Bisexuality refers to an orientation towards both men and women, although this term can be expanded to include non-binary individuals who do not fit into these gender categories. Bisexuals may experience stigma from various sources, including heterosexual people who question their commitment to one partner, homosexuals who view them as confused, and even within the LGBTQ community where they are viewed as promoting bisexual visibility for its own sake. This negative attitude has been linked to higher rates of depression, anxiety, substance abuse, suicidality, and poor health outcomes. Therapists can play a crucial role in helping clients process internalized stigma and develop integrated, authentic identities, but which approaches are most effective?
Evidence-based therapy is considered the gold standard for mental health treatment because it relies on scientifically supported interventions. Cognitive Behavioral Therapy (CBT) teaches clients to challenge negative thoughts and behaviors, replacing them with more constructive ones. Mindfulness-Based Stress Reduction uses meditation to help clients focus on the present moment without judgment, reducing rumination about past or future events. Dialectical Behavior Therapy focuses on improving emotional regulation through mindfulness and skills training. Acceptance and Commitment Therapy teaches acceptance of uncomfortable thoughts and feelings while committing to positive actions that align with personal values. These approaches have all been shown to effectively reduce internalized shame and promote self-acceptance, making them valuable tools in working with bisexual clients.
Some therapies use a narrative approach based on theories like Social Constructionism, Feminist Theory, or Queer Theory. These frameworks emphasize the social construction of identity rather than innate biological traits, encouraging clients to recognize how their experiences shape who they are. They may also explore power dynamics related to sexuality, such as how societal norms reinforce heteronormativity at the expense of non-heterosexual individuals. Some clinicians incorporate sensory-based techniques into this work, guiding clients to connect deeply with their physical bodies and cultivating self-love through touch, movement, or creative expression. Others use a relational model where clients develop new relationship patterns by practicing vulnerability and authenticity in their interactions with others.
It is worth noting that no one approach works for everyone, so therapists must tailor treatment plans to each client's needs. Bisexuals may benefit from combining multiple modalities depending on what resonates most strongly with them.
Someone drawn to a spiritual perspective might prefer a more holistic blend of practices while another who struggles with anxiety may find CBT particularly helpful.
The goal is to help clients feel empowered in their bisexuality and live authentically within diverse communities.
Evidence-based therapy has proven effective in treating many mental health issues, but it is essential to consider individual differences when working with bisexual clients. Narrative approaches can be helpful in challenging stigma and promoting self-acceptance, while sensory-based practices encourage connection with physicality and intimacy. Therapists should combine these strategies to create a personalized plan tailored to each client's unique experience and goals. By doing so, they can play an important role in supporting bisexual individuals as they navigate complex social norms and develop integrated identities that reflect their true selves.
What therapeutic approaches are most effective in helping bisexual clients process internalized stigma and develop integrated, authentic identities?
The most effective approach for helping bisexual clients process internalized stigma and develop integrated, authentic identities is cognitive behavioral therapy (CBT), which focuses on changing negative thoughts and behaviors through goal setting and skill building. This approach can help clients challenge their negative self-talk and internalized biases while developing healthy coping mechanisms to manage stress and anxiety related to identity development.