COUNSELING APPROACHES AND RELATED ISSUES IN SEXUAL RELATIONSHIPS Rafidah Aga Mohd Jaladin Abstrak Secara khususnya artikel

ini berfokus kepada hubungan homoseksual di kalangan wanita, iaitu lesbianisme. Masalah golongan minoriti lesbian memang sukar difahami kerana lesbian merupakan 'golongan yang tidak diiktiraf' di negara kita. Namun, untuk menjadi seorang kaunselor yang berkesan, perlu ada persediaan diri dan kelayakan profesional yang mencukupi untuk memberi khidmat kaunseling kepada mereka yang memerlukan. Masalahnya tidak ramai yang tahu latar belakang kehidupan lesbian dan bentuk permasalahan yang dihadapi oleh golongan ini. Kertas ini cuba memberi pendedahan tentang kehidupan dan latar belakang lesbian di dalam masyarakat kita. Tumpuan utama akan diberikan kepada pendekatan yang boleh digunapakai untuk memberikan khidmat kaunseling kepada golongan lesbian. Isu yang berkaitan dengan etika dan nilai masyarakat dalam membantu klien lesbian turut dibincangkan. Introduction In the Malaysian context, it is generally unknown how much people know about lesbianism and to what extent they would accept the lesbians' existence and their unique lifestyle. It is undeniable that an abundance of information about lesbianism exists on the internet, in newspapers, magazines, films, novels, books, and other sources. However, we do not know whether this information is meaningful to Malaysian people. Being in a Muslim majority country with strong traditional values, most Malaysians tend to view lesbianism as a disgraceful and shameful act. Malaysian society in general also rejects homosexuality. The phenomenon of lesbianism can be detected if one truly pays attention to the "hidden" issues normally discussed in newspapers or magazines. The most frequently sought-after columns that lesbians use as a medium of expression are "Bisikan Rasa", "Nostalgia", "Nukilan Rasa" and the like. Lesbianism has been known and practised secretly among a minority of female students at boarding schools (especially at segregated schools), and among artists, police and army officers, and even among professionals and intellectuals. How to understand lesbianism in the Malaysian context and how to deal with the lesbian community are the major concerns of people in the helping profession. It is also the focus of this paper. This paper is aimed at describing lesbianism with special focus on the various approaches for counseling lesbian clients. Some ethical and value issues in counseling lesbian clients are also discussed to help counselors and counselor trainees to be aware of, and predict, the potential problems.

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they may also be women who are very proud of acting and feeling like men without a need to change their sexual organs (Rozienah Husain. 1988). 3. on the other hand. and (2) they have gender disorder because they are attracted to females only in terms of obtaining love. They differ from the first two categories because they are only interested in women (physically and sexually). and in expressing their feelings. The homosexual type refers to women who have sexual relationships with other women. and Homosexual.refers to women who accept themselves as lesbians and live like lesbians and who can easily adjust themselves to their environment. An interview with a registered counselor (Hushim Salleh. Adaptive lesbianism .Definition and Female Sexual Identity Problems The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies lesbians and gays in Group A referring to sexual disorders due to sexual identity problems. are women who feel like men and want to change their sexual organs in order to feel complete (Meriam Omar Din. However. Secretive lesbianism .refers to women who secretly practise lesbian actrvitres.refers to women who are in great need of finding another woman to sleep with. 2. they are proud of their lesbian lifestyle. or fear. Types of Female Homosexual In Malaysia. worry. 2002) in Malaysia was conducted and it was hypothesized that the roots of lesbianism are two-fold: (1) these women have gender identity crisis and seem to not know themselves completely. there are six types of female homosexual behavior that counselors or counselor trainees should be aware of (Rozienah Husain. Transsexual. mak nyah or pondan (Mohd Tajudin & Mohamed Mansor Abdullah. sexual identity disorders can be classified into three different types: Transverse-Style. 1999). 2001). Addicted lesbianism .refers to women who portray themselves as lesbians without shame. Mat Saat Bald (in Rozienah Husain. They accept themselves as women and do not want to be associated as men (King & Bartlett. 4. 1988). Sometimes. 1988). This group of women is also sexually interested in men. According to Dr. 2001). in fact. Obvious lesbianism . Transsexuals. Transverse-style refers to women who like to dress and act like men but have no intention of changing their sexual organs. sexual satisfaction. married lesbian women carry out lesbian activities without their husbands' knowledge. They may know they are females but they do not understand their sexual desires. They may act like ordinary women but their object of desire is another woman. Only those very close to the women know about their hidden agenda. These are: 1. They are also known as heterosexuals or bisexuals or locally known as bapok. 116 Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya . Lesbians fall under this category of gender identity disorder.

Their sexual relationship does not involve usage of artificial penis or other sexual gadgets because most lesbians confess that orgasm with female partners is much more satisfying than with male partners (Rozienah Husain. for example cross-dressing. A child's first contact and interaction is with parents. Prostitute lesbianism . even though sexual in nature. 1999). 1988). Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya 117 . the ego-dystonic lesbian is sexually attracted to another woman but at the same time feels guilty about it. If the woman found her female partner more sexually satisfying. 6. 2001). She feels forced to act and behave like a lesbian because of her sexual instinct.refers to women who seek female partners while at college or when there are no men around. Lesbian Lifestyle Lesbian couples behave like spouses in a house. Noriah Ishak. Contributing Factors in Lesbianism According to Mat Saat Baki (Rozienah Husain. and about 90% will behave like ordinary women and have relationships with men. In Malaysia. Seasonal lesbianism . About 10% of them will remain as lesbians after school or college life. the child might use this experience to guide her future actions. there are five factors that contribute to lesbianism. and this relationship will determine the child's identity and social interaction in later years. 1988) and other experts in the area (Meriam Omar Din. One will take the "masculine" role and the other will take the "feminine" role. Lesbians' lives are established by their stance and this can be classified into two types: egosyntonic or ego-dystonic lesbianism. the woman might tum to another woman for sex.5. If parents encourage the child (intentionally or unintentionally) to behave inconsistently with her gender. Those women who have had experience of sex with both male and female can develop a personal preference for the better partner. Lesbians in the relationship have their own social roles. This is the type of lesbian that can be bought when needed. 2001. the lesbian lifestyle is very difficult to detect compared to gays' because lesbians are perceived as normal women living together as housemates and their relationship.refers to women who have sex with other women as a means of getting money. Second is the woman's sexual experience (Diamant. Due to this guilt. she may no longer want to have sex with a man. is perceived as best friends. then there is a possibility that it will continue. The ego-syntonic lesbian feels comfortable with her life as a lesbian. If the first was with a female partner. Sometimes this applies to the woman's first sexual experience. On the other hand. Most lesbian clients in Malaysia have the egodystonic stance. she views herself as abnormal and is always in a state of fear. Or if the first was with a man and it was a bad experience. she does not worry about being lesbian and happily accepts herself and enjoys her life as a lesbian. First is the woman's childhood experience. but they behave like normal women outside. Sex roles are played accordingly and interchangeably.

University of Malaya. Axis III (general medical conditions). estrogen) but more male hormones (testosterone) and this causes the female to act like a man. Counseling Lesbian Clients from Several Approaches In the Malaysian Counseling Association (PERKAMA) 10th Convention held on 12-13 May 2001 at the Academy of Islamic Studies. she cannot be labeled as a lesbian until the woman admitted it herself (Mat Saat Baki in Rozienah Husain. However.g. Malaysian counselors and psychiatrists presented several approaches in counseling clients with sexual identity problems such as lesbians. it means that she has an inclination towards lesbianism. If a woman was raped by her father. Axis IV (psychosocial and environmental problems).g. Counselors or other professionals should be cautioned that if a woman experiences any of the abovementioned factors. 2001). the non-traditional approach. according to Hushim Salleh (2002). Four approaches are relevant to the topic of interest: the traditional approach. if a woman experimented having same-sex sexual experience. The last factor is the woman's traumatic experience during childhood or adolescence. brother or other male family member. she may generalize her hatred and hate not only them but the rest of the male population. for example. and she liked it a lot. 118 Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya . 1988). The main reference in counseling a lesbian client is the DSM-IV because this manual classifies all the symptoms a client may portray into five axes: Axis I (clinical disorders or other conditions that may be a focus of clinical attention). Fourth is the experimental experience of the woman. and influence of parenting style (e. she might continue doing it. Lesbians and gays fall under the category of gender identity disorder. The convention theme was "Managing Gender Identity Problems: Collective Responsibility". are early exposure to socialization (coming from a female dominated family or attending girls' boarding schools). The Traditional Approach Psychiatrists normally use this approach because it is heavily based on the medical model where symptoms are the main indicators of the client's problem. having autocratic parents who restrict their daughters' socialization with male friends). Axis II (personality disorders or mental retardation). Each axis explains the type of disorder or mental illness experienced by patients or clients in the hospital or counseling setting (Mohd Tajudin & Mohamed Mansor. The following section shall discuss the gist of these approaches. object-relation therapy.Third is the woman's hormonal regulation. Some women have less female hormones (e. and the Islamic approach. and Axis V (global assessment of functioning). Other contributory factors.

they can encourage and help the lesbian clients to make bigger changes in their lives. They use the manual as reference in addition to the humanistic approach in their counseling process (Mohd Tajudin & Mohamed Mansor. The non-traditional approach discusses the client's case based on the following five factors: a. If counselors are aware of these small changes. b. gender role analysis. This exploration stage is crucial because the clients will disclose their history: when. The changes are observed in terms of their coping mechanism.The Non-traditional Approach Counselors and psychologists who use the DSM-IV manual as reference normally use this approach. founded by Rogers. beliefs. Hushim Salleh (2002) reported that lesbian clients he helped had problems with their sexual orientation. 2001). both counselor and client would discuss the pros and cons of each alternative so that the client can take appropriate action. However. d. (3) encouraging clients to share their subjective experience. Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya 119 . Meriam Omar Din (2001) suggested a typical Person-Centered Counseling (PCC). Counselors can thus prevent clients from committing further self-destructive behaviors that invite permanent consequences. followed by generation of alternatives. The final stage would be (5) helping clients to tackle "here-and-now" problems in a continuous manner so that they understand the actual problem. 2002). life stage developmental approach. trauma analysis Mohd Tajudin and Mohamed Mansor (2001) suggested that all these factors can give holistic information on the nature of the client's problem. locus of evaluation. This is different from the traditional approach used by most psychiatrists because the non-traditional approach does not totally rely on the manual to identify the client's problem. how and why they were involved in lesbianism. thoughts. c. where. In the next stage. physical appearance. the counseling process will start with rapport in order to establish truce before focusing on the exploration stage. ecological analysis. Thus. and e. and communication skills. This approach has five requirements: (1) accepting and being accepted. (4) detecting clients' awareness in terms of the changes that happened to them. (2) building the clients' trust. Then comes the problem identification stage. then the best theory to use is Rational Emotive Theory (Hushim Salleh. cross-cultural approach. If the problems are based on the client's sexual orientation.

while remembering the old self' (Noriah Ishak. (7) identify the client's needs. The middle therapy is about helping the client gradually see. "seperti menatang minyak yang penuh" (Noriah Ishak. counseling a lesbian client using the Islamic perspective may cause some difficulties because of the conflict between Islamic teachings and lesbianism. i. this approach may be of help because the goal of the client and the counseling process would coincide. p.IOl). and oneself to herself. explore alternatives. and (11) end the counseling process once the client is ready to act and change. the significant others. p. It takes into account the self. and plan strategy. Specifically. This interaction influences and shapes her external and internal life. 2001. 120 Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya . (4) assist the client in exploring herself. Sometimes. (10) help the client to gain insight into her problem. (5) express understanding and empathy. this approach is used to explore the clients' internal psychological process that refers to their life meanings. middle and final therapy. understanding. This interaction brings a unique meaning to the person experiencing it and can only be explained by the person. The therapy uses specific concepts such as the third reality (referring to the client-counselor relationship). understand. (6) guide the client's exploration and help her to understand. and then reconstruct and change old meanings about oneself to others. an object-relation therapist must focus on the theme of the story presented by clients in the counseling session because this theme has its own unique meaning from the clients' perspective. The therapy also assumes that the individual's meaning of life indicates the individual herself. (8) help the client to set goals. The Islamic Perspective Islam does not allow lesbianism in Muslim society because "Allah the Almighty condemns those men who appear like women and those women who appear like men" (Asmungi Sidek. 2001. However. working models (referring to an individual's cognitive schema).Object-Relation Therapy Object-relation therapy differs from other therapies in terms of understanding the clients' issues and problems. and learning about the client. attachment (referring to early childhood attachment and adult attachment). (9) encourage the client to act and bertawakkal (have absolute trust in Allah). p. building trust. 2001. The counseling process has three stages: initial. The therapy assumes that each meaning assigned to life episodes is due to the individual's interaction with others. if the lesbian client would like to change her sexual orientation because of guilt feelings. Norazman Amat (2001) presented 11 steps of the Islamic counseling process as guidelines for Muslim counselors: (1) set proper goal. Thus. challenge. Thus. the counselor may say "it is okay to be the new you. (3) establish therapeutic counseling relationship with client. and how these two interact. 11). (2) say prayers to Allah.?). and holding environment (referring to the way the counselor should treat the client. The final therapy is where the counselor encourages the client to understand the new internal working model and to use the model as a guide to change. tolerate.e. The initial therapy focuses on creating a conducive environment.

workforce or relationship. 1988). Besides ethical issues. The ethical codes of the American Counseling Association (ACA).. and the National Association of Social Workers (NASW) clearly state that discrimination on the basis of minority status . 1999). Therapists must confront their personal prejudices. prejudice. Is the client expressing a feeling? Is the declaration based on experiential factors? Is it based on fear? All are possible because lesbians have had different life experiences. Corey et al. ethnicity. children. A number of special situations are likely to produce "a crisis" or need for counseling (Weinstein & Rosen. Lesbians are known for their desire for a long-term relationship and sometimes this ends up in anguish over the dissolution of a relationship. it is important to explore and understand what is meant by that declaration. Lastly. the lack of support for grieving. and stereotypes regarding sexual orientation" (p. Counselors who have negative reactions to homosexuals have to be careful not to impose their own values on their clients because they are bound by ethical and moral obligations. Thus. With the reality of these diseases. the religious and Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya 121 . the American Psychological Association (APA). In addition.be it race. lesbians often bring to counseling the struggle between concealing their identity and "coming out" (Taylor. The first involves the decision to "come out". for example. or sexual orientation . facing discrimination. At the same time. myths. gender. counselors need to have sufficient knowledge and skills to provide sensitive treatment to lesbians. In most cases. value issues also arise in counseling lesbians. lesbians often face the loss of friends or partners. (1998) commented. and oppression in a society. Secondly. they may project their misconceptions and their fears onto their clients. but they are exacerbated by the lack of societal support. 1970). Counseling lesbian clients may become more challenging when it involves value conflict between religion and homosexuality issues.lOO). Counselors should not take such labels at face value and at the same time should not negate their possible validity. employer or anyone. Weinstein and Rosen (1988) contended that when a person comes in for counseling and states that she is a "homosexual". "Unless counselors become conscious of their own faulty assumptions and homophobia. Thirdly. Weinstein and Rosen (1988) identified four special situations in counseling lesbians. Coming out refers to sharing one's identity with others such as parents. lesbians may have problems with sex-related diseases such as AIDS and genital human papillomavirus infection in women who have sex with women (Marrazzo. 1998). and also the fear of infection.is unethical and unacceptable (Corey et al. A client's religious values can be a source of conflict to a person who is struggling with sexual identity issues.Ethical and Value Issues in Counseling Lesbian Clients Lesbians are a minority group and working with them is challenging especially to those with restrictive attitudes and values towards homosexuals (Peterson. 2000). the problems of loneliness and grief are common among lesbians. friends. These problems are not unique to homosexuals. (1998) cautioned all counselors to be aware of the conflict between religion and homosexuality because it may pose problems for both clients and counselors. the confidentiality in dealing explicitly with the clients may cause some problems because laws in the various states differ with respect to the confidentiality of professional records. fears. spouse. Corey et al.

that is. 1986). 1985). In view of this conflict. and following the counseling association guidelines. myths. Most proposed quite similar strategies. These guidelines are consistent with the goal of helping the lesbian client advocated by most mental health professionals. 1996). Specifically. state. Schneider & Tremble. to accept her sexual orientation and to cope with the possibility of stigmatization (Schneider & Tremble. regional. Studies have shown that workshops developed to enhance expertise of service providers who work with lesbian clients are proven effective. many writers have voiced their concern: Is it ethical to counsel lesbian clients without having received specialized training with this population? Implications for Counselors Researchers have given many recommendations to address the issues in counseling lesbian clients. Most experts in this field suggest that counselors increase their awareness of ethical and therapeutic considerations in working with lesbian clients by taking advantage of continuing education workshops sponsored by national. they proposed the following guidelines when counseling lesbian clients: (1) to change counselors' attitudes toward lesbians. and (5) to continue educating themselves about lesbian identity development and management (Eliason. 1988. Conclusion To understand lesbianism in a society that prohibits the practice of lesbianism is not an easy task because of the many value issues and conflicts a counselor has to consider. (3) to confront counselors' personal prejudices. always consulting other experienced experts. We cannot always be the best in helping others but we can always try the best possible way to help them as long as we adhere to ethical guidelines.. However. such as to first critically examine any myths and misconceptions they hold about lesbians. fears. 1986). (4) to acquire specialized knowledge about the lesbian population in general and about the meaning of a lesbian identity to particular individuals (Schneider & Tremble. (2) to acquire a body of knowledge about community resources for these clients. and stereotypes regarding sexual orientation (Weeks. 1986). Their benefit is not just in helping lesbian clients but they also contribute to changing society's stereotypes and prejudices toward this minority population so that lesbians get societal support when needed. 1998.moral values of counselors can also pose problems in maintaining objectivity when working with clients who want to explore their sexual feelings. 122 Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya . and then to obtain specialized training in working with lesbian clients. and behaviors. Weinstein & Rosen. attitudes. and local professional organizations (Corey et al. there are ways to prepare ourselves for helping a lesbian client such as by fully understanding the code of ethics.

King..L. 12 (3).2730-2736. Norazman Amat (2001). J. Marrazzo. Persatuan Kaunseling Malaysia. 175 (8). 127-132. M. 183 (3). Masalah Pendidikan Jilid 26 Hakcipta@2003 Fakulti Pendidikan Universiti Malaya 123 . British psychiatry and homosexuality. Terapi pengurusan kecelaruan gender berasaskan DSM-IV: Satu diagnosis ringkas menggunakan pendekatan "Non-Traditional". 2001). Pendekatan dan proses kaunseling kecelaruan gender. The British Journal of Psychiatry. CA: Brooks/Cole. Kecelaruan gender dan perspektif agama Islam.References Asmungi Haji Mohd Sidek (2001). M. J. 2001). A. Persatuan Kaunseling Malaysia.. Meriam Omar Din (2001). & Mohamed Mansor Abdullah (2001). Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei.S. Scranton. Archives of Internal Medicine. Counseling and values: A philosophical examination. Persatuan Kaunseling Malaysia. G. Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei. Issues and ethics in the helping professions (5th ed. & Bartlett. 2001). Peterson. Noriah Mohd Ishak (2001). M. Terapi kecelaruan gender (Terapi "Object-Relation"). Pacific Grove. Diamant. Journal of Nursing Staff Development. Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei. A. 159 (22). Lesbians' sexual history with men: Implications for taking a sexual history. Mat Saat Baki (2001). 2001). 2001). (1999). Mohd Tajudin Haji Ninggal. and bisexual people: Reducing negative stereotypes via inservice education.. Corey. Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei. Eliason. 106-113. J. Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei. American Journal of Obstetrics and Gynecology. Genital human papillomavirus infection in women who have sex with women: A review. gay. (1996). Pengurusan kecelaruan gender dari perspektif Islam. (2000). Persatuan Kaunseling Malaysia. (1970). Persatuan Kaunseling Malaysia. Konvensyen PERKAMA ke 10: Kaunseling Kecelaruan Gender (12-13 Mei.A.). Persatuan Kaunseling Malaysia. 2001). & Callanan. P. (1998). (1999). Ujian psikometrik identifikasi kecelaruan gender. 770774. Working with lesbian. PA: International Textbook Company. Corey.

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