Monthly Archives: January 2013

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DID YOU SEE: gay men and body dysmorphia

Denver-based psychotherapist Larry Cappel published a piece online last weekend that caught my attention: “Why Gay Men Hate Their Bodies.” He makes some good points. I found myself agreeing sometimes, violently disagreeing at times, and contemplating my own personal experience with body dysmorphia in myself and others.

I tend to bristle at blanket statements about “gay men this” and “gay men that” — such as “Gay men…frequently have a hard time finding someone to fall in love with who isn’t also wrapped up in the same impossible quest for a Hollywood body.” It’s too easy to contest that kind of vast overgeneralization. Cappel’s argument is stronger when he pinpoints his observations: “Gay men who are obsessed with their own body image tend to only date others who are also just as obsessed with how they look, making it hard to break the cycle. It’s pretty rare to see a gym-toned gay man with a gay man who is just average in appearance.” My immediate response is — well, it depends on where you’re looking. Slick fashion magazines? Pornography? Church newsletters? The gym I go to (the West Side YMCA) has a lot of gay members, and you can definitely see buff guys working out every day of the week, but you also see plenty of guys every age and shape on the treadmills, taking classes, lifting weights, and hitting the showers.

One of the best things about gay marriage being legalized in several states is that we are seeing public acknowledgement of hundreds of gay couples, many of whom have been together for years and most of whom don’t look like movie stars or fashion models, thereby giving the lie to the horrible myth that says “Stay young and beautiful if you want to be loved.”

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Like Cappel, I have clients who fret that they’re too fat, too thin, too old, not muscley enough, and/or their dicks are too small, they don’t live up to some standard of gay male beauty, therefore they can’t bring themselves to date or have sex. This is almost always perplexing to me, because evidence to the contrary is sitting right in front of me. But it’s never very helpful for a therapist to say, “That’s a dumb thing to think! Stop that right now!” With someone who’s suffering with self-judgment about his looks, I usually try to find out where he got his ideas about what he’s supposed to look like. He had to be carefully taught some standard of appearance — who or what does he see as the authority in this matter?

That investigation is easier said than done. A lot of these messages get implanted so young that you can’t remember where they came from, except a vague sense of “society told me.” There is a stereotype about gay men that we are fixated on appearances — that’s fine when it comes to fashion and design and flowers and food and interior decoration, but it makes us shallow as people. Well, that judgment overlooks the impact of our personal histories. Unless you grew up in an unusually accepting environment, you probably grew up quite fearful that other people would find out that you’re “different.” To survive, you probably paid close attention to other kids to figure out how you were supposed to look or act in order to pass for some version of normal. This hypervigilance carves all kinds of wounds on our souls, not the least of which is internalized homophobia — a conscious or unconscious aversion to looking “gay” (which usually means effeminate) and overvaluing acting “straight” (which often means hypermasculine).

When men I talk to can actually identify where they got their ideas about what they should look like, nine times out of ten the answer is gay porn. Now, gay porn is an extremely delightful form of contemporary entertainment, and I enjoy it as much as anyone else. It’s also an extremely codified realm whose inhabitants bear little relationship to what average gay men look like. Nevertheless, porn implants the notion that every guy has a huge dick and big muscles, every guy can get it up and fuck on command or get fucked at will and shoot a huge load every time. Somewhere in our brains we know intellectually that it’s an edited medium, that the films and pictures leave out all the messy bits, that the models all take enhancement drugs (often injecting them into their penises) in order to perform like porn stars. Yet somehow we can’t help comparing our bodies to their bodies and finding ourselves lacking.

Cappel’s article references Alan Downs’s book The Velvet Rage, which I too think offers a very astute analysis of gay male emotional development and a roadmap to authenticity. Downs outlines three stages of emotional development for gay men. The first has to do with working through toxic shame around being gay. The second has to do with working through shame about imperfection. Shame and anxiety about imperfection is pretty universal — those traits pretty much go with the human condition — but I agree with Downs’ assertion that gay men often go through a particularly intricate dance of striving to be excellent (The Best Little Boy in the World) in order to compensate for the perceived flaw of being gay. In that stage, any flaw can seem threatening to one’s sense of worthiness, and there’s a huge emphasis on getting validation from others. In this state of vulnerability, if you’re not being actively validated, it feels like you’re being actively invalidated, which is excruciating and infuriating and enraging…but rage is unattractive and socially unacceptable so you have to mask it: thus, the Velvet Rage. The third stage of development, in his view, is authenticity, where you have learned to validate your own existence, regardless of other people’s opinion. Again, easier said than done. But it can be done, with hard work and support.

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FOOD FOR THE JOYBODY: the myth of “New Year, New You” and theories of change

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Thanks to my friend Ben Seaman, I started exploring the prolific writing of Oliver Burkeman and came upon his column for Newsweek/The Daily Beast on failed New Year’s resolutions, which has some smart things to say. One passage stood out for me:

[A]s the Buddhist-influenced Japanese psychologist Shoma Morita liked to point out, it’s perfectly possible to do what you know needs doing—to propel yourself to the gym, to open the laptop to work, to reach for the kale instead of the doughnuts—without “feeling motivated” to do it. People “think that they should always like what they do and that their lives should be trouble-free,” Morita wrote. “Consequently, their mental energy is wasted by their impossible attempts to avoid feelings of displeasure or boredom.” Morita advised his readers and patients to “give up” on themselves—to “begin taking action now, while being neurotic or imperfect or a procrastinator or unhealthy or lazy or any other label by which you inaccurately describe yourself.”

The column also talks about the alluring fantasy of creating change by “making a fresh start,” throwing everything out and building a new structure from scratch — a task so daunting that it’s rarely successful. I tend to subscribe to the ideas laid out by Arnold Beisser in his essay “The Paradoxical Theory of Change,” one of the pillars of contemporary gestalt therapy. Beisser’s perception is that we don’t change by willing ourselves to do something different but by examining carefully what it is we are actually doing right now, which paradoxically arms us with more information and more options that we often skip when we’re trying to motivate ourselves by envisioning that “fresh start.”

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Sex in the cinema: THE SESSIONS

SEX IN THE CINEMA: The Sessions

Have you ever wondered what someone who works in the field of sex therapy thinks about The Sessions? I can tell you.

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A few weeks ago I watched Ben Lewin’s film, in which Helen Hunt plays Cheryl, a sexual surrogate who is hired by Mark, a severely disabled man (John Hawkes) living with cystic fibrosis. Like many Hollywood movies these days, the film is “based on a true story” about Mark O’Brien, a journalist and poet in Berkeley, California, who was the subject of an Academy Award-winning short documentary feature called Breathing Lessons, which mostly portrayed the life of someone who spends much of his day in an iron lung. The Sessions zeroes right in on the most intimate aspects of O’Brien’s life, his relationships with the staunch female caretakers who bathe him and evince subtle/overt disgust for his body, and his wistful desire to experience sex before he dies. The sexual surrogate that Hunt plays is herself a kind of sacred intimate, a social worker whose job entails getting naked and physically intimate with her clients, with the intention of healing.

My overall response is to be impressed with Hollywood for being willing to make a film on this subject and to treat it with as much honesty and respect as they did. I give Helen Hunt a lot of credit for being willing to be so free with her body and the filmmakers for making a film that many people can identify with whose circumstances are very different from Mark O’Brien’s. The tone is neither sniggery-salacious nor overly solemn. I keep thinking about the moment when she invites him to touch her breasts and says, “If you touch one, you have to touch the other. It’s kind of a rule.”

As a professional, I could take issue with a few things that are “Hollywoodized” and not an accurate depiction of sexual surrogate work. Her first session with him is way too rushed. Most sexual surrogates do NOT walk in the door and get naked nearly as quickly as she does. Especially with someone whose issue is lack of sexual experience, there’s usually a process of progressive desensitization to anxiety-provoking situations. Of course, that would be tedious to document on camera. The film plays up the dramatic moment of her “hurting” him at the beginning, to establish his extreme sensitivity, but it makes her look obtuse, and that seems pretty unrealistic to me. In the scenes where he ejaculates immediately, the movie suggests that the encounter is over when that happens, which is exactly the nightmare that men who struggle with rapid ejaculation fear. In real life, in Mark’s sessions with the surrogate, she didn’t end the session there but continued to work with him to let him regain his erection and experience arousal longer. And at the end, her emotional attachment to him is exaggerated in a way that is sentimental and melodramatic — typical for a Hollywood movie but way overplayed as a depiction of how most sex surrogates deal with completing treatment.

It’s very interesting to go back and read Mark O’Brien’s essay “On Seeing a Sex Surrogate,” which was published in The Sun. You can read it online here. You’ll see that the movie hews to certain facts and embellishes many others. At the time of his sessions with Cheryl, he was 4’7″ and weighed 60 pounds. Such a brave man!

You can also view Breathing Lessons online here (and I encourage you to).

I don’t do sexual surrogacy, but – as I’ve written about elsewhere – there are similarities and differences between sexual surrogates and sacred intimates. For instance, I’ve worked on and off for nine years with a man who has a version of increasingly disabling muscular dystrophy, gets around in a state-of-the-art motorized wheelchair, and has very little ability to move his limbs. Getting him out of the chair and onto the massage table, and then back, is extremely arduous, but it is very meaningful to him to receive the kind of loving touch I offer, which is somewhat different from what he receives from his husband. And it’s meaningful to me to provide a safe place for him to have this experience. I always feel very honored to work with people who have unusual bodies, knowing how emotionally fraught it is for them to show themselves to others. And I think they get about me that I have a lot of reverence for the life and pleasures that are possible in each individual body.