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by Joe Zagame

Dec 6, 2023

From the HIV/AIDS Clinic to LGBTQ+ Inclusive Therapy: A Therapist’s Authentic Journey Navigating the Depths of Empathy

QueerPsych spoke with Joe Zagame to discuss working at an HIV/AIDS outpatient clinic, being an LGBTQ+ therapist, and focusing on the “here-and-now.”

Can you tell me more about your experience working at the HIV/AIDS outpatient clinic at New York Presbyterian Hospital? How has that experience shaped your approach to therapy, especially with members of the LGBTQ+ community?

Working at the HIV/AIDS outpatient clinic at NY Presbyterian Hospital was a formative experience for me early in my career. I learned first hand the toll HIV/AIDS takes on our Community. But beyond that, it allowed me to interact with individuals from diverse backgrounds who were facing not only health challenges but also emotional, psychological, and social struggles. The clinic provided a safe space for people to share their fears, hopes, and vulnerabilities.

This experience helped me understand more deeply the importance of empathy, respect, and non-judgment in these relationships. I brought this appreciation for the complexity and intersectionality of each individual into my own work and constantly remind myself of the importance of this safe and non-judmental space I provide.

Your profile mentions working with diverse individuals and couples from various backgrounds, not only those living with HIV/AIDS. How do you ensure a culturally sensitive and inclusive approach in your therapy sessions?

I approach this by first remembering that my intention is to create space where individuals feel seen, felt heard and respected. In practice, this begins with cultural and experiential humility. I approach each therapeutic relationship with the awareness that I don’t know everything about their unique experiences or background, but rather I’m there to listen with openness to learn more about how these backgrounds shape their experiences. Outside of the therapy room, continuous learning and education for myself also help me to build more cultural consciousness.

Could you explain your approach to Emotion-Focused Therapy (EFT) and how it benefits LGBTQ+ individuals and couples specifically?

Emotion-Focused Couples Therapy is an approach that emphasizes understanding and working with emotions to promote psychological healing and growth. It’s particularly effective in addressing emotional distress, relationship challenges, and self-acceptance issues, making it well-suited for LGBTQ+ individuals and couples. For individuals, EFT helps build self-compassion and acceptance, which can be even more powerful for folks dealing with coming out, discrimination or rejection due to their identities or orientations.

Ultimately the goal is to enhance self esteem and build resilience. For couples, it helps to facilitate open communication about emotions and needs and a greater understanding of each individual’s experiences. Again at the core is building a secure and lasting bond between partners that serve as a foundation for navigating the joys and challenges of a relationship, especially if that’s a little more challenging being LGBTQ+.

As a trained practitioner in Accelerated Experiential Dynamic Psychotherapy (AEDP), how does this approach enhance the therapeutic experience for your clients?

At its core, incorporating AEDP therapy means cultivating a therapeutic relationship built on safety and connection with the client. It provides safe space to go beyond an intellectual discussion of emotions or pain. It helps clients access emotional experiences directly and then build healthier patterns of thinking and feeling after accessing the core emotions. In my view this leads to a greater emotional intelligence, new healthier patterns of thinking and feeling and ultimately greater resilience.

In your practice, you emphasize creating a safe and supportive atmosphere for clients to explore their difficulties. How do you establish this atmosphere, especially for LGBTQ+ clients or those living with HIV/AIDS who might have faced discrimination or stigma?

To me, creating safety and support for a client is first about having an open mind. That means listening actively, without judgement. A sense of humility that I may not understand their background or point of view, but can have an appreciation for how all these factors influence their lived experience. And above all validating their experience.

While this is essential for all folks, it’s even more important for those that identify within the LGBTQ+ community given the unique challenges we all face. I understand that LGTBQ+ individuals may have faced  discrimination or stigma that can impact their mental and emotional well-being.

Your focus on the “here-and-now” is intriguing. Could you explain how you guide clients, including LGBTQ+ individuals and couples, in experiencing the healing power of connection in real-time during sessions?

The “here-and-now” approach is really all about experiencing the emotion in real time. Rather than take the approach of intellectualizing an event or emotion of the past, we’re discussing it in the session and unpack it as it’s being felt. As a relational therapist, I’m there alongside the client helping them to understand the emotion in real time and bringing myself into the process with my own feelings and thoughts.

Parenthood is mentioned as part of your identity. How has being a parent influenced your understanding and empathy towards the challenges faced by LGBTQ+ individuals and couples?

Becoming a parent has opened my eyes to the fact that inside we’re all kids in some way: struggling to understand and managing our emotions. Witnessing kids deal with their own emotions and help them to understand them on their own is an important part of our jobs as parents. This gives me empathy for the journey that we’re all on – even as adults. I try to remember this perspective in my work. It reminds me that in some ways we are all just kids on the inside trying to figure out what’s going on in this journey of life.

Intersectionality, Mental Health, Wellness

by Joe Zagame

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