When I was ten years-old my school headteacher outed me as gay to my parents. He saw this as his duty to save me from choosing a life of depravity. He asked me bluntly “are you homosexual?” Uncontrollably through my tears, I fiercely denied it. He continued “if you choose this lifestyle, you will end up alone or dead”. It was 1988 and Thatcher’s Conservative government had just introduced Section 28. As the head delivered his terrifying warning, my over-sensitive young psyche split, and shattered into a million pieces. As an already, anxious child, bullied from the age of six, I did what I could to survive the perceived threat; I ate. In fact, I developed a life-long sugar addiction so severe, that I ate myself to nearly twenty stone over the next decade. Later I found that alcohol and drugs helped me cope with coming out on to London’s gay scene; a place that rejected my size but welcome my over-indulgence. I spiralled out of control, until aged thirty, when a doctor literally saved my life by telling me about recovery. I got sober.
My story isn’t so unusual in linking addiction to childhood trauma. Put simply, I have a dysfunctional mind, ruled by my limbic brain, deeming me powerless to control the behaviours I use to self-medicate uncomfortable feelings. Basically, I’m sensitive and sometimes feel my feelings too much. So, I look for ways to not feel using alcohol, drugs, food, sex, shopping, work, co-dependency, relationships, whatever. But when I start engaging in certain behaviours, I can’t seem to stop them. And then I can’t stay stopped. I believe many addicts and LGBT people are sensitive and hyper-vigilant like this because of our childhood trauma, as David Smallwood suggests, in his book Who Says I’m An Addict?
In my early recovery, there were aspects of me that remained hidden; the gay parts. While I wasn’t drinking or drugging, I also wasn’t telling anyone I spent hours in gay bars, acting-out my fear of intimacy through anonymous sex. I felt utterly ashamed. Of course, it wasn’t the sex itself that was shameful, it was my thinking around it. Gay shame. I started attending LGBT recovery meetings, where I heard my story told again and again by other gay men. I wasn’t the only one who had grown up frightened, bullied, kicked, spat on, laughed at and judged just for being gay. It was here my true journey in recovery began.
Today, growing up LGBT in the UK is more widely accepted than in the 1980’s. LGBT people have secured equal rights. The language and lexicon around gender and sexuality is adapting to become more inclusive. Yet in 2019, homophobic protests took place outside a Birmingham school over government approved same-sex teaching; homophobic and transphobic hate crime has doubled over five years; and two thirds of LGBT people still fear holding their partner’s hand in public. In parts of Eastern Europe, Africa and the Middle East, being LGBT is still a crime, and is in some cases, punishable by death.
I am not the first gay man to admit to having had a tough time growing up gay. LGBT people have had decades of negative messages hurled at us from straight society - sometimes physically, from religion, education, health care, government, media and often our own families. We can spend our lifetime internalising this and believe we are as bad as they say. In his ground-breaking book Straight Jacket: Overcoming Society’s Legacy Of Gay Shame, Matthew Todd, addresses the issue of growing up LGBT and how it affects mental health. It explores why LGBT people experience higher rates of depression, anxiety, low self-esteem, substance misuse, suicidal ideation and early death than the general population.
As a therapist working on the frontline of London’s LGBT community for the past five years, I have seen these issues manifested in my work with chemsex - what many are calling a mental health crisis in our community - which I tend to agree with. Chemsex is a subculture of mainly of gay and bisexual men who use crystal meth, known as ‘Tina’, and GBL or GHB – known as ‘G’, to facilitate sex with each other. Chemsex parties are often promoted on dating apps such as Grindr. These drugs offer the experience of intense, almost mind-blowing sexual euphoria. Crystal meth releases four times as much dopamine than cocaine into the brain, causing the need to chase the high after just one hit. It can cause long-term psychosis, and paranoia. After a full on weekend, some men have been known to take their own lives on a crystal meth comedown (referred to as ‘suicide Tuesday’) and many more have attempted. G is sold as an industrial cleaner, is taken in liquid form. It can be fatal, with many users slipping into a coma from accidental overdose. A 2017 report found there was a G related death in London every 12 days. In 2019 an investigation and television documentary uncovered a hidden epidemic of addiction, violence, sexual assault, rape, overdose, death and suicide associated with G. In the UK, G remains a class C drug.
Chemsex is a very complex issue, and recovery from it can be obscured by levels of denial, stigma and compounded shame. In therapy, these underlying problems need to be unpicked, understood and addressed gently with compassion, respect and sensitivity. There are many reasons why gay and bi men engage in chemesex, including stigma, shame, self-loathing, low self-esteem, loneliness, fear of intimacy, body image, sexual triggers, previous sexual assault, HIV diagnosis, and internalised homophobia. There is often layer upon layer of trauma to address. For many, there is a fear that sober sex will never offer the same intense high, which is why relapse can be so common. It can take up to 18 months to recover from crystal meth addiction, due to the damage done to the brain’s receptors; and we still don’t fully know enough about the long term-damage. Helpful guidance for chemsex recovery can be found in the book, Lust, Men and Meth by David Fawcett.
Harm reduction can be a great entry point into recovery, in that it helps some to understand if they can use safely or not. While I support this as a crucial step towards recovery, I feel there is a tendency to focus too much on harm-reduction, over abstinence, as a long-term solution to chemsex recovery. For many who find they cannot stop simply by using their willpower and cognition alone, harm-reduction can be futile, lead to relapse and simply delay and confuse the recovery process. Certainly, when I meet chems users who identify they have a problem, they are often beyond the point of any kind of safe or controlled use. The drugs and the pull-back into them, are just too powerful. G is literally killing people. Crystal meth can cause long-term damage to the brain and even suicide. Working therapeutically with any gay man serious about recovery, I would always encourage abstinence. Only when someone is abstinent, are they able and safe enough to address their underlying trauma. Anything less feels like simply changing the deck chairs on the Titanic.
Relapse for gay and bi men can be triggered by sex, loneliness, isolation, boredom and shame. Working with clients individually, I also encourage them to get involved in an LGBT recovery group or support network, as part of their relapse prevention. The shared sense of identification and connection with other LGBT people in recovery is a vital step in healing their traumas. Understandably, this process cannot be facilitated in individual therapy. Much of our lives growing up LGBT is experienced in isolation, even when we brave coming out. Some LGBT people - including myself, have experienced the gay scene as harsh or unkind. At our worst, we can be judgemental, critical and shaming of each other. Many users of dating apps like Grindr say they experience this kind of toxicity on-line. I believe it to be a projection of our own shadow; hurt people hurt people. Yet, in LGBT fellowship groups, with the foundation and structure of an ongoing recovery programme, we have the chance to become our best. We recover our own wounded child from the shadows, and begin to love ourselves, and allow ourselves to be loved. Even for those without an obvious addiction, many LGBT people suffer in silence without healthier places to connect. As a community, we need to address this more.
A Change Of Scene is a free community group I run, where up to forty gay and bisexual men attend monthly to share their life stories with each other. At a recent event, the topic focused on sexual consent. An overwhelming amount of men felt they struggled with boundaries and saying “no” to a sexual partner, due to their low self-worth. Many felt there was a worrying normalisation of risky, dangerous and sexual practice in gay culture – with a tendency to over sexualise ourselves. All agreed there is a deafening silence of denial within the LGBT community about both of these issues.
The recovery community in London has been responding positively to some of these needs over the last few years, with growing numbers of LGBT specific meetings, as well as BAME, gender and agnostic focused meetings of Alcoholics Anonymous, Narcotics Anonymous, Crystal Math Anonymous, Sex and Love Addicts Anonymous, Sex Addicts Anonymous, Overeaters Anonymous and Adult Children Of Alcoholics & Dysfunctional Families springing up across Britain. London’s newest recovery venture The Soho Recovery Centre, hosts packed meetings of these fellowships every day. Of course, recovery is far from black and white with one size not necessarily fitting all. I work with clients using a range of different approaches to support their recovery. However, 12-Step meetings are free, available every day and there are no waiting lists. For the vast majority of people attending world-wide, long term recovery is real and absolutely possible. It does work. LGBT fellowships offer a ready-made community to join; there is a shared purpose and sense of belonging; healthy friendships are encouraged using principles based on kindness, intimacy and humility. I believe therapy should work alongside the recovery process too, especially LGBT people, so they feel as fully held as possible.
There are many voices yet to be represented in LGBT recovery. Lesbian and bisexual women are often missing, despite high levels of alcoholism found amongst them. BAME people are often overlooked - despite higher numbers contracting HIV. And nearly half of young trans people have attempted suicide in their early lives. LGBT organisations are working tirelessly to address these issues, but with literally zero budget. I have been privileged to work with some of them. But I often wonder how my straight peers in treatment centres, the NHS and those working privately, manage in really knowing how best to support their LGBT clients. This is absolutely not a criticism – but a question. Some of my clients have told me they felt anxious speaking to their previous therapist about genderfluidity or chemsex, in fear of being judged. And some of them have been. Some therapists I have met said they find these subjects equally uncomfortable, and fear saying the wrong thing or offending. Often, these are the reasons why some clients seek out LGBT therapists. When a client brings something which I’m not sure how to respond to, I simply ask them to help me understand. It becomes an invitation for them to be seen and heard. And although that’s what many of them are terrified of, they are actually craving it. Intimacy.
Group work is a huge part of the recovery process, as it allows intimacy to develop. As a dramatherapist and counsellor, my therapy groups offer a safe space for gay men to connect and explore authentic intimacy. LGBT people are hungry for it. As an intervention for recovery, dramatherapy is a powerful tool to help re-connect aspects of the split self, though play, stories, embodiment, music and movement. Clients will take gradual steps out of their shadows, moving towards integration. Despite my difficulties growing up gay, I am grateful to my headteacher. Healing my gay wounds has given me the gift of recovery, and in turn, a desire to help others. At the end of a year in which LGBT people across the world celebrated the 50th anniversary of the Stonewall riots, I am left with this. Whilst we continue to celebrate LGBT pride with love, respect and diversity, when will it feel safe enough for us to honestly come out of our closet, meet with our shadow, integrate with our light - and heal? It’s time to get well.
Dramatherapist and Counsellor
Simon is an addiction counsellor, dramatherapist, trainer and group facilitator. He works in private practice in Central London and also at Mount Carmel Rehab in South London