Homophobia and shame in women struggling with sexual orientation and borderline processes: A self psychology perspective

Nancy S. Davidson (1995)

Women struggling with their sexual orientation often bring to therapy a wide range of prior narcissistic injuries. The past literature in this area has identified the need for clinicians to be adept in differential diagnosis and to distinguish between "coming out" material and symptoms of personality disorder. This paper specifically focuses on the female client struggling with both her sexual orientation and severe early narcissistic injury. A Self Psychology perspective is used to understand the borderline process and its link with a shamed core sense of self. A clinical case study examines how the individual with a shamed core self struggles with the shame of internalized homophobia and the stigma of a lesbian identity. The author postulates that such clients confuse the shame they experienced from early childhood with the shame of struggling with a lesbian sexual orientation. As a part of this process, the borderline defenses become manifested within the client's internalized homophobia. In order to help the client acquire a positive lesbian identity, the therapist must help the client disentangle both her profound childhood shame and borderline defenses from her internalized homophobia. The author reviews the literature that is necessary for the clinician to guide a client through this complex process, discussing Self Psychology, shame, internalized homophobia, and stages of lesbian identification. The case study is presented within the context of this literature.