Journal of Rural Community Psychology - The Use of Erikson's Theory with Gay Men

The Use of Erikson’s Developmental Theory with Gay Men from Rural Communities

Gay men face many challenging issues in their lives. For instance, they may deal with a variety of mental health issues and have difficulty with the development of a stable identity. Though these difficulties arise for many gay men, those who live in rural areas may feel especially burdened by such problems. Past research on these issues will be reviewed. Erikson’s theory of life span development is explored and how the theory can be applied to gay men. One hypothesis examined is that middle aged or older gay men, especially those from a rural community, may reverting back to behaviors related to previous stages of Erikson’s theory (specifically: identity vs. role confusion and intimacy vs. isolation) once they begin to identify as gay and have intimate relationships with those of the same sex. Research considerations are discussed, as well as recommendations for mental health professionals working with rural gay men.

The Use of Erikson’s Developmental Theory with Gay Men from Rural Communities

Life span development has been examined by many theorists (Cass, 1979; Coleman, 1981; Gill, 1999; Minton & McDonald, 1984; de Monteflores & Schultz, 1978; Richardson & Hart, 1981). One of the most influential life span development theorists is Erik Erikson. A student of Freud, Erikson believed that although biological and physical aspects of development were important, the social environment had a greater influence on the developing individual. This led to the creation of his eight-stage theory of psychosocial development (Kail, 1998). This theory proposed that an individual progresses through a series of eight stages throughout that person’s life span. Van Manen and Whitbourne (1997) explain that during each stage the person is faced with a challenge that must be met in order to obtain the goal of that stage. Furthermore, if the person does not meet the challenge of a particular stage, the individual will still move through the stages, but will continue to face obstacles when dealing with situations that are relevant to that stage. These stages are outlined in Table 1.

While all eight of Erikson’s stages are important in life span development, the later stages are more relevant to the development of adolescents and adults. For example, in stage 5, an adolescent is faced with identity versus role confusion. This is when a person begins to feel the need to integrate partial identifications into a cohesive sense of self (Lytle & Bakken, 1997). Since theories like this have arisen, adolescent development has become synonymous with the task of forming a unique and self-chosen identity (Gill, 1999). This can be a very difficult process for some people, while others seem to easily move to the next stage. It is thought that those who “possess both feminine and masculine gender-role behaviors [are] more likely to display adaptive behaviors, high self-esteem and identity achievement” (Lytle & Bakken, 1997, p. 176). In contrast, those who possess uncharacteristic masculine or feminine gender-role behaviors may have more difficulty in obtaining a strong sense of their identity.

A major criticism of Erikson’s developmental theory is the extremist thinking used when the theory was developed. Erikson believed that a person either resolved a conflict and obtained the characteristic goal of that stage, or the person did not resolve the conflict and was at the opposite pole of that stage. Erikson neglected the possibility that there are varying degrees of resolution for each conflict. Some people are able to move smoothly through the eight stages of development while others may have more difficulty. Therefore, his theory may not be an appropriate way to explain the development of all people. Although there are some criticisms about Erikson’s theory, an adjusted view of his theory is highly applicable to the psychosocial development of gay men.

Before we can explore how this theory can be used with gay men, we need to look at various factors that can influence a gay man’s development. For instance, gay men may face certain mental health issues. There may also be difficulty with the development of a stable identity for gay men. These issues will be reviewed. Although, there are many difficulties that arise for gay men throughout the country, those who live in rural areas may have additional challenges and feel more overwhelmed when dealing with these same issues. The additional problems that arise for those in rural areas may include increased isolation, lack of resources, discrimination, homophobia and violence. These issues for rural gay men will also be reviewed.

Treatment difficulties. In the past it was problematic for gay men to seek mental health services because of the diagnosis of homosexuality as a psychological disorder. Until 1973, the Diagnostic and Statistical Manual of Mental Disorders, second edition (DSM-II) included homosexuality as a disorder. However, it has since been accepted that homosexuality is not a mental disorder, but rather an inborn characteristic of a person and that “it does great harm to label conditions as pathological if they are not” (McConnell, 1994, p. 115).

A mental health professional’s attitudes and quality of care for gay men can be a hurdle for those seeking services (Doucett, 1999; Foster, 1997). Lindhorst (1997) states that because of their sexual orientation gay men experience discrimination from mental health professionals. Lindhorst goes on to say that social workers, more so than any other mental health professional, have homophobic reactions to gay men. According to Doucett (1999) mental health professional’s knowledge about gay issues, such as psychological and socio-cultural problems for this group, has progressed over the past decade. Mental health professionals are also reporting a higher level of comfort with gay clients. However, there are still incidents of biased and inadequate care for gay men. Identified characteristics that influence the quality of care for gay men included a mental health professional’s lack of education about the theories concerning the etiology of sexual orientation and a lack of social affiliations with gay men. This supports the American Psychological Association policy statement that quality of treatment for gay men is correlated with social comfort.

Beyond difficulties with treatment, other problems that can impact the mental health of gay men include depression and suicidal ideation, substance abuse or dependence, homophobia, and discrimination (Mays & Cochran, 2001; Sullivan & Wodarski, 2002). We will provide a brief overview of important findings related to these problem areas and encourage the reader to explore the wealth of research that has been conducted on these topics and the impact they have on gay men.

Depression and suicidal ideation. If a gay man is not able to be himself in public situations, he may develop feelings of loneliness, worthlessness, low self-esteem, and increased internalized homophobia (D’Augelli, Grossman, & Hershberger, 2001; Muchmore & Hanson, 1990). Other researchers (Bagley & Tremblay, 2000; Westefeld, Maples, & Buford, 2001) confirm this by stating that gay students are more depressed, lonely, have fewer reasons to live, and are at least four times more likely to attempt suicide than a control group of college students.

The high prevalence of suicide attempts among urban and rural gay youths ranges from 12% to 42% (D’Augelli, Hershberger, & Pilkington, 2001; Paul, Catania, & Pollack, 2002; Waldo, Hesson-McInnis, & D’Augelli, 1998) with up to 50% contemplating self-harm (Rivers, 2001). Most who attempt suicide make their first attempt before the age of 25 (Paul et al., 2002). The attempts mainly followed awareness of same-sex feelings and before disclosure of sexual orientation to others (D’Augelli et al., 2001).

Risk factors for gay men who attempt suicide include problems related to sexual orientation, parent’s reaction, a hostile environment, and victimization because of sexual orientation (D’Augelli, 2002; Paul et al., 2002). D’Augelli (2002) goes on to report that more than three quarters of his participants had been verbally abused, fifteen percent had been physically attacked, and more than one third reported losing friends because of their sexual orientation. The loss of friends is among one of the strongest predictors of suicide attempts (Hershberger, Pilkington, & D’Augelli, 1997).

Substance abuse or dependence. Problematic alcohol and substance use occurs with gay men. Alcohol use among gay men ranges from 73.7% to 85% (Stall, Paul, & Greenwood, 2001; Skinner, 1994). Significant levels of “high-frequent” alcohol use were disclosed by 8%-13.6% of participants and 12% report three or more alcohol-related problems (Greenwood, White, & Page-Shafer, 2001; Stall et al., 2001).

Several researchers (Greenwood, et al., 2001; Hughes & Eliason, 2002; Rosario, Hunter, & Gwadz, 1997; Skinner, 1994; Stall et al., 2001) have found that recreational drug use is also highly prevalent among gay men. For example, 37.5% of gay men admit to smoking marijuana (Skinner, 1994). Also, up to 43% of participants engage in multiple drug use (Greenwood et al., 2001). Additionally, drug abuse symptoms were common (Rosario et al., 1997).

Homophobia. Homophobia is a problem at all ages. Even young children who begin to realize that they have feelings of attraction towards those of the same gender are affected by homophobia. According to Martinez and Sullivan (1993) “Statistics suggest that homophobia remains the nation’s most enduring form of prejudice” (p. 249).

Cloud (1997) states that homophobia may be a cause of the varied violent reactions that people have when they find out that someone is attracted to those of the same gender. There have been repeated incidents in which someone was harmed because of their sexual orientation. Participants who have been physically attacked report lower self-esteem, more loneliness, isolation, suicidal attempts, and poorer mental health than others (D’Augelli, Grossman, & Hershberger, 2001; Walsh & Crepeau, 1998). Homophobia has also been linked to problems with identity formation (Walsh & Crepeau, 1998).

Rivers (2001) adds that bullying at school, based on sexual orientation, has a long-term effect on gay men’s lives. In one study, over half of the participants received verbal abuse because of their sexual orientation and eleven percent had been physically assaulted (D’Augelli, Pilkington, & Hershberger, 2001). Other studies have shown that 62%-66% of students identifying themselves as gay said they had been in a fight or had been verbally, physically or sexually harassed (Cloud, 1997; Hurwitz, 2000). D’Augelli, Grossman, and Hershberger (2001) go on to say that those victimized tend to be more open about their sexual orientation and have more gender atypical behavior. Additionally, males were targeted significantly more often than females. Rivers (2001) adds that the bullying is unlikely to be reported teachers or primary care givers.

Discrimination. Many people live in fear of the discrimination that may come if they disclose their sexual identity to their families, friends, employers, and coworkers. The level of discrimination that a gay man faces can vary. Factors such as cultural values, schools, colleges, and universities can create an environment that decreases discrimination or these factors can promotes these problems and minimizes the legitimacy of gay men (Walters & Hayes, 1998).

Those who are not open about their sexual orientation may experience additional difficulties in their lives (Muchmore & Hanson, 1990). When gay men try to hide their sexual orientation from their coworkers and employers they often indicate that “this concealment creates a great deal of stress and anxiety, requires a large expenditure of effort, and results in dissatisfaction, feeling misunderstood, pressured, detached, and alienated” (Day & Schoenrade, 1997, p. 148). Additionally, Mays and Cochran (2001) report that perceived discrimination is associated with reporting a decreased quality of life. There is also evidence that higher levels of discrimination increase the chances of developing psychological problems.

Not only does hiding one’s sexual orientation cause stress and anxiety, but when a gay man perceives discrimination, his work attitude is more negative, he has a reduced number of accomplishments, fewer promotions, and a decreased level of status (Barret, Pollack, & Tilden, 2002; Day & Schoenrade, 1997; Ragins & Cornwell, 2001). This is additionally difficult for some individuals since the number of accomplishments and amount of status that a person obtains are often a part of the individual’s identity.

Ragins and Cornwell (2001) report that a gay man’s disclosure of sexual orientation at work is related to discrimination. The more open he is about his sexual orientation, the more likely he is to perceive discrimination. Additionally, gay employees are more likely to report discrimination when they are employed in groups that primarily consisted of heterosexual. Discrimination is also significantly reported in organizations that lacked supportive policies and are not covered by protective local and state legislation. Organizational policies and practices have the strongest impact on whether a gay man perceives discrimination.

Those who identify as gay must face the difficult task of developing a stable identity. The process of identity development is different for gay men and heterosexuals (Cox & Gallois, 1996). Rosario, Meyey-Bahlburg, and Hunter (1996) describe some developmental stages that gay men go through when becoming aware of their sexual orientation. Their participants had a history of sexual activity with same and opposite sex partners during their early teen years. These researchers also state that gay men are aware of their sexual orientation earlier than females. It is likely that those who consider themselves to be gay know from an early age that they have an attraction to those of the same gender, even though they may try to deny their feelings. There are several ways that someone may accomplish this. Cox and Gallois (1994) state that the first is “avoid[ing] all homosexual activity” even to the extreme of “get[ing] married to avoid homosexual feelings.” This allows the individual to feel as though he has joined the dominant social group. However, the individual is likely to experience feelings of “self-hatred and despair” if the homosexual feelings continue (Cox & Gallois, 1994). Some people, often referred to as “passers,” will “attempt to separate their lives into two worlds, one heterosexual and the other homosexual, hoping that the two will not coincide” (Cox & Gallois, 1994, p. 18).

Others try to cover their sexual identity by admitting to their attraction to the same sex if asked about it, but not actively demonstrating their sexual orientation (Cox & Gallois, 1994). They try to gain the acceptance of the heterosexual community as well as those belonging to the gay community. Cox and Gallois (1994, p. 19) also report that some people choose to “blend [by] acting in such a way that is appropriate for their gender and see their sexual orientation as being irrelevant” to any other aspect of their lives.

All of the issues mentioned previously are problematic for those who consider themselves to be gay. However, for those who live in a rural community, these problems may be multiplied. Boulden (2001) states that living and being raised in a rural community shapes how a person views life. Some gay men describe life in rural areas as the embodiment of “don’t ask, don’t tell” mentality and the need to constantly be on guard. It is very difficult for a gay man who lives in a small community to develop a strong sense of identity because of the ridicule that may be placed upon the person’s choice to come out to those in the community.

As previously mentioned, discrimination and homophobia are issues that most gay men have to deal with at some point in time. Although homophobia and discrimination can occur in any setting, recent media coverage has brought attention to this issue in rural areas. For example, Matthew Shepard was a student at The University of Wyoming in 1998 when he was brutally beaten and killed because he was gay. Two citizens of Laramie, Wyoming could not accept that Matthew was open about his sexuality and were very uncomfortable in his presence. They took him to a field, beat him to within inches of his life, and left him tied to a fence to perish. Another example of a hate crime against a gay man in a rural area took place in Grant Town, West Virginia. Arthur J. R. Warren, Jr. was beaten by two men. These men proceeded to run over his body in order to make his death look like a hit and run accident.

These are just a few examples of things that may happen to gay men in rural communities. Many people believe that “things like this don’t happen in small towns” but there are an overwhelming number of cases in which gay men in rural areas are discriminated against and even prosecuted for their sexual attitudes and behaviors.

There are several other issues that are common to rural gay men. These include feelings of being different, internalized homophobia, negative aspects of living in a rural area, and family censorship (Boulden, 2001; Cody & Welch, 1997). Boulden (2001) also describes how these feelings, combined with the negative attitudes of others towards gay men, may lead to a depressed mood for those in this situation.

Contributing to this is the fact that many gay men in rural areas feel isolated socially and geographically (Cody & Welch, 1997; McCarthy, 2000; Smith, 1997). The general opportunity for gay men to develop social groups and activities in rural areas is sharply restricted since it can be problematic to find a core group of gay friends and feel like a part of a gay community (Boulden, 2001; D’Augelli & Hart, 1987; D’Augelli, Collins, & Hart, 1987). Developing a group identity may be further hindered by a “lack of access to information, to a public meeting space, and to connections with other [homosexuals]” (McCarthy, 2000). According to McCarthy (2000), providing opportunities for sexual minorities to feel connected with a small group of friends and acquaintances is critical. This helps those rural residents, who typically feel isolated and invisible, develop a sense of identity because they can be “seen.” Nardi (1999) expands on this idea stating that friendship is the central element of gay man’s life. Through friendship, gay men are able to create, transform, maintain, and reproduce their identities and communities.

It is often necessary for many gay men living in rural areas to travel long distances in order to experience social contact with other gay individuals (Smith, 1997). However, in recent times, new technology has allowed for different types of communication between people who are geographically distant. For example, for many rural people, the Internet has developed into a place where those in the gay community can meet, acquire new friendships, and gain support (Lindhorst, 1997). As can be seen, rural gay individuals may need to go to additional lengths to develop opportunities to meet others (D’Augelli & Hart, 1987).

Gay men may not experience the same degree of resolution to the conflicts in Erikson’s stages of development. Macatee (1999) states that gay men have a more complex developmental process than heterosexual men. Specifically, gay men may go through a different developmental process of individuation and identity formation. These variations in development can negatively affect a gay man and his ability to adjust to peer culture, create issues with intimacy, hinder self-acceptance, and produce feelings of vulnerability.

Nomberg Silver (2001) provides further support for the notion that gay men have additional obstacles when developing their identity. Her study supports Erikson’s theory that individuals have various developmental tasks that need to be resolved as they develop. This resolution allows for coping mechanisms to be cultivated which assist in reducing anxiety. Prejudice directed toward gay men in our society may have consequences in regard to ego development, levels of anxiety, and related distress.

Van De Ven, Rodden, Crawford, and Kippax (1997) found differences between older and younger gay men in terms of living alone, having children, and the likelihood of disclosing their sexual orientation. Additionally, gay men over 49 years old have less social attachment, cultural involvement, and sexual involvement.

These age differences may also be found with developmental tasks. We hypothesize that younger gay men of today will be able to proceed through Erikson’s stages of psychosocial development closer to the age ranges he established for each stage rather than “back tracking” through the stages. We suspect that middle aged or older gay men must revert to the “identity versus role confusion” and “intimacy versus isolation” stages when they begin to accept being gay as a part of their identity and begin engaging in intimate relationships. Middle aged and older gay men may have to re-evaluate the conflict for those stages and make new choices. Cornett and Hudson (1987) agree, stating that Erikson’s theory holds special promise for understanding and aiding gay men in mid-life development.

The reasons why we believe that there may be age differences are related to the changes that are occurring in our society related to gay issues. According to Gil (1999), the political and cultural changes that have occurred should impact how one understands adolescents today. Friedman and Epstein (1996) report that in earlier years, there were not many well-known people who were comfortable enough with their sexuality to come out publicly. Therefore, those growing up in the early to middle 1900’s did not have many role models to follow. It is very difficult to be comfortable with being gay, when there are no examples or possible outcomes to look to for assurance. Today, even though there are more media role models for those who are gay, it can still be very trying to develop a secure sense of one’s own identity.

New technology could influence development. The rise of the Internet plays a role in rural gay men building a sense of community and provides a source of support to work through various developmental stages (Haag & Chang, 1997). This is another factor that wasn’t available to older generations and could currently influence a range of age groups in achieving various developmental stages.

Many political, social, and cultural changes that have also occurred. For example, several nations, as well as the state of Vermont, allow same-sex unions to be legally recognized. Many companies are providing domestic partner benefits to their employees. Political changes include openly gay and lesbian candidates being elected to various government positions. Student groups that support gay and lesbian adolescents are becoming more prevalent in schools and communities. Since these changes, gay men may feel more comfortable and supported to come out earlier and work through these developmental tasks. As these various changes continue, the age that gay men go through Erikson’s developmental stages will more closely align with the ages that heterosexuals experience these psychosocial conflicts.

In addition to age differences, we believe that there are differences between urban and rural gay men. In contrast to urban gay men, we hypothesize that rural gay men will have to re-evaluate the conflict in the “identity versus role confusion” and “intimacy versus isolation” stages. Informal comments collected from rural middle age and older gay men and their family members illustrate how they recognize the changes that gay men experience once they more fully begin integrating being gay into their identity and start intimate relationships. These comments are highlighted in Table 2.

Table 2 Personal Communication with Rural Gay Men and Family Members
Gay man 30 years old	“When I began to date gay men, I felt like I my emotions, thoughts, and behaviors went back to an earlier age. I was 28 years old but I felt and acted like I was 13 or 14 years old.”
Gay man 33 years old	“Once I started dating, it was really weird. I felt like I had the brain of a 32 year old but the emotions of an adolescent.”
Gay man 37 years old	“I only came out of the closet a year ago. I feel like I am just now starting to know the ‘real’ me.”
Gay man 43 years old	“I always knew I was gay, but it wasn’t until I came out and started acting on those feelings I felt like I was learning who is the real ‘me.’”
Mother with 27 year old gay son	“[My gay son] went through his rebellious stage after he came out to her. He was never rebellious as an adolescent. Even though he was 10 years older than an adolescent, it was as though he had to go through that stage at some point.”

We believe that gay men from rural areas will have additional barriers to deal with while going through Erikson’s developmental stages because of the factors related to living in a rural region. McCarthy (2000) describes how the development of lesbian identity is positively correlated with opportunities in urban areas such as information, support, and finding others who are gay or lesbian. For rural residents, these opportunities are not present and this could hinder the development of social group identity. Additionally, lesbians turned more to other lesbians for support with personal problems (D’Augelli et al., 1987). It is logical to conclude that if these factors can influence the identity development of a lesbian living in a rural area, then these factors can also influence the identity development of a gay man.

Macatee (1999) feels that mental health professionals need to examine additional ways to help gay men in the process of identity formation. This could involve modifying the entire way that a gay client thinks about himself (Gonen, 1971). Education about the stages of identity development and the various issues that gay men face is necessary for mental health professionals to implement effective treatments with this population (Shernoff, 1998). Mental health professionals also need to evaluate their own perceptions of gay clients and explore what attitudes they hold that may interfere with their successful treatment gay men (Foster, 1997).

Shernoff (1998) stresses the importance of people in the mental health field to understand rural clients who identify as being gay. He warns that mental health professionals need to recognize that gay men living in rural areas may be at any stage of the life cycle. Therefore, it is crucial for the mental health professional to thoroughly assess the client’s developmental history. They should also be familiar with the models and stages of gay identity formation. In doing this, professionals can better assist this population as they develop their identity across their life span.

Mental health professionals should also encourage professional organizations at the national and local level to take a stand supporting the protection of civil rights and prohibit discrimination against gay men (Lindhorst, 1997). Additionally, mental health professionals are in a unique position to aid other professionals, such as educators, those in the medical field, and religious leaders, as they interact and foster the development of gay men.

A large and random sample is required for a study to easily generalize to the public. However, this may be difficult to accomplish in rural areas. In order to facilitate this, researchers may want to include numerous rural areas in the study. Another problem that should be considered when conducting research on this topic is that those who participate are only those who were willing to identify themselves as gay. Those who are unwilling to disclose being gay may indicate that they are straight/heterosexual or not volunteer to be a part of the study.

As we have proposed, rural gay men will go through Erikson’s psychosocial stages, however, often later than the age ranges established for heterosexuals. Therefore, research methods should be employed that clearly identify the stages of Erikson’s model that each participant has achieved. In addition to geographic differences, we believe that there are distinct variations among age groups of gay men and the degree to which they regression to earlier developmental stages. Therefore, it will be important to examine a sample of gay men from a wide range of ages.

Future research also needs to examine the psychosocial development of those who identify as lesbian or bisexual. This needs to be explored since there could be differences in their development compared to gay men (McConnell, 1994).

If a theory of gay development can be more firmly established, there may be hope for professionals in many different fields be able to better understanding gay men’s lives. As a result, these professionals may be better equipped to help others become more supportive of the gay community.

We are in the process of conducting a pilot study to provide a deeper exploration into the development of gay men from rural communities using Erikson’s developmental theory. The goals are to empirically examine the hypotheses we have proposed, gain a better understanding of rural gay men, and aid mental health professionals in their work with this population.

Mental health professionals have the opportunity to help gay men cope with everyday experiences, come to terms with their identity, increase social interactions, and find their place in the community (D’Augelli & Hart, 1987; Smith & Mancoske, 1997). We hope that this article has given the reader a basis for conceptualizing how a gay man’s thoughts, feelings, and behaviors are often based on how well he has resolved the conflicts proposed in Erikson’s psychosocial stages of development.

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Correspondence should be directed to Dr. Keith Beard, Psychology Dept., Marshall University, One John Marshall Dr., Huntington, WV, 25755 Electronic mail: beard@marshall.edu

Table 1 Erikson’s Eight Stages of Psychosocial Development
Psychosocial stage	Age	Resolution
Basic trust vs. mistrust	Birth to1 year	Infants learn to trust that their needs will be met OR mistrust develops
Autonomy vs. shame & doubt	1 to 3 years	Children learn to make choices and take control of their lives OR become uncertain and doubt that they can do things by themselves
Initiative vs. guilt	3 to 6 years	Children learn to initiate activities and acquire directions and purpose OR they feel guilty for their attempts at independence
Industry vs. inferiority	6 to adolescence	Children are curious and are eager to learn OR they feel inferior and lose interest in tasks
Identity vs. role confusion	Adolescence	Adolescents begin to see themselves as unique and integrate various roles into one identity OR they become confused about what they want out of life
Intimacy vs. isolation	Young adulthood	Young adults are able to commit themselves to another person OR they develop a sense of isolation and they have no one in the world but themselves
Generativity vs. stagnation	Middle adulthood	Adults are willing to have and care for children and devote themselves to work OR they become self-centered and inactive
Integrity vs. despair	Old age	Older people reflect on the meaning of their lives and accept death with dignity OR they feel despair for unaccomplished goals and failures