Out On The Couch
Bisexual Polyamorous Clients in Therapy
Before getting into this article, I would like to locate myself. I am a white, bisexual, able-bodied, ambiamorous, cisgender woman with anxiety and a chronic illness who has been in both monogamous and polyamorous relationships. As someone who identifies as bisexual, has navigated both polyamorous and monogamous relationships, and specializes in working with these communities, I believe that it is important for clinicians to understand the unique experiences of bisexual polyamorous individuals.
As an affirmative therapist throughout the COVID-19 pandemic, I have worked with clients with marginalized identities who have been experiencing higher-than-baseline levels of anxiety and depression due to the pandemic. This has filtered into much of our work, even if their primary presenting problem was originally to navigate their sexual orientation or relationship orientation, or to navigate concerns within their relationships. COVID-19 has highlighted the fact that, as clinicians, it is important to recognize that our clients’ identities do not exist in a vacuum – just as our own identities do not exist in a vacuum. Therefore, it is always important to take into account the impact of both internal and external factors in clients’ lives while working with them – as well as how our own experiences may or may not come into the therapy room.
Potential Benefits of Polyamory for Bisexual Clients
Bisexuality has been defined as “the potential to be attracted – romantically and/or sexually – to people of more than one gender, not necessarily at the same time, not necessarily in the same way, and not necessarily to the same degree” (Ochs, n.d.). Studies show that bisexual people prefer polyamorous or open relationships in greater frequency than people of other sexual orientations (Weinberg, Williams, & Pryor, 1994). One benefit of polyamory for bisexual people is: “polyamory and bisexuality propose a plurality of loves, both in the number of partners and genders thereof” (Anderlini-D’Onofrio, 2004). Polyamory can be a beautiful thing for many bisexual individuals who want to add diversity to their sexual and romantic lives with people of more than one gender.
However, they don’t always have a “preference” in their partner’s gender; it is more about the people they are dating and how polyamory enhances their lives. In fact, 70% of bisexual polyamorous participants in one study did not care whether their partners were of the same or different genders at any one time (Weitzman, 2006). Their preference for polyamory, therefore, may come from the fact that more bi-identified men and women tend to believe that monogamy in relationships is less enhancing and more sacrificing than gay-identified or straight-identified individuals (Mark, Rosenkrantz, & Kerner, 2014).
Bisexual Erasure and Strategic Identities
Polyamory offers an exceptional way to provide a buffer against bi erasure or invisibility and challenges the risk of falling into heteronormativity (Robinson, 2013). In fact, non-monogamy has been identified as a “strategic identity” to maintain bisexual visibility in the world (Klesse, 2011; Moss, 2012; Robinson, 2013; Weitzman, 2006). A strategic identity is an identity that serves a political, social, or interpersonal function. In this case, the function of polyamory could be visibility and support of bisexuality as an authentic identity. When bisexual individuals can express their identity more fully and be visibly bisexual, especially in the context of a polyamorous relationship, they also tend to have more:
- Freedom to have partner choices of all genders,
- Freedom to speak openly about the full range of their attractions and fantasies,
- Opportunities for group sex, and
- Sexual and romantic enjoyment of different genders.
Therefore, if bisexual individuals engage in polyamorous relationships, they can express their sexuality more freely – both for themselves and within the larger world.
Potential Disadvantages of Polyamory for Bisexual Clients
There are also unique disadvantages to being both bisexual and polyamorous. These individuals may be doubly stigmatized as “confused” or “promiscuous” (McLean, 2011; Weitzman, 2006). They may experience prejudice and discrimination from both the gay and straight communities (e.g., prejudice from gay partners about other-gender partners; prejudice from straight partners about same-gender partners). This internalized stigma and biphobia from partners (either monosexual or bisexual partners) can also lead to potential increased rates of intimate partner violence. Turell, Brown, and Herrmann (2017) found that bi-negativity and the oversexualization of bisexual individuals was a risk factor for higher rates of jealousy and IPV. This risk was highlighted by bisexual participants who are also polyamorous.
On an individual level, bisexual people may experience guilt about reinforcing the stereotype that “bisexual people aren’t/can’t be monogamous.” And, they may also experience their own or others’ misperceptions that same-gender relationships are somehow less important than other-gender relationships (Weitsman, 2006).
As clinicians, it is our duty to challenge these cognitions if we have any of them; by reinforcing these stereotypes, we would be harming our bisexual clients as well. We can challenge our own thoughts and feelings through:
- Being curious about clients’ lived experiences
- Identifying and being curious about our own reactions and expectations for our clients’ lives
- Reading, following, and engaging with media created by bisexual polyamorous folx
- Educating ourselves about the reality of bisexuality and polyamory
- Seeking supervision or consultation with another polyamory-affirmative clinician
Clinical Work with Bisexual Polyamorous Clients
Having explored the potential advantages and disadvantages of polyamory for bisexual individuals, clinicians will hopefully be better positioned to provide a safe space for their bisexual polyamorous clients. Helping bisexual polyamorous clients with their relationships may include talking about safer sex practices with many genders, assessing for biphobia, assessing and creating safety plans for IPV, as well as addressing any other clinical issues.
Clinical work may include an exploration of how competition shows up in their relationships (if it does at all). Some partners of bisexual individuals may take comfort in knowing that they are currently the only person of a particular gender that the person is dating; therefore, they may feel as though there is less of a risk of their bisexual partner leaving them. For others, they may be acutely aware that their body is different from that of their metamours’; therefore, they may be concerned about never being able to fulfill a particular role or sexual desire for their partner (Armstrong & Reissing, 2014).
In doing this work, affirmative clinicians should also be on the lookout for any potential biphobia or IPV within a relationship. Couples’ therapy or multi-partner relationship therapy is not recommended in cases where IPV is prevalent.
Unique Stressor: A “Choice”
Bisexual polyamorous people also often are asked to make a choice between a partner and their relationship orientation. This is because potential other-sex partners of bisexual individuals tend to have expectations of monogamy (Armstrong & Reissing, 2014). This decision is a frequent reason couples end up in my office: one person craves non-monogamy, while the other can only envision a monogamous relationship for themselves. This is not always related to one person having a bisexual identity, but it can be one aspect of mono-poly relationship experiences. When faced with a monogamous-minded partner, some bisexual individuals do end up feeling like they have to make a choice, and may explore their options in our office. Some questions a bisexual client may be struggling with are:
- Do I stay in a monogamous relationship, or do I go?
- What does this say about my identity?
- Am I being true to myself?
- What will my community think?
- Will I be rejected from bisexual spaces or polyamorous spaces?
- Would I be a “sell-out” for choosing a partner of one gender or choosing a monogamous relationship?
Bisexual erasure happens to bisexual folx all the time; it is a weight we often feel, even if we aren’t expressing it. Therefore, an affirmative clinician should try to be aware of both the explicit and implicit choices that a client may be making when they are exploring the pros and cons of their relationship structures and how they are designing their relationships. While polyamory may help some bisexual folx combat bi erasure and be more visible, it also brings other difficulties with it. There is no one “correct” way to structure relationships, but exploring the various options, benefits, and disadvantages with bisexual individuals may help clients find the best choice for themselves and live more authentically in their life.
Anderlini-D’Onofrio, S. (2004). Plural loves: Bi and poly utopias for a new millennium. Journal of Bisexuality, 4, 1-6, doi:10.1300/J159v04n03_01
Armstrong, H. L. & Reissing, E. D. (2014). Attitudes toward casual sex, dating, and committed relationship with bisexual partners. Journal of Bisexuality, 14, 236-264. doi:10.1080/15299716.2014.902784
Klesse, C. (2011). Shady characters, untrustworthy partners, and promiscuous sluts: Creating bisexual intimacies in the face of heteronormativity and biphobia. Journal of Bisexuality, 11, 227-244. doi:10.1080/15299716.2011.571987
Mark, K., Rosenkrantz, D., and Kerner, I. (2014). “Bi”ing into monogamy: Attitudes toward monogamy in a sample of bisexual-identified adults. Psychology of Sexual Orientation and Gender Diversity, 1(3), 263-269. doi:10.1037/sgd0000051
McLean, K. (2011). Bisexuality and nonmonogamy: A reflection. Journal of Bisexuality, 11, 513-517. doi:10.1080/15299716.2011.620857
Moss, A. R. (2012). Alternative families, alternative lives: Married women doing bisexuality. Journal of GLBT Family Studies, 8(5), 405-427. doi:10.1080/1550428X.2012.729946
Ochs, R. (n.d.). Bisexual: A few quotes from Robyn Ochs. Retrieved from https://robynochs.com/bisexual/
Robinson, M. (2013). Polyamory and monogamy as strategic identities. Journal of Bisexuality, 13(1), 21-38. doi:10.1080/15299716.2013.755731
Turell, S. C., Brown, M., & Hermann, M. (2017). Disproportionately high: An exploration of intimate partner violence prevalence rates for bisexual people. Sexual and Relationship Therapy, 33, 113-131. doi:10.1080/14681994.2017.1347614
Weinberg, M., Williams, C., & Pryor, D. (1994). Dual attraction: Understanding bisexuality. New York, NY: Oxford Press.
Weitsman, G. (2006). Therapy with clients who are bisexual and polyamorous. Journal of Bisexuality, 6, 137-164. doi:10.1300/J159v06n01_08
Check Out Stephanie’s CE Courses on working with polyamorous clients
Maintaining Hope & Self-Compassion for LGBTQIA+ Clients During Covid-19
By now, we are all experiencing the impact of the ubiquitous trauma and stress surrounding COVID-19 in some way. What might have started with a distal awareness of the problem quickly snapped to a reality that the world will forever be changed by this virus. You might have also noticed the varying “stages of grief” through which our clients and we ourselves are shifting, the unfortunate stage of denial being the one that has caused the most irrevocable damage to the world.
On the one hand, many may find the universality of this experience comforting–it is rare that everyone on the planet understands the same thing to some degree. The current situation presents a valuable opportunity for emotional validation and a sense of common humanity (i.e., increased self-compassion due to awareness of the common human experience of suffering). It often takes personal experience and connection to a situation to increase empathy and compassion, and we are seeing a lot of that right now.
On the other hand, I wish there was this strong of an empathic connection and worldwide response to problems like climate change, the murder of black and brown bodies, and the impact of capitalism on class disparities. Interestingly, each of these intersects with the effects of COVID-19, especially the disparity of the impact on (and deaths of) black folks in our country.
No matter how we process and move through this situation, many feel its impact as a trauma. While we work to validate our clients’ experiences and help them make sense of something entirely unprecedented, it is also important to remember that this situation impacts different people very differently. The disparities affecting various marginalized populations are amplified during this time. It is crucial to acknowledge the potentially devastating impact on the LGBTQIA+ community, especially on transgender and gender nonbinary (TGNB) individuals, many of whom are no strangers to trauma and grief. More background on this can be found in The Affirmative Couch’s course Gender Minority Stress and Resilience in Transgender and Gender Nonbinary Clients.
How our LGBTQIA+ clients might experience a compounded impact of grief and/or trauma related to COVID-19:
Physical distancing in unsafe and/or unaffirming living situations due to quarantine
- College students who were suddenly asked to leave campus
- Those in domestic violence or other abusive home environments
- People who have not disclosed or come out to their families/housemates
Social isolation due to the pandemic
- Being physically distant from one’s chosen family or an affirming environment (e.g., at a university)
- Being unable to explore communities or experiences that might be affirming, such as closed, limited, or postponed LGBTQIA+ centers and Pride month activities
Lack of resources to access safe space and online support for LGBTQIA+ Clients
- Limited resources to pay for stronger Internet connection, or lack of multiple devices
- Lack of privacy or safe space to seek online support or therapeutic help
- Food, housing, or job insecurity during this time
COVID-19 factors specific to TGNB people
- Canceled or postponed lifesaving gender-affirming surgeries
- Barriers to beginning gender-affirming hormones, monitoring bloodwork, and receiving preventative affirming healthcare
- Risk of misgendering via phone/video and distress/dysphoria of seeing one’s face via video conference
- Inability to affirm one’s gender expression due to lack of support and/or awareness of other household members
- Limited or no access to gender-affirming haircuts (i.e., hair can make or break someone’s experience of dysphoria on a given day)
- Increased body insecurity and disordered eating in response to the fatphobia strengthened by this crisis; you can read more about this in my article At the Intersection of Fat & Trans
How therapists can help our LGBTQIA+ clients during the coronavirus crisis:
The impact of each of these concerns is amplified for those with intersecting marginalized identities related to, for instance, race, class, ability, and mental/physical health status. To make matters worse, many of our clients experience anticipatory grief for the continued losses ahead as well as for the uncertainty of when things will “return to normal.” Here are some ways in which we might help our LGBTQIA+ clients, especially members of the TGNB community, to navigate this situation and find ways to practice self-compassion, gratitude, and hope.
Supporting LGBTQIA+ Clients with boundaries during the pandemic
This is not an “opportunity” for people to do the things for which they don’t usually have time. “Productivity porn” is shame-inducing for many who are experiencing this situation as a trauma. It is okay to limit time spent on consuming the news and social media. To paraphrase an important sentiment, this is not just remote work. You are at home during a pandemic crisis and attempting to work.
Providing validation for LGBTQIA+ clients
Acknowledge to your clients that employing all self-care strategies possible still may not help beyond simply keeping them afloat during this time. Surviving a traumatic experience takes an extreme emotional and physical toll, and it’s okay if clients’ eating habits and bodies change, if they sleep more than usual, and if they struggle to get work done.
Helping LGBTQIA+ Clients Develop Self-compassion
I can’t emphasize enough how important it is for our clients to be mindful and self-compassionate. Whatever thoughts, feelings, and behaviors emerge during this time make sense given the impact of collective traumas. Even if someone acts in a way that is inconsistent with their values, they are still worthy of self-nurturance and connection. You can learn more about these concepts through The Affirmative Couch’s course Helping Transgender and Gender Nonbinary Young Adults Develop Self-Compassion.
Finding and Celebrating little moments of joy and gratitude with LGBTQIA+ clients
- Ask clients to reflect on a vulnerable moment where they were able to nurture themselves or others
- What was one show/movie/podcast/song that made them smile or laugh?
- What is one thing they’re looking forward to in the upcoming week?
- What are three things about the past week for which they felt most grateful?
- Direct them to some of the many inspirational, hopeful, and positive ways in which people have been expressing themselves and creating via social media.
Finding meaning and connection
- Can clients volunteer virtually? Reach out to someone who is more isolated? Offer to drop off groceries for an elderly neighbor?
- What creative talents might be employed to help others?
- Engage clients in storytelling and/or writing–expressive writing exercises like these can be particularly useful–to help work through their feelings
- If they have financial resources, what organizations might benefit from their support?
- Connect virtually with supportive others, especially in spaces that are queer- and trans-affirming. Balance their socializing with meaningful conversation and moments of fun
- Help your clients explore whether local or statewide LGBTQIA+ organizations are running online groups and support spaces, and/or offering other forms of connection
Looking for Hope for the future (i.e., not focused on a specific time when things return to “normal”)
- Who is the first person a client can’t wait to hug again?
- What restaurant are they excited to go to first?
- For students, how will it feel to step back onto campus again?
- What is the first event/trip/appointment they’re looking forward to rescheduling?
A final note: These points are important for clinicians to keep in mind as well. We need these reminders now more than ever. Most of us are not at our best right now, and it is foolish to pretend to our clients that we are. This is a time for us to hold that we are all human, and that authenticity models for our clients why it is important to be less hard on themselves for struggling. At the very least, consider reading this “Dear Therapists” blog post.
Berinato, S. (2020, Mar 23). That discomfort you’re feeling is grief. Harvard Business Review. Retrieved from https://hbr.org/2020/03/that-discomfort-youre-feeling-is-grief
Thebault, R., Tran, A.B., & Williams, V. (2020, Apr 7). The coronavirus is infecting and killing black Americans at an alarmingly high rate. The Washington Post. Retrieved from: https://www.washingtonpost.com/nation/2020/04/07/coronavirus-is-infecting-killing-black-americans-an-alarmingly-high-rate-post-analysis-shows/?arc404=true
Patton, S. (2020, Apr 11). The pathology of American racism is making the pathology of the coronavirus worse. The Washington Post. Retrieved from: https://www.washingtonpost.com/outlook/2020/04/11/coronavirus-black-america-racism/
Tucker, M. (2019). Gender minority stress & resilience in TGNB clients. Retrieved from: https://affirmativecouch.com/product/gender-minority-stress-and-resilience-in-transgender-and-gender-nonbinary-clients/
Tucker, M. (2019) At the intersection of fat & trans. The Affirmative Couch. Retrieved from: https://affirmativecouch.com/at-the-intersection-of-fat-trans/
Ahmad, A. (2020, Mar 27). Why you should ignore coronavirus-inspired productivity pressure. The Chronicle of Higher Education. Retrieved from: https://www.chronicle.com/article/Why-You-Should-Ignore-All-That/248366
Tucker, M. (2019) Helping TGNB young adults develop self-compassion. The Affirmative Couch. Retrieved from: https://affirmativecouch.com/product/helping-transgender-and-gender-nonbinary-young-adults-develop-self-compassion/
Pennebaker, J.W., Blackburn, K., Ashokkumar, A., Vergani, L., & Seraj, S. (2020). Feeling overwhelmed by the pandemic: Expressive writing can help. The Pandemic Project. Retrieved from: http://exw.utpsyc.org/#tests
Katy (2020, Mar 21). Dear therapists. Navigating Uncertainty Blog. Retrieved from: https://navigatinguncertaintyblog.wordpress.com/2020/03/21/dear-therapists/