The Cognitive-Behavioral Approaches (CBA) offer a theoretical and practical framework to understand and support identity development, especially in LGBTQ+ individuals. They focus on the interactions between thoughts, emotions, and behaviors, and how these interactions shape identity and self-esteem.
A key concept in CBA is cognitive schemas. Schemas are mental structures that organize our perception of ourselves, others, and the world. They are built on our early experiences and influence how we interpret situations. In LGBTQ+ individuals, schemas may be marked by experiences of stigmatization, rejection, or discrimination. For example, a gay person who has grown up in a homophobic environment may have internalized a schema of “I am abnormal, I do not deserve to be loved”. These negative schemas can cause significant psychological distress and hinder identity acceptance.
The CBA tools enable us to identify and modify these schemas. Cognitive restructuring aims to identify negative automatic thoughts derived from schemas, and replace them with more realistic and adaptive thoughts. For example, faced with the thought “I am abnormal”, an alternative thought could be “my sexual orientation is part of human diversity, it is not an anomaly”. This restructuring process can reduce emotional distress and develop a more positive self-image.
Another important concept is coping strategies. Faced with stress and difficulties related to their identity, LGBTQ+ individuals can employ various strategies. Some strategies are functional, such as seeking social support, self-assertion or activist engagement. Others are dysfunctional, such as avoidance, denial, or substance use. The CBA aims to strengthen positive coping strategies and reduce negative ones, to allow for optimal psychological adjustment.
The issue of identity assertion is central in supporting LGBTQ+ individuals. CBAs propose techniques to develop self-assertion and manage emotions related to coming-out. Coming-out can be a stressful and anxiety-provoking step, which can reactivate negative schemas and fears of rejection. CBT therapists can help individuals identify their emotions, welcome them with kindness, and develop strategies to control them. They can also work on assertive communication skills, allowing the individual to affirm their identity in a clear and confident manner.
An interesting CBA tool is gradual exposure. It involves gradually exposing the individual to situations they fear, reducing anxiety, and increasing their sense of control. For a trans person for instance, this could mean gradually exposing themselves to other’s gaze in their gender identity, starting with safe environments and slowly expanding the contexts. This exposure helps challenge anxious thoughts and enhance self-confidence.
Finally, a high importance is placed on the quality of the therapeutic relationship within CBAs. The therapist must show empathy, respect, and validation towards the individual’s identity. A safe space for the individual to freely explore their questions and emotions must be created. The therapeutic relationship is seen as an agent of change, allowing the individual to experience a supportive and affirming relationship and internalize it to transform their self-esteem.
For example, in the follow-up of a young lesbian woman, the CBT therapist was able to identify schemas such as “I am not normal”, “others will reject me if I tell them I am a lesbian”. These schemas caused considerable anxiety and a tendency to hide her sexual orientation. The work consisted of identifying these thoughts, questioning them and replacing them with more realistic thoughts like “my sexual orientation is a legitimate part of my identity”. Alongside this, gradual exposure therapy was introduced, encouraging the patient to increasingly openly discuss her homosexuality with trusted individuals. Gradually, the anxiety decreased, and the patient was able to confidently assert her identity as a lesbian.
Cognitive-Behavioral Approaches thus provide relevant tools to understand and support identity development in LGBTQ+ individuals. They allow work on cognitive schemas, coping strategies, and self-assertion, relying on the quality of the therapeutic relationship. Their pragmatic and compassionate approach serves as valuable allies in LGBTQ+ individuals’ path to acceptance and self-realization.
Key takeaways:
– Cognitive-Behavioral Approaches (CBAs) provide a framework to understand and support identity development in LGBTQ+ individuals, focusing on the interactions between thoughts, emotions, and behaviors.
– Cognitive schemas, built from early experiences, impact self-perception and can be marked by stigmatization for LGBTQ+ individuals. CBAs aim to identify and modify these schemas through cognitive restructuring.
– Coping strategies in response to identity-related stress can be functional or dysfunctional. CBAs strengthen positive strategies and reduce negative ones.
– Assertion of identity and management of emotions related to coming-out are central. CBAs propose techniques for self-assertion, assertive communication, and emotional regulation.
– Gradual exposure allows the individual to gradually face anxiety-provoking situations related to their identity, reducing anxiety, and increasing their sense of control.
– The quality of the therapeutic relationship is crucial, based on empathy, respect, and validation of the individual’s identity. It is a significant agent of change that transforms self-perception.
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