Conclusion

Whatever the etiology of an individual's addiction, successful long-term recovery requires him to come to terms with himself and his/her homosexuality, and to learn to cope with life. In the treatment of the gay alcoholic, the therapist must not only keep perspective on the client as an addict, but also as a homosexual, with all that may mean to that person in his biopsychosocial setting. This includes being aware of the special challenges discussed above of internalized homophobia and the related low self-esteem, a lifestyle in which alcohol, drugs and gay bars may be central, and the particular problems of aging in the homosexual community. Especially, older gay men need information and encouragement to find the joys which can be contained in the second half of life (Smith, 1982).

The therapist must be sensitive to the gay subculture and to subcultural changes. The therapist must also be aware of the developmental tasks, as described by Erikson (1959), that gay men face throughout their lives. For instance, the stage of generativity can involve more than just parenting. Twelve-Step groups give ample opportunity, through 12th-Step work for mentoring and nurturing others, and for utilizing that most noble of the ego defenses: altruism.

References

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