Gay Men and Coping with Specific Traumas – PART ONE

Gay Men and Coping with Specific Traumas – PART ONE

Throughout my career as a gay men’s specialist psychotherapist (for 30 years in 2022), I’ve helped a lot of gay men who have been the victims – and survivors – of various kinds of trauma.  I use the terms both “victim” and “survivor” to validate a common experience in trauma, which is acknowledging the unfortunate, damaging, difficult, even harrowing aspects of the experience(s), which is the victimization part that needs recognition and support for the guys who have been through difficult life events, and the aspects of healing and living through the experience, to have a “reclaimed life” on the other side of the healing process (although that process is often ongoing, and can mean different things throughout the lifespan).

In previous articles, I’ve discussed trauma for gay men overall.  Back then, I discussed how “trauma” is when we get overwhelmed by an experience, either as individuals or collectively, like 9/11.  Here, I’d like to focus on the types of trauma an individual can face, in a gay male context, and how to cope with them.

At one time in the history of clinical discussions of trauma, it was defined as a “life threatening” experience, or “experience outside the realm of normal human functioning,” but the term has evolved from that, in part because it’s culture-bound.  What is “outside normal human functioning” for someone might be an everyday occurrence for someone else, such as someone living in a war zone.

In trauma, the experience overwhelms our expectations and our ability to cope.  We don’t know what to do with it.  Nobody ever taught us that such things were even possible in this world.  We are forced to observe and endure the experience, a bad one, and then somehow recover from its ill effects, which can be physical, mental, psychological, neurobiological, social, or financial.

Here, in the first of this two-part series on gay men coping with specific traumas, I’d like to discuss some examples (although not an exhaustive list; sorry if I’m leaving out a category that you have experienced!) of the specific traumas that I’ve helped gay men heal and recover from over the years.

They are in some broad categories, and for those who have experienced these kinds of traumas, perhaps this is a validation of what happened to you (or perhaps a partner, spouse, or other loved one).  This is also how I’ve seen gay men make a good life for themselves in the aftermath of a traumatic experience, often through the benefit of therapy or coping skills coaching.

In the previous article, I discussed how not all “bad days” or “inconveniences” are traumatic experiences.  We don’t want to invalidate the experience of trauma survivors by trivializing the definition (“Karen!”).  But it can be subjective.  Two people can experience the same event, and one person might experience it as trauma (and develop PTSD symptoms later), and others not, as my mentor, the pioneering gay psychotherapist, the late Michael Shernoff, LCSW, researched and wrote about in New York after 9/11.  There might be many underlying reasons why this is so, such as genetics, upbringing, cultural support, underlying chronic mental health conditions, and so on.  Being a gay male, as a sexual minority, and the minority stress that comes with it, can be a considered a “risk factor” for experiencing an event as a trauma.

Traumatic experiences are events that happen to us in life that overwhelm our normal psychological defenses.  They are generally events or experiences that threaten our lives, or at least our well-being, which can be physical, emotional, relational, social, or professional.  They are events that trigger very specific mechanisms in our neurobiology, psychological defenses, as the mind and the body try to cope with what is happening to them.

They tend to be events that we remember in a specific way, such as a tape recorder or video recorder in our minds, and they are remembered in our brain’s memory areas in a special way.  They are considered a psychological injury, which requires a mental healing, not unlike the way our bodies might recover from a physical injury to our skin, muscles, bones, or organs, like skinning your knee and a scab forms.

There have been many clinical interventions or schools of thought on which type of psychotherapy might help someone recover from a trauma.  Many of these have been researched, and I used to teach these “schools of thought of psychotherapy,” or “clinical intervention models,” to graduate Social Work students when I was an adjunct associate professor at the University of Southern California (USC) in Los Angeles.

Many psychotherapists will assert that their favorite approach to treating trauma is “the best,” but research has shown that many approaches can lead to effective outcomes, such as EMDR therapy (Eye Movement Desensitization and Reprocessing), TF-CBT (Trauma-Focused Cognitive-Behavioral Therapy), Prolonged Exposure Therapy, Narrative Therapy, and Psychodynamic Therapy, to name a few.  When you’re the client, it’s not necessarily important that you know about these approaches, only that your therapist does.  Therapists can sometimes bitterly argue that “their way is best,” but that doesn’t speak well of therapists.  We can all kind of “dork out” on discussing the pros and cons of the helping techniques.  I like to use a hybrid that’s very individualized for each person, but any technique that works to help you – especially those grounded in sound research to be known to be effective, which is called “evidence-based practice” can be helpful.  It is a very special, individualized, and even professionally intimate process that has to do with who you are, at your core.

But for gay men, as always, we have needs that your “average” (read: straight) client does not.  This is why I am a gay men’s specialist therapist, because our community (local, nationally, globally), has needs that your average straight therapist (or even gay male therapists who are not specialists in working with gay men) can’t meet, clinically and culturally, for any therapeutic situation, including trauma recovery.

Gay men grow up, in general, globally, with the Minority Stress of being a sexual minority group, so in a sense, we have usually been traumatized a lot by the time we are adults.  We might have experienced family rejection, bullying at school, rejection from civic groups or religious institutions, criminal victimization in society, or discrimination in the commercial workplace.  This complicates the issue, because when a gay man (or others in the LGBT community, BIPOC communities, etc.) experiences trauma, it can have a “cumulative effect” like we are “kicked when we’re already down.” So the support you receive for recovering and healing from traumas is not just about the trauma, but traumas that happen in a gay male cultural context.

Now, let’s examine some of the specific categories of traumas that can happen to people, which I’ve helped guys with in my practice over the years, and some ideas that might help gay men cope with them. There are eight of them, and I’ll cover the first four in part one, and the second four in part two.  Let’s start, in no particular order, with these categories:

1. Medical (congenital condition, accident, illness, chronic vs. acute)

While all traumatic experiences can be frightening, tragic, and at best, “inconvenient,” medical traumas affect our physical selves and functioning.  I wrote a previous blog article (“Coping with Sudden Crisis: A Personal Story”) about my own near-death experience from a severe staph infection in my leg, one year ago, in October, 2021.  So many of us worldwide have of course experienced the trauma of being ill from COVID-19, or even lost our loves ones to it, since its start in early 2020.  For gay men, the AIDS crisis certainly holds significance in recent history, either for ourselves, or loved ones, friends, or even people we’ve heard about in the news.

A medical trauma can be coping with a congenital condition that we are born with, such as my two friends who are gay men with Cerebral Palsy, or a medical trauma can come from an accident, such as an industrial accident at work, a car accident, or a home accident (such as in the kitchen, bathroom, or garage) or it could be an illness like COVID-19, stroke, heart attack, influenza, diabetic crisis, sciatica, cancer, diabetes, or so many others.  These conditions can be chronic, certainly with HIV/AIDS, or acute, such as a broken bone that we might heal from in a number of weeks in a cast or with physical therapy.

Coping: The aftermath of a medical trauma is not just about the physical recovery, but also the mental one.  Coping with the news of being diagnosed with a terminal illness, or an illness/injury, I believe, involves your assembling your own team of both professional and personal support resources.  Professionals would be, certainly, your primary doctor (physician), but also perhaps a specialist physician, or some kind of imaging technicians (for MRI, X-ray, CT, ultrasound, etc.) nurses, and social workers/therapists.  But your personal team might be your partner, or a parent, or a sibling, or a neighbor, or a peer support group (local or online), and friends.  I would include pets as part of a personal support system, and research backs this, which led to “companion animal” laws for people with disabilities, even in apartments that “don’t allow them.”  Between rallying your professional support team, and your personal support team, you cultivate the tools either to address the medical issue for cure, or learn to cope with a medical condition that needs ongoing care or a permanent adjustment in life.

Coping psychologically involves profoundly accepting that medical issues can happen, to any of us, at whatever severity.  The older we get, the more likely we are to have some kind of “relationship” to medical hardship.  The Dialectical Behavioral Therapy model teaches us about “Radical Acceptance” of this, which, paradoxically, helps to overcome a challenge.  We focus not on what we can’t do, at least right now (or perhaps evermore) but what we can do.  We look at the options and possibilities that are right before us that help us to put ourselves in our best light.  We might rest in a hospital, skilled nursing facility, or at home.  We might take prescription medicines.  We might undergo physical therapy.  We might need to learn new skills on how to cope with everyday life, but in a different way than before.

We remind ourselves that we are more than our illness. This has been my experience, living with HIV/AIDS for 32 years now, in 2022.

We “radically accept” that we might not function exactly as we did before, but we find a new way of functioning.  We don’t let our condition define us, or even stop us, exactly, but we learn to accomplish things in a way that works for us as we are, now.  Aging can be that way: we function on how we are in the present day. This can be true, even for the very elderly.

We forgive ourselves and whatever conditions created the medical situation.  Spiritually, we might need to forgive God for “making us this way” if we were born with a disability, or, from a non-religious/Secular Humanist perspective, we forgive Nature itself.  We forgive some kind of circumstances; for example, I’ve had to do forgiveness work for the fact that I was probably exposed to a life-threatening staph infection due to improperly cleaned and maintained gym equipment, at the old 24 Hour Fitness Sport club in West Hollywood, where I live, which has now closed.  Others might have to consider forgiveness for other circumstances, and even the people who caused them, such as people who have been injured by a drunk driver.

Coping can mean accepting that we were made, or we became, “perfectly imperfect.”

Therapy can help you to identify, implement, and then re-evaluate and re-implement, your own adaptive coping strategies, cognitively and behaviorally, for the medical trauma that you have experienced.

2. Legal (suing or being sued)

A legal experience can be traumatic.  Being sued for something in civil court, or the need to sue someone else, is commonplace in the national and global court/justice system.  But the bureaucracy, the antagonistic arguing and negotiating, fighting any inherent injustices or biases, and carrying out the behavioral experiences (like having a deposition interview or testifying in court) can all be stressful experiences.  Facing perhaps the perpetrator of a crime against us in a courtroom can be a traumatic experience, with so many feelings coming at once.

A divorce, a problem with an estate or inheritance, a personal injury claim, a custody battle for children, or a civil or criminal action against someone who has wronged us, can all be stressful or traumatic.

We seek criminal or civil justice, but as any lawyer will tell you, justice is not always served.  It’s a flawed system that can be biased against LGBT people, BIPOC, the poor, and many other issues about social or political privilege.

Coping: Coping for a legal challenge involves somehow coordinating the legal, bureaucratic elements, with the emotional impacts they have on us.  In my practice, I’ve helped clients cope with the anticipatory anxiety that can come before sitting for a deposition, or being cross-examined in a courtroom by the opposing counsel.  I’ve helped guys to weigh the pros and cons of seeking legal action against someone who might have discriminated against them in the workplace, such as for being gay, or HIV-positive, or having a psychiatric disability.  Coping often means getting the best legal advice you can, from a private attorney (if you can afford one, or get one who will work on contingency), or from a community-based legal clinic.

Coping is working through the justice system process, which usually involves talking about the situation and somehow negotiating a resolution.  It means being very patient with a notoriously slow-moving process, measured in months or years, not days or weeks.  It also involves personal support, talking to a therapist, partner, friend, mentor, or family member to keep perspective on life “outside” of the legal case proceedings.

Overcoming the trauma, ultimately, is putting the criminal or civil case experience behind you, and moving on as if the entire episode never happened, which can be difficult.  Legal battles can be disillusioning, because they can reveal a vile underbelly of human conduct and behavior, but they can make us somehow wiser about how to protect ourselves, our loved ones, or our business.

3. Academic (betrayal, abuse, probation/expulsion)

An academic trauma has been perhaps more rare in my observation in my practice, but a client recently shared this with me.  “Flunking out” of an academic program is a real setback that makes us re-evaluate our academic or professional aptitude.  Not getting accepted to a program we’ve applied to can require some life adjustment and careful career re-planning.  Being disciplined by an academic institution can be a trauma, especially if our interests were somehow not aired or protected in a fair process.  Minorities, especially, can often not get a fair shake.  Conditions that sully the “sanctity” of the academic experience, such as an instructor who is sexually harassing us, or is pretty obviously guilty of some kind of academic integrity violation, to us or to others, can be demoralizing.  We put our trust in academic institutions for our academic and professional development and well-being, and if someone betrays that trust, it’s an affront.  The recent scandal at USC, where the old, crooked Dean pled guilty and was sentenced to house arrest (instead of jail, at age 83), caused a lot of trauma with its students, faculty, staff, and alumni, like me.  And the aftermath of that was very badly handled, which caused a collective trauma to the stakeholders, and very individualized hardship.  There were other scandals involving a student health doctor who sexually abused female students, and another Dean who allegedly did drugs with students, and basically got away with it because he brought in money.  The highly-publicized celebrity admissions fraud scandal caused shockwaves.  Stories of campus “date rape” or other corruption at various, venerable academic institutions over the years have caused countless traumas, to people who had put their trust in an otherwise “respected” institution.  Fraud around financing and student loans is another example.  We don’t hear about “academic trauma” often as a topic, or category, but these examples, and more, show that it’s very much an important issue that needs a collective response.

Coping: Coping with academic trauma requires us to reflect on how being involved in an academic program fits into our overall life goals, by way of our career goals, and the educational underpinning for that.  Sometimes we have to re-assess, get expert mentorship advice, and re-evaluate our options for strategizing our professional goals.  We need to remind ourselves that the relationship to an academic institution, good or bad, or mixed, is inherently temporary.  It’s just one part of our lives, and even only one part of our professional identities and careers.  Like the AA saying, we “take what we want, and leave behind the rest.”  We have a relationship to the material being taught, and the positive relationships we might form with faculty or fellow students, and if there is debris around that, we work to contain that and leave it behind as we continue to focus on lifelong learning and growth.  School is just the beginning, and while we want a sentimental experience that makes things like “homecoming” or class reunions fun, if we didn’t have a good experience, or even had an academic trauma, we need to re-focus on the other ways that professionals develop to have rewarding careers.

4. Crimes (white-collar or violent)

Similar to the above-mentioned medical traumas, being a victim of crime is certainly a trauma.  I’ve helped guys in my practice who are sexual abuse survivors, rape survivors, gay bashing survivors, and discrimination survivors.  The crimes that cause us trauma can be “white collar” or violent crimes.  Being the victim of a car accident from someone who was driving under the influence is a being a victim of a crime.  Being forced out of a job for some kind of discrimination is being a victim of a crime. They take many forms, some of them criminal law, and some of them “just” ethics.

Crime is traumatic because it’s often the first time we’ve been exposed to the whole range of what behaviors human beings are capable of.  The selfishness, greed, self-indulgence, arrogance, narcissism, bigotry, antisocial actions, self-aggrandizement, aggression, and just plain foul mean-spiritedness have all been hallmarks of either crimes I’ve experienced as a survivor of workplace bullying and discrimination, or that I’ve helped my clients with.  It’s a terribly demoralizing experience, and yet it’s not all that uncommon, especially for sexual and gender minorities.

Experiencing a trauma as the result of a crime another person commits against us makes us “civically indignant;” we say, “That’s not right! Why, there ought to be a law!”  Well, in most cases, there is.  There are many laws on the books in every jurisdiction in the world that generally protect people from assault, battery, theft, harassment, swindling, vandalism, or exploitation.  Sometimes things can be perfectly legal, but still are traumatizing, such as a mean boss who isn’t technically breaking a law, but is making our lives miserable because of their own personality deficits (my three-part article series on “personality disorders in the workplace” is here).

Coping: Just like coping with the other types of trauma, coping with the trauma in the aftermath of a crime is often a combination of the legal aspects, such as with cops or attorneys, and the personal aspects, such as emotional support for what we went through, and what we’re continuing to go through.  We can seek justice in criminal or civil court, but justice is not always served in these situations, sometimes for some kind of weird technicality.  We struggle, sometimes, with whether to “forgive” our perpetrator, which can be difficult if they show no remorse for what they did, or if they essentially “got away with it,” which has happened to me several times.  We cope with criminal trauma by taking care of the legal or administrative aspects, such as an internal hearing in a sexual harassment case, and we cope by reminding ourselves that there was life before, and will be after, all of that.

Sometimes being a survivor means “living well is the best revenge.”  Laws that we are bound by prevent revenge or vigilante action, no matter how much we’d like to even the score that way.  Coping with criminal trauma means living our best life despite the actions of others that hurt us.  It means coming to terms with the disillusionment that comes with learning just how awful some people can be toward their fellow Man, and how violent the Human Animal can get.  And in the process, we learn who our real friends are, and we learn the grace that human beings can demonstrate, too.

In Part Two of this discussion, I will discuss workplace, Family of Origin, Political, and Social/Peer traumas, and how to cope with them.

Notice how each of these sections, and these are not the exhaustive list of the kinds of traumas a person can endure, has an adaptive coping.  Evolution and history teach us all that adaptive coping is not survival of the fittest, but of those most able to adapt to their surroundings to survive and thrive for as long as life takes us.

Whatever traumatic experiences in your past, currently, or even what you might face in the future, consider identifying and implementing the adaptive coping response that will mitigate them.  They might be classic, or they might be unique to you.

And if you need help with mounting an adaptive coping response, consider therapy or coaching.  These professional support services are probably most often utilized for trauma, because, as the saying goes, shit happens.  But you don’t have to face it alone.  Company doubles our joys and halves our sorrows.  For more information, call 310-339-5778, or email Ken@GayTherapyLA.com.