Mar 29

Project Fearless Award: My Acceptance Speech

This past weekend I received an award from an important new non-profit organization called Project Fearless that, as its Facebook page states, “will destigmatize and provide mental health resources to the LGBTQIA community in Rhode Island and Southern Massachusetts by partnering with local agencies. We aim to direct prospective individuals to affordable treatment options. Project Fearless will also provide financial assistance to low-income individuals seeking mental health treatment.”

It’s so awesome to now hold the distinction of being “the inaugural winner of the Project Fearless Award for Excellence in Therapeutic Service to the LGBTQ Community.”

Below is a reprint of the remarks I presented at the event, minus the appreciation and thank you’s to Project Fearless and those who’ve supported me over the years.


First, I have a confession to make to Project Fearless–which is that I’m anything but fearless, especially when it comes to this kind of thing, talking in front of a big group of people—which I know some people call public speaking, but I call public freaking.

But despite this fear I did take on some public speaking/freaking earlier in my career, in the 80’s and 90’s mostly. Since the 1970’s I’d always been the token out person everywhere I worked. Most coworkers didn’t really get LGBT issues–the QIA+ was silent back then. Many didn’t even know they were actually seeing LGBT clients. Their clients were invisible.

So, I couldn’t NOT do it. I felt it was my duty to start offering workshops to other mental health professionals. And to the community.

Around the same time I was at a career crossroads: I knew I had to get out of my mainstream agency and expand my own small practice–but could I do it? For lots of reasons, it so happened, I couldn’t think straight about it. (Think straight about it.) (Too old a joke?)

So…What do people do to sort out issues…? I looked for a therapist. My first choice was to find a gay or lesbian one; unfortunately I couldn’t…

Which was too bad because what many people didn’t get back then was my need to be an out therapist to clients.

I couldn’t be deterred, though. I’d seen the positive results. When clients at the mental health center were brave enough to broach the subject with me, I came out to them–and always to much appreciation and relief. There was no question it helped.

I did ultimately decide, of course, to do things my way and build my full-time practice–which is not limited, by the way, to our community. Even brave non-LGBT folks also come see me.


1) It matters a lot that Everyone be comfortable and safe in therapy.

2) Being authentic in both our life and our work benefits everyone.

3) Fears: We all have them. And life has never been about not having them; it’s about dealing with them so we can move on and do the things that are important.

Speaking of which, Congratulations to Project Fearless–a venture that is SO going to matter! And one that’s been needed for a very long time!

Mar 20

Three Memoirs About Surviving Gay Conversion Therapy

As if the practice of conversion therapy isn’t bad enough for any age client, just imagine being one of its most likely victims: a teenager who’s trying to come to terms for the first time with all sorts of identity issues, not just sexual orientation. Imagine being torn from your family, probably a religious one, and sent far away to places where strangers try to make you something you’re absolutely not.

Three adults who’ve survived such teenage experiences have penned recent and highly praised gay conversion therapy memoirs.

I. Steven Gaines, One of These Things First: A Memoir (2016)

Meghan Daum, New York Times, summarizes:

For Steven Gaines, growing up as a ‘homo’ in Brooklyn in the 1950s and ’60s meant being ‘a freak, nature’s mistake,’ so at 15 he tries to kill himself by punching through the windowpane of his grandparents’ bra and girdle store. Threatened with hospitalization in a dumpy state mental facility in Queens, he talks his way into a six-month stay at the famed Payne Whitney clinic, in the ‘Ivy League of psychiatric hospitals,’ where former patients have included Marilyn Monroe, Carson McCullers, Jean Stafford and William Burroughs.

Kirkus Reviews adds further details:

Gaines was put under the care of a psychiatrist to whom he finally confided the cause of his distress: ‘I THINK I AM A HOMOSEXUAL,’ he wrote in a sealed note. ‘Homosexuality can be cured, like many other disorders,’ his doctor told him, news that buoyed Gaines’ spirits. ‘I would jump through hoops of fire,’ he thought, ‘if I could be normal.’

Primitive techniques designed to make him straight did not work, of course. Unfortunately for him, Gaines proceeded into “another decade spent trying to ‘cure’ his homosexuality with the same analyst,” Daum reports, “a process that involved sleeping ‘with women regularly, as prescribed’ and becoming ‘a connoisseur of the female body the way a Jew appreciates the Vatican’.”

Kate Tuttle, Boston Globe: “A longtime journalist and artful chronicler of New York lives, Gaines’s look back at his own is shocking, funny, and sometimes shockingly funny. A real treasure.”

II. Alex Cooper, Saving Alex: When I Was Fifteen I Told My Mormon Parents I Was Gay, and That’s When My Nightmare Began (2016)

Another 15-year-old, this time female, another misguided “therapy” attempt. When Cooper came out to her Mormon parents, she was taken to church authorities who placed her, says the author, in “an unlicensed ‘conversion therapy’ center in the Utah desert” that was mentally and physically abusive.

For eight whole months Cooper was stuck there. School Library Journal: “With the assistance of caring teachers and friends, Cooper legally escaped the respected Mormon family who were trying to ‘cure’ her, and a Salt Lake City pro bono lawyer helped her win the right to live with her parents as an openly gay teenager.”

Kate Kendell, National Center for Lesbian Rights: “Alex’s engrossing and shocking story is the triumph of courage, authenticity and hope over shame, bigotry and ignorance. The nightmare of Alex’s story is a key reason we will soon succeed in ending the cruel and dangerous practice of conversion therapy.”

III. Garrard Conley, Boy Erased: A Memoir (2016)

Conley was a 19-year-old Arkansan in college when forced to undergo conversion therapy away from home. The program in Memphis was “an institutionalized Twelve-Step Program heavy on Bible study” (publisher’s blurb), in which he endured “a hellish tutelage under John Smid,” the leader of this so-called Love in Action group (Meghan Daum, New York Times).

Eventually Conley did manage to escape this cult-like environment, and since then has accepted his gayness. Who else got away from Love in Action? Smid himself. He’s actually no longer affiliated with the ex-gay movement at all, having become an “ex-ex-gay counselor”—who’s now in fact openly gay, according to Daum.

Mar 13

All Kinds of Compulsions We “Can’t Just Stop”

Suffused with and overwhelmed by anxiety, we latch onto any behavior that offers relief by providing even an illusion of control…

While extreme compulsions often appear odd, irrational, pitiable and self-destructive, our emerging understanding of compulsions implies something quite different: Even the craziest-looking compulsions are adaptive, even pragmatic, and all too human. A compulsion is at once psychological balm and curse, surface madness (or at least eccentricity) and profound relief. Sharon Begley, Wall Street Journal

Behaviors such as OCD, hoarding, exercise, shopping, video-gaming, hyper-conscientiousness, and even hyper-do-gooding, all possibly responses to anxiety, are examined by science journalist Sharon Begley in Can’t Just Stop: An Investigation of Compulsions.

Compulsions, says Begley, “are repetitive behaviors that we engage in repeatedly to alleviate the angst brought on by the possibility of harmful consequences.” Examples of compulsions of varying levels of severity are offered (Wall Street Journal):

There’s the woman who hit the treadmill so compulsively that she could do little else—and all because, every moment that she wasn’t exercising, the thought of fat cells proliferating in her body drove her nearly mad with anxiety. There’s the actor who was so certain he suffered from a dire illness that he compulsively pressed his doctors to give him CT scans, over and over, to assuage his angst. And there are the millions of us who feel compelled to check our phones before we get out of bed in the morning and constantly throughout the day, because FOMO—the fear of missing out—fills us with so much anxiety that it feels like fire ants swarming every neuron in our brain.

Publishers Weekly notes that Begley’s research and writing “demystifies compulsive behavior, exploring its history and manifestations and the many difficulties its sufferers face in finding appropriate diagnoses and treatment.”

Selected Reviews

Joel Gold, MD: “At once fascinating and compassionate, funny and informative, this volume should be on the bookshelf of every psychiatrist, and on the nightstand of anyone who enjoys absorbing and incisive writing.”

Gary Greenberg, therapist and author: “Sharon Begley has done us all a service, writing about compulsion without writing about disease and offering a new perspective on a phenomenon that is common if not universal. People troubled by their own compulsive behavior will appreciate her nuanced and balanced approach and perhaps come away with a new understanding of themselves.”

Publishers Weekly: “Begley’s final chapter on brain function in the compulsive mind contains fresh insight that could fundamentally alter how we think of, and treat, mental illness going forward.”

Mar 03

Hardest Part of Being a Therapist (“7 Questions Project”)

Being a therapist: what’s it really like?

Several years ago psychologist Ryan Howes conducted The Seven Questions Project in which he asked “big names in the world of psychotherapy” a series of pertinent questions. Although not everyone answered his request to participate, the ones who did were thoughtful in their responses.

When I recently found his series of Psychology Today blog posts about this and reviewed his queries, the one I found most interesting was the fifth: What’s the toughest part of being a therapist? (For the others, click on the link provided above.) And then I read Howes’s own conclusion regarding the project, which included the following:

“Best Question: I thought it would be questions one, four or seven, but question five (the toughest part of being a therapist) turned out to be the most revealing.”

Below are selected excerpts of some of the therapists’ answers to this specific question.

Thomas Szasz (1920-2012)

Individual psychotherapy — that is, engaging a distressed fellow human in a disciplined conversation and human relationship – requires that the therapist have the proper temperament and philosophy of life for such work. By that I mean that the therapist must be patient, modest, and a perceptive listener, rather than a talker and advice-giver…

Even if the foregoing conditions are satisfied, the therapist’s task may not be easy or enviable, as he may be required to be passive in the face of the client’s self-destructive behavior and tolerate the client’s choosing to stick to his familiar, self-limiting life strategies and not risk entering on the path of liberation.

Harriet Lerner

The toughest part of being a therapist is that you constantly run up against your limitations.

Jeffrey Barnett 

One major challenge of being a psychotherapist is to pay attention to our own functioning, monitor our effectiveness, and to practice ongoing self-care…Just like our clients we must deal with life’s challenges and stresses.

Nada Stotland

Perhaps the most difficult aspect of doing psychotherapy is listening to and absorbing patients’ psychic pain.

Irvin Yalom

Well, I think it’s just holding so much pain at times. Worrying about my patients. Seeing some people that I really can’t help, who in some ways are beyond help. Or seeing a sociopath knowing I can’t really do anything for him or can’t reach him. Or watching some people who are throwing their lives away on drugs and there’s so little you can do about it.

James H. Bray

Not taking client’s problems home with you. Many people come for psychotherapy with significant emotional distress and pain. It is important to leave that with the client and not take it home with you.

John Gray

…Whenever I even start to notice a sense of frustration within myself I recognize that I’m not giving a very good message to my client. Whenever you’re frustrated with someone you’re telling them, “you’re not enough, you’re not doing it right, you’re not living up to my expectations.” That’s not helping the client, it’s not helping yourself.

Glen O. Gabbard

The toughest part of being a therapist is being truly “present” with the patient. The demands placed on a therapist in a typical day of psychotherapy are truly extraordinary. The therapist must be present in a way that allows the patient to feel heard, validated, and understood.

Donald Meichenbaum

The toughest part of being a therapist is how NOT to get caught up with all of the questionable psychotherapeutic “BULLSHIT” that pervades the field.

David D. Burns  

…Learning to accept failure on multiple levels is, to my way of thinking, the key to become a world-class therapist. But that means humility, and setting your ego aside, while you develop superb new technical skills.

Feb 07

Presidents in Therapy: Does It Happen?

Not much is actually known regarding presidents in therapy, probably in large part because of general mental health stigma that’s multiplied disproportionately by the unfair and unrealistic expectations both the public and the pols have of those elected to the highest offices. So, have any presidents gone to therapy?

One instance that’s been widely enough reported and believed is that President Richard Nixon (1913-1994), to whom Donald Trump has regularly been compared, did receive psychiatric treatment both inside and outside of the office. (See previous post.)

Meanwhile, there’s been much debate about our current president’s mental state and whether it’s fair to try to diagnose him using the DSM-V. A recent Facebook petition circulated by psychologist John Gartner declaring Trump to have at least three different personality disorders (narcissistic personality disorder, antisocial personality disorder, and paranoid personality disorder) that potentially render him dangerous has, at this writing, over 20,000 signatures from various mental health professionals.

On the other side of the debate are such upholders of the don’t-diagnose-from-afar Goldwater Rule as psychologist Steven Berglas and psychiatrist Allen Frances, who have a whole different take on the subject (Hara Estroff Marano, Psychology Today). States Frances, for example: “Donald Trump is evil—bad not mad—and incompetent.” This is what, according to Frances, makes him “a threat to democracy.”

‘I wrote the criteria for personality disorders,’ says Frances, professor emeritus at Duke. The public diagnoses being bandied about are inaccurate and ‘miss the point,’ he argues. They ignore the criterion that symptoms must be causing distress and impairment. ‘Donald Trump causes distress to others, not to himself. He is rewarded for his behaviors.’

Do we know for sure if Donald Trump has never been diagnosed or in therapy? Of course not. He’s not nearly that transparent. Maybe he’s in therapy as we speak. At least someone at Someecards has imagined so.

Following are three installments of their comics about Trump Therapy. Click on the links and enjoy these brief sessions with his shrink!

  1. Some Comics: Trump Therapy, Session I
  2. Some Comics: Trump Therapy, Session 2
  3. Some Comics: Trump Therapy, Session 3