Vol.:(0123456789) 1 3
Current Psychology
https://doi.org/10.1007/s12144-022-03086-y
Minority stress and the inner critic/oppressive sociocultural schema
mode among sexual and gender minorities
Bruno Luiz Avelino Cardoso
1
· Kelly Paim
2
· Ramiro Figueiredo Catelan
3
· Ethan H. Liebross
4
Accepted: 4 April 2022
© The Author(s) 2022
Abstract
Several adverse psychological outcomes among sexual and gender minorities (SGM) are well documented in the literature.
Notwithstanding the emergence of these data, SGM still receive little attention regarding psychological interventions, which
include Schema Therapy (ST), an emerging integrative psychotherapy approach. Even though revisions have been proposed
to expand ST’s understanding of emotional needs, schemas, domains, and schema modes, there is a gap in our understanding
of SGM. Based on that, the main goal of this theoretical essay is to propose a specifc ST intervention for SGM, addressing
sociocultural aspects aiming at promoting a healthy functioning that can interpose oppression and internalized prejudice.
To this end, we will present (a) the minority stress theoretical framework; (b) the ST model applying to SGM clients; and
(c) a few strategies of ST intervention for SGM clients, highlighting the need for strengthening individuals’ healthy schema
mode. It should be noted that, despite clinical work being relevant, there are social variables supporting and maintaining
maladaptive structures. We hope the therapeutic interventions proposed promote dialogue on this subject and encouraging
positive societal changes.
Keywords Schema therapy · Sexual and gender minority · LGBT · Intervention · Clinical practice
Connection to a social group is one of our most atavistic
survival mechanisms as a species. By building peer relation-
ships, individuals begin to understand the rules of a given
context and to identify themselves as part of a community.
In some cultures, moving away from a well-established
group pattern can lead to social exclusion and negative sche-
matic sensations. For example, in some religious contexts,
where there are rigid heterosexist norms, certain people are
labeled as “wrong” or “sinful” for having non-heterosexual
orientations. Experiencing these microaggressions invali-
dates individuals’ identities as they slowly come to internal-
ize societal prejudices (Lomash et al., 2018).
For decades, Western culture has been pathologizing the
existence of sexual and gender minorities (SGM) by judging,
labeling, and confronting any expressions and identities out-
side the heteronormative standard, that is, the idea that het-
erosexual people are superior to non-heterosexuals. Cultural
myths regarding “real men and women” are still prolifc and
predominant in many environments. After the events linked
to the Stonewall riots in 1969, in which the SGM commu-
nity of New York City rebelled against the intolerance and
prejudice towards them, social and professional movements
in the Psychology and Psychiatry felds began to pressure the
American Psychiatric Association to remove homosexuality
from the DSM, a decision that took form in 1973 (Drescher,
2015). However, the diagnosis status of homosexuality was
only ripped from the World Health Organization’s Interna-
tional Classifcation of Diseases in the 1990s, after mounting
pressure from the lesbian, gay and bisexual (LGB) move-
ment (World Health Organization, 1992).
Several adverse psychological outcomes among SGM
are well documented in the literature. A meta-analysis of
* Ethan H. Liebross
ethan.liebross@stcatz.ox.ac.uk
Bruno Luiz Avelino Cardoso
brunolacardoso@gmail.com
1
Institute of Theory and Research in Cognitive Behavioral
Psychotherapy, Avenida Jerônimo de Albuquerque, n.
25, Edifício Pátio Jardins, sala 417, Cohafuma, São Luís,
MA 65.074-220, Brazil
2
Brazilian Association of Schema Therapy, Porto Alegre,
Brazil
3
Institute of Psychiatry, Federal University of Rio de Janeiro,
Rio de Janeiro, Brazil
4
The Pennsylvania State University, State College, PA, USA