Sexual Orientation and the Addictions

Change and growth are essential parts of human development. Sometimes help is needed for change necessitating psychotherapeutic interventions. The desire for some specific changes, however, may be based on misunderstanding, fear, or prejudice. The therapist must take a clear and objective view, understand what motivates the change, and not promise the impossible. Gay men and lesbians, or people who are begining to become aware fo a homosexual orientation, may wish to try and change that orientation based on a combination of internalized and external homophobia. This combination lead to the higher exxpression of the illness of substance abuse among gays and lesbians. The gay and lesbian substance abuser who has not been able to accept and integrate his or her sexual orientation may well seek the help of psychotherapy to change orientation, hoping to somehow get life back on track. Denial of sexual orientation, however, usually extends to denial around issues of substance use and abuse. Before any real movement can occur in therapy, the therapist much help the substance abuser recognize the illness of substance abuse, and the need to have treatment for it. As part of the early recovery process of getting clean and sober, sexual orientation must be discussed and ways to accept and live with being gay or lesbian explored. After six months of being clean and sober, a patient may be in a position to effectively utilize psychotherapy to explore and resolve internalized homophobia. Usually, the desire to change sexual orientation subsequently disappears, and the patient learns how to fully accept and integrate a gay and lesbian identity into their new found sobriety.