When I work with clients in therapy, we could be working on many issues related to either their Personal or Professional Self. Much of the time, the work is addressing bigger problems over time, but some of the time, there is a sudden crisis or event that really throws someone off, and needs immediate attention.
A crisis by common definition is an experience or event that is outside of your everyday routine, and it requires a special response. It involves a rallying of what I call "internal resources" — such as calm, focus, determination, courage, and persistence, as well as outside resources, which could include things like emergency medical help, psychiatric emergency response, crisis counseling, aid from the police, legal services, paperwork processes, Internet resources, and real goods (such as a place to stay if your home got flooded). Managing a crisis involves identifying and rallying both your internal and external resources. When facing a crisis, you want to assess the situation, and then develop a response that will restore you back to previous equilibrium, the way things were before the crisis occurred (as much as possible, anyway).
Below, I list some common situations of crisis that anyone could face, but each of them has some special considerations for gay men due to various social, legal, political, or cultural presssures. These are things that I've seen in my practice probably over the past 12 months, and while not an exhaustive list, these are some things to keep in mind to manage, and even prevent, the worst of them:
1. Workplace Discrimination or Bullying Incident
While other demographics can face discrimination, gay men can frequently be the victims of workplace discrimination. I've worked with a number of guys over the years facing this, and our work sometimes consists of reacting/responding to the incident in the proper legal way (such the client making a report to Human Resources), and I have also referred clients to various attorneys who help clients file claims against the offending entity. While anti-gay workplace discrimination is still (maddeningly) legal in many states, it is illegal in California, and many of my clients who have filed legal complaints and lawsuits have achieved fair settlements (such as cash) for their troubles, and there are many times when I have seen justice served well. However, that's the legal side. There is also the personal side, and experiencing discrimination can be shocking, frightening, disorienting, and enraging. While a lawyer (or mediator, arbitrator, etc.) can help with the practical/legal side, workplace interpersonal events like that are not necessarily physical violence, but they are emotional violence from one person at an organization to another. I experienced this in my own career at a non-profit organization, where I was the victim of both HIV discrimination and sex discrimination as a male in all-female office; my husband was victim of anti-gay discrimination when he worked at a museum in Los Angeles, where a new female executive systematically forced out every gay male employee in her department over time; some of my clients have been victims of anti-gay slurs or denied opportunities; and others have been victims of workplace violence (one friend had a male boss who threw a chair at him; he settled for enough money in the legal settlement to pay for his graduate school degree). While all of these examples, and more, ultimately had "happy endings", where the victims turned into thriving survivors, at the time of the crises, they didn't feel so good. Dealing with things like this requires rallying a Support System (made up of people in both your professional and personal realms), and identifying/implementing a series of steps for "adaptive coping". These steps of response include:
a. Staying calm, and taking some time to quietly think about what has happened.
b. Thinking about who can help, and getting consultation with them.
c. Thinking about verbal reports, paperwork, or calls/phone calls to be made.
d. Taking steps to write down and document the sequence of events, including names, dates, times, and circumstances (this would be critical for a legal case).
e. If forced out or laid off, copying documents that are relevant to your claim onto a zip drive (or emailed to yourself) that would support documentation for your case.
What to keep in mind in these kinds of things is the objective things (timeline, documents) and then ALSO get support for emotional and persona side, because being the victim of interpersonal workplace conflict, discrimination, or even workplace bullying is really an adult trauma. It feels like you have been the victim of a crime, because, well, you have been!
2. Financial Setback
Many things can create a financial setback such as a sudden tax bill, a dip in a business you run, income property tenant move, sudden home repair, layoff, lousy raise or expected bonus, medical bills, or economic downturn. Coping with this usually involves:
a. Acknowleging the loss, "taking it in"
b. Assessing your finances; what's coming in, what's going out; what can be cut; what can be cultivated (taking on a second job temporarily, getting a loan)
c. Getting advice from free (online?) sources, or inexpensive resources (books such as those by Suze Orman), or more expensive but perhaps still very valuable consultations (financial planner, tax advisor, broker).
d. Making a plan for recovery (new job search; accessing benefits such as disability pay, worker's comp, or unemployment; negotiating a payment plan; consulting an attorney regarding bankruptcy; making a new business plan; downsizing your personal budget, etc.)
3. Car Accident
First of all, any car accident that you survive (and others) is considered a good one. Coping with this usually involves calling your insurance company and sometimes the police. Attending to any medical needs comes first, then things like exchanging information about car insurance with the other driver(s), taking photos to document the incident, and making sure everyone is out of the way of any further risk (such as at the side of the road). Your call to your insurance agent can help a lot; those staff are trained to deal with crisis calls from the field. The second part of it is coping with the emotional side. I've worked with guys whose therapy involved coming to terms with the loss of a beloved vehicle, coping with physical injury or loss, and recovering from traumatic symptoms, such as Post-Traumatic Stress Disorder (PTSD). With so many gay men living in urban areas that are congested with cars, and with many gay men having that "typical male" (gay or straight) "special relationship" with their cars, even an accident where there are no major physical injuries can still be traumatic. As with the others, making a plan to attend to both the practical and the emotional sides of things makes up the adaptive coping response.
4. Household Disaster
Just like cars, gay men often take special pride in their homes,which can be both an appreciation for the esthetic (a common gay men's trait) and perhaps some male competitiveness. So, when a pipe bursts, a fire flares up, a leakage from another home (such as a condo above yours) happens, or other disaster occurs (tree falls, sewer pipe breaks, pool cracks, etc.), these can shake the foundation (figuratively, and literally in an earthquake) and your sense of safety and comfort in your home and "sanctuary" from the world. Like the others, this involves practical external resources (such as firefighters, water disaster management companies, plumbers, tree surgeons, pool engineers, etc.) and the internal resources of how to make the place you live feel safe again. Sometimes, this means making another location your "home and hearth" for a little while, or even a permanent change of residence. (I wrote an article of when the building where I had my office burned down, here).
5. Loss of a Loved One/Illness/Death of a Family Member
One book I always recommend for clients who are in crisis due to a breakup or the loss of a loved one (family, friend, pet, etc.) is How to Survive the Loss of a Love. This is perhaps the most difficult crisis situation there is, with the possible exception of sudden medical injury/illness to your person. While "death is a fact of life", the death of a loved one (or their sudden illness or medical crisis) is never easy and carries aspects of trauma. Bereavement counseling is a major component to the duties of a therapist, because death and other major loss are common human experiences, regardless of place in history, geographic location, or demographic. The number-one thing for coping with this type of crisis is rallying emotional support from as many different sources as possible, as many things might help. Comfort from partner/spouse, other family members, friends, and neighbors can be personal supports; comfort from professional supports might include from a physician, funeral director, bereavement group, and of course therapist, in addition to resources such as books/audio/websites. In order to incorporate a major loss into life, it takes time. Bereavement and grief that is facilitated in some way does help, such as being educated and reassured on the major stages of grief made famous by Elizabeth Kubler-Ross: 1) denial; 2) anger; 3) bargaining; 4) depression; and 5) acceptance. These stages are non-linear in nature (they can come and go in any order, and each stage can be revisited, even more than once). Time does heal, but so does having interpersonal support, and therapy can help a person "make meaning" from loss and trauma. For gay men, the loss of a loved one can force them to revisit losing peers if you lived at the height of the deaths from the AIDS crisis. Some gay men would have the extra impact of loss if you or someone you knew was the victim of a hate crime. For gay widowers, they can experience an "invalidation" of their loss, as if their same-sex relationship was not "as good as" a straight widower's (more on this in the book, Gay Widowers, by my late friend and mentor, Michael Shernoff, LCSW).
6. Business Crisis
Since I work with so many gay men, and in West Hollywood/Los Angeles, this includes many self-employed gay men, I often hear of crises that are related to challenges caused by downturns in business or economic changes. Helping these guys often involves applying my skills and experience in executive coaching and career coaching/job issues. Work means a lot for everyone, but for gay men, we can sometimes have an "extra" focus on our careers because most of the time, we don't have children to raise. So when our business is going well, we thrive, and when things are disappointing, we really feel it. Like other crises, this involves assessing the situation and identifying/cultivating resources and options. In business, this can mean finding ways to cut expenses, or increase revenue. Unlike other crises, a business crisis is often a "growing pain" in our professional life, and it can almost be, what my friend Casey Truffo, LMFT (a supremely talented business coach) calls "a gift wrapped in dirty paper". When we experience a crisis in business, beyond managing the scary and depressing aspects of loss, we can find new ways to grow, cultivate new skills, form new networking relationships, learn more about our product/service market, and strengthen our weak spots to innoculate ourselves against future loss. These crises are a short-term pain for a long-term gain.
Since gay male culture still can be centered quite a bit on bars and clubs (although this is changing), anytime there is alcohol involved, it can include driving, and that is a dangerous (and expensive) combination. Getting a citation for driving under the influence can be a profound existential "wake-up call", and it usually means that we have to really consider, mindfully and sensitively, what I call our "relationship" to alcohol (or other substances). I explore a lot of this in my article, here. Recovering from this type of crisis involves managing any legal tasks/mandates, coping with the financial impact from fines and fees, and going through a soul-searching process about what needs to change in order to prevent this kind of charge (and its related risks of disaster) in the future. In my practice, I apply models such as the Harm Reduction Model, and Motivational Interviewing, as well as Cognitive-Behavioral Therapy, all of which are evidence-based practice models for therapy (vetted for positive outcomes in formal academic/clinical research). I also help guys deal with reducing/controlling/managing their alcohol/drug use, or helping them achieve/sustain sobriety (which one this is varies from client to client, based on a careful assessment of their goals), through my services for addiction recovery. Recovering from this type of crisis not only involves coping with the event, but also dealing with the "risky environment" in which it happened, and how to develop tools for emotional/physical/legal/social safety.
8. Sexual Mistake
While not limited to gay men, they can have what I call "sexual mistakes" that can lead to crisis. Sleeping with someone you legally or socially "should'nt", being exposed to HIV transmission risk, risking legal consequence (such as a "lewd conduct" arrest), or even just having sex with someone you regret later, can all be considered "sexual mistakes" that you wish you could do over. This can be a small crisis such as feelings of guilt, or a major crisis such as an upset to a relationship (such as if you break a monogamy agreement) or employment (such as sleeping with a subordinate in an office setting). While I differ from therapists who label such behaviors as "sex addiction", and while I prefer a whole different approach that is based in sexual self-empowerment and evidence-based models and diagnostics that are more professionally accepted, there can be crises that are related to sexual acts. Counseling on this can certainly be helpful, although strong debate exists on exactly how to address it. There are themes in this, such as personal choice, "accountability", self-awareness, guilt, social pressures, social prejudices and double-standards, and cultural/economic/religious influences. Much of recovery from this kind of criss involves self-compassion.
Finally, the crises in our lives involve quite a bit of existential self-reflection. No one gets out of this life alive. By middle age, most of us realize that we cannot get through life without trials and tribulations, both ones we receive and ones we inflict on others. We have to have realistic expectations of life, and to paraphrase Shakespeare, "our lives are a fabric, a weave of good and ill." While we can't stop crisis events from happening to us, to our loved ones, or in the world, we can believe in and commit ourselves to the concepts of life-long learning, skill-building, resilience, personal growth, compassion, and meaning. Jack Canfield, one of my favorite authors (among others) has said that "Event + Response = Outcome". We can't prevent crisis events from occurring in our lives, at least some of the time. But we can control our adaptive coping response to them, and this can change the ultimate outcome very dramatically — for better or for worse. Life gives us both our joys and our challenges. How we cope with these challenges informs our character and our quality of life for the duration.
Ken Howard, LCSW, is a gay and HIV-positive (25 years) licensed psychotherapist (LCSW) and life/career coach who has specialized in working with gay men, as individuals and couples, for over 23 years. He helps many gay men (and others) resolve the issues that undermine your quality of life, and helps you to thrive.
For help improving your personal or professional life, whatever your current challenges are, consider sessions with Ken for counseling, coaching, or therapy sessions, at his office in Los Angeles/West Holllywood (near Beverly Center mall), or via phone, or via webcam, anywhere in the world. Call 310-726-4357 or email Ken@GayTherapyLA.com for more information.
Ken is also available for expert witness work on legal proceedings involving gay issues, all LGBT issues, HIV issues, and issues concerning psychiatric illness or disability, as well as organizational consulting for non-profit organizations, corporations, college campuses, and conferences.
To get your copy of his self-help book, Self-Empowerment: Have the Life You Want!,visit www.Amazon.com , or wwwLuLu.com. It's your "portable therapist" for the challenges you face today in your mental health, health, career, finances, family, spirituality, and community.