Millions of LGBTQ Americans have religious trauma. Psychiatrists want to help| Trending Viral hub


For those who abandon their religion (as Swift-Godzisz, Long and Boiter have done) It’s “like the rug was pulled out from under you,” according to Winell.

“His life needs to be rebuilt gradually,” he said. “It’s a reconstruction of who you think you are and what you believe now. One of those new beliefs is that being LGBTQ is okay.”

In terms of treatment, Winell said he first helps his patients learn to care for themselves.

“Instead of entrusting all that care to God, I teach them how to be self-reflective and how to regulate their feelings from their own perspective, rather than that of the Bible,” he said.

From there, teach skills that help with trauma response, such as writing down negative messages that you grew up believing and changing them to something that can be interpreted as positive and hopeful.

“What used to be: ‘My life is a test, and then I die and go to hell,’ can change to: ‘My life is an adventure and a journey,’” he said.

She also works with her patients on relaxation by teaching them breathing exercises and body scan meditations, among other techniques. In certain cases, he recommends combining these tools with medications.

A debate among mental health providers

As more LGBTQ people share their experiences with religious trauma, there is debate among mental health experts about how it should be characterized in the Diagnostic and Statistical Manual of Mental Disorders, the American Psychiatric Association’s reference guide for coding , classify and diagnose mental disorders.

In the fifth and final edition of the decades-old manual, the DSM-5-TR, religious trauma is included in the “Religious or Spiritual Problem” category, as a Z code, not as an official mental disorder. Z codes are listed at the end of the DSM and are called “other conditions that may be a focus of clinical attention.” Other examples They include various forms of “child psychological abuse,” “homelessness without shelter,” and “victim of terrorism or torture.”

Koenig now works with a group of public health experts and psychiatrists at Harvard University. expand “Religious or spiritual problem” as a Z code in the DSM to include “Moral problems,” such as moral injury.

Moral damage, which is not currently listed in the DSM, can occur when an individual believes that they have acted in a way that deeply conflicts with their morals and values, resulting in guilt, shame, or deep feelings of loss of trust. It has been applied to war veterans and, more recently, to health professionals who did not feel they could provide adequate care to those suffering during the Covid-19 pandemic.

“For centuries, people have been manipulating and weaponizing religion in condemning LGBTQ people,” Koenig said. “Moral harm – particularly for religious LGBTQ people – can create a lifetime of shame and guilt. Living with it can eventually result in mental health problems, such as suicide, depression and anxiety, because that is what produces moral injury, and you can stay stuck in it for years and decades.”

Koenig said it is critical that the combination of “Religious or Spiritual Problem” and “Moral Problem” (which is currently under review by a DSM committee) find a place in the manual as code Z. By adding moral injury, he explained, the Providers will be able to collect more specific data and prescribe more specific treatments, such as whether it is appropriate to recommend pastoral support for those suffering. They will also be able to more effectively document what part of the patient’s trauma came from her family or community’s religious beliefs and what part came from a separate worldview that being LGBTQ is immoral.

“For religious people who identify as LGBTQ, it is not just Christianity that is at stake,” he said. “It is the entire moral fabric of the culture that has been passed down from generation to generation that has caused this condemnation.”

Getting a new disorder or code added to the DSM involves sending an extensive proposal to the manual steering committee, which was then reviewed and sent together to the board of directors of the American Psychiatric Association for approval.

“Having it as a Z code will validate and encourage financial support, and then there will be more money for research, which will help us learn more about how we can treat people who suffer moral injuries like religious trauma,” Koenig said.

A further step would be to change “Religious or spiritual problem” from a Z code to an official disorder in the DSM. While Koenig isn’t sure where he stands on the matter, since the process would be even more rigorous and could take years, Winell said he “definitely thinks it should be there” as a disorder.

“Right now, most therapists don’t know much about it. They will do an interview with a new client and talk about family, education, substance abuse, but they won’t touch religion,” he said. “So if it were a real thing in the DSM, it would be covered and the millions of people who are struggling with this across the country would be able to get better help.”

Winell added that a disorder classification in the DSM would give religious trauma more credibility in the eyes of medical professionals and give those who experience this type of trauma the ability to name what they are going through. She also predicted that this would result in more research in the area and that religious trauma would become part of the curriculum of university psychology courses.

Drescher, who was part of the APA committee that in 2013 changed gender identity disorder to gender dysphoria in the DSM in an effort to eliminate stigma, disagrees with Winell on this issue.

“We don’t need diagnoses to understand what is happening. … Medicalizing social issues is how Homosexuality was originally labeled as a mental disorder.” Drescher said, noting that homosexuality wasn’t officially removed from the DSM until 1973. “So the idea that we’re now going to turn anti-LGBTQ ideas into psychiatric diagnoses doesn’t sit well with me.”

This, he added, could allow a future generation to “simply flip the switch” and pathologize homosexuality once again.

And although Drescher, who has practiced psychiatry for more than four decades, is not optimistic about changing the hearts and minds of today’s anti-LGBTQ church leaders who are “set in their ways,” he is still hopeful about the future.

“Younger religious people do not consider LGBTQ people as their enemies. They know them as their friends, their neighbors and their fellow congregants,” he said.

“So as the new generation grows up, LGBTQ religious people will be welcomed with more acceptance rather than being stigmatized and having to hide who they are, and hiding less of who you are means you can grow up feeling better about yourself and maybe experiencing less anxiety. , depression and other mental health problems.”

If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You also can visit SpeakingOfSuicide.com/resources for additional support.


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