Queer Traumas, Queer Strategies: Deploying Prolonged Exposure Therapy Within a Queer-Affirmative Framework for Treatment of PTSD and Its Reactivation in a Young Soldier

This case provides a flat-footed model for how to conduct Queer-affirmative clinical work and achieve recovery, successfully treating PTSD, Queer traumas, and the commonly invisibilized stressors experienced by Queer people, including LGBTQ + Veterans. This is the case of a young gay solider, Felix, who presented for two rounds of trauma therapy: first for combat-related trauma and then second for a sexual assault and reactivated posttraumatic stress. The principal method deployed and adapted was Prolonged Exposure therapy (PE); intentionally considering the low reliability in defining reactivated trauma as well as in models for Queerly adapting this clinical method. PE here was overlayed with and fortified by a Queer-affirmative framework, largely architected by Queer Theory-driven understandings of identity and the social world as well as an empirical appreciation for chronic gender/minority stress. In both treatment episodes, this affirmative adaptation of this exposure therapy was successful in moving the client’s PTSD into remission as well as increasing his self-actualizaiton and positive, compensated sexuality and gender identity. Several essential clinical implications and considerations for practitioners are provided, including instituting Queer trauma-informed and HIV-informed frameworks, increasing clinicians’ self and social reflections as part of their Queer practice, drawing on the expertise of interdisciplinary approaches and methods in doing Queer work, purposefully deploying the power of language, and focusing on the shared foundational issue here that links, but synergizes, the psychological processes at play and on-going Queer experiences: in-/validation.