DID YOU SEE: New York Times Magazine’s Health Issue

The Sunday New York Times Magazine’s May 15 “Health Issue” really GOES THERE. Informative unflinching articles cover breast-reduction surgery (as a feminist issue), Brazilian butt-lifts (the women who have them and the women who take care of the women who have them), gender-affirming phalloplasty (reported by a trans-identified journalist, which makes a huge difference), and a straight cismale’s experience with the weight-reduction app Noom. These excellent articles follow on the heels of last week’s cover story by the scrupulous, ever-deep-diving journalist Susan Dominus on how war has turned Ukraine’s booming surrogacy business into a logistical and ethical nightmare for surrogate mothers, their existing families, and the families anxiously awaiting new arrivals in the midst of this unpredictable conflict. The New York Times doesn’t always live up to its reputation as the gold measure for American journalism — its recent lame portrait of late Mayor Ed Koch’s sad love life as a closeted homosexual rightfully drew the fury of observers who remember just how Koch’s destructive homophobia impacted New York City’s response to the AIDS crisis — but then sometimes, like this week’s magazine, it does.

photo by Naila Ruechel for the New York Times Magazine



Many people try their best to avoid conflict, but relationship researchers say every conflict presents an opportunity to improve a relationship. The key is to learn to fight constructively. Marriage researcher John Gottman has built an entire career out of studying how couples interact. In one important study, Dr. Gottman and his colleagues observed newly married couples while they were having an argument. The researchers found that analyzing just the first three minutes of the couple’s fight could predict their risk for divorce over the next six years. That means the most important moment between you and your partner during a conflict are those first few minutes. By focusing on your behavior during that time, it likely will change the dynamics of your relationship for the better.

Here’s some general advice from the research about how to start a constructive argument with the person you love:

Identify the complaint, not the criticism. If you’re upset about housework, don’t start the fight by criticizing your partner with, “You never help me.” Focus on the complaint and what will make it better. “It’s so tough when I work late on Thursdays to come home to dishes and unbathed kids. Do you think you could find a way to help more on those nights?”

Avoid “you” phrases. Phrases like “You always” and “You never” are almost always followed by criticism and blame. Instead, use sentences that start with “I” or “We,” which will help you identify problems and solutions, rather than putting blame on someone else.

Be aware of body language. No eye-rolling, which is a sign of contempt. Look at your partner when you speak. No folded arms or crossed legs to show you are open to their feelings and input. Sit or stand at the same level as your partner – one person should not be looking down or looking up during an argument.

Learn to de-escalate. When the argument starts getting heated, take it upon yourself to calm things down. For example, use the phrase “What if we…” or “I know this is hard…” or “I hear what you’re saying…” or “What do you think?”

–Tara Parker-Pope, “How to Have a Better Relationship,” New York Times, October 13, 2017

DID YOU SEE…?: New York Times on Women of Sex Tech

In last Sunday’s New York Times, reporter Anna North wrote a fascinating story called “Women of Sex Tech, Unite” about the savvy female entrepreneurs — many of them millennials — who are pouring their attention, energy, talent, and skills into developing sex toys and related products and helping other women who are marketing and distributing them.

North writes:

In 2017, women entrepreneurs in the field still seem to be very much in the minority. Today around 70 percent of sex product companies are run by men, according to an analysis by Unbound. But women, many of them millennials, are starting to harness their economic and social power to disrupt the industry, both on the business and on the consumer side, Ms. Fine said. Millennials can be more comfortable talking about sex than their elders, explained Helen Fisher, an anthropologist and research fellow at the Kinsey Institute. “It’s a transparent generation that’s practical, go-getting, tech-oriented and eager to have it all.”

Besides providing surveying the modern history of sex toys without the usual sniggering tone, the article mentions a whole bunch of resources (products, companies, websites, publications, podcasts) that I’d never heard of but that I’d like to know more about, in the interests of supporting women in expanding their access to greater sexual pleasure and erotic awareness.

North leads with Janet Lieberman and Alexandra Fine, two Brooklyn-based entrepreneurs (above) who started Dame Products, the first company to receive Kickstarter funding to develop a sex toy.

If the movement has an ideological center, it’s probably Women of Sex Tech, a group founded last year by Polly Rodriguez [pictured below center, with her team], 30, the chief executive and co-founder of Unbound, a Manhattan-based sex toy company that sends subscribers a box of products every quarter, and Lidia Bonilla, 38, who started House of Plume, which sells storage boxes for sex toys. Based in New York, the group has since expanded to include more than 70 people, including members in California, Spain and China. New York City-based members include Meika Hollender, the co-founder of Sustain, which makes organic and fair trade lubricants and condoms; Mia Davis, who created a sex education app called Tabú; and Bryony Cole, the host of the popular podcast, Future of Sex.

Check out the whole article here and let me know what you think.

DID YOU SEE: “Prince’s Holy Lust”

Among the outpouring of tributes to the musical genius Prince, who died Friday morning at age 57, two in particular caught my attention.  One is the CNN interview with community organizer Van Jones, who talked about all the ways that Prince quietly used his money and his fame to help people all over the world, an inspiring model of selfless service. You can watch that online here.

More to the point of this blog, in the Sunday NY Times, music critic Touré wrote an op-ed piece about how from the very beginning Prince embodied, articulated, and championed healing the split between sexuality and spirituality.

The piece begins:

“Let me tell you why ‘Adore’ is the central song in the Prince canon. Because in ‘Adore’ you get the commingling of two keys to understanding the man and his music: his sexuality and his spirituality. In the second verse he paints the picture: ‘When we be making love / I only hear the sounds / Heavenly angels crying up above / Tears of joy pouring down on us / They know we need each other.’ They’re having sex under a sprinkling of angel tears, which are flowing because of the angels’ admiration of their love.

“This is the erotic intertwined with the divine. The Judeo-Christian ethic seems to demand that sexuality and spirituality be walled off from each other, but in Prince’s personal cosmology, they were one. Sex to him was part of a spiritual life. The God he worshiped wants us to have passionate and meaningful sex.”

Read the whole piece online here and let me know what you think.

DID YOU SEE: NY Times Magazine on sex education

Bless Julie Metzger. The former pediatric nurse (originally from Pittsburgh, now based in Portland OR) has found a smart and effective way to educate adolescents about their sexual bodies. Bonnie Rochman’s terrific article in the New York Times Magazine March 29, “Rewriting ‘The Talk’,” describes the two-part course on puberty Metzger designed and has taken around the country. Each class lasts two hours, and there are separate classes “For Girls Only” and “For Boys Only,” attended by kids and their parents.

On a recent winter evening, Metzger stood at the door to the hospital auditorium and greeted every mother-daughter pair with animation, as if she’d known them for years, and told each girl to take an index card and a ballpoint pen with the name of her company, Great Conversations, on it. The first hour of each class amounts to an informative stand-up routine — Metzger sticks a sanitary pad on her shoulder to show that it won’t slip around — but the second hour is devoted to answering the girls’ questions. Metzger believes that having kids pose questions fosters intimacy and allows parents to hear for themselves what their children’s concerns are. In the first class, when the focus is on the physical changes caused by puberty, Metzger tends to be asked: Why do we have pubic hair? What does it feel like to have a growth spurt? How do I know when I’m getting my period?

As the girls scribbled on their index cards, some used their elbows to block an inquisitive mother’s gaze. (Bolder girls will sometimes go so far as to write things like “This is from Susan in the third row, in the red shirt.”) After intermission, during which Metzger collected the cards into a disorderly pile, she put on a pair of thick red reading glasses and began.

Can boys stick a tampon in their penis?” she read. “Absolutely not. They can try, but I wouldn’t recommend it.” She flung the card to the floor.

Do you always get a baby from having sex?” she read. “My husband and I have been married 28 years. We may have had sex over 1,000 times. I am happy to report we do not have 1,000 children. There are ways to show and share your love without having a baby.” Another card flew out of her hand.

Metzger’s company represents a distinct shift from the usual approach to sex education. She believes that adolescence and puberty should be the purview of children and their parents, not solely that of children and their teachers. “The idea that we are talking to two generations at the same time is at the core of this,” she says. Because they are voluntary, Great Conversations courses are free to be more frank than school-based sex ed; they can sidestep detractors who think kids shouldn’t be taught about masturbation, for example.

Check out the whole article online here and let me know what you think.


A meditation on love

Love is the mucillage that sticks the construction-paper pumpkins in the scrapbooks of our lives.
— David Mamet

What is love?
Baby, don’t hurt me
Don’t hurt me
No more.

Valentine’s Day is a commercial bonanza second only to Christmas for the gift-giving industry. Businesses that sell flowers, chocolate, perfume, and greeting cards are busy and happy this time of year. For people who aren’t in romantic relationships, Valentine season can be excruciating, a taunting reminder of being left out of a central social ritual. Not everybody wants to be in a relationship. Plenty of people who are in relationships wish they weren’t. But most people experience at some time a deep, poignant, archetypal longing to have a Special Someone in their lives. I honor and respect that longing, and I treat it seriously when it shows up in conversations with friends and clients.

Lately there’s been a lot of conversation about an article that appeared in the Sunday New York Times’s popular Modern Love column called “To Fall in Love with Anyone, Do This.” Vancouver-based writing instructor Mandy Len Catron began her essay by saying, “More than 20 years ago, the psychologist Arthur Aron succeeded in making two strangers fall in love in his laboratory. Last summer, I applied his technique in my own life, which is how I found myself standing on a bridge at midnight, staring into a man’s eyes for exactly four minutes.” The method Aron crafted in order to generate love consisted of having two people answer a serious of increasingly personal questions (three sets of 12 questions) and then spend four minutes looking into each other’s eyes.

to fall in illo
Catron reports that her own experience confirmed Aron’s findings, though she conducted the experiment not with a complete stranger but with someone with whom she already felt an attraction. “Much of Dr. Aron’s research focuses on creating interpersonal closeness. In particular, several studies investigate the ways we incorporate others into our sense of self. It’s easy to see how the questions encourage what they call ‘self-expansion.’ Saying things like, ‘I like your voice, your taste in beer, the way all your friends seem to admire you,’ makes certain positive qualities belonging to one person explicitly valuable to the other. It’s astounding, really, to hear what someone admires in you. I don’t know why we don’t go around thoughtfully complimenting one another all the time,” she writes.

“Most of us think about love as something that happens to us. We fall. We get crushed. But what I like about this study is how it assumes that love is an action. It assumes that what matters to my partner matters to me because we have at least three things in common, because we have close relationships with our mothers, and because he let me look at him.”

Catron’s article quickly went viral. In just a few weeks, a cottage industry has sprung up around The Questions. The Sunday after her column appeared, the Times noted that the article had generated more than 5.2 million visits to the page online, 365,000 shares on Facebook, and 745 comments on the Times website. The newspaper also published the complete list of The Questions Themselves. Inevitably, the following week the New Yorker published a parody of the questions, “To Fall Out of Love, Do This.” (“5. What’s your favorite song? No, it’s not. I’ve never once heard you listen to that song.”)

to fall out illo
The online magazine Dame ran its own witty version. (“12. What would it take for you stop talking about the Paleo diet? 25. A nuclear bomb is detonated near your home, and you are slowly dying from radiation poisoning. Name the internal organ you’d like to keep functioning the longest.”) Last Sunday, the Modern Love column’s editor Daniel Jones wrote about the 36 Questions phenomenon, and the NY Times has even designed a smartphone app so you can conduct the experiment yourself.

Which I encourage you to do. Let me know how it goes. I probably won’t be going through the sequence myself. Personally, I love questions. I’ve spent most of my professional life asking questions, as a journalist and as a psychotherapist. And I also love being asked questions. Not everyone feels the same way. My sweetheart dreads it when I ask probing questions – he feels interrogated and fears that he will give the wrong answer and fail the test. When I asked one of my sisters why she didn’t call me more often, she confessed, “Because you ask difficult questions.” So I have come to understand that what I consider loving attention and genuine open-ended curiosity can come off as intrusive and demanding. There are, obviously, other ways of creating closeness and intimacy. Anything you do to reveal yourself to someone else, gradually and repeatedly, contributes to building trust and connection.

Eye contact is another ambiguous tool. It can be a great way to connect energetically but it can also feel threatening or challenging. I’m struck by how Catron’s article describes the closing extra-credit exercise of Aron’s experiment as “staring,” a word that seems to describe a hostile activity, something we’re taught as children to avoid. But I know from my experience teaching workshops about intimacy that no matter how careful I am to frame the experiment as “gazing into the other person’s eyes,” some people inevitably refer to it as “the staring exercise.”

Catron beautifully captures the vulnerability of the eye-gazing experiment: “I’ve skied steep slopes and hung from a rock face by a short length of rope, but staring into someone’s eyes for four silent minutes was one of the more thrilling and terrifying experiences of my life. I spent the first couple of minutes just trying to breathe properly. There was a lot of nervous smiling until, eventually, we settled in. I know the eyes are the windows to the soul or whatever, but the real crux of the moment was not just that I was really seeing someone, but that I was seeing someone really seeing me. Once I embraced the terror of this realization and gave it time to subside, I arrived somewhere unexpected. I felt brave, and in a state of wonder.”

Looking into someone’s eyes is an extremely brave activity. It’s never clear what you’re going to see looking back at you. Sometimes what gets mirrored back are your own harsh self-judgments or the scrutiny of a critical parent. It takes a lot of practice and presence to hold still long enough to witness the quality of acceptance in another person’s eyes. But that is the essence of intimacy – into-me-you-see.

My favorite meditation on this subject is Bobbie Louise Hawkins’s wonderful poem, “Take Love, For Instance”:

How can it be desirable, that flurry of feeling that if it continues and maintains intensity we call Love?
How perverse we are relative to our own good to have that in our feelings that from the age of thirteen or so, younger all the time they say, until seventy or whatever, no end to it they say, we give over or are given into the “divine emotion.”
Divine mix of anxiety, insecurity, longing that drives us until if we are fortunate, lucky in love, we have a brief relief that shines like fulfillment.
The constant fool’s miracle, like fool’s gold, but inherent; an inherent miracle. Passion brought to bear on eyes that shine back.
And then, or somewhat later, downhill all the way.
From here to there. Remember there.
Caught in the clutches of a one-way ticket. Express.

We are poor.
We are poor.
There is nothing here.

And we sling our everything into the void of it, to be caught.
What is that appetite that pretends to sustenance and ends with all the color gone from the day and no one funny anymore. The appetite that carries veils and obscures our memory.

And can you in that moment’s tender voice say No to it? How mean to refuse it, this little miracle that does so want in. Feel it knocking at your heart.

Poor heart.

See what followed me home.
Can I keep it?





THE PARADOX OF PORN: the Internet as sex educator

The New York Times recently reported that a woman in Los Angeles sat down at her desk at the end of a long day and discovered that the search history on the family computer included “child porn.” A couple of days later, her 13-year-old son admitted that he had typed in that search. “He said he was looking for porn made for children,” the mother said. “He explained, embarrassed, that he just wanted to know what his body was supposed to look like at his age.”

I can relate to that. Can’t you? Kids are insatiably curious about bodies, their own and others’, especially in that time of life when their bodies are changing. And as advice columnists routinely attest, the #1 concern they field from readers boils down to “Am I normal?” The paradox of pornography is that it puts naked bodies on full display in all their voluptuous glory – a godsend to anyone who’s curious and in the dark about such things. At the same time, the kinds of bodies you see in pornography often convey a distorted picture of what constitutes “normal.” Not all the time, but a lot of the time the women’s boobs are enormous, the men’s dicks are gigantic, the crotches are shaved and hairless, and the skin is smooth, white, and waxy. And the paradox for kids is that we live in an era when any naked pictures of humans under the age of 18, even cartoon drawings, can be construed not just as pornography but as grounds for serious legal prosecution. The agony of hormonally activated adolescents starving and literally dying for lack of information about sex was the subject of Frank Wedekind’s deeply wild, long-suppressed 1891 play Spring Awakening, as well as the terrific 2006 Broadway musical based on the play. These days when kids go looking for a little bit of sex education online, they’re more likely to end up with TMI.

ken-bruiser collage

It would be great if we all grew up in body-positive households where nakedness occurred casually and appropriately from an early age, not necessarily equated with sex or something “dirty.” I was impressed to visit Iceland, where virtually everyone sits in hot tubs almost every day, and to note that the dressing rooms mandated the strictly enforced hygienic protocol that every person shower completely naked – and not in separate curtained-off cubicles but in open (sex-segregated) gang showers. Kids grow up seeing all sizes and shapes and ages of naked bodies, displayed in all their beautiful specificity yet with a community ethos of respectful modesty and mutual acceptance. Korean spas convey a similar healthy openness. It would be great to be exposed early and often to the notion that what you see in the mirror reflects exactly what you’re supposed to look like. If you don’t grow up in that kind of culture, how do you satisfy your curiosity? “Playing doctor” used to be the way kids explored seeing each other’s naked bodies. Nowadays it’s Doctor Google who holds all the answers.

You can be a lot older than 13 and still turn to online porn with the same questions: am I normal? What is my body supposed to look like? The Internet is kind of like the Bible – with enough persistent clicking around, you can find whatever you want there, to support any theory you want. Fretful parents can absolutely find scary images. Gender-queer explorers can find kindred spirits. Diversity hounds can find an XXX-rated Noah’s ark. People with crippling qualms about their own bodies can find evidence to support harsh self-judgments. “Over-exposure to porn, especially idealized body types, has led to disappointment with normal guys and a need to fantasize to achieve orgasm,” D.R. told me. “It’s also led to an unhealthy view of and disappointment in my own size and output.” (The word “output” is his modest way of voicing what I’ve heard from other men – porn can instill a sense of inferiority not just about the size of your dick but also the amount of jizz you shoot.)

Yet for every guy who feels shamed and intimidated by the invidious comparisons that online porn facilitates, someone else sees past the imperfections and experiences liberation. “Internet porn and social media is so great,” enthused S.A. “It’s making me 100% confident there are tons of guys who share my interests in various things to various degrees, some a lot more than me. I really think looking at naked guys, their genitals, butts, seeing all their curves and what used to be sort of weird-looking parts, so many variations in bodies, is very helpful to my emotional, psychological, social, and even physical health.”

It’s not easy being totally honest about sex, about bodies, about pornography, about curiosity. But I think it’s worth pursuing. What do you think?



DID YOU SEE: NY Times column on grief

Patrick O’Malley’s sensitive column “Getting Grief Right” in yesterday’s New York Times Sunday Review reinforced what I myself know from both personal and professional experience: grief knows no timetable. Mourning the loss of a loved one takes as long as it takes. It is not at all unusual for a bereaved person to fret that “it’s taking too long” or to worry that other people will think they’re crazy for still feeling consumed with unpredictable waves of sorrowful tears. Grieving people often accuse themselves of “wallowing” in their misery. And there are plenty of guidebooks and bereavement counselors out there who mean well — by applying Elisabeth Kubler-Ross’s theory about the stages of death and dying to the experience of grieving, or by suggesting that the first year is the worst and that things get better after the first round of anniversaries. But often that sort of “designer grief” doesn’t really help. Just as often, it makes the person who’s mourning feel worse, misunderstood, or enraged. Nor does medicating a bereaved person with antidepressants make sense. Grieving is a normal and healthy process for which there is no shortcut or substitute.

grief illo by arianna vairo

I resonated most with O’Malley’s suggestion that the story of loss has three chapters, and they look different and roll out in time a different way for each person. “Chapter 1 has to do with attachment: the strength of the bond with the person who has been lost. Understanding the relationship between degree of attachment and intensity of grief brings great relief for most patients. I often tell them that the size of their grief corresponds to the depth of their love.” Chapter 2 has to do with the death event itself. The impact of a sudden death, a freak accident, or a young child will automatically have an entirely different magnitude from the death, however painful, of an elderly parent or someone who has been ill for a long time. Chapter 3, says O’Malley, “is the long road that begins after the last casserole dish is picked up — when the outside world stops grieving with you.” This is when a support group or therapy can be helpful in providing a space where you don’t have to explain or make excuses for the feelings of drift, disorientation, and sadness that go with the territory of grief.

Check out O’Malley’s column here and let me know what you think.

DID YOU SEE: Richard Kearney on touch in the Sunday NY Times

2007 postcard

Almost every day I have at least one session with a client that confirms two of the basic principles underlying my Body and Soul Work practice: “Touch Heals” and “Healing Through Pleasure.” For people who live with chronic pain, either emotional or physical, the nervous system constructs a four-lane highway between the brain and the cells that signal pain and suffering, so that virtually all other perceptions get left in the dust. But even just an hour of skillful, safe, loving touch can shift someone’s experience entirely, serving as a reminder that alongside pain and suffering, even a chronically ill body is capable of joy, pleasure, and relief.

In a fascinating and thoughtful essay published today in the New York Times’ Sunday Review, philosopher Richard Kearney, who teaches classes about the history of eros at Boston College, discusses the place of touch in our digital culture. He notes that we are much more likely to touch screens these days than each other, even when negotiating sexual connections via social media. Scholar that he is, he looks back to the ancient Greeks for similar dialogue about the rivalry between the sense of touch and the sense of sight:

In perhaps the first great works of human psychology, the “De Anima,” Aristotle pronounced touch the most universal of the senses. Even when we are asleep we are susceptible to changes in temperature and noise. Our bodies are always “on.” And touch is the most intelligent sense, Aristotle explained, because it is the most sensitive. When we touch someone or something we are exposed to what we touch. We are responsive to others because we are constantly in touch with them…

Aristotle was challenging the dominant prejudice of his time, one he himself embraced in earlier works. The Platonic doctrine of the Academy held that sight was the highest sense, because it is the most distant and mediated; hence most theoretical, holding things at bay, mastering meaning from above. Touch, by contrast, was deemed the lowest sense because it is ostensibly immediate and thus subject to intrusions and pressures from the material world. Against this, Aristotle made his radical counterclaim that touch did indeed have a medium, namely “flesh.” And he insisted that flesh was not just some material organ but a complex mediating membrane that accounts for our primary sensings and evaluations.

Consider for yourself what you touch on a daily basis. How much flesh do you make contact with in your life? How do you perceive it in relation to touching other surfaces? Do you appreciate it more, or do you notice any distinction at all?

Check out Kearney’s essay in full here and let me know what you think.

julia jellison

Understanding Social Anxiety

This article was published online by Edge On the Net August 14, 2014.

What’s the difference between fear and anxiety? Fear is a normal emotional response to a clear and present danger. Anxiety is the persistent experience of fear in the absence of threat.

I gleaned this succinct and useful distinction from Richard A. Friedman’s front-page essay in the New York Times Sunday Review called “Why Teenagers Act Crazy.” Friedman, a psychiatrist and professor who directs the psychopharmacology clinic at the Weill Cornell Medical College in New York City, summarizes recent research suggesting that “Largely because of a quirk of brain development, adolescents, on average, experience more anxiety and fear and have a harder time learning how not to be afraid than either children or adults.”

Friedman notes that “the brain circuit for processing fear — the amygdala — is precocious and develops way ahead of the prefrontal cortex, the seat of reasoning and executive control. This means that adolescents have a brain that is wired with an enhanced capacity for fear and anxiety, but is relatively underdeveloped when it comes to calm reasoning.”

illustration by Gary Panter for the New York Times

illustration by Gary Panter for the New York Times

Although we associate adolescence with an impulse toward adventure and novelty seeking in the name of rebellion and individuation, this risk-taking is not necessarily carefree. Apparently, adolescents have difficulty learning how not to be afraid. “While we have limited control over the fear alarm from our amygdala, our prefrontal cortex can effectively exert top-down control, giving us the ability to more accurately assess the risk in our environment. Because the prefrontal cortex is one of the last brain regions to mature, adolescents have far less ability to modulate emotions,” writes Friedman.

“Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger. Way back on the savanna, for example, we would have learned that the rustle in the grass or the sudden flight of birds might signal a predator — and taken the cue and run to safety. Without the ability to identify such danger signals, we would have been lunch long ago. But once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this.”

Because of their relative difficulty in learning to be unafraid, adolescents may not be good candidates for exposure therapy or the use of stimulants like Adderall. “Stimulants, just like emotionally charged experiences, cause the release of norepinephrine — a close relative of adrenaline — in the brain and facilitate memory formation. That’s the reason we can easily forget where we put our keys but will never forget the details of being assaulted.”

Difficulty telling the difference between real and imaginary dangers isn’t confined to teenagers, though. As I read and thought about Friedman’s article, I immediately thought of two different adult gay male clients describing almost identical experiences of social anxiety. Both these men are smart, educated, attractive guys in their forties who have interesting jobs and are established in their fields (publishing and education). And yet both of them feel intensely uneasy walking into a party with other gay men.

Sandy* has been challenging himself to say yes to social invitations more often, so he forced himself to go to a friend’s party but did so with considerable dread. As soon as he arrived at the party, he “knew” it wasn’t going to be fun for him. Everyone knew everyone, he alone was the outsider. He stayed for an hour and then had to leave. At his job, he’s conscientious, organized, motivated to do well, intelligent, experienced, sympathetic, reasonable, a good collaborator. He feels 75% comfortable at work. Where’s that guy in social setting? He disappears, replaced by insecurities: How do I act, sound, look, behave? What can I say that would interest anyone?

Doug* struggles with similar issues of worthiness. He will happily engage with people who approach him in social settings but can’t bring himself to initiate contact because he can’t imagine that he has anything to offer. At a recent social event, he had the impulse to flee early on, but in contrast to Sandy he was able to leave the room and find a private space to collect his thoughts. He realized that he was acting as if there was something deeply scary going on that he had to get away from. But he had to admit that there was no danger in the next room – it was just a group of people hanging out, getting to know each other, and wanting to have a good time. By summoning his inner resources (that executive function Friedman ascribes to the prefrontal cortex) and accurately assessing the level of risk, he was able to expand his tolerance for braving the social environment longer. It takes practice but it pays off.

[*Names and details are changed to protect confidentiality.]

We could say that both Sandy and Doug were caught in the grip of their inner teenager, highly sensitive to fear of rejection, the danger of social disapproval or scorn, and the belief that they would be unable to survive rejection or humiliation. It’s as if every social encounter were an episode of Project Runway, with a visible or invisible committee judging your every move and fully prepared to send packing anyone who doesn’t make the grade.


Brain functioning tells part of the social anxiety story, but not the whole story. I was fascinated the following Sunday to read a letter to the editor in the New York Times responding to Friedman’s article. The author, Robert Epstein, is a senior research psychologist at the American Institute for Behavioral Research and Technology and wrote a book called Teen 2.0.

Epstein said: “Studies have shown that about half of American teenagers meet the criteria for some form of mental illness, including anxiety disorders, but I disagree with Dr. Friedman that this is largely because of the properties of a teenage brain. That is a myth perpetuated by a handful of researchers, some of whom are funded by the pharmaceutical industry, which has successfully created a huge new market for psychoactive drugs by promoting the faulty ‘teenage brain’ idea. In more than 100 cultures around the world, teenage turmoil is absent; such cultures don’t even have a word for ‘adolescence.’ If the teenage brain were responsible for the turmoil of our teenagers, we would see it everywhere. We don’t. The turmoil of our teenagers is due entirely to societal practices that infantilize young people and isolate them from responsible adults, trapping them in the frivolous, media-controlled world of ‘teen culture.’ Anthropological research also demonstrates that when Western schooling and media enter cultures where teenagers are highly functional, they typically take on all the pathological characteristics of American teenagers within a decade. The problem is our society, not the brain.”

I’m a little dubious about Epstein’s insistence that his theory “entirely” explains teenage turmoil, but I was grateful for his acknowledgement that cultural factors play a huge role in how social behaviors evolve. Here are some things I understand about social anxiety in adult gay men.

Almost every gay man spent many years of childhood and adolescence either actively suffering harassment, bullying, and abuse for being perceived as gay/effeminate/different or spending considerable amounts of energy trying very hard not to be noticed in order to escape being harassed, bullied, or abuse. For fear of being excluded, we became experts at excluding ourselves. That conditioning doesn’t go away overnight. It takes a lot of time and growth and community-building and external affirmation to get comfortable showing yourself and being accepted as a sexual being. The ultimate goal is to be able to validate your own existence and not give so much weight to what other people think. That usually requires serious commitment to therapy, spiritual work, or some form of self-study.

illustration by Yann Kebbi for the New York Times

illustration by Yann Kebbi for the New York Times

It’s not uncommon for gay men to put socializing on the back burner during their twenties and thirties and to spend all their energy during that time pursuing their professional or academic ambitions. By the times they’re in their forties and fifties, they may well have established a solid professional identity, a sense of accomplishment, and considerable self-esteem – but still feel underdeveloped in the emotional/sexual/romantic arena. It’s not uncommon for men in that position to find socializing deeply awkward, embarrassing, or threatening because they feel highly self-conscious and often ashamed about their inexperience. It’s easy to look around a club or a party and assume that everybody else has superior social skills and feels perfectly at ease and sure of themselves. It’s easy to forget that as gay men we all grew up watching the rituals of heterosexual courtship happening all around us in school and in movies and TV shows. We probably didn’t get to experience the gay equivalent of adolescent flirtation, holding hands walking down the hall, sipping sodas through two straws, etc., so as adults we had to learn to go through those awkward stages of social contact. Every gay guy knows how clumsy and nerve-wracking that can feel. We know how it feels to be outside looking in. And our peers aren’t nearly as judgmental about that as we might imagine they are. But you only learn that by getting out there and doing it, which takes courage and practice and support.

Then there’s the social media, which has the potential to be a handy tool for meeting people and making connections but just as often it turns out to be a shield to hide behind, to avoid contact. How many times have you been in a bar or a public place where the majority of the people around you are staring at their glowing screens rather than communicating with the people standing next to them? We’ve gotten so accustomed to indirect, mediated forms of communication (email, text, Facebook, Twitter, Instagram, Scruff, Grindr, Manhunt, Recon, Adam4Adam, etc.) that we’ve formed our most intimate relationships with our devices and grown strangely out of practice with direct approach and spontaneous interaction. After all, Candy Crush doesn’t make fun of you. Netflix doesn’t give you attitude. E-mail doesn’t judge.

I see this in myself. Just the other day, I had a series of email and text-message exchanges with someone I haven’t seen in a while trying to find time in our busy schedules to get together, go for a walk, have a conversation, and catch up. Then I ran into him at the gym unexpectedly. We could have had some conversation in the locker room. We could have arranged to have coffee right after working out. At the very least we could have seized this opportunity to make a date. Instead, we greeted each other warmly but awkwardly, went about changing clothes and working out, and even sat on opposite sides of the steam room. I realized afterwards that we were acting as if our real relationship existed in our mediated communication and casual face-to-face encounters were some kind of temporary distraction – rather than the other way around.

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This helped me to understand how easily social anxiety can sneak into our lives. It’s astonishing how much stamina and mindfulness and tolerance for discomfort it can take to stay present in a social interaction without feeling like every momentary lull in the conversation is an agonizing silence or that you’re in the glare of the spotlight and you’re expected to put on a show. I’m thinking about my client Ralph, who prefers communicating in writing because he’s a perfectionist. He’ll labor over each text message or email or G-chat, polishing and deleting and revising until he gets the words just right, which includes making it look like the message was casually tossed off. Then anxiety sets in when he has to meet someone in person that he’s been flirting with on social media. Face to face, in real time, he feels pressure to live up to the witty banter he’s been flinging around on his smartphone. If the conversation doesn’t flow as easily as he thinks it should his self-consciousness can spiral into feeling fraudulent, which doesn’t make for a relaxing meet-and-greet. Paging Cyrano de Bergerac!

The split between the amygdala and the prefrontal cortex that Friedman talked about in his New York Times article doesn’t automatically go away when you turn 21. It comes and goes all our lives, this challenge of learning not to be afraid, of summoning our executive control to see whether there’s real danger nearby or unwarranted fear and then to calm the skittish teenager inside who doesn’t know how to tell the difference.

That’s obviously easier said than done for a lot of people. It takes practice. That’s where taking a meditation class or joining a meditation group can be very helpful – the process of slowing down, watching your mind wander off into the woods, and gently bringing it back instills good practice for expanding your tolerance for situations that cause anxiety. With practice, it gets easier and easier to stop yourself when you’re going into a frenzy and consider: what am I afraid of? Am I really in danger, or am I really not? Most of the time when we fear that we’re being judged negatively by other people, it’s really our own harsh self-judgments that are causing our distress. Meditation can also help you learn and develop an attitude of kindness and compassion toward yourself.

There are other ways to work through social anxiety. Toastmasters is a popular approach, or any fellowship group that encourages people to get together and practice speaking openly in a social setting. Sometimes it takes medication and/or psychotherapy to dislodge old habits of being afraid. And sometimes maturity bestows its own blessing – one of the great things about aging is that at a certain point you stop giving a shit what other people think. But the good news is that your organism is built to understand the difference between fear and anxiety.