[grimtopaz]

I've been in CBT with the same therapist for 1.5 years. I think we have a solid therapeutic relationship.

We are working on my core beliefs that I'm "defective", "unlikable", "different" (you get the point).

I've brought up the fact that my sexual orientation (bisexual) makes me feel "different" and I have had many people react extremely negative to me coming out. I mentioned that I worry that if "people knew" they might avoid/reject me/make judgments. I've also shared past struggles (feelings for same-sex friends, assumptions people have made about me, and general shame.)

I feel that this ties into my "unlikable/defective/different" schema, and I think I have made that very clear. However, every time I bring the subject up - she really doesn't follow up or say anything - not even a generic emphatic comment like "that must be so difficult" or even "there is NOTHING wrong with you".

The first time I brought my bisexuality up, she just said that she is very open-minded, she doesn't think any differently about me because I'm bi, and that she conceptualizes sexual orientation as a spectrum. She also said that were she is from, people are very open/liberal about sexual orientation. This was a reasonable answer, but I remember her saying something like "let's set this aside". "This" being my sexual orientation, I suppose.

I want to believe that she truly does not have a problem with it. She has not said anything judgmental, and she really treated me the same after my disclosure. However, I can't understand why she just doesn't say anything when I talk about it, but jumps at any other topic. It's clear that it is an issue for me.

I want to bring this up to her, but I don't want her to get defensive. Also, I like her a lot, and I worry she'll say this is "outside her scope of competence" and will want to refer me to an LGBT therapist (I'm in treatment for depression, so I'm not looking for LGBT counseling, even though sexual orientation is an issue.)

She trained/lived in big cities, so I'm sure she has been exposed to LGBT patients.

Thoughts about what might be going on and how to bring it up?

[HazelGirl]

She's a CBT therapist, which means that she doesn't focus so much on individual problems, and more with underlying thinking patterns. I think her lack of response is a reflection of her methods, not her judgments.

[unaluna]

Maybe she's putting it aside cuz you're married to a guy? Unless you are actively involved in another relationship, or are planning to be, what problem are you trying to solve? Just that you feel different or that people would not be accepting? That sounds like an issue that would be better addressed with a focus on your feelings, not on what you presume other people are thinking. If there are particular people or incidents, such as parents or schoolmates and bullying, that might be a key. Plus some people dont think bi is a real thing, they see it as pre-gay

[grimtopaz]

Different thoughts:

My therapist and I have worked on individual problems, childhood contributions to psychopathology, as well as maladaptive thinking patterns. She's doing more Schema Therapy work than the more "superficial" CBT.

The classic "depression triad" addressed by CBTers includes "views of the self", "views of others/the world", and "views of the future". Thus, how I view myself, issues of hopelessness, and what I assume others think should all be explored. We have discussed how gender affects my experience of things, I don't know why she is treating sexual orientation as a different thing (not that they are necessarily equivalent).

Even though I am married to a man, that does not make me any less bisexual. It is an identity, something I've struggled with, and I am still attracted to men and women. I actually fear that she does NOT understand this (a lot of folks do not), which is incredibly invalidating to my experience.

I guess my thought would be that she would be interested in addressing any thinking pattern (eg., "there is something wrong with me") that relates to my schema, and thoughts about being different.

Psychologists are also trained to address/take into account issues of diversity (religion, SES, sexual orientation, gender, race, immigration status).

She also doesn't follow up when I talk about issues of race...but that's a whole other story.

[archipelago]

I'm not sure if I follow completely, but I have a few responses. I'm bisexual too and have experienced a lot of bias from both straight and queer communities about it. I think that is a given for this culture. There are studies that show that bisexual women experience more "micro-aggression" and therefore stress than straight or lesbian woman.

I'm not fond of CBT, but even if I were, I would say that this is not part of your "schema." It is part of a big social problem. And you are correct in experiencing it as a difference and difficulty.

Therapists regardless of theoretical orientation have to be aware of and sensitive to diversity issues; it is part of the ethical code. In other words, you are not allowed to ignore it and can't possibly say it is out of scope of practice or whatever.

But I don't have practical advise because I don't know how to talk about such things with someone with a CBT orientation. My therapist is relational and interpersonal so our relationship and who we are as people is the vehicle through which the therapy works. It is hard for me to imagine how a therapy would work without taking the relationship and who you are as central. I have heard that CBT types are starting to see the importance of the relationship and have begun to add it. I suppose you could say that if she seems not to want to talk about how you are interacting.

[HazelGirl]

Hm...maybe she just doesn't have the ability to understand things that are so different from her experiences (which is her problem, not yours).

[growlycat]

Maybe she wanted to set it aside because you had more pressing issues affecting your life that needed addressing right away?

[archipelago]

I understand what you are saying. I'm also married to a guy, but am clearly bisexual and always have been and continue to be. I have had an open relationship so I have had relationships with women while married. This is a bit difficult for many people to understand since open relationships I guess are thought of as a fad of the 60s or 70s. My therapist occasionally gets confused though he was a free love hippie type back in the day.

Anyway, regardless of what your therapist personally is able to understand, in professional terms therapists are required by codes of ethics to handle diversity issues. If they don't get it, it is there responsibility to figure it out, not yours.