (1988). Living the Spirit: A Gay
American Indian Anthology, St. Martin
Press
Roscoe,W (1995). Queer Spirits: A Men’s
Myth Book, Beacon
Scanzoni, L & Ramey-Mollenkott,V
(1994). Is the Homosexual My Neighbor? A
Positive Christian Response, San Francisco:
Harper
Wilson, N (1995) Our Tribe: Queer Folks,
God, Jesus, and the Bible, Harper Collins

Joseph M. Amico, M.Div., C.A.S.

Gays experience something like a second adolescence as part o f
the coming out process. During that time, behavior could be confused
with sexually compulsive behavior. Gays also experience
shame due to heterosexism. Coping mechanisms for shame can
include the use of mood altering substances as well as compulsive
sexual behavior. The Sexual Behavior Assessment Tool (SBAT) is
a way to assess the sexual behavior and delineate sexual compulsivity
from coming out behavior. Case examples are given in this
article to demonstrate the difference between coming out issues
and sexually compulsive behavior in gay men.

INTRODUCTION
The key factor in assessing the gay, lesbian, or bisexual client for
sexual compulsivity is understanding the stages of the coming out process.
Behavior, commonly understood as sexual compulsivity, may actually be
a phase in the client’s process of coming out to him or herself. Before
concluding that a gay, lesbian or bisexual client is sexually compulsive,
determine the client’s developmental stage of coming out. The “coming out
process” could be compared to a second adolescence. It is a developmental
stage but can happen during any age of the chronological process. Two
such theoretical models were developed by Cass (1979) and Coleman
(1981/1982).

Vivienne Cass (1979) identified six stages of the coming out process in
a theoretical model. This model was used at Pride Institute, a treatment center
exclusively for chemically dependent gay/lesbian/bisexual/transgender clients, in
assigning coming out levels to each client for the purpose of developing a sexual
behavior instrument. The six stages are Identity Confusion, Identity Comparison,
Identity Tolerance, Identity Acceptance, Identity Pride, and Identity Synthesis.
Eli Coleman (1981/1982) developed a similar developmental model using
five stages. The five stages are pre-coming out, coming out, exploration, first
relationships, and identity integration.

There are two purposes in writing this article. The first is to assist the
clinician in differentiating between sexual compulsive behavior in gay males
and behavior common to coming out issues. The second purpose is to assist
the clinician in understanding the role sex addiction plays in some chemically
dependent gay men.

Methods
Through comprehensive assessment tools conducted on intake we discovered that
forty percent of our clients reported some type of compulsive sexual behavior.
Originally, we used an instrument known as the Gay Sexual Addiction Screening
Test (SAST). We quickly determined that this instrument was geared more to gay
male behavior and not sensitive to the issues surrounding lesbians and bisexuals.

A task force was developed to create a new comprehensive instrument.
During the process, primary counselors assigned a coming out level to each
client as they conducted interviews for our comprehensive psychosocial. During
the interview, clients gave a full sexual history and answered the following
questions regarding their sexual orientation:
1. Who in your family, friends and workplace knows of your sexual
orientation?
2. What is the level of acceptance by family of your sexual orientation?
3. If you could change your sexual orientation, would you? 4. How
do you feel about your sexual orientation?
Based upon the answers of these questions, counselors then assigned a
level for that person’s stage of coming out.
Counselors were provided a sheet with a synopsis of Cass’s (1979) six
stages of homosexual identity formation. One hundred thirty-seven clients were
surveyed using this process. Over two thirds of our clients were assessed
Chemically Dependent Gay Men 293
as being in the first three stages of identity formation (Identity Confusion,
Identity Comparison, and Identity Tolerance).

In order to do a more adequate assessment, we have asked the following
questions as part of conducting a sexual history:
1. How old were you when you had your first sexual experience? How
old was the other person?
2. Describe your first sexual experience with an adult.
It is not uncommon to hear a response like age 16 with another 16- or 17year-old
in answer to the first question followed by a story where the client was much
younger in the answer to Question 2. Question 2 often involves stories with
family members, teachers, clergy, counselors, Boy Scout leaders, neighbors,
babysitters or other adults in “nurturing” positions.

The correlation of chemical use and these sexual histories is also important
for the assessment. All of our clients complete a Chemical Use History in three
stages. It is not unusual to see marked increase in chemical abuse at the onset of
coming out issues and abuse issues described above. For the person exhibiting
compulsive sexual behavior we have developed the following tools:
1. The primary counselor completes the psychosocial including the
sexual history and sexual orientation issues.
2. All clients attend instructional workshops on “What Is Abuse” and on
“Sexual Compulsivity and Addiction.”
3. A support group for those who identify sexual compulsivity is offered to
discuss such issues in confidence with peers and a trained facilitator.
If a client or the primary counselor questions sexual compulsive behavior,
the SBAT (Sexual Behavior Assessment Tool) is administered. The SBAT is
the instrument we developed after our clinical study using the Cass model and
looking at the behavior of our trial population. Once the client completes the
SBAT, the primary counselor or facilitator of the Sexual Compulsivity Support
Group consults with the client regarding his/her answers. If sexual compulsivity is
deemed an issue, the client completes a Sex and Love History, which is presented
in the Sexual Compulsivity Support Group. If this issue continues to be assessed
as a barrier to recovery, the client completes a First Step for sexual compulsivity
followed by relapse assignments on dual addictions. Prior to discharge, a client
is expected to develop a definition of abstinence and boundaries for sexual
behavior.
Results and Discussion

It is striking that many therapists have assumed that a client who would selfidentify
enough to enroll in a gay identified treatment center would be in the
later stages of identity formation. Not true. Many of our clients were struggling
with their identity, which contributed to relapse issues with chemicals as well as
with unwelcome sexual acting out practices. The discerning clinician needs to
delineate the difference between outward labeling of sexual orientation and inner
integration of what it means to accept one’s sexual orientation.

A surprising number of clients continue to state that they would change
their sexual orientation if that were possible, although they recognize that it is
not possible. These are often individuals who are fully out to family and friends.
Without such examination, these individuals were traditionally seen as accepting
of their sexual orientation because they were “out” to others; when in fact, they
only quality for Stage Two of the process: somewhere between accepting their
behavior as homosexual but devaluing what it means to be homosexual.
Consider “Bill.” Bill was in his mid twenties and came to treatment with a
dual diagnosis of Chemical Dependency and Sexual Addiction. Bill had grown
up in a conservative Southern Baptist preacher’s home. At an early age, Bill
determined that he was gay. His father preached that gays were an abomination
and going to hell. Out of desperation to find a “positive” identification for being
gay, Bill moved to New York City when he turned 18. Bill found other men “like
him” in subway bathrooms, gay bars and sex clubs. He became immersed in
compulsive sexual activity with much guilt but telling himself that this is what it
means to be gay. As his guilt and shame about his behavior deepened, so did his
use of alcohol and drugs until inpatient treatment was required. Once Bill was
in an all gay environment where he learned of diverse homosexual behavior, he
learned that the sexual practices that he defined as gay were not necessary as part
of the acceptance of being gay. Bill was not sexually compulsive after all: he had
been practicing multiple anonymous sex because that was the only gay life that
had been introduced to him. He so desperately needed to identify with others
who were gay that he was willing to compromise his sexual values in order to “be
gay.” What a relief he felt when he realized that he now had options regarding his
sexual behavior and still be identified as gay.

Another key factor in assessing gay and bisexual men is the issue of
sexual abuse. Many gay and bisexual men do not identify adolescent experiences
with older men as abuse even though the experiences meet clinical
definitions of abuse. We found a significant number of clients answering
“No” to the question of “Have you ever been sexually abused?” in our
Chemically Dependent Gay Men 295 initial assessments. During our thorough sexual histories we discovered that a number of these same clients reported having sex with older men in their adolescence. When questioned, these clients would report such comments as “It wasn’t abuse. I went looking for it. I enjoyed it. I wanted it. I returned for more.”

Take the case of Jed.
Jed reported a lonely childhood. He knew that he was different from other
boys. Other children had made fun of his effeminate behavior. Several of the
boys in Jed’s neighborhood warned him to stay away from the “weird” guy down
the street. Jed suspected that the “weird” guy may be weird in the same way that
he was. Jed went to the “weird” guy’s home to discover that this man understood
Jed’s “problems,” comforted him, and made him “feel good” by having sex with
him. For the first time in Jed’s adolescence, he felt affirmed and accepted. He
continued to return to the home to participate in this “acceptance.”
During the process of sharing Sex Histories in the peer group, the ability
to assess the compulsive behavior as part of the coming out process rather than
needing treatment for addiction becomes clearer. Let’s look at a couple of case
studies for examples.

“Lester” was a middle-aged lawyer with multiple chemical dependency
treatments. After a family intervention with support from his employer, Lester
entered our facility for extended care. His counselor picked up on sexually
compulsive behavior during the biopsychosocial interview. He was given a
SBAT and referred to the Sexual Compulsivity Support Group. When Lester
presented his Sex History in the group, it became evident that his behavior was
focused around his shame about being gay. Lester used chemicals to get the
courage to act out with men, while in his heterosexual marriage and since his
divorce. He did not act out sexually when sober but had great fears regarding his
performance with men. He was referred to a local support group for men who
have sex with men. He continued in the Sexual Compulsivity Support Group
by his own choosing but did not identify any further compulsive behaviors or
preoccupation throughout his treatment.
“Doug,” in his late 20’s, came to the “optional” Sexual Compulsivity
Support Group his first day in Chemical Dependency treatment. In the next
group session, he presented his Sex History, which demonstrated progressive
compulsive sexual behavior. Doug’s history began at age 6-10 by playing doctor
with peers. From age 11-15 he was “picking up older men.” By age 16-20, his
interest turned to Sado Masochistic behavior. In the 2 years prior to treatment
Doug was using hustlers one to two times a week and is “addicted to violent hard
core sex” (Doug’s words) with one person for 4-hour sessions. He expressed
shame over revealing secrets he had never shared before. In his first step, Doug
was clear about preoccupation and failed attempts at being able to control his behavior. Consequences included dropping classes in school because he was having sex in the bathrooms, contracting herpes and anal warts by age 15, bruises from the S & M activities, lack of sleep due to cruising for hours, two suicide attempts, and an HIV diagnosis 2 weeks prior to entering treatment.

Lester clearly acted out sexually after using chemicals and used the
chemicals to reduce the shame due to heterosexism. During treatment, Lester
“came out” to his adult sons and involved them in the family program. The
combination of working a program of sobriety for chemicals and becoming
comfortable with his sexuality may reduce ongoing sexual compulsive behavior.
Doug had been acting on his sexual addiction long before chemicals were
a problem in his life. Although he is now chemically dependent, he will also
need to work a program for his sexually compulsive behavior in order to
reduce the pain of his shame and guilt to stay sober.

Doug also has a great deal of shame about being gay and will need
to work on that issue as part of his continuing care plan; however, both
the drug and sex addictions will need to be addressed in order to do this
emotional work. Following the presentation of his Chemical Use History in
the group, Doug expressed a strong desire to get drunk. Following his First
Step for Sexual Addiction in the group, Doug could not initially identify
any feelings but expressed the urge to leave treatment. The “flight or fight”
syndrome of addiction was at work. After feedback from the group, Doug
was able to express the pain, shame, and guilt of his behavior as well as the
uncomfortableness with his sexual orientation. He demonstrated there in
the group how he had used chemicals and sex to dissociate from his feelings.
With the group’s help he was able to express the feelings. 1t is this practice in
12 Step groups for both addictions that will make therapy as well as recovery
a workable tool for Doug. Because shame is a driving force for addiction,
and shame due to heterosexism is such a force in a gay man’s life, addiction
is a “natural” to deal with feelings. The power of the dual addictions works
in the following way: a gay man attempts to stay sober from alcohol and
drugs, he acts out sexually, which produces shame (due to heterosexism).
The shame pushes the urge to use and he relapses.

Conclusions
There are several factors to weigh in assessing sexual compulsivity/addiction
in gay men, lesbians, and bisexuals. Clinicians need to obtain thorough sex
histories as well as determine where the client lies in the process of coming
out. Assessment tools then need to be used or developed regarding the actual
sexual behavior in relationship to coming out behavior. Gay men, lesbians,
and bisexuals undergo a second adolescence in the process of coming out.

Chemically Dependent Gay Men 297
During that process, which can be quite prolonged, especially if alcohol and drugs
are involved, a client may be exhibiting behavior that commonly is diagnosed as
sexual addiction. For some, finding ways to cope with the shame of being gay will
reduce the sexually compulsive behavior. For others, the behavior has been a longer standing way of coping with shame and other feelings that have turned into a true addiction, often a dual addiction with chemicals, spending (especially shopping for gay men), eating disorders, gambling, and any other compulsive behavior. Because gays learn early in life how to hide their true identity in order to be accepted, the secret life of sexual addiction is a natural. It was often begun long before they used chemicals or other compulsive behaviors and is so much a part of who they are they define their behavior as what it means to be gay. The skillful clinician will ferret out the coming out issues apart from sexual compulsivity and addiction.
REFERENCES
Cass, V. (1979). Homosexual identity formation: A theoretical model. Journal
of Homosexuality, 4, 219-235.
Coleman, E. (1981/1982). Developmental stages of the coming out process.
Journal of Homosexuality, 7, 31-43.
Neisen, J. (1994). Counseling lesbian, gay and bisexual persons with alcohol and
drug abuse problems. Arlington, VA: NAADAC Products.
Neisen, J. (1993). Healing from cultural victimization: Recovery from shame
due to heterosexism. Journal of Gay and Lesbian Psychotherapy, 2, 49-
63.

Ninety days can be thought of as a relatively brief span of time or an eternity.  Of course, perspective factors in all things and as a man who has been actively addicted to crystal meth for the good part of eight years (or shall I say an eternity? Again, perspective.), the ninety days clean and sober I celebrate today are tantamount to infinity.  Sobriety has returned me to me, to the present time in my own nation, to the real world.  I’m here, and, more important, I am happy to be here, dare I say happy to be me?  dare I declare, “happy?”

I know the wise and caring souls who have steered me to this swell location would insist I commend myself above all others, but I credit in equal measure a place called Frank’s House.  Now, Frank’s House is far more than a mere property, more than a building with numerous bedrooms, terraces, walkways, picnic benches, arbors, refrigerators, driveways, offices, bathrooms and sheds.  It’s a feeling, a concept, a conglomeration of personalities who are warriors engaged in a concerted and ongoing effort to combat an enemy to the human spirit, an adversary with seemingly boundless weapons of mass destruction, a force of evil more demonic than Satan himself: a place for victory over such peril, a place of recovery.

Ninety days ago Frank’s House took me in, gave me cozy sanctuary and bounteous food, surrounded me with brothers in recovery, counselors and therapists, televisions, hot water, Big Books, a dog, a reservoir to walk around, groups, meetings, commitments, opportunities to be of service, shoulders on which to cry, a means to find the channels to those tears, insights, love and a road map to self-love. Oh and friends with intimate knowledge of the ruinous void that was my existence under the influence, whose entry into my life has replenished the stock of soulfulness and unconditional love, enabling me to replace deadness and drugs with meaning and fulfillment.

Image by rezavoody via Flickr

Of coarse, treatment professionals always do a good job of helping GLBT clients be honest about who they are, right?  Well, not always.  In fact, some clients have reported that their counselors actually told them not to disclose their sexual orientation in groups.  Some of the reasons the counselors gave for this advice included:  ”You are here for your [issues], not your sexual orientation.”  Or, “you can tell me, but other staff / clients would not be as accepting.”  Unfortunately, there are horror stories from the other side of the spectrum – clients whose counselors forced them to disclose their sexual orientation in group, only to be tormented and abused by peers outside of the group.

It is no wonder that many GLBT clients in treatment report feelings of isolation, fear, depression, anxiety, anger, and difficulty trusting others.  The pervasive effects of cultural victimization becomes clearer once the victimization is identified as abuse.

Discrimination against GLBT’s traditionally has been referred to as homophobia.  This generally is defined as an irrational fear or dread of homosexuals.  However, in recent years homoseuality has begun to be associated more negatively, sometimes sparking violent feelings and behaviors on the part of heterosexuals;  the growing instances of “gay bashings” across the country have been alarming.

Today, heterosexism is a better term to describe the broader context of cultural victimization and oppression of GLBT’s.  Heterosexism continues to promote heterosexual lifestyles, while ignoring or dismissing other possibilities (Niesen 1990).

The negative effects of heterosexism include:

• Self-blame for one’s sexuality or the victimization suffered.
• A negative self-concept developed as a result of years of growing up hearing derogatory messages about homosexuality.
• Anger directed at oneself resulting in destructive patterns that may include drinking, drug abuse, and/or suicide attempts.
• Development of a victem mentality towards life, in which

Heterosexism has caused many GLBT clients to live a duality.  On the outside, they follow the heterosexual model so they can fit in and get along with others.  On the inside they want desperately to be themselves and let everyone know who they are.  This duality leads to secret keeping.  And couselors know that it is “the secrets that keep us sick.”

So take this person, put him or her in the treatment setting and now he or she is keeping secrets about their secret-keeping.  This type of vicious cycle offers bleak prospect for recovery.

Franks House is the nation’s only Gay owned and operated alcohol, drug and mental health program whose leadership has provided over 25 years of pride and service to the Gay, Lesbian, Bisexual and Transgender community.

Call 1-800-DIAL-GAY to discuss your needs.