brainstorming therapist ace-(client)-advice

I’m still mulling over Elizabeth’s suggestion to put together some advice (or “what not to do”s) for therapists of aces.  It wouldn’t need to be ace 101 for therapists, since that already exists.  Building off of that… here’s what I think would be some applicable sub-topics.

  • signaling that you’re ace friendly — Some therapists will put it in their bio or have a little sign in their office indicating they’re (at least nominally) supportive of LGBT identities.  Given the… complex relationship between the LGBT community and the ace community, aces can’t always take this as a sign that they’re in a safe space.
  • making negative assumptions — A client who brings up their asexuality may not be doing so because their asexuality is something they want your advice on.  Like other biographical information, this may be some background information that’s necessary to clarify other things the client wants to tell you about their life.
  • pathologization — Sometimes clients may express personal or interpersonal distress over not feeling sexual attraction/not wanting sex/being averse to sex, etc.  They may or may not identify as asexual.  This distress is the problem to work on, not their sexuality itself.

Obviously, I’d go more in-depth with these.  These are just summaries of what springs to mind.  What other “Don’ts” would you want a therapist to be aware of?

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13 responses to “brainstorming therapist ace-(client)-advice

  • Arrela

    Uh. I can give you a list of stuff therapists have said, if you want? Granted, a lot of it is about me being queer in general, not ace specifically, but still. The current one knows I’m ace because I put it in a form (that actually asked for orientation and let you fill it in yourself, hurray!), but hasn’t said anything about it yet, so we’ll see. The previous one I didn’t actually tell, because, well. I mentioned that my mother had not taken it super well when I came out to her and they started talking about me still being young (22 at the time!) and that I probably didn’t know yet anyway and that it was too early to label myself a lesbian (which I… didn’t) etc etc. Don’t be that person. Reversely, the one before that kept calling me a lesbian, even after I asked her for the third time to please not do that. Don’t be that person either.

    Generally I would say, respect the language your patient uses to describe themselves. If you find yourself wanting to say “But what you actually are is ___” or “Well, but that’s just another word for ___” or “You are too young to know if you are ___” just, Don’t.

    One of my biggest issues with this in therapy is all the forms and questionnaires you have to fill out, though. I realize that they are standardized, but they are so, almost borderline triggering, to fill out. On a scale of one to six, how shy are you when interacting with the opposite sex? (wtf on so many levels) On a scale of one to six, how often do you initiate contact with someone for the purpose of romance/sex? On a scale of one to six, how much do you agree with the statement “my interest in sex is significantly lower than normal and/or has recently decreased markedly”? (what is normal??) If there was an n/a option for these things my life would be so much easier.

    Oh, and a last thing, maybe don’t rely on your patient for information? If you suddenly find yourself with an asexual patient and you’re like “well what on earth does that mean” maybe ask google some questions before you interrogate your patient. I know that I react really badly to having to explain these things, and in a therapy setting it would make me feel incredibly invalidated, like I am just making up stuff that isn’t real in order to appear more special or explain away symptoms or something.

    Okay, this probably wasn’t very coherent, sorry. But I have a lot of anxiety about being ace in therapy. I actually debated with myself for a very long time whether to out it in when I filled out that form. So this is important to me. I might come back with a more coherent comment when it is not midnight. Thank you for doing this!

    • Coyote

      That’s all very useful, actually. Thanks!

      And… I have not encountered one of those forms before. o-o Granted, my only experience with therapy was just visiting a university therapist… and most of the paperwork I filled out was just standard consent forms and some basic medical/background stuff (“how much do you drink alcohol” “how many people do you live with”).

  • Elizabeth

    Dealing with identity policing and gatekeeping coming from anyone in the client’s life (including other aces/the ace community) is a big one—it may instill enough doubt and anxiety that a client might come to the therapist to work through that. To go to a therapist and then only encounter yet more gatekeeping/policing… is very bad.

    Relationship difficulties and recognizing when a relationship is abusive is another big one. Ideally, therapists *should* already be educated about how to recognize abusive relationships in general (but not every therapist understands this, and some of them do perpetuate abusive situations), but when it comes to ace people specifically? They often don’t know how to recognize red flags.

    Abuse totally aside, there are other relationship issues that come up that ace clients might go to therapists for advice about, that the therapist may try to give advice for based on “common wisdom” that doesn’t really… work for a lot of aces. Like for example (and this is a real thing that my therapist told me has happened), a younger client may have their parents tell the therapist to talk to the client about dating. But a conventional dating script may make absolutely no sense to an ace client. They may be thinking “okay… but why would we do that?” when the therapist is telling them about dating or role-playing a dating scenario. Or, they may not understand the social cues of romantic/sexual relationships that the therapist is relying on them already having an understanding of… does that make sense?

    That last part… I don’t know if you will find a lot of examples from advice blogs about that sort of stuff (I don’t follow any advice blogs, so I truly have no idea), but it’s worth keeping an eye out for it. Whether it’s good or bad advice, it’d still probably be helpful for therapists to see what sorts of problems ace clients might encounter with relationships, because I think a major problem is that they just don’t have those kinds of problems on their radar at all.

  • Libris

    – Don’t try to look for ways in which they could be not asexual/interpret anything that could possibly be vaguely sexual as ‘look not ace now!’ (fairly obvious, but still)

    – Don’t keep focusing on how low sex drive can be a symptom of xyz mental illness; your patient knows, and does not need you questioning and pathologising their identity. If they don’t ID as ace and are confused about a change in sex drive, mentioning that illnesses can do that may be helpful, but mention it with other possibilities (including being ace! or just having a low sex drive!), and don’t push it as the answer they Should Accept.

    – Don’t assume that IDing as gay/bi/lesbian/pan/etc is incompatible with IDing as ace. Don’t assume that IDing as one of those and ace just means you’re ~repressing~ your sexual urges because of the stigma against same-gender sexual attraction. (Don’t assume anything about IDing as trans and ace, same as IDing as trans and any other sexual orientation.)

    – A lot of therapy is often about questioning your assumptions and thought processes. Don’t assume that this extends to identity. Getting your patient to constantly question their identity is /not/ helpful; it’s more likely that you may need to help them /not/ constantly question it, if anything.

    – Don’t assume that beliefs about sex = attitude towards sex. Working through toxic or harmful beliefs about sex may or may not affect a person’s sex-repulsion, and your aim should be to work through the beliefs on their own merits, not to take a change in attitude as the only possible proof that said beliefs have changed, nor to take a change in attitude as proof that their sex-repulsion/asexuality never existed in the first place. (I was thinking here of the kind of toxic purity culture beliefs, which it’s fairly likely that people would bring to therapy, but it applies to any beliefs around sex that are Actually Harmful that people are seeking help with.)

    – Similarly, if you’re dealing with ace survivors, don’t base how well your treatment is working on whether their sexuality or attitudes towards sex are changing. And don’t invalidate their sexuality/sex-repulsion/etc based on their experiences.

    – Don’t assume that IDing as ace means you can’t have a partner, and don’t assume that any partner-relationship needs help/therapeutic advice just because one of the people is ace. Don’t ask prying questions about it when it’s not appropriate. Relatedly, if your patient does come to you for relationship advice, don’t assume that asexuality is the underlying problem. (Tangentially, but also: do not assume that if your patient is dating someone trans, that it’s because they are ace! Please have competence in trans issues as well!) Don’t assume that if someone doesn’t want a partner, that that is a problem. (Either due to being aromantic, or just, well, not wanting a partner right now!) Don’t assume that if someone is in a partnership and asexual, that it’s automatically because their partner is doing something wrong/abused them/raped them/is not good at sex/whatever faulty assumption. Don’t assume that if someone is demi it is because their partner is good at sex.

    – DON’T ASCRIBE ASEXUALITY TO DISABILITY.

    – Maybe a less important one, but one I’ve had personal issue with: don’t assume all kink is sexual/motivated by sexual attraction (and therefore makes you not ace).

  • Sciatrix

    Things that have worked for me:

    -Pay attention to your client’s body language/tension if you don’t know a lot about asexuality and want to know more. Some people will feel okay explaining; some won’t; you should use nonverbal as well as verbal cues when deciding how much to pry. Ideally, please do your homework outside the therapy room, but if that’s difficult, try asking what your client wants you to understand about them specifically.

    -Expect your client to be defensive or tense when coming out. It’s a deeply scary thing for many aces, and often we get judgmental or otherwise negative responses when this happens. Do not assume that tense, scared declaration of asexuality means that an asexual identity is necessarily a problem or upsetting for the patient; it might just be that they are tense and scared about declaring it to you.

    -Let your client take the lead on explaining what it means to be ace; don’t assume that you can tell what other people’s reactions will be to declarations of asexuality or discussions thereof better than your client can. People tend to have a very split reaction to learning that someone else is asexual: either straight up “eh, don’t care [why are you telling me]”, intense interest and curiosity, or extreme discomfort and feeling threatened. If you fall into the first category, it can be very easy to assume that coming out as asexual is super easy for ace people and to invalidate the real reactions from people in the second two.

    -Listen to what your client is saying. Listen to what your client is saying. Listen to what your client is saying. Do not assume that they are lying straight off the bat. Please.

    Things that have not worked well for me in therapy:

    -For the love of god, do not bring up Dan Savage as a cue that you know what asexuality is and you are good to go. Please do not do that thing; it’s a specific flag which will immediately cue many aces to be wary.

    -Don’t assume that “client told me they were asexual: asexuality must be the problem!” Sometimes it comes up as a way to inform existing dynamics. Listen to what your patient wants to work on.

    Will think harder on this.

  • Tristifere

    – Do not think in the dichotomy of “people distressed about lack of sexual desire” = sexual disfunction vs. asexuality = “people are not distressed about their lack of sexual desire”. As said in the original post: asexuals can be distressed about their sexuality. We live in a society which constantly tells us we’re abnormal – there are plenty of aces who are distressed that they are unable to live and have relationships according to that arbitrary societal norm. If you’re unclear as to why the above is a false dichotomy, read this paper; it’s very good.

    – In a similar vein: not everybody is going to walk into your practice proclaiming that they’re Ace and Proud, ready to educate you and able to be assertive when you or anybody else reacts negatively or ignorantly to their sexuality. There are questioning aces, distressed aces, aces who are ashamed, aces who feel uncomfortable discussing their sexuality with others, etc. Do not take their lack of (visible) confidence in their sexuality as an indication that they are, in fact, not ace, or that their identity needs to be challenged.

    – Not everyone knows asexuality is a sexual orientation. Being knowledgable about asexuality and common ace experiences can help you identify when a client might benefit from being introduced to the concept. (I feel there might be relevant academic papers on this topic, like on asexual identify formation? Can’t seem to find any at the moment, though)

    – Sciatrix already touched upon this, but because this is especially relevant for me: Coming out is hard. Coming out to (mental) health professionals can be even harder. I personally find it particularly hard when dealing with mental health professionals, because I’m already in an emotionally vulnerable state when I have to seek them out. Handling the mind-game of “how will they react”, the ace 101, the possible hostile reaction and the pathologization, etc. is hard in that state of mind. So, do not underestimate the courage it takes for your client to tell you they’re asexual.

  • epochryphal

    leaaarrrnnn abt greyyyynesssss.

    chill the fuck out on puberty and natural unfoldings of connectedness/desire /sensuality whatever, even if you’re trying to say it’s kink or something other than sex. stop w t universals

    if someone is questioning don’t steer them away from aceness or greyness? even subtly?? don’t steer at all preferably??

    idk i think there’s a lot of stuff that’s “not solidly happily asexual” relevant (i was talking on talia’s comments i think)

  • Linkspam: November 13th, 2015 | The Asexual Agenda

    […] Coyote started a thread to brainstorm advice for therapists with ace clients. […]

  • Recommended Reading: November 16th, 2015 - Resources for Ace Survivors

    […] wrote “Is this abuse?”: A Guide for Aces, started a thread for brainstorming advice for therapists treating ace clients, and compiled a list of Examples of Bad Ace Advice. The bad advice post has had several responses […]

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