Why did I become a therapist? I feel like there was never anything else I could have ever been. I tried another career path, but it never felt right. Five minutes into my first psychology class, I thought, “Oh, this is what I’m supposed to be doing!” I guess you could say that my therapeutic specialty is split into two parts. I became a therapist with the intent of focusing solely on treating sexual trauma, domestic violence and PTSD (which is where I placed an emphasis during my internship). However, I have unexpectedly developed a second specialty in working with Transgender clients, due to the word-of-mouth support of my clients dealing with this issue.
How do I treat victims of sexual trauma/violence? These survivors often need both practical and emotional assistance. First of all, I teach some basic breathing techniques and grounding to help them to self soothe as they go through the difficult process of recovery. Next, I often go through some Psychoeducational information about how traumatic memories/flashbacks are created and recalled. Helping the survivor learn to advocate for herself/himself as she or he is going through the court system is vital; as frequently, people question their honesty and integrity.
Essentially, we work on helping them piece their lives back together. When a survivor comes in for therapy, they want to know that they’re going to get over it. They want to know how they’re going to go back to work; they want to know how they’re going to be able sleep at night; they want to know how they’re ever going to start dating again; and they want to know how they’re going to be able to stop crying in front of their kids. Basically, they want to know how they’re going to function again. Together we work through their coming to understand that they will never be exactly as they were before…but that they are going to be able to get through (and past) this. They learn that they can be whole.
Beyond all of this, my role as a counselor is sometimes to simply be present through this unbelievably difficult time. Being violated is a very isolating experience. So, there’s real value in having someone who will let you be angry, scared- however you’re feeling…and above all, someone who will believe you. Therapy with a survivor all depends on what each person needs; and even that can differ from day to day. As a therapist you have to practice awareness, and give each person what they need in that moment.
By allowing the client to be and to feel, they are able to find a way to regain a sense of control over their own lives. This can develop from something as simple as reminding them that they are under no obligation to rehash their story to me. Often they’ve had to tell their story many times; just giving them permission not to tell it again can be therapeutic. Someone’s already forced them to do something that they didn’t want to do; that’s why they’re in therapy. I’m certainly not here to make them do anything they don’t want to do. My approach is to treat them with kid gloves now, because, at some point, someone else didn’t. The most amazing part of my job is watching someone take back control of their own lives and empower themselves.
How do I treat Transgender clients? Well, my first transgendered client came to see me initially because of trauma. However, over the course of therapy he changed his focus to navigating the process of his transition. He felt connected to and understood by me, and wound up referring me to a transgendered friend. That friend referred a friend, and so on, and so on… The transgender community is quite small, so verbal approvals can go a long way. It seems that even if therapists are sensitive to LGBT issues, they may not necessarily be sensitive to the needs of transgendered clients. So, it’s essential for my clients to know up-front that I am someone they can trust to support them every step of the way throughout this process.
Over the years, I have grown to understand the needs of the transgendered; needs which are (again) both practical and emotional. Each client’s needs are different because, for each client, transition is highly individualized. Some clients find that they are only interested in, or comfortable with, transitional components that can be achieved without medical assistance. However, other clients find that they will only feel whole if they complete a full surgical gender-reassignment. Together we work through the practical issues, some of which are dynamic (i.e. beginning hormone therapy or having facial reconstructive surgery), and some of which are quite subtle (i.e. using public bathrooms or legally changing their name).
As with clients of all backgrounds, the emotional needs of transitioning clients can trump the practical ones. So, we work through the emotional challenges that are unique to transgendered individuals. Again, as with traumatized clients, being transgendered can feel very isolating. A client once described it to me be saying, “I’m a minority, within a minority. Society hates gays; therefore, they loathe me.” I assist them with processing the difficult emotions that stem from society’s judgment. However, most often we talk about the difficulties that stem from their own families. If a transgendered individual comes to me, chances are their family is ostracizing them in some way. If they had an accepting and loving family, they might not find themselves in need of additional support; although it’s certainly possible. Together we work through telling their family and finding appropriate supports within their family; nurturing the positive relationships and (when necessary) saying good-bye to the negative ones.
Ultimately, regardless of the client I’m seeing or the issue they’re presenting with, I always carry the mentality that fire refines gold, and challenges refine us. As Nichole Nordamen sings, “How could I know the morning, if I knew not midnight?”
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