Breaking up is Hard to do

We can't talk about love, sex, and relationships without talking about break-ups.  Like death, break-ups are one of the hardest things to "know what to say" when it happens to a loved one, and it's even harder to know how to feel when break-ups happen to you.

As a sex-positive therapist, I like to see when my clients find a partner or sexual experience that changes their world for the better, and suffer alongside my clients when I hear their heart breaks or failed sexual endeavors. But, one often overlooked aspect of my career, is that I am very often (more often than not thus far) a break up counselor, and not a wedding planner.

One of my all-time favorite clients (yes, favorites totally happen, I can't even lie), came in my office for our first session and asked if I did couples therapy to help people break up.  Shocked that I responded in the affirmative, I realized that it may be strange that people think the act of breaking up needs therapy too.  And they do, often more than decisions to stay together through struggles and disappointments.

Yesterday, my longest-term client at my current practice had what we call in the business "a breakthrough."  She had been struggling throughout our work together about whether she should stay in her current relationship and how she can grow through the struggles she faced with her partner.  But yesterday, she made a decision.  In a way she hadn't before.  Yes there were times she felt she could make it through.  Yes there were times she was planning to leave.  But I saw in her face something that I had never seen before: TRUTH.

In this moment, she realized what had been her truth since we met (and probably before).  She finally said it and HEARD it.  She finally gave in to her truth, rather than fighting against the pain of what it meant.

She decided she had to leave.  She has to break up.

And it is a damn hard thing to do.  Besides the logistics of moving out, finding a new home, telling family members and others in their lives together, there was something else.  Something we so often ignore.  Or run from.  Or plan around.  There was truth.  Truth that breaking up is what she needs to do for herself, for her sanity and safety, and for her own progress.

The experience and privilege I felt sitting in this room with her during her process overwhelms me still.  To know that I witnessed this beast of burdensome truth come out of her and finally be present for her in an undeniable way, is something I will always be indebted to.  Again, I am in awe of the wonderful work I get to do and the wonders of the humans whom I am lucky enough to see.

Busy. Busy. Busy.

Quickly all of my blog posts will become Kurt Vonnegut references.  It's bound to happen.

But I think that "busy, busy, busy" is quite relevant in all aspects of life.  And not just that busy feeling we all get that is so overwhelming we don't even have time to update our blogs...  It's used by Vonnegut to allude to that crazy cosmic thing that happens when the world works all together to get some magic to happen.  Like a coincidence, but bigger.  It's when everything just lines up and makes sense.

This idea, I fear, is often how we idealize and romanticize romance.  That is just that: perfect, cosmic, meant to be.  There will be no work.  No effort.  No struggle.  It will just make sense because the universe, or God, or Kurt Vonnegut grant it to be so.  

But, this, my friends, is bull shit.  Complete and udder.  And, as a therapist, I have to tell people this.  Every day.  Every single day I have to bring this delusional sense of love and what a relationship "should" be to the forefront of individuals' minds.  Because, we think that the world will bring us love that is perfect and we won't have to work for it at all.

The truth is that more than likely the universe, or Allah, or the Flying Spaghetti Monster, don 't have any magical or overpowering plans for our love life.

However, this is where I come in, as a therapist, not a divine presence.  Telling people day in and day out that they have to WORK for their relationships, their love, their happiness is often defeating for them to hear.  But it is also empowering.  Being told that nothing will fix your terrible relationship but you and your partner is overwhelming, but uplifting.  Because then you CAN change it.  You are no longer burdened by the delusion that it is meant to be "just so," and there is nothing you can do about it to fix it or make it better or change it. It isn't meant to be easy.  At all.  And that's okay.  Actually, it's beautiful.  

By rewriting what we understand romance to be, we rewrite how we understand romance in our lives.  We stop being angry and hoping our partner will read our mind, and we begin to start sharing what makes us angry in the first place.  We stop hoping that our relationship will look like our best friend's or our parents' or our neighbors' and simply begin to enjoy what makes our relationship work for us.

There is no prince charming, there is no perfection.  There is only our hard work that makes romance and love "easy."

In the words of my beloved Tyler Durden: "I say never be complete, I say stop being perfect, I say let... lets evolve, and let the chips fall where they may.

Boo!

In lieu of Halloween looming in our futures, let's talk about some scary shit.  Sex.  Yep, sex is scary.  For a lot of different reasons for a lot of different people.

I sit with one woman who is "afraid" of sex with her boyfriend because she knows it will lead to sexual disappointment, frustration, and no satisfaction on her part.

I sit with a man who is "afraid" of sex with his wife because of the damage he has caused her and his family from his multitude of affairs and sexual compulsivity.

I sit with a woman who is afraid of sex with her husband because being vulnerable sexually also means she is vulnerable to him physically, and has been physically abused by him in the past.

I sit with a woman who is mean and distances from her current boyfriend because a past boyfriend of hers had emotionally abused her so badly she defends against any form of affection out of fear that it will become abuse.

What does all of this have in common?  Fear.  More specifically? Fear of intimacy.

Boo!

The thing we are all afraid of on a real, deep-down level:  Intimacy with another.

For whatever reasons, whether it's because we've disappointed someone, because we've been hurt emotionally/physically/sexually, because we don't know what others will think of us, because we have been told we aren't good enough, because we've been abandoned, people are afraid to commit, to jump, to be vulnerable, to take risks.

Intimacy means that your partner could leave and hurt you.  Intimacy means that you could hurt your partner.  Intimacy means allowing others to see the shitty sides of you, not just your awesomeness.  Intimacy means allowing someone new to be different than the person before them.  Intimacy means letting go in a real way and hoping that your partner will be there to catch you.  Intimacy means talking out loud about inadequacies and frustrations about your partner TO your partner in an honest and constructive way.

Intimacy means doing all of these things and knowing/hoping/believing that the other person (friend, partner, otherwise) will still be there to love you.  Regardless.  Regardless of your past.  Regardless of your anger.  Regardless of your crazy side.  Regardless of your sexual inadequacies.  Regardless of the mess of a person you are, that no one knows about.

One of my favorite exercises to have couples do with one another when they are struggling with fears of intimacy and abandonment is to have the couple take "breaking up" off of the proverbial table.  It doesn't exist.  It's not an option.  Not anymore.  Believing that the other partner is there, no matter what, and moving forward TOGETHER, is how real intimacy can take place.  *Now, I would not suggest this method of intimacy for clients in abusive relationships, or relationships where one partner does want to leave or is not fully committed to the relationship.*

By giving your all to another, you take a risk, you act vulnerably, and you form intimacy.  By having this "safety net" of commitment; you can show off your crazy and know that the other will be there for you and won't leave.  This doesn't give you license to go bat shit, but it does allow you to put down guards that are built out of fear that if you show the slightest glimmer of vulnerability, you will be alone.

So, try it.  The next time you or your partner are holding back from connecting, from truly seeing one another, ask if you can take "breaking up" off of the table as something to fear.  Either way, this will illicit a conversation worth having.

I'm Coming Out

In honor of National Coming Out Day, I thought I would reflect on a personal, professional, and ongoing struggle I have as a clinician, a sex educator, and a queer-identified person.  How to be out in a therapeutic room as a therapist is one of the biggest questions and internal debates I've had with myself throughout my short-lived career as an intern and grown-up therapist.  Some clinicians live by the mantra to be out and proud, both in and out of the clinical setting.  Some clinicians work hard to be a "blank slate" in the therapeutic space, allowing clients to "make" the clinician whomever they (the client) needs them (the therapist) to be. *I tend to fall to this side of the argument*

Whatever the idea, reason, and purpose behind being out or not as a clinician is certainly valid and purposeful for the clinician, I would hope, just as having family pictures up in your office or not is something *little* clinicians must be thoughtful of when creating the therapeutic space.  It must thoughtful and should not take away from the client and your effort to help them.  However, I have seen the shift in the therapeutic alliance that happens when a client who viewed you as a straight woman, begins to see you as a queer woman.  To see the client change their view of you as their therapist ever so slightly to become more aligned with your personal truth and self-concept can be an amazing and scary process.  For one, it allows the client to become more connected to you and see you for who you truly are (this is true of any and all identifying information a client may learn about you).  For another, it can connect the client to the clinician as another queer person, and this can be huge!  To know that another suffers like you, lives like you, is oppressed like you can be a therapeutic text book all on its own as far as therapeutic interventions.  This is why there is such a large push in the queer community for queer celebs to come out and show others how "being out" can empower and unite an oppressed group.

So, do I use myself in the room to be a "role model" or a "success story" for being out?  I don't tend to think so.  My queerness is different from yours and yours and yours.  Because I'm currently in a heterosexual, monogamous relationship with a cisgendered person, I tend to appear a lot less queer than I do when I date a lady or someone who is trans or am a part of an open relationship.  Am I queer enough to be an inspiring role model?  Or, is the real question still just am I queer enough (the personal struggle of many queer people)?

I know that as a queer woman who dates mostly men, I get overlooked and minimized often in my queer identity among peers.  Would this hold up with clients?  Would I not be "enough?"  Or, another fear, that clients begin to believe I am in a lesbian relationship, but then see me in "real-life" with my male partner.  Could this undo a whole relationship built around my queer identity?  And, what happens when you are out and open and proud in a clinical relationship; does this open a Pandora's Box of personal questions and boundary crossing?

When is being queer helpful, when is it a violation to my personal life?  When does it matter for clients to know my sexual orientation? When doesn't it?  I think the "right answer" is, as always, it depends on the client.  But, how do you know?  How can you know?

I guess today is more questions than answers.  Sorry about that, but as I said, this is one of the biggest struggles I've faced as a clinician and who I choose to be with my clients.

In a lighter note, let us not forget on today (ok, yesterday technically) of all days, to dance our pretty little queer asses right out of the closet.

Taking Risks

Therapy, and life as it were, is about taking risks.  It is, that might be cliche and silly for some of you, but really, what is life without the possibility of heartbreak, hurt, and loss?  Bland, safe, but lacking an essential sort of passion.  I recently recounted the story of how I realized that sex therapy and a life of sex education was undoubtedly in my future plans: "I was always the one who would ask the questions no one else would," and "I was always the one who would speak up and talk openly about sexuality, as if no different from any other topic."  Many of my peers and friends who have studied sexuality alongside me have shared similar stories of high school sex ed class and college "counseling" to friends with pregnancy scares, coming out issues, or just everyday sexuality questions.  For whatever reason, when I brought this story up to a newly-introduced colleague, she sent me something later on about risk-taking, and that I had reminded her of the necessity to take risks in my story of self-discovery through health class, if you will.  This is what she sent my way:

DARE TO RISK

To laugh is to risk appearing the fool. 

To weep is to risk appearing sentimental.        

To reach for another is to risk involvement.      

To expose your ideas, your dreams, before a crowd is to risk their loss.  

To love is to risk not being loved in return.              

To live is to risk dying. 

To believe is to risk failure.  

But risks must be taken, because the greatest hazard in life is to risk nothing.  

The people who risk nothing, do nothing, have nothing, are nothing.         

They may avoid suffering and sorrow, but they cannot learn, feel, change, grow, love, live.        

  Chained by their attitudes, they are slaves; they have forfeited their freedom. 

Only a person who risks is free.

  I think as a recent grad, this strikes a lot of nerves for me as a new professional.  Personally, this hits home as something I tried tirelessly to get a loved one to understand, with no avail.  It also shows me how important current friendships and loves are becoming because of the risk involved.  Professionally, thinking about risks for clients is something that I must attend to constantly.  Even if I think I see a connection somewhere, does not make it so or, more importantly, easy for my client to see.  We only see and understand what we can at the moment.  Sort of like the saying "God only gives you what you can handle," but less religiously-induced.  The idea that we as humans with intellect can only understand so much at certain times.  The process is necessary. And hard.  It's fucking hard.

  I remember one of the most meaningful things a therapist ever said to me: "Thank you for reminding me how hard real work can be for a client, and helping me help you take your time."  At the end of grad school I had nearly lost my mind, and wanted only to process what I could see on a surface level, i.e. the terrible relationship I was in that I glorified endlessly as perfection.  My therapist pushed me hard, and when I resisted, her response was the above.  She had forgotten how hard therapy can be, and that even if the therapist "gets it," the client needs time to get it for themselves and make it there own.

  Even when we, as clinicians, see connections, these may be false.  They may be misguided.  They may not be true for the client.  I have to remember that I take a risk clinically every time I formulate a case concept.  I take a risk of labeling, diagnosing, and pathologizing something for an individual that may be the only way they have been able to function.  I must remember to hold with care all that clients give me, and to take careful risks.  However, these risks are where the work gets done.  These risks are necessary.  No matter how scary they are, for myself or my clients.  

  We must be willing to go deeper, to take risks, to truly challenge ourselves and our worldviews.  Without this risk, we would have no introspection, and minimal treatment results, and my job would be bologna. 

I have no idea what I'm doing.

Today I was contacted by a local LGBT community support group, I have been trying to connect with to gain support and referrals through.  When contacted by the intern, I thought to myself, "ah, an intern" in a rather minimizing fashion.  I quickly realized that six months ago I was an intern.  I have been an intern more than anything else in my life, really.  So, I think that I'll use the space I have provided myself to check in about my gut reaction to an intern, or a new professional.

I know that as an intern, I felt I had to justify my qualifications, regardless of how prestigious the internship.  As an intern, you're a nobody, or at least I felt like that a lot.  Not in a terrible, self-esteem bruising kind of way.  Just as a fact.  I have no idea how such and such agency works, teach me.  I have no idea how this policy is implemented, someone show me.  You know, you just are accepted (if you're lucky) as the kid that doesn't really know what's going on, but hopefully will before the end of the year so the agency can get some free labor out of you.

Now, as a new professional, I advertise my prestigious internships and work I have done in the past five years so that people will take me seriously.  Why do I have this internal checker that says "they aren't going to think you're good enough, better tell them you are"?  Why can't I just know, and hold, and trust, that I am a good clinician, whether I'm full of it or not?  It's like this terrible, self-defeating voice in my head which says "I'm too young," "I'm too femme,"  "I dress this certain way, which isn't good enough for someone somewhere," "I'm a woman."  Do all of these things make me less of a clinician?  False.  They don't.  These things most certainly EFFECT treatment, and I'm not saying that gender, appearance, age, experience, etc, don't effect treatment, but these are things that I can't change, so why freak out about them and try to justify these Truths about me, when they are not going to change?

A lovely PostSecret I found months ago that hit home as I started my new career.

I don't have any idea what I'm doing, in a lot of areas of my life, but I do know that I love being a therapist, and already (as an intern, actually) I saw and heard how I affected my clients lives in real ways.  And I still have no idea what I'm doing. How about that?

-by Becky

So, if you're going to read a blog "by Becky," you probably want to know a little about Becky, right?   I figured.  It's my intuition.  Which makes me a great therapist.  And friend.  I'm great at both.  But, you'll learn that soon enough.

So, Becky.  Where to begin?  Well, since this is a blog about my burgeoning professional career as a sex therapist, let's begin at the beginning of my development into becoming such a thing.  Therapy, as it were, has been "what I've wanted to do" since I was 14.  Good therapists and nasty divorces will convince of this (but I digress).  I worked at an inpatient facility while I was in college, where I obtained a BS in Psychology and a double major in Religion.  Initially, I wanted to work with adolescents, but after working with adolescents on an inpatient unit for two and a half years, I changed my mind.  I decided to work with adults, parents really.  

I decided, for several reasons and at my mother's dismay, that sexuality and sex therapy was my true academic and professional calling.  I wanted to work with couples so that they could learn to communicate and model this for their children.  I wanted to talk about a topic I think is too taboo for school all the time (because I was that kid in health class).  I wanted to help others, like I had helped my peers through high school and college, find happy, healthy, safe sexuality.  I wanted to give people, all people, the right to decide what type of sex they wanted to have, if they wanted to have it at all.  I really just wanted to talk openly and honestly about something I think people are too scared or too ashamed to talk about in most places in their life.

I went to grad school for two Master's at once, because I was that kind of motivated.  There, I studied Clinical Social Work and Human Sexuality Education.  These two programs "work together" to provide graduates with abilities to work clinically in sexuality-intensive areas.  My focus entering grad school was HIV, an area of sexuality I still hold dear to my heart.

While in grad school and living in Philadelphia, I worked part-time at a residential facility with seniors with acute mental health diagnosis.  I had an internship as a medical case manager with individuals living with HIV and a clinical internship in college counseling.  Both of these internships sealed my fate as a clinician at heart, and taught me a lot about who I was becoming and how I can best serve people.

So, I have returned to Lancaster County, my birthplace, to instill hope, healing, and sexual health for my clientele.  I work in private practice at the southern end of county, and enjoy every moment.  Every day I am in awe of what parts of themselves my clients allow me to hold, how these individuals trust me and my knowledge, and allow me to be present with them on their journeys through life.  Wowzers.  Every day.

But, most importantly of course, I get to talk about sex.  A lot.  All day, if I had my way.  Just wait until we get to talk about that stuff.