Exploring the Dynamics of Shame, Sexuality and Therapeutic Engagement with Gay Men: A Social Constructionist Reflexive Thematic Analysis

Background
The western world has undergone a remarkable process of change and re-construction regarding the sexual and intimate lives of its citizens. Changes in law have coincided with greater acceptance and visibility of LGBTQI+ individuals, same sex and other non-traditional relationships. Despite this, sexual minorities are still positioned as vulnerable to marginalisation, discrimination, poor mental health and threats to their safety. Through a network of associated discourses, shame as a result of stigmatisation is widely assumed to account for the distress experienced by this population.

Following this logic, it would appear that gay men would benefit from exploring issues relating to gay shame in therapy. Research also associates shame with poor therapeutic outcomes. It is argued therefore that engagements with shame in relation to sexuality may be a crucial factor in the development and maintenance of the therapeutic relationship. There exists however a very limited body of qualitative research exploring gay men’s understandings of shame and sexuality and how these issues were engaged with in therapy.

Aims
Utilising a social constructionist epistemology, this research aimed to explore how six gay men constructed their understanding of shame in relation to sexuality and how these issues related to their experience of therapeutic engagement. Data collection involved semi-structured interviews. A reflexive thematic analysis was used examine the rich interplay of discourses available to the six participants that gave rise to subjectivity, subject positioning and practices. Three overarching themes and five sub-themes were identified.

Findings
The participants constructed shame as foundational to their identity as gay men, a defective subjectivity rooted in gender transgressions and de-validating childhood experiences. Shame was also constructed around the concept of a unified self, where shame resulted in a fragmented sense of selfhood. Participants spoke of self-hatred, hiding and practices of shame avoidance to navigate heterosexist oppression within a hegemonic, heteronormative society. Therapeutic engagement was constructed as a validating space and a tool to aid in the reconstruction of the self, characterised as the quest for authenticity and self-acceptance. De-validating experiences in therapy were constructed as re-shaming events. Finally, shame was also constructed through the discourse of affect, characterised as existential angst or a hypervigilant anxiety to the threat of exposure to shame. How the emotion of shame was engaged with in therapy reflected psychotherapeutic discourses on shame and different theoretical orientations.

Conclusions
From a social constructionist standpoint, shame in the context of the participants was conceptualised as ontological to their subjectivity as gay men, which means to say that shame informed their understanding of themselves in the world. The emotional experience of shame was interpreted to be a socially and relationally constructed chronic affective state.

By adopting a shame informed approach to therapeutic practice and organisational culture, Counselling Psychologists and psychological services can become more competent when working with gay men and other services users when addressing shame. Practitioners can benefit from an awareness of how dominate psychological discourses may conceal how shame is implicated in power struggles within the therapeutic relationship, helping them reflect on how they understand their client’s experience. Furthermore, the therapy room is arguably never a politics free space, and the institutions of psychology can still be seen to uphold normative assumptions, which may constrain individuals from diverse sexualities. Rethinking dominate discourses that inform therapeutic practice can provide a more effective, diverse and inclusive therapeutic space.