Transcending Pathological Accommodation: An Intersubjective Self Psychology Approach to Affirmative Therapy

Abstract Minority stress, including that experienced by sexual minority (SM) individuals, has been studied extensively in social and developmental contexts. Still, sexual orientation microaggressions (i.e., exposure to frequent heterosexist/homophobic language) can persist within the family structure. The focus of this paper is on the internalization of these experiences and the deleterious impact they could have on identity and developed systems of pathological accommodation, referring to attempts at rejecting one’s sexual identity to achieve acceptance from parents. A composite case is presented to demonstrate the effects of persistent discriminatory events within the family structure; this serves as a set of model scenes, that in aggregate, can lead to internalized homophobia. This paper explores a treatment process that integrates concepts of intersubjective self psychology and affirmative therapy to arrive at a theoretical approach that helps to mitigate internalized homophobia as can be present in gay identifying male clients.