Building A Practice That Embraces Sexual Diversity

It’s just a fact that there aren’t enough LGBTQ therapists to work with all the LGBTQ clients out there. Nor are there nearly enough polyam therapists to work with all the polyam clients, or enough kinky therapists to work with all the kinky clients. The same goes for every other marginalized population. 

The good news is that you don’t need to be a member of a marginalized population in order to work effectively with members of that population. You just need to be warm and compassionate, willing to listen and learn, and open to challenging some of your ingrained assumptions. 

Here’s my advice for building a practice that embraces sexual diversity:

  1. Invest in continuing education about diverse sexualities (LGBTQ people, asexuality, gender diversity, polyamory and other consensual non-monogamies, kink, etc.) Very likely you have a license with continuing education requirements; why not focus some of your continuing ed on expanding the range of populations you’re prepared to work with? 
  2. Use inclusive language on your website and your online profiles. Your potential clients pay attention to the language you use. They’re on the lookout for signs that you may or may not be prepared to work with them, and this is a great and easy way to signal that you are. For instance, it might benefit you to avoid using language that assumes your potential clients are heterosexual and in monogamous relationships. 
  3. Use inclusive language on your intake forms. For instance, on my forms, I have a write-in line for gender, and another for pronouns, so my clients don’t have to select from limited options or take on a label they don’t choose for themselves. 
  4. Be open about the fact that you’re still learning. Your clients don’t need you to be perfect, they just need you to be warm, compassionate, and open to learning and feedback. If you make a mistake, make a good repair. Let your clients know you welcome an honest conversation about their experience of working with you. If you use incorrect pronouns, and they correct you, respond warmly, with kindness and gratitude. If they give you any kind of feedback at all, take it seriously and honor it as a demonstration of differentiation of self. It is not easy to speak up in this type of situation. Your client is awesome for pushing back, and you should do all you can to make it easy for them to give you honest feedback. 


The world needs more therapists who are competent and confident working with marginalized groups of all kinds. This advice focuses on people who are marginalized on the basis of sexuality, but it holds true for any marginalized group. There are clients out there who need you, and you have an opportunity to make a big difference. Go for it!

Spotlight on Hinges: A Polyam Relationship Role

One of the most common polyam relationship structures is a V. That describes one person (the center point of the V) with two partners (each end point of the V). Those two partners may have other relationships, or they may not. But for our purposes, we’re just considering the V shape. In particular, I want to talk about the person at the center of the V, also known as the hinge. 

The hinge role comes with particular challenges. It requires a very sophisticated ability to consider and balance the needs and desires of two different individuals, who may or may not know each other, and may or mat not like each other, while still maintaining one’s sense of self. It is very easy for hinges with weak emotional boundaries to end up in a situation in which they’re just running back and forth, trying to please everyone and meet everyone’s needs. In addition to completely exhausting themselves, this strategy tends to create a sense of instability and insecurity in both of their partners. The saying “you can please some of the people some of the time, but you can’t please all of the people all of the time” is very relevant here. This is a situation that can really benefit from strength and leadership.

Rather than trying fruitlessly to please everyone, hinges will need to proceed with the expectation that at times they will have to disappoint one or both of their partners. They will need to be able to get clear about what they believe, separate from their partner’s expectations for them, and take responsibility for their own preferences and choices rather than pass the buck. Think of the uncomfortable tension between partners that can arise from a statement like this: “Susie needs me to be home this Friday, so I have to cancel our date.” Compare that to this: “Susie and I had a good talk the other night, and I realized I have not been present enough in that relationship lately. I decided I want to spend Friday with her this week. I’ll miss you, but I think this is the right thing to do.” This is a challenging balancing act, and it requires tons of differentiation of self.

If you are working with a hinge, assess the aspects of differentiation of self. Identify which skills they are struggling with, and help them grow in those areas. Signs of insufficient differentiation in hinges include:

  • People-pleasing behavior or avoiding the hard conversation
  • Deception or lies of omission 
  • A “my way or the highway” stance
  • Excessive anxiety about situations in which partners’ interests conflict 
  • Lack of willingness to recognize personal choice, and take responsibility for decisions

If you are working with a hinge who is struggling, you have an opportunity to make a big difference in the relationship system. Depending on how the hinge handles things, they can bring a lot of stability to the system, or they can end up sowing tons of chaos. Provide your clients with psychoeducation about why differentiation is essential to successful polyamory. For more on building differentiation of self, check out these past posts: 

Three Aspects of Differentiation of Self: Part One

Three Aspects of Differentiation of Self: Part Two

Three Aspects of Differentiation of Self: Part Three

What I Learned From Writing A Book

I have some exciting news: I’m writing a book about working with polyamorous clients in therapy! I haven’t talked about it much, but now that I’m finally coming down the home stretch, I’ve been spending a lot of time thinking about the process of writing, and what I’ve learned over the past two years I’ve spent working on my manuscript. 

Here’s what I’ve learned from the process of writing a book:

  • Your audience may evolve as you write. I began writing it because I wanted to address what I see as a pressing need: the fact that it’s very difficult for people in non-monogamous relationships to find therapists who are prepared to work with them. I want my book to primarily serve therapists who are interested in learning more about working with polyamorous clients. Still, the more I work on it, the more I hope that it can also be a resource for polyamorous people who don’t have access to polyam-friendly therapy, or who don’t have access to therapy at all. I feel that I am writing in the midst of a cultural shift, as polyamory becomes a much more visible part of our culture. It will be very interesting to see how things shift in the coming years, as more people decide to explore polyamory and more therapists find themselves working with polyamorous clients. 
  • There’s no better way to clarify what you think than by writing several hundred pages about it. The process of writing has forced me, over and over again, to clarify my points, rethink my assumptions, and add depth to my thoughts. I want to make sure I’m offering my best work, and that process has involved a lot of reflection, self-critique, and many rewrites. What I’ve found is that the process of deepening my writing works like a spiral, which mirrors the type of personal growth experience we all deal with when working with a challenging impasse, or trying to change ingrained habits; we revisit the same territory, deepening our understanding each time. 
  • You can always go deeper, and there’s a fair amount of controversy. Polyamory is a huge topic. At a certain point, I realized that the more I wrote, the more the topic expanded, and increased in complexity. It’s exciting to realize that there’s such fertile ground for future exploration; this topic is very deserving of deeper discussion. I have a lot of teaching and speaking engagements in the upcoming months; I hope if you come see me, you will share your thoughts. I’m very much enjoying being in a deep dialogue on this topic!