Counselling Bisexuality: A qualitative exploration of 'affirmative' therapeutic engagement with bisexuality

Although there have been an increasing number of studies which focus on affirmative
therapy with LGBTQ clients, there have been a limited number which have focused
on an affirmative approach to bisexuality. Due to the popular discourses in society
that erase bisexuality it is important for counselling psychologists to consider how
these clients are understood by therapists and how therapists engage affirmatively
with this cohort. The aim of the thesis was to consider how socio-cultural and
professional discourses interact with, and impact on therapists' conceptualisations of
bisexuality. This study also aimed to explore the ways in which affirmative therapists
understood and spoke about bisexuality and affirmative therapy and how these
understandings could influence therapeutic engagement with 'bisexuality'. The
research questions were: In what ways do therapists conceptualise what it is to be
'affirmative' in their therapeutic engagements with LGBTQ clients?; In what ways do
affirmative therapists understand bisexuality?; In what ways do therapists
affirmatively engage with 'bisexual' clients in their therapeutic practices?
A qualitative design was used and eight 'affirmative' therapists were interviewed. An
inductive Thematic Analysis was carried out using a social constructionist
epistemology and a relativist position. Three themes were presented. The first theme
presented therapists "theoretically open" professional views on sexuality that were
social constructionist in basis and validated sexual fluidity and bisexuality. The
second theme presented rigid views around sexuality. This theme presented an
overwhelming dichotomous positioning of therapists when they referred to their own
or their client's sexuality. The third theme presented the resistance of the therapists to
adopt the hegemonic affirmative approach.
Findings suggested that, in line with previous research, therapists understanding of
what it is to be affirmative did not appear to be LGBTQ specific. Therapists viewed
the world in rigid sexual categories, which may have the potential to impact on their
ability to be affirmative to bisexual clients and those clients occupying a more fluid
position. There was also resistance to the hegemonic affirmative approach due to
incompatibilities with certain theoretical orientations, as well as an incompatibility with some clients. The lack of concern for formalised affirmative therapy for bisexual
or sexually fluid clients became particularly salient when considering the biphobic
and rigid positions of some therapists. Often a therapist who did not believe in the
need for specific hegemonic affirmative therapy, adopted a position against nondichotomous
sexualities, which in turn adds weight to the argument that affirmative
approaches are perhaps necessary, as therapists were unable to view sexuality as a
multitude of different and valid experiences.
The thesis concluded by advocating the need for more training on counselling
psychology courses as well as stressing the need for counselling psychologists to
intensely consider their own sexuality and consider a social obstructionist position in
theory, as well as in practice, in order to ensure the ability to be affirmative to
'bisexualities'. It was argued that it is important to think about sexuality with regard
to all the varieties of experiences that clients can have in order to validate the sexual
journey of each client.
In summary, the main message of this thesis is that therapists appear to hold
dichotomous understandings of sexuality and so therefore this suggests it may be very
difficult for them to be affirmative to bisexual or sexually fluid clients. Therapists
found it difficult to appreciate the multiplicity of experiences and understandings their
clients had presented. Instead therapists chose to view sexuality from rigid positions,
often underpinned by their own experience of sexual development and mirroring
dominant societal discourses. This has implications for the way in which counselling
psychologists could approach sexuality within therapy because rigid dichotomous
related interventions, or subtleties in talk, may limit and restrict clients' developing
bisexualities.
Finally, this thesis also recommends that researchers continue to examine ways in
which counselling psychology can ensure an affirmative stance to bisexualities. taking
into account the limitations that popular dominant discourses create for developing
sexualities.

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