Out walking a few months ago, I noticed a baby navel orange that had been dropped on the ground.
What happened to our capacity for relating?
There is something that I have been noticing for a while now, in every part of my life.
Over the last three years, our capacity to honour working arrangements, connections, friendships, and even simple responses has often become severely impaired. Of course, I include myself in this.
So how have we come to this normalisation of burnout? Behaving as if those around us are disposable, and it is simply too much effort to put ourselves in others’ shoes and understand the consequences of our actions, because we are just too zoned out.
We were already overloaded
Looking back to long before the pandemic, many of us were already at the limits of our capacity to endure stress. This might be due to a minority or global majority identity, past trauma, juggling survival (perhaps with disabilities, housing issues, chronic health issues, and/or chronic financial stress), and the sheer exhaustion of living in a society that is, increasingly, trying to kill us. Then there was and is climate change and the rise of fascism.
Even if we had ‘enough’ resources for the day or week or month, or even the year, and were in good health, the spectre of that changing was ever present.
When you’re already on the edge, small setbacks feel like big ones, and big ones feel like catastrophes. If you haven’t had time to recover from one thing, and another one happens, you are dealing with more than one layer of response, and these layers can quickly pile up. This over time is likely to reduce your capacity for empathy and your energy to receive others’ bids for attention or help, let alone your capacity to respond to them.
The impact of sudden change
We have all had different responses to the pandemic. But one thing is true, that we all had to adapt to Covid-19 very quickly. Over time, we realised our resources were shrinking : social, personal, and financial. While time seemed to stretch, and some felt persistently hopeful that we were almost out of the woods (we aren’t, still), many people found themselves with less energy. Many people stepped away from relating because it just took too much personal resource.
Remember the frenetic activity of those suddenly finding themselves at home all days? Creating mockups of famous paintings using saucepans and pet cats, learning Italian, and baking sourdough. Those whose labour keeps society propped up were neglected, while being expected to keep turning up for work, or they would lose everything.
The pandemic itself
If you have Long Covid, (or greatly fear getting it for all sorts of valid reasons) you will have been navigating that on top of the huge society wide denial by many governments that the pandemic is still happening. A very redundant form of individualism has been normalised and encouraged, as if to check whether others are okay – family wide, community wide, or country wide – is seen as laughable. An infantile notion of ‘freedom’ has been invoked, freedom from ‘lockdown’ which sounds carceral and something to be rebelled against, instead of a way to keep us all safe.
People as a whole have been encouraged since the start not to take the pandemic seriously. So many aren’t wearing masks now, or acknowledging the decreased capacities, and increased access needs, of a significant minority of people. I am sad to see this even in queer/left community.I wrote more about this here.
This is a trauma response
Before you think I am condemning all humans, it is very clear that this negligent apathy is also a trauma response. Many people have been struggling to connect the way they did before. They may have felt abandoned by close people, friends, partners, and the social system they exist in. They may have experienced multple bereavements, both due to Covid-19, waiting lists, or inadequate medical care due to a deliberately depleted NHS. They may have hated working from home, or been laid off work, or lost their business. They may have been evicted by a rogue landlord.
Life has changed, and this is the new normal, but many people still feel that we can get ‘back to normal’ with no consequence. I find this somewhat delusional – but I am well aware sometimes our delusions and denials are all we have in order to remain upright.
Traumatic dissociation is a major driver of what I am talking about in this post. Dissociation is a very valid survival response and most of us fall into it at some time or another. It may for example be masking a flight response, or a freeze, or any other response to overwhelm.
And what is hard to talk about here is that trauma can make us self-absorbed, selfish and worse. Trauma isn’t pretty. The fight response often isn’t, and the fawn safety response (tend and befriend, caretaking, or appeasing) tries to be pretty, but often can only be sustained on the surface. I’ve even noticed a hierarchy of trauma responses – basically fawn is the most acceptable, and fight the least – which deserves unpacking in another post.
How do we reframe our existence, heal, and reconnect?
I wish I had an immediate answer to this.
I admit that I have been shocked to the core by the behaviours and attitudes of people that I thought I knew. And I know I’m not alone in this. I’ve been baffled at being ignored, over and over, when attempting to maintain a collaboration. Again, I know I’m not alone. Endless one-sided initiation feels like a mug’s game, and trust seems in short supply now.
One thing this society does is divide and rule. The more we fight each other, the more we remain divided. I also know that it is not that simple, and in many cases of discrimination there definitely aren’t two equal sides.
I hear people in certain circles criticising individualism and insist on community all the way, especially in terms of transforming society from the extractive to the supportive. Which is fine, but many of us have not been trained in how to be in community, and we have no experience of how to do it at all, let alone well. And when we do try, very often abusers (emotional, financial, or sexual) find their way into positions of power. It happens over and over again.
There is a lot of work to do here, and a lot of healing and reconfiguring. And we have to start somewhere. As in therapy, sometimes all we can do to begin is make the unconscious concious, by naming what is going on and keep it from falling below the surface again.
I chose this image (by Brooke Lark) because it reflects the struggle of decision-making in the kitchen, whatever the reason for it.
You wouldn’t think that cooking was a challenging topic, especially at this time of year! *sardonic laughter*
As you read this, you might be recovering from holiday cooking. If this is a huge pleasure for you, (and someone else did the clearing up), I’m glad. But I know this is not the case for everyone.
Actually, the more I’ve reflected on our personal relationship to food and cooking, the more I feel an edge of shame and stigma – and a sense of authoritarianism – around the subject. I have known people who would be horrified by the idea of eating, and offering, anything but fresh ingredients cooked from scratch. If you are one of them, you may find something to think about here.
There’s a gigantic post to be written about food, who has enough of it, who doesn’t, food quality, economic power, the carbon cost of moving it around, labour (everything from who harvests and processes food to who prepares it and who consumes it), and what is called privilege but is also known as relative (or actual) structural advantage. This is not that post.
Here I’m looking at the personal experience of getting and preparing food, and why many more people than you think find it a giant chore and actively stressful on an ongoing basis.
Anything on this list may be further impacted by holiday periods (like right now), when eating/hospitality rituals are at their most significant.
This list is not exhaustive or exclusive
This post was greatly helped by a long discussion thread which ran to over 100 posts and was clearly bringing a lot up for people.
Please note: None of these headings are exclusive – what I have written in some of them of course can apply to others. It’s a rough and ready roundup and for sure I will have missed something.
Not everyone loves to cook
There, I said it.
Not everyone is able to cook
… for themselves or others, for all sorts of reasons.
(TL;DR: Shame features a lot here.)
(1) General food shaming and snobbery
The media is full of images of perfect looking food and recipes. Not all are super posh and expensive and presented by thin white people, and many writers go out of their way to present cheap and easy recipes. But it can seem like we’re never doing enough to make this somewhat mythical-looking proper healthy food. Many of us are too busy or too tired, whether from work or from life, or too skint to think about it.
If this topic is making you uncomfortable – (think of all those politicians saying that they could make Christmas dinner out of three chickpeas and an apple, and why didn’t all these feckless people on low incomes just learn to cook properly?) – it’s worth wondering why. Many people regularly order takeaway or eat microwave or freezer meals or eat food from tins, for many of the reasons you will read in the list below. Yes, you can critique the nutrition in some of it, and the relative expense of takeaways, for sure.
But this is far from being a lazy option, because remember the systemically abusive productivity ethic that sits behind the word lazy.
(2) You never learned to cook and you’re ashamed about it
There are many possible reasons you never learned to cook much. Only a tiny proportion of people never learned because their family was well off enough to employ a full time chef. It’s more likely that your caregiver/s weren’t into it or had no time for it. Perhaps they were out working and/or socialising all the time and you had to make do with what was in the cupboard. Or there was no money for fresh foods that needed to be prepared. If your family was hungry and skint it is unlikely that they were making elaborate things that take ages. Quick, tasty and filling are the most important factors, via takeaway or microwave.
If your childhood was like this you may have mixed feelings about it. If there was trauma attached to it (see below), the kitchen may just seem like a no-go area.
(3) Preparing and sharing food was a fundamental expectation from your earliest days
You may have grown up in a family/culture where cooking for others was an axiomatic part of existence. It is what you did, and to not do this would have been a source of great shame. Being a poor host would be unthinkable. If you were assigned female at birth (see below), you may have been drafted in to help your mother and other relatives prepare large meals. You learned a lot and quickly because there was no choice. Of course that didn’t mean you automatically enjoyed it, and if this is the case, your lack of enthusiasm may cause you to feel as if you are betraying your roots and culture. You may then force yourself to perform ‘Good host and amazing cook’ when you are not feeling it.
Your childhood may have left you with great cooking skills, and the capacity to please others with them – but if food was used as a substitute for love in your family, and not acknowledged as such, control and emotional blackmail may have been in the frame.
(4) Lack of money
It is getting harder and harder to survive in this country if you are on a low income or benefits. We have been at ‘heating or eating’ for a long time now. And heating bills are going up and up. Making sure you have enough for both you and your children or dependants is becoming a normal aspect of daily life for an increasing number of people. Having to be creative, not about flavours or colours or sheer fun, but about whatever you can find that will keep you going for a few hours, is not a joyous experience. If you are struggling to feed yourself or others, you are eventually liable to be traumatised (see below), also from chronic shame, which no one should ever underestimate. You may enjoy dumpster diving, but equally you may not be able to do it or have the energy or time for it.
You might be visiting food banks, unless shame has prevented you and you are waiting for true rock bottom before you go there. Often we think we are waiting for rock bottom when in fact we are already there.
(5) Gender essentialism
If you were assigned female at birth it is more likely, the world over, that you will be expected to cook for others as a matter of course. And to put others’ needs before yours. I don’t need to put an essay here about the implications of this for human relations everywhere, and the assumptions that ride on it. You may have grown up in a family where everyone sat around doing their thing while your mother cooked meals for everyone. Snacks and cups of tea may have mystically appeared by your side at random times and this was Just The Order of Things. If this was modelled to you when you were young, whatever gender you are, if may be harder to shake off than you think. ‘Bad homemaker!’ ‘Bad woman!’ ‘Bad human!’
Tradition can create self-induced pressures: ‘My mother always did it this way!’ You may find yourself experiencing resentment, whether you act on it or not.
(6) Cooking for family
I’ve heard plenty of folks say they loved cooking until they had to cook for their children, however much they love them, and as the years passed their love for preparing food eventually just evaporated. Bring on the freezer meals! Sometimes the mainstream media gets on a high horse about this, even today.
If being a really good cook was part of your identity before having family, you may need some time to adjust.
(7) Eating disorders
You may have had, or currently have, an eating disorder. So preparing food is going to affect you in a number of possible ways. You may have been keeping this a secret from most or all of the people you know. You can just about deal with putting something together for yourself (if you live alone), but when others are around it’s a whole different matter. Even thinking about food may bring a lot of difficult feelings that you would rather keep away from others.
(8) Allergies and intolerances
There is increasing awareness of food allergies and intolerances, which themselves may be increasing. They may cause minor/temporary but life impacting discomfort; cause illness and periods of incapacity; or be actively life threatening. There are many risks in not preparing your own food. If you can get hold of foods that are safe you should be okay to cook. But you will likely need to cook from scratch if you have, for example, a nut allergy or if you are coeliac. (See also having the spare time and money to obtain these foods). If you have Mast Cell Activation Syndrome, you may become increasingly vigilant about new reactions to foods.
Other autoimmune conditions may make cooking complex, so someone might use meal replacement shakes so they know exactly what they are consuming.
(9) Weight shaming
If you live in a larger body, you may have experienced fat shaming from childhood, (and certainly as a adult), as everyone around you pathologised you. Every bite you eat may bring feelings of trauma and stigma. Plus, experiencing other peoples’ judgemental hypervigilance in the guise of caring, as well as medical gaslighting, will also cause harm.
Also, if you wish to lose weight whatever your size, cooking for others may become incredibly stressful. You may feel shame at what your body looks like and what you perceive it to look like; shame at having succumbed to diet culture or having dieted unsuccessfully; and feeling as if you have let everyone down by wanting to lose weight, particularly if you have friends in larger bodies than you. It’s a minefield of shame, whose layers are numerous. None of this will make cooking enjoyable.
(10) Disabilities, physical and mental
Cooking from scratch may be physically tiring for you, or impossible to carry out without help. You may have ME/CFS or Long Covid and have experienced gaslighting around those conditions, and therefore not tell anyone about them. Preparing food may exhaust you for many reasons, but you may not have your access needs fully met. Medication, including pain meds, may also make cooking into a challenging and even unsafe task.
Pre-chopped and peeled foods are a godsend to many. There is a lot of ableism around critiques of these accessible forms of food, and this includes ready made meals.
Depression and anxiety can make cooking much harder too. Take care when suggesting that someone ‘Just batch cook!’ – it may not go down well.
(11) Childhood or past trauma
As you can see above, childhood trauma around food may leave its mark on you – screaming fights in the kitchen, or meals thrown across the room, particularly at Christmas and other holiday times, perhaps fuelled by alcohol or drugs. Caregiver/s may have forgotten to feed you, or have simply ignored you, and you had to find what you could find in the cupboard. Kitchens themselves, and the sounds they make, may become a trigger. As holiday times are seen as ‘family time’, therefore group eating time, if you have experienced abuse in your family you may experience difficult feelings.
(12) Current trauma
If you are recovering from more recent traumatic experiences or grief, you may be in a dissociated state and find it very hard to coordinate in the kitchen. Food may taste different, or have no taste, and everything may feel pointless. You may have lost your appetite, or may be eating whatever comfort foods are easiest to find. These may not be the healthiest but will need minimum preparation. You may be forgetting to eat at all.
And decision making can be a huge struggle for some people at the best of times, even over the simplest things.
(13) Executive dysfunction
This may be defined as struggling with time management and planning; following detailed instructions; adapting to new input; trying not to lose things, and general difficulty with self organisation. It can impact someone due to ADHD, trauma, or brain injury, etc. This may affect someone’s capacity to list and choose food, follow instructions and focus on what needs to be done in what order. For many people this may be a lifelong struggle. Cooking here needs to be the most efficient journey from A-Z with the minimum in between.
I am using a broad definition here, encompassing both differences you are born with and acquired ones.
If you are, for example, autistic you may (and everyone is different) have a range of foods that you simply cannot eat. You may have safe foods that may seem repetitive or bland to others, but you know you need to have a supply of them. Eating outside those foods may cause distress. You may experience sensory processing issues when shopping for food because supermarkets can be exhausting. (24 hour ones may be a blessing here, with peaceful 4am expeditions possible.) The lights, the noises, the random people, are all stressors.
Tastes and smells when cooking may make it enormously challenging. Plus there is the mess of cleaning up afterwards, the issue of food waste, and stress over who does the labour if there is more than one of you.
There is also the performance aspect of cooking for others that may cause huge anxiety. Being looked at while making something and possibly having your labour judged and commented on, may feel like just too much. Similarly experiencing the pressure to be creative, the pressure to make something pretty, or the dread of cooking on a group rota in a shared home.
You may become hyperfocused and forget to eat for hours and hours at a time. If you have issues with interoception, you may not know when you are hungry, or mistake it for another sensation in the body. (Or you may take all sensations to be hunger and eat more than you need.)
Sometimes, if the resources are there, people get meals delivered because it is absolutely an access issue. Having entire grocery shopping delivered however may not work if the company won’t deliver inside your home.
(15) You just hate cooking!
If none of the above apply to you, you are totally allowed to hate cooking for no reason other than you would rather do just about anything else!
As you will hear in neurodivergent and other circles: fed is better than not fed.
If there is someone in your life who might benefit from reading this list, please forward it to them.
I wish you the best possible festive break, if you are having one.
I spotted this damaged Christmas tree ornament in TKMaxx. There was another broken one, in the form of an owl with an unintentionally heart-shaped hole in its chest. I couldn’t bear to photograph it.
This is neither a festive post nor a beautifully crafted one. You have been warned.
If anyone feels personally judged or attacked by this post, I would encourage you to sit with it. Remember this is a systemic, collective issue and it can be changed.
1. The pandemic is still going.
The pandemic is not over. Not even close. In the UK and worldwide people are still dying every day. Over two million people in the UK (let alone the world) have Long Covid. This means symptoms that continue beyond 12 weeks, and in some cases over 2.5 years. (You can end up with Long Covid from a very mild infection, not just from a transmission in the early days pre-vaccinations. ). These symptoms may be such that a person’s capacity to go about their daily life is impaired. They may have to give up work. Do you understand what it means when a person is no longer able to earn a living in this society?
2. Perhaps you have a trust fund?
Let’s cut to the chase. I may have missed something. It may be that the majority of people in the world, the UK especially, are privately wealthy and do not care if they, or someone close to them, can’t work again. I can’t help thinking that this doesn’t add up, but hey.
3. ‘But it’s just like a cold or a bit of flu, no?‘
Superficially perhaps. It enters the body via respiratory channels, but can affect many organs, which is why you have people experiencing chronic fatigue (remember how people with ME/CFS were gaslighted for so long?), heart rate changes, breathlessness, anxiety, cognitive deficits – do I need to say more? And a person in prevous good health could experience this, not just ‘Oh did they have existing conditions oh well there you are then nothing to do with me I am healthy.’ (Vaccinations have helped enormously, but they don’t keep it away completely.)
4. The great leveller?
The pandemic taught non-disabled people what it was like for those confined to their homes or only able to travel with difficulty and extensive planning. All those who could – (what have been called middle class workers) – took their work online. Events – (and there are a potentially lot of those in a therapist’s life like mine, for example) – went online. And it was great! You lost some of the networking capacity for sure, but it made a more equal playing field. Neurodivergent people, disabled and chronically ill people, people struggling with their mental health, those on lower incomes who can’t always get childcare, etc – lots of those people could now attend trainings and meetings. And it kept everyone safer from the virus by removing travel from the equation.
5. Not all benefited from this ‘levelling up’, however.
Anyone doing labour that cannot be done on screen had to keep on going to work in person. That’s a lot of people cleaning, delivering, processing food, working on transport, working in retail, building and of course healthcare. All of them keeping our society going. Without those workers we would have no society. Instead of treating those workers with respect (eg free masks, priority vaccinations etc), our administration played games with the entire population.
6. Please remember the lies you were fed.
As well as being regularly and deliberately confused about what was happening via the media, with ‘bubbles’, endlessly shifting ‘tiers’ and u-turns (remember Christmas 2020), we were left with an idea that Covid-19 was some kind of naughty enemy of the British Empire that could be dealt with by using infantile language about ‘moonshots’, and maybe a really embarrassing gun battle on the Thames (sounds familiar?) with people dressed as doctors hurling custard pies at people in racist-looking virus costumes.
We didn’t quite get to ‘freedom fries’ but the F word was used, as if the doughty brits were really going to stick it to a virus. And the people in charge who pushed it out were merrily attending parties and going on holiday all along, while ordinary people died in their hundreds of thousands. People were being literally suffocated to death by misinformation, a disproportionate number of them People of Colour.
7 ‘Then why isn’t everyone masking up wherever possible?‘
We have been told it’s over when it’s not. Even though it’s winter now and wouldn’t it be great not to catch all the other seasonal viruses? Every time I go on public transport in London I am one of the very few people wearing a mask. The other week, on a very crowded delayed Overground train, I was lucky enough to get a seat and therefore have a close up view of someone’s workplace pass clipped to their belt. An actual doctor working at an actual hospital – in a soupy rush hour crowd – not wearing a mask. And yes, I hear stories of hospitals and clinics not enforcing masks and staff not wearing them. (Not all, thankfully.)
8 ‘Hold on, not everyone is able to wear a mask!’
Yes. Some people have a sensory or trauma response, or a respiratory one, which means that mask wearing is acutely stressful for them and just not possible. So all the more reason for everyone else to wear one to boost everyone’s protection and allow those who can’t to live a reasonable life.
And yes masks can be pretty grim if you’re wearing one all day. (Think about the doctors and nurses with dented bruised faces.) I see why many people would be willing to take the risk – I really do see this. And yes I can see why that doctor on the overground wasn’t wearing one, as maybe he had been wearing one all day. But even so – how can we do better?
9 ‘But not everyone can afford masks, esp N95 ones!’
Yes, I agree. imagine if the government gave out masks instead of wasting millions – billions – on mysterious deals that benefit only the very few. Masks for all sounds a lot more worth it, doesn’t it? This would never happen because it might start showing people how they have been corralled into a ‘me first’ space, even while having what they have stolen from them in broad daylight.
10. ‘So why are so many events going back to in-person only, then?’
Good question! It’s like everyone’s forgotten what ‘access’ means. It is directly ableist, with all the knowledge and resources we have now, not to make your seminar/conference event a hybrid one. [As with this entire post, someone will remind me of exceptions to this. There are always exceptions.]
Unfortunately plenty of ableism goes on even in online-only events. This especially confounds me when I see it in the therapist/practitioner world. I have online access needs myself and I admit that I have become a bit of a professional annoyance to some events organisers.
11 ‘Lighten up, will you, lefty killjoy!’
No, I won’t. But I don’t want anyone to stop going to gigs, pubs, theatres, parties and on holiday either! They are a fundamental part of life for many people. But if we all did a little bit to make these things more accessible for everyone, life would be better, no?
PSA: Until we as a society learn to look after each other better, we will remain in thrall to toxic values that are dragging us all down. Do I really need to name these values? Toryism, neoliberalism, Thatcherism and of course another F word. Of course, many brown and black and trans and queer and working class – and of course disabled – folks have been shouting about this for literally ever.
It’s not that we shouldn’t look after ourselves too, but if we remember that our actions have consequences, and if we pull up everyone behind us, then we all benefit. I’m not sure why that’s so hard to understand. We have all been encouraged to sink into an intoxicating swamp of individualised wellness. Keep working on yourself as the problem, so that you don’t see the structural issues which of course no one person can change alone and will just make you feel worse.
Best order another scented candle. But none of that will get us out of this.
12. Lefty Queers, why aren’t you talking about this?
This is part of the reason for this post. I am feeling increasingly heartbroken when attending queer events where no one is masked (or seeing pictures/videos of them online), despite this community having a higher than average number of disabled and vulnerable people in it, and a lower than average income. This is a community that often speaks of little else but ‘community’, but here seems to be talking the talk rather than walking the walk. Are you content to collude in exclusion?
(Despite my words above, I am also cynical about some usage of ‘community’ as a carry-all badge of goodness and sincerity. It often involves ingroups and outgroups which are not always acknowledged. However, this is not the post for unpacking my thoughts on this because, trust me, we would be here all week.)
13(a) Please read this important article:
Please read this piece by queer disabled activist Leah Lakshmi Piepzna-Samarasinha: Abled-Bodied Leftists Cannot Abandon Disabled Solidarity to “Move On” From COVID. I’ve been sharing it around the place and am baffled by the relative lack of engagement. There are plenty disabled folks who have been effectively written out of in-person engagement by this ongoing ableism.
I’ll say again, if anyone feels personally judged or attacked by this post, I would encourage you to sit with it. Remember this is a systemic, collective issue and it can be changed.
14. OK I’m done
I’m tired from writing this. I will try to put some links in later on. I hope this post is at least a thought-starter for someone.
If you are still looking away in order to maintain an ‘us and them’ paradigm in terms of health and disability, please remember that however positive-thinking you are, however immune you feel to the issues here, you can still be taken from ‘us’ to ‘them’ in a heartbeat.
Well, it’s been a year. Such a year, in fact, that I haven’t blogged since last Christmas.
This is a quick post to tell you about two books I’m in in 2023.
Pink Therapy: Erotically Queer
Pink Therapy are adding two more publications to their existing collection of books for GSRD Therapists, Erotically Queerand Relationally Queer. Edited by Pink Therapy founder Dominic Davies and psychotherapist and author Silva Neves, both books contain a wide variety of topics and approaches.
My chapter, in Erotically Queer, is about working with LGBTQIA+ menopausal clients.
These books will provide a very thorough grounding for anyone working with, or planning to work with, Gender, Sex and Relationally Diverse clients. These two books will be published in 2023. This is great news for our profession!
Bloody Hell! And other stories – Adventures in Menopause from Across the Personal and Political Spectrum
Edited by feminist author, speaker and powerhouse Mona Eltahawy, this anthology will be published by Unboundin the next year.
In Mona’s words:
‘Too often when feminism takes that brave dive into the deep end of a taboo, it takes along just a select few: white, wealthy, cisgender, heterosexual, able-bodied women.
Bloody Hell! And Other Stories is the antidote. […]
‘It is not just cis women who experience menopause. Non-binary people, trans men and other gender non-conforming groups also experience menopause and do so under even greater levels of silence and taboo.
‘This anthology aims to expand the Menopause Moment/ Wave/ “Movement” beyond white and cis women.’
Globally, nationally, community-wise, and personally, it has been extremely challenging. While for me this time has also been transformative, grief has also been ever-present, particularly in the last six months. So last week I was very glad to participate in a grief-tending workshop, of which more further down the page. But first, the year.
It’s all very exciting and I’m delighted by the increasing support and attention that this project is getting.
Another good thing: after they Found Something on a scan, I spent a month wondering if my breast cancer had come back. It turned out to be the shadow of a mole. Oh the relief.
Sad and challenging things
This was a year of losses. Three people died, all of whom I had a different kind of connection with and all of whom were, in different ways and degrees and at different times, significant presences in my life:
• Sue (who I had known for about four years, was part of various communities I am in, and was a powerful presence in them).
• Ruby (who I had known since the mid 90s, who I met at a bar when I was first exploring the scene, and who took me to my first Pride in 96 or 97).
• Tobias (who I had known since 2010, whose events started up just as I was coming out of a two year physical and mental health hole since having a stroke in 2008, and via whom I met a whole new community of people who remain friends today.)
All of you, Rest In Power.
And then there was the loss of, and damage to, some significant connections due to miscommunication and conflict. This is what happens when we are carrying more trauma than we know how to deal with. ‘Community’ feels like a fragile thing at times, particularly in the shadow of a pandemic, and self care comes in many different forms. Covid times have amplified all of our experiences in this. My work as a therapist reminds me of this daily.
What I have described above is just part of what happened this year, but by the end of it I was feeling washed up and unformed, like a plastic bag on a beach.
Embracing grief
Then, a week or so ago, I was scrolling on Facebook when I saw a link to a workshop which really resonated with me and I thought, it’s time.
Embracing Grief was hosted by Tony and Sarah Pletts of Love & Loss, and Bilal Nasim. (Disclosure: I have known Tony and Sarah for a number of years. I know them as highly experienced in holding spaces of all kinds and don’t hesitate to recommend their work.)
I had been swinging from dissociation to sadness to anger and back, with a strong need to feel both supported myself, but also to support others. This is where group work, at its best, can be so effective. Our three guides facilitated and held us, a group of 10 participants, all with very different stories to tell about why we were there.
They took us into it gently in stages, so by the time we got to taking turns to share, (and there was a very open invitation on how you might wish to do this, or not), I felt able both to open up about my own experiences and to listen and support others as they shared theirs.
By the end I was lying on the sofa by my Christmas tree, wrapped in a blanket.
In the days after the workshop, I felt less broken and somehow more solid. But also with the permission to lean into whatever I was feeling. The losses I experienced this year still hurt, but through this experience I felt more able to integrate them.
Thank you Tony, Sarah and Bilal for helping me anchor myself as winter comes.
Truthfully I don’t know how – or even whether – to celebrate World Menopause Day. What I do know is that if you are reading this, you may be seeking some clarity about your situation, whether for you or someone close to you.
Things are gradually changing for the better. Awareness-raising is increasing and more people are shouting about menopause, particularly those who are generally excluded from the mainstream narrative, for example: people who are LGBTQIA+, Black, neurodivergent, or who experience surgical or premature menopause.
‘Why did nobody tell me?’
But there is so much more to do and, while society learns to adapt to the needs of this enormous population group, a lot of people are still floundering. Particularly those without the resources to have their voices heard via the media. But whoever you are, and whatever resources you have access to, you may still be wondering why no one ever said a word to you about peri/menopause.
Perimenopause is a Thing
I mean, you probably knew that – but if you’re in your 30s you need to be knowing about it now. If you’re in your mid-late 30s to early 40s and are experiencing changes in your mood or body, or exacerbations to existing conditions you may have, this may be peri and you need to know about it. You are not ‘too young’, no matter what anyone tells you. Looking back, mine started at 39 and possibly earlier.
Menopause is a Hormonal Transition
A hormonal transition means change. A change in outlook. A change in desire. A change in what you can tolerate. It may mean a shift in how you view your sexuality and your gender. I’ve spoken about this in a talk called ‘Menopause – Agent of Queerness?’
Menopause is Compounding and Multifactorial
Whatever is already going on for you, whether connected to your identity or to your life experience, menopause is going to interact with it. If you are already affected by past or present trauma, mental and physical ill health, disability, financial concerns, domestic abuse, lack of resources, minority or minoritised identity, menopause will exacerbate it. (Eventually, it may help things too, but there is a lot to get through first.)
And the way menopause is promoted, and treated, in society mirrors systemic bias, whether ageism, racism, ableism, misogyny, or transphobia.
As above, I could say the same about the whiteness of much menopause information and resources. People of colour’s experiences are barely being heard about or acknowledged. It’s not good enough.
‘I need help – but what kind of help?’
In some corners of social media there is a certain pressure to be super positive about menopause. If you are seeking cheerleading, there are plenty of practitioners and they are easy to find.
But I’m thinking you came onto a therapist’s website because you need somewhere to talk about what’s going on for you on a number of levels. To name aloud what’s happening to you inside and outside.
There may be anger, fear and shame. You may not feel able to talk about the things that are going on in your mind and body. Your working life and relationships may be in turmoil. You may be wondering who you ever were and realising that, looking back, it all felt like a costume. Parts of you may be opening up, and other parts may be shutting down.
You may be non-binary or trans or queer and have very few places to explore how menopause intersects with your life. You may be cis and straight but feel totally alienated by the mainstream menopause narrative.
Whatever you need to bring, I can offer you a place to talk about it.
You will find it in the journal Sexual and Relationships Therapy, which is published by Taylor & Francis. SRT is the in-house journal of COSRT, the UK-based therapist organisation College of Sex and Relationship Therapists.
You can read more about this research on my other blog here.
Please check out my site queermenopause.com for more information on the project as a whole, and the resources page.
I started this project two years ago. I am incredibly grateful to the friends and colleagues who helped me shape my ideas, and to the participants who gave me their time and told me so many important stories.
If you are struggling with anything to do with menopause and would like to explore more deeply what is going on for you, you can contact me here.
What is Normal? Psychotherapists Explore the Question
Confer is a psychotherapy training and CPD organisation that also publishes books. In 2018 their 20th anniversary conference explored the meaning of ‘Normal’. And now there is a book. A number of well-known psychotherapists are published here, includingIsha McKenzie-Mavinga, Foluke Taylor and Bret Kahr, exploring what ‘normal’ means for them as practitioners.
It’s fair to say that in life, as well as in psychotherapy, much is normalised that should not be. There is an overwhelming societal drive to blame the individual for systemic failings. Individuals therefore feel that they have ‘failed’ because they are struggling against forces that are bigger than all of us. Hence, for example, the rise of the wellness industry and what is known as ‘McMindfulness’.
Closer to home, psychotherapy trainings in the main still treat diversity and inclusion as bolt-ons rather than systemic ground-up necessities. Whether someone is LGBTQIA+, brown or black, disabled, working class, kinky, a sex worker, consensually non-monogamous, traumatised or neurodivergent (to name only a selection), it is seemingly up to those of us in those groups to adapt to the system. The system finds it very hard to adapt to us, preferring to reframe in terms of pathology.
There is so much to think about here, and so much important that needs saying.
Still Hot! 42 Brilliantly Honest Menopause Stories
Still Hot! was put together by Kaye Adams of Loose Women and journalist and author Vicky Allan. They interviewed 42 people about their experiences of menopause. A number of the participants are well known, such as Susie Orbach and Lorraine Kelly. There is an interview with the non-binary actor Bunny Cook, who took part in the Holland & Barratt Me-No-Pause campaign.
Still Hot! has a mainstream focus. I took part because I wanted to raise the profile of queer approaches to menopause, and because we always, always need more testimony! And the truth is, no one, LGBTQIA+ or not, is well-served at the moment. The more we normalise public awareness, the more menopause will be understood. One of the barriers to understanding is ageism – systemic and internalised. The more people learn that perimenopause (the initial phase of menopause) can start in your 30s, for example, the more we may start to dismantle the idea that it only happens to ‘older folks’.
Books like this are a very welcome addition to the public conversation.
Contact me
If you are interested in having therapy with me, or commissioning writing, you can contact me here.
Trans Awareness Week runs from 13th to 20th November.
The last day of Trans Awareness Week, November 20th, is the annual International Trans Day of Remembrance, when people gather to mourn the loss of all the trans and gender diverse people who were murdered, or died by suicide, during the previous 12 months. There is always a long list of names. Many are trans women of colour.
Content note
This post isn’t ‘How to be a better ally’. And it’s not a gender explainer either (links at the bottom), nor a point-by-point bad science debunker. So who and what is it for?
This post is for anyone who is still unsure where they stand on trans rights. It’s about how to look at your feelings and wonder about them, for greater awareness and the benefit of all. I’m going back to the individual and the personal because you can strategise all you like, and read activist blogs and talk for hours about what you might do, but until you look at yourself and your beliefs, you won’t get very far.
Please note: Shaming (of yourself or anyone else) is not the aim here – we are all, no matter who we are, in a process of unlearning something.
History is repeating itself
Anyone who does not believe that trans rights are human rights, I will very gently suggest, is on the wrong side of history. Sure, it may not look like it right now, if you only get your information from mainstream media. An entire community gaslighted and abused – it ought to be illegal to say this stuff. (Oh, wait…) But remember what people said about gay men and lesbians back in the 80s – about contagion, perversity, the danger to children? Here are all the tropes again with another minority. How long do we have to wait for the current wave of prejudice to burn out?
Are you still unsure about trans rights?
This post is for anyone who still thinks trans and non-binary lives might be a debate – (but biology surely!) – and that there might be dangers here, but is not sure about that either, having seen trans and non-binary people coming into discussion threads with lengthy clarity and boundless energy, explaining, arguing, asserting the rights of gender diverse humans, pointing out the bad science, over and over and over.
There is a price to be paid for this seemingly boundless energy. You may not see the overwhelm and exhaustion from having to repeatedly respond to query after query after devil’s advocate after ‘I happen to believe…‘ from yet another cis person on yet another thread. It takes a colossal amount of emotional labour. Sometimes people tag trans people into very toxic threads, (perhaps even with good intentions), and they end up seeing yet more ‘opinions’ on their right to exist in the world, and wading through comments posted by overnight biologists talking about ‘large gametes’. Do you really want to contribute to this?
Trans rights are not a debate. ‘Debate’ is often a debased activity. It’s really about who gets upset first, making the other the ‘winner’. Either that, or it’s a theatre for false opposition (see: a lot of mainstream media content, unfortunately).
Where to start? With yourself.
You may have trans friends, but they’re okay as individuals, right? Or perhaps you think you don’t know anyone trans or non-binary? Actually, you probably do. They may be keeping quiet because they are unsure of you.
Expecting someone to debate their own right to exist – and only live a life free to be who they are after you have allowed them to – is inhumane. You likely know this, deep down.
How to move forward in understanding – some suggestions and thought starters
You could look at them in order, or just one or two. It may be that something in this list rings bells for you more than the rest – go with that. Whatever takes you forward.
• Be open about your unsureness, and the beliefs that support it: Let them out to air, write them down privately if you need to, share them with yourself or a trusted cis friend (don’t ask a trans person to do this work with you, as their labour will be double). Breathe. What else comes up?
• What do you fear? Next time you have that ‘Yes but what about’ feeling, ask yourself where it may be coming from. What causes you to see one minority group as having fewer rights than another? Perhaps you heard negative views in your family as a child?
• Think about when you saw something negative written about trans people. Were this writing by a trans person? If not, reflect on why you think a cis person would know better, however respected or high profile they may be. Perhaps you read even just one negative newspaper article when young, (particularly if you grew up before the internet) that somehow buried itself in your brain.
• Reflect on where you saw the negative commentary. Think about how much you actually trust mainstream media. Remember the last time you saw an article in mainstream media about a subject you are an expert in? I can pretty much guarantee it made you angry very quickly, with all the inaccuracies and mispresentations.
• Think about your own history. It may help to think back to a time that you were othered, excluded, had assumptions made about you, were threatened, or attacked. Think about the different intersections in your identity that others decided were unacceptable. If you find yourself saying ‘But but this is different!’ No, it’s not. Your feelings were your feelings. Imagine experiencing those feelings every day, because each day brings a batch of new attacks on your dignity, personhood, or right to exist. Again, it may help to talk or write about this.
• Reflect on your own gender. How did/do you know who you are? What stories do you tell yourself about your gender? I’ve linked below to some helpful books.
• Read or watch work by trans and non-binary authors, artists, and speakers. As more and more trans and non-binary people testify about their own experience (and many would dearly love not to have to do this, over and over again), they have created a body of work waiting for you to read or listen to. It’s all out there.
Not everyone is a big reader, or has time to be. There are many videos. Or you could start with Twitter or Instagram. Follow hashtags like #TransAwarenessWeek, #TransAwareness, or #Trans. Those hashtags will lead you to organisations and individuals who post a lot, about information and personal experience. You will see anger and frustration and you will start to understand why. Busy Twitter threads are a very quick way to understand how groups of people feel about their lives. Twitter can be absolutely terrible but, if you take care, you will find a lot. (The language around gender diversity evolves quite fast. Reading these fast moving media will show you how this happens.)
• Listen, read, and do the work. Please don’t ask a trans or non-binary friend – or stranger online – to educate you. Not unless they have very specifically offered this.
And finally…
I have kept this post within a number of boundaries or it would have been thousands of words long.
You may have read my list of suggestions and thought they could apply to your relationship with many other groups that you do not share an identity with. And you would be right. I have been inspired to write this post by many things – my own evolving identities, the wellbeing of my communities, and the appalling misinformation being spread around.
It has also been inspired by a number of Black authors who are doing a lot of public engagement around anti-racism, particularly as Black Lives Mattergains more and more traction. I am particularly grateful to Leila Saad for the highly structured and tightly held anti-racism journey she offers in her book: Me and White Supremacy.
Mermaids. Charity that supports trans and non-binary children and young people under 20, and their families.
Julia Serano Tireless writer, unpicker of complexities, and debunker of myths (and biologist).
Watch
Disclosure – Documentary on Netflix in which trans actors and writers discuss the history of trans portrayal in film and TV. It will shake up your view of many popular films.
The speakers were Dr Dwight Turner (psychotherapist, academic, and forthcoming author), Dr Keren Yeboah (psychologist and author of the study ‘Power and the ‘hidden self’: reimagining the therapeutic use of power in work with Black people diagnosed with psychosis’), Ebinehita Iyere (youth practitioner working with young people affected by the youth justice system), Sharon Frazer-Carroll (occupational therapist, organisational expert and founder of Time To Talk Black), and Dr Isha Mckenzie-Mavinga (psychotherapist, academic, and author).
A note on trauma
Trauma is a spectrum, not a binary. Despite the best efforts of many, society as a whole is only just beginning to comprehend the multifarious nature of trauma, what trauma means for people individually and collectively, and the different ways it can manifest. Many now accept that you don’t have to be a combat veteran, refugee, or incest survivor to be traumatised and to experience PTSD or CPTSD, and that trauma in your ancestry is likely to manifest in the present.
It’s also more understood that ‘minor’ daily incidents, known as microaggressions, can cumulatively cause a high level of distress in a person. And that ongoing fear of threat can cause as much harm as an actual incident. But some, especially those with power, may find it harder to accept that certain populations experience this more than others. The challenge comes when these same people realise that it is they themselves who are causing the harm. Without deep reflection, it is hard to own our acts and do the work.
The multiple impacts of systemic inequality
At the conference every speaker, in different ways, outlined the systemic construct of whiteness and Blackness (the racial complex that binds us) and its impact, through racism, on Black lives. We heard about trauma responses to racism and the impact on mental and physical health, including internalised racism (or our ‘internalised supremacist’), and how quickly you lose touch with your humanity when you are forced to adapt to a culture that someone else has created.
Gaslighting and double standards
We heard about the harms done by the white-constructed mental health system to Black patients with psychosis, (for example being criminalised on entering the mental health system, and having anger mislabelled as a pathology) and the constant location of issues solely within the Black community, and the minimisation of the racism that creates this.
Ancestral trauma held in the unconscious
We had an interactive discussion about whether Black trauma exists, and whether therapists should undertake specific training about it. We were reminded that in 2020 the (white) world is waking up to a reality that many have already lived with for a long time, and that white therapists need to do more self-reflection and investigation. The silence of early lockdown ’emphasised the noise in peoples’ heads’ – the ancestral trauma, bursting to speak, that is so often buried in the unconscious.
Examining racism in supervision and training
We heard about the process of unmasking racism in clinical supervision, and the reminder that Black therapists are impacted by racial trauma while also hearing about it, and yet sometimes feel unable to name racism to a white supervisor. And when a Black student is expected to educate the rest of the students in the room, and do the labour of caretaking White fragility, (and keep their own feelings in check to protect others as well as themselves within a white system), they cannot give time to their own development.
The whiteness of the therapy world
Self-care
For the last hour of the conference, the primary theme in the panel discussion was self-care. When Black therapists speak about interaction with white colleagues, the word ‘exhaustion’ quickly comes up. There will be times when Black therapists cannot be with white friends and colleagues, because of this exhaustion, rage, and hurt. White people cannot expect to be rescued from this – ‘It’s not about you’. One speaker spoke of ‘trying not to be drawn into other peoples’ awakenings.’ Another quoted: ‘Just because we are in the same storm, does not mean that we are in the same boat.’ White therapists are advised to read, especially outside therapy subjects, and process shame and guilt by finding a place where it’s okay to talk.
Challenging course leaders
How do Black trainees stand up and challenge their course leaders? One speaker sent their comments to all their leaders and fellow students, and spoke out on social media, adding: ‘Get your message right and don’t endanger yourself.’ It is important to create Black spaces if there were none previously. But ‘realise you can’t do it all.’
Beyond eurocentric trainings
In the Q&A, someone asked: ‘Where are the Black and Asian modalities?’ The response came: ‘Here we are!’ The teachers, supervisors, and learnings are already here! They need to be listened to, and training organisations need their wisdom and experience in order to build equality-based and culturally competent trainings from the ground up. There are plenty of people and organisations out there who can help: Kaemotherapy, Race Reflections, Me & White Supremacy, Radical Therapist Network, Resmaa Menakem, and others can all contribute to new forms of training that prove the organisations truly value every student equally.
When I attended the inaugural BME Voices Talk Mental Health conference back in October 2018, I was surprised to see so few other white therapists there, perhaps 10% of the delegates. This was an indication of the work we have to do to make counselling and psychotherapy truly reflective of all populations, in respect of both therapists and clients. However, after the events of 2020, and the increasing profile of Black Lives Matter, I suspect this year the numbers were greater.
There is a long way to go
Every speaker had something positive to say about how we might go forward. But it was also clear that, in many ways, things have barely changed in 30 years. There are of course many individuals of all backgrounds desiring change in the mental health system and psychotherapy – but the process is slow. And, unfortunately, it is not clear that organisations are truly listening. One major piece of evidence of this is the ScopEd project, a proposed framework for a hierarchical classification of therapists, and promotion of particular member organisations. ScopEd was not mentioned at the conference (as I recall), but I feel it fits strongly with the theme.
A missed opportunity
This is not the post to go into detail about this, but I will describe it in brief. There was an opportunity for some real systemic thinking to address the huge missing pieces currently within mainstream therapy trainings, (race, racism and white supremacy being one of the most significant, but not the only one). Instead a top-down medical and analytic model is being proposed, and many counsellors may be put out of business by being deemed incapable of taking paid work. This hierarchical structure does nothing to address racism, misogyny, homophobia, biphobia, transphobia, classism or ableism, and does not seem to address systemic factors at all, even though they affect all of us every single day, therapist or client. It also doesn’t address the access issues that prevent so many people (particularly Black, and working class) from training as therapists in the first place. While I would agree that training standards do need to be addressed, it is the counsellors who are bearing the brunt of this project, rather than the training organisations who trained them.
In his book How to be an antiracist, Ibram X Kendi states, over and over again, that it is racistpolicies that need to change, and that only working towards anti-racist policy will have meaningful impact. Sadly it feels as if this is being played out, however unintentionally, in the counselling world. Of course, good intentions mean nothing without deep reflection on the impacts of our actions.
I am very grateful to all the conference speakers for sharing so much, and to Helen George, founder of BME Voices Talk Mental Health, and co-host Leoni Cachia. I’m looking foward to the next one already.
First off, I’m aware that I haven’t been posting on here much during lockdown. I keep starting things, and then experiencing a sense of extreme pointlessness. Each time I decide to write about opening up relationships, or peak experiences, or sexual and non-sexual BDSM from a therapists’s perspective – (or for that matter, the urgency of queer haircuts in a time of Covid) – I remember that we have an incurable virus at large at the beginning of winter, people dying, fascism everywhere, and the earth going up in flames.
Menopause takeover?
A Martian dropping by might think this site was really all about the subject of menopause, or that menopause had somehow taken over. Perhaps, along with the murder hornets, walking sharks, and some nervously awaited geese, a further horror come true of 2020 will be the entire population being forced into menopause until a vaccine is found. This would be most interesting.
Queermenopause.com unveiled
Menopause has not taken over, but, while my research goes through the peer review system, I’ve been working on a project that I hope will be helpful in the future. The project is a new website which I am delighted to reveal: queermenopause.com.
Menopause happens to people. Trans men, non-binary people, and intersex people are excluded when menopause information is restricted only to cisgender women. The site has an LGBTQIA+ focus, but I also want to offer resources that apply to anyone whose experience of menopause is excluded from, or not sufficiently acknowleged by, the mainstream. There is a lot of work to do. First blog post here: Welcome to queermenopause.com. You can also find this project on Instagram @queermenopause.
I am also seeking to inform practitioners of all kinds about the LGBTQIA+ experience of menopause, and about menopause itself.
Queer Menopause in the media
I have been seeing my clients online all the way through lockdown, and I’ve also contributed to a couple of books. One is an interview for Still Hot!, a collection of 42 interviews about menopause experience. I’m also happy to say that Diva’s queer menopause feature from December 2019, which I took part in, is now available online: This is the end… of your period.
Moving forward…
I’m very glad to have this project off the ground, and I will be adding to it as time goes on. Please get in touch if your work is relevant to this project.I welcome suggestions of practitioners, trainers and researchers who are working in this area.
This year’s Pink Therapy Queer Desire conference was, as always, excellent and full of good things. This year, 2020, was a particular triumph as, due to Covid-19 and the necessity for social distancing, it was held entirely online. What we lost in terms of face-to-face networking we gained by the fact of the conference happening at all. I felt very proud to be involved in it.
My talk – ‘Queer Menopause – Where Gender, Sexuality and Age Collide‘ – was the first outing of some of my research from last year (‘How can therapists best support their Queer Menopausal clients?’). While that piece of work was focused mainly on LGBTQ+ menopausal clients’ experiences in therapy and the healthcare system, as you can probably imagine, sex and relationships came into it fairly often.
Menopause isn’t going to go away
So much is happening in the world right now that, totally understandably, it’s hard to look at anything else but our own survival, that of our communities, and the future of society. However, like all other health-related issues of the body and mind, menopause isn’t going to go away. The issues I have discussed in my talk, and the unacceptable lack of information and support I have underlined here, are going to remain – until we collectively do something about them.
Whoever you are, wherever you go
Whoever you are, whatever age you are, whether you have ovaries or not, menopause is going to affect either you or someone close to you. Remember, oestrogen can start to fluctuate (in other words Perimenopause) in your 30s, so it’s not just a ‘middle aged thing.’ And if you have your ovaries removed surgically, menopause can start almost immediately, however young you are.
To be informed about this is to care for yourself, and others too.
SURVEY ALERT!
The US sex educator and activist Heather Corinna is doing a LGBTQ+ Menopause survey for queer folks. Please fill it out and help bring all this much needed research into the spotlight.
MORE RESEARCH NEEDED!
If you’re a LGBTQ+ identified researcher, or are thinking about doing research, and something in my talk inspires you, go for it. The more folks work on this, the less it can be ignored and sidelined and the more visible it can be. (And of course the same goes for cisgender heterosexual menopause research too – that is still very needed.)
Further Queer Desire conference videos
Everyone is experiencing Covid-19 differently, but if you do have some spare time for watching videos, and are interested in sex and sex therapy, here are the four other conference talks. They are great and I learned something from all of them:
If you’re struggling with any aspect of menopause, or someone close to you is, therapy can help. if you would like to work with me, please contact me on the link below. And if you work with menopause yourself and would like to make your offering more gender, sex and relationship diversity inclusive, I also offer consultancy.
The world is experiencing a pandemic of Coronavirus, or Covid-19 flu. Due to the way it’s transmitted, people are being advised to severely limit in-person contact with others, and to take great care around hygiene. As everywhere, the situation in London is very much ongoing – and changing rapidly.
This post is to announce that, due to the current situation with Coronavirus, I am now seeing my clients entirely online. This will remain in place until things change again. This means I will be working either by video/audio link using Zoom (or another similar service as backup), or by phone. My colleagues are doing the same, or working towards it.
The benefits of online therapy
I would like to say more about this as not everyone feels comfortable with the idea of working with a counsellor or psychotherapist remotely. I have been working online and by phone for a number of years, and I would like to reassure anyone who is looking for therapy at the moment but has never done it online before.
There are significant advantages to working online:
We do not need to be in the same location to work together. Online access has created a revolution in therapeutic communication and relationships.
We have greater choice of working times, as I am not tied to the in-person hours I have at my office.
It provides access if you are unable to leave your home for any reason, or if you find in-person work very difficult.
Very importantly, we can continue to work during unusual periods like this when meeting in person is not possible.
There are also challenges:
Finding a private space to have therapy. This is important to reflect on, if your home or workplace are not right for this.
Feeling comfortable using a medium that you may not have used before, or which you have previously mainly used for social or sexual contact.
The reliability and safety of the technology.
If you’ve never had counselling online before, I have tried to answer some of the queries you may have:
Doesn’t it feel weird doing therapy while looking at each other on a screen? I think we all felt weird the first time we did any kind of video call, even with someone we know well in real life. The first time you have a session on video as a client, it’s okay to take some time to feel into it, make sure you are sitting in a comfortable position and, if you need to, feed back to your therapist about what’s going on for you.
I’m worried it might feel distancing. It may do at first, and it’s important to honour whatever you’re feeling at the time. However, humans are highly adaptive, and it’s likely that, it will gradually start to normalise.
Don’t you lose something by not being in the same room? You lose some body language for sure. But your senses recalibrate.
Isn’t it strange to do therapy by phone? My experience is that you can do very effective therapy by phone. With only hearing to guide us, our senses recalibrate further and our focus increases.
Do I have to install anything on my computer/phone? You may well need to download an app and/or sign into a website. I am happy to guide you through this.
What if something goes wrong and the tech doesn’t work on the day? This happens occasionally. Wi-fi can go down. Services may be busier as more people take their lives online. However, I have several apps on my laptop as backup, andwe can use our phones. Depending on the access issues, we can look at each other on video while speaking on the phone, or even typing on messenger. (For the latter, a discussion on confidentiality is necessary.) If everything goes down completely, we can reschedule.
What about confidentiality? In terms of what we say to each other, my approach to confidentiality is the same as when we are working in a room together. As for protection when working online, as soon as electronic media are being used for communication, there is a slightly greater risk. This is unavoidable. It’s about balancing the possible risks with your needs at the time. Some VOIP apps are seen to be more secure than others, and it is my responsibility as the therapist to check up on this.
When reflecting on whether I and a new client are a good fit, I take a number of things into account – and working online is not going to be the right thing for everyone. I’m also aware that for some people, the act of leaving your home, travelling to your therapist’s consulting room, and coming back again, is part of the process, and it feels odd not to have this.
While these tools – computers, phones, and the internet – are not perfect (because humans made them) they are enormously useful, especially at times like this when there are very few other options.
While we all try to adapt to this rapidly changing situation, therapy may not be uppermost on your mind. However, if you would like to start therapy and are interested in working with me online, on video or by phone, please get in touch.
It’s World Menopause Day today – 18th October 2019
If you have any interest in human welfare, and the welfare of those you love, please read.
I would love to go into detail about the results of my Queer Menopause study, (which I am about to start writing up), but in the academic world you are supposed to keep fairly quiet about everything until it’s coming out in a peer reviewed journal. At best this means likely a year’s time! And that assumes it’s going to be accepted by the journal I will be pitching it to.
So I will simply take this moment to thank everyone who participated in my study. I am very grateful to you for sharing so much on such a crucial topic.
However, it’s safe to say, from my reading online, personal experience, and conversations everywhere that menopause can have a huge impact on life. [Tip for happiness: If menopause has been easy for you, that’s great. But I’m not going to debate with you about why the system needs to change.]
The general response to menopause is a reminder that we are still living in an ageist, ableist, sexist, misogynist society.
Folks desperate for help are going to their GPs, but the response is a lottery. You may get lucky first time, or your GP may realise the limits of their knowledge and refer you on to a menopause clinic. But equally you may be dismissed, gaslighted, and lied to. You may be told ‘It’s natural, just get over it’, or fobbed off with antidepressants.
Of course, hormone treatment is not simple, and it carries health implications, but the implications of oestrogen deficiency are equally concerning. The fact that so little is truly known makes me suspect that if people took the time to look hard enough at hormone function, we would be less hung up on the gender binary, which would make a lot of us very happy, but some other folks, clearly, very upset.
PSA: hormones don’t have genders. All bodies need oestrogen and testosterone to function.
The whole thing is doubly stressful for queer/trans folks, who may end up having to do a huge amount of education work around gender and sexuality while trying to get help from the healthcare system. And the general media narrative about menopause is suffocatingly heteronormative and often incredibly infantilising. We can do better – on a number of fronts.
And if you’re in your 20s and 30s, don’t think it starts at 50 and you can forget about it for a while
Perimenopause (the phase up to when your periods stop) can start in your late 30s or earlier. My periods started to fluctuate when I was 39. Fluctuating oestrogen levels can affect mental health for years before your periods stop.
The effects of menopause can be inherited, so it’s worth finding out, if you can, how your biological mother experienced it. It’s also biopsychosocial, which means, put simply, it’s constructed within the body, the mind, and the world outside. If older women/AFAB (Assigned Female At Birth) folks were respected in society, I have no doubt the experience would not be as bad.
Things are starting to change
Workplace policies are being created, and campaigners are pushing for changes in the law. I would like being in menopause to be a protected identity. At worst it disables people to the point where they cannot work due to physical and mental ill health, and they lose relationships and careers. I think everyone should have the possibility of subsidised time off work. I would also like to see menopause pensions to cover this too.
If you run a workplace, please think about how it could be more welcoming to folks in menopause.
If you are struggling, don’t suffer in silence
Go to your GP armed with the NICE Guidelines 2015. If they won’t help you, find one who will, or ask to be referred to a menopause clinic.
I wrote this first thing this morning. As time passes I will add some links. Thank you for reading.
This year, when I’m not working with my clients, I’m doing a Masters in Counselling and Psychotherapy with the University of East London.
In brief: I’m doing my MA dissertation on queer menopause, and how therapists can best support and validate their LGBTQIA+ menopausal clients.
After looking at several dissertation ideas, this one stood head and shoulders above the rest. The idea crystallised after a day in December 2018 when I had conversations with about five different friends about our experiences. I sense a lot of excitement about the topic, especially as there is very little existing research out there.
UPDATE on 5th November 2019
I’m adding this for clarity, and making a few changes below. My call for participants has now ended and I am in the process of writing up my findings. Thank you very much to everyone who took part, and everyone who took the time to write to me.
I’m going to keep this post as simple as possible because this subject has many aspects to it. This is a qualitative study using Thematic Analysis. My aim is to open some doors, shine a light, and give a voice to those who have not yet been heard. I want to create a building block that will inspire others to doing further research in this area.
Call for Participants (now ended)
‘How can therapists best support and validate their queer menopausal clients?’
As my subject is counselling and psychotherapy, my research focus is on what queer menopausal clients would like their therapists to know. (‘Therapists’ could also extend to other health practitioners.) This question may evolve over time.
I am seeking to interview LGBTQIA+ identified people who have experienced perimenopause/menopause, and for whom my question above has resonance. I have ethical clearance from UEL.
Menopause happens to people with ovaries, not all of whom will be women. (I am using a very specific definition of menopause in this section, and this is the main menopause to which my study refers, but not to the exception of all other experiences. More on this further down.) Put very simply, the body slows down oestrogen production and menstruation eventually stops. When menstruation has stopped for a year, the person is said to be post-menopausal. This all sounds quite straightforward. Many people might welcome their periods stopping and, if they were having PIV sex, losing the risk of getting pregnant.
In fact, fluctuating and diminishing oestrogen levels can have many different effects on the body and mind. People (and experiences vary widely) can experience hot flushes, night sweats, insomnia, anxiety, depression, weight gain, memory loss, reduced libido, and thinning of the tissues around the vagina and urethra, leading to stress incontinence and increasingly painful penetrative sex.
Some barely notice anything at all. Others are so badly affected that their relationships fall apart and they have to stop work. Most fall somewhere along a spectrum between these two points.
Perimenopause – it starts much earlier than you think
If you’re under 40 and reading this (or even under 45), this may feel like something you don’t need to think about. But, actually, menopause can start in your late 30s. (And earlier if your ovaries were removed.) The first phase of menopause is known as perimenopause. Previously regular as clockwork periods may start to become more random. You may bleed more heavily at times. You may experience mood swings, and as hormone levels start to fluctuate, this may exacerbate existing physical and mental health issues.
No, I hadn’t heard of it either, once upon a time. Well, I kind of had, but there was no ‘official’ info so I took no notice of the changes that, now I look back, were clearly going on in my body from the age of 39 and perhaps even earlier.
LGBTQIA+ Menopause – a subject in need of a spotlight?
Where menopause is concerned, the media narrative, overwhelmingly, concerns cisgender heterosexual women – who are generally married to men, and who are experiencing loss of capacity (and desire) for penis-in-vagina sex. It is frequently framed around increased self-hatred due to the visible signs of ageing, and the idea that someone should be locked in increasingly desperate combat with their own body as their perceived attractiveness to men is reduced.
There are a number of peer-reviewed studies of lesbian experiences over the last 30 years. However, there is (that I have found so far) next to nothing out there about everyone else on the LGBTQIA+ spectrum. Bisexual women may pop up in studies, but in numbers so small that they slip through the cracks. And what if you are non-binary or trans? Or intersex? Or asexual?
Unfortunately, despite cisgender heterosexual women representing a large percentage of the menopausal population, the variation in medical advice and appropriate treatment for them is nothing short of a disgrace. Too many experience gaslighting and dismissal from doctors, despite the NICE guidelines. So the situation for anyone not cis or not heterosexual, who is concerned about their symptoms, could be much worse.
For example, someone AFAB (assigned female at birth) and non-binary may have a struggle when trying to access medical help as perimenopause starts to kick in. There are multiple pressures: (a) explaining menopause symptoms in the first place and being taken seriously (and this assumes the person realises what is happening in their body), (b) having to explain non-normative gender, and (c) if a person has existing mental or physical health problems, they may be exacerbated by fluctuating hormones. There may be a lot of confusion that adds to the person’s distress.
The point is, we just don’t know. Mystifyingly, the academic journals devoted to menopause that I have seen so far (I stress so far) barely mention LGBTQIA+ experiences. And the journals devoted to older LGBT adults barely mention menopause. The therapy journals barely mention menopause either – whether in terms of clients or therapists.
If you are reading this and thinking, ‘Hold on, what about X study/project?’ I will be very glad to hear from you.
Ignorance about our own bodies
One of my concerns is that so few people know what the early stages of menopause look like – (and this is across the whole ovary-owning population) – that many may miss out on a chance to understand their bodies better, and perhaps avert a future health issue. It may be that a person isn’t having problems, but would benefit from knowing what their body is doing.
Not all bad
It’s really important to say that menopause is not necessarily terrible – for some it is a very welcome rite of passage. Culturally, it is seen more negatively among white people in the west than in many other cultures. (There are also differences in experience and responses between classes and races.) But we are not given the choice in knowing about it. Systemic (and internalised) ageism causes society to relegate this subject to ‘silly old women’ and at times to make fun of it. This is not helping anyone, other than those who profit from insecurity.
Hormones
I am wondering how the hormonal changes at menopause may interact with the hormones someone is already taking for gender affirmation/transition. At what point does the latter fully counteract the former? My sense is that this has not been studied much. I am also wondering about menopause, (or the idea of it), causing dysphoria for some transmasculine people – and not everyone wants to, or is able to, take hormones.
Queering gender – and sex?
If someone is living as a cis woman and then menopause comes along and removes her capacity to bear children and receive a penis in her vagina, is she still a woman? If the normative ‘rule’ is that the ‘only true sex’ involves a penis in a vagina, what does that mean for sex post-menopause, where this may cease to be viable? This embodied chronological ritual encourages a default queering of sex.
Other kinds of menopause
As above, my main focus is on the menopause that happens to people born with ovaries. However, it doesn’t feel right to talk about queer menopause and leave out people assigned male at birth (AMAB) who are taking hormones. Exogenous hormones can have a wide range of impacts on the body.
Who am I?
I’ve been in private practice in London for six years. I’m bisexual, and post-menopausal. You can find more about me and my work here.
Contact me
If you would like to find out more about this study, or if you have some information or knowledge you would like to share, I would love to hear from you. You can contact me here.
It stands out especially at the moment when the mainstream media is unfortunately promoting harmful and inaccurate information about trans and non-binary people.
Revision of the Gender Recognition Act
One of the reasons for the explosion in media coverage of trans lives and issues in the past year or so is the revision of the Gender Recognition Act (GRA), which was originally created in 2004. If you would like to see improvements to the GRA – especially in terms of allowing people to self-define their gender without having to go through overlong and at times humiliating processes, and including the rights and recognition of non-binary people – please fill in the consultation here. (Closing date 19th October 2018.)
This excellent podcast by Meg-John and Justin provides useful pointers about the Act and the current situation for trans and non-binary people overall.
If you don’t know much about it, there is nothing wrong with feeling confusion when reading about gender variance/non-conformity. What you may well be responding to is a media filter, and fear-mongering headlines which have the power to lodge themselves in the mind and remain there. (And if you think you don’t know, or have never known, any trans or non-binary people personally, you very likely do.) None of this is helped when someone’s right to exist is framed as a ‘debate’.
I am somewhat suspicious of the concept of ‘debate’. What it often means is ‘a contest between a privileged person and a less privileged person to see if the less privileged person gets upset first’. (It’s a sibling to the ‘false opposition’ trope that has taken over so much media output.) Pushing someone to explain themselves over and over has less to do with information-gathering than tiring the person to the point where they have no energy to carry on, so that they will make mistakes that can be used against them.
But the good news is that there is plenty of information out there, and an increasing number of accounts of contemporary trans lives. For example, see Trans, A Memoir by Juliet Jacques, and Trans Like Me, by CN Lester.
A much-needed history
Christine Burns, the editor of Trans Britain and a contributor to it, has been a stalwart campaigner for many years and it was exciting to see the crowdfunder on Unbound build up so quickly. [Disclosure: I contributed to it.] This book is much needed – partly as a history, partly as an illuminating account of activism before the internet and after, and partly as a counterbalance to some of the transphobic material that has been going around for too long.
We are living in a time of fascist resurgence, which is creating a heightened sense of permission to attack anyone who may be considered ‘other’. But, as Meg-John points out in the podcast, so many complaints and fears about trans people have a mirror in the cisgender population. If cis people don’t have to prove they are cis, why do trans people have to prove they are trans? Just as some trans people access medical services, such as surgeries and hormones, to feel more comfortable in their gender, so do some cis people.
A book in three parts
Trans Britain comprises early history, the birth of activism, and modern day trans and non-binary life. It offers very detailed accounts, through historical stories of pioneers from previous centuries and then to living memory and the rise of the newspaper exposé, starting with a reminder that binary gender is largely a western concept.
The 1960s were a time of increased media salaciousness, but they were also a time when people started to organise on a bigger scale. However, first of all they had to find each other, and for a long time the pressure to conform by ‘passing’, and living in stealth, was an obstacle to this. Ignorance and fear and lack of legal protections meant that if a person was known to be trans they could lose their job and their home. One contributor writes heartbreakingly about their isolation in the 60s and 70s as psychiatrist after psychiatrist offered terrible help and left them struggling alone. Some spent years playing along with the whims of autocratic and idiosyncratic clinicians. Some others got lucky with the medical profession. For example, in the 1940s, one doctor helped his trans patient by using the pretext of ‘a supposed intersex condition’ as a cover for their surgery.
Christine Burns: ‘Movements often start with campaigns for what can be legislated. […] Populations en masse somehow need to be persuaded that previous ideas for what was acceptable have to be revised. It is not legal sanctions that ultimately bring about lasting changes, but shifting cultural norms.’
With profound patience and tenacity, and endless meetings and reports, activists pushed for change. The Gender Recognition Act was created in 2004, around the same time as the explosion of social media, which enabled people to communicate with each other, and share and promote ideas to a previously unimaginable extent. In 2007 came the landmark study ‘Engendered Penalties’, the largest ever study into trans marginalisation, with nearly 900 participants.
Spectrums not binaries
But challenges alone don’t define people, and the ‘born in the wrong body’ narratives of the past have given way to a more powerful and wide-ranging set of voices and platforms. Gender non-conforming people have had a major influence on contemporary culture, (eg Transgender Tipping Point, Time 2014). With this increasing visibility have come a number of supportive and educational organisations such as Gendered Intelligence, All About Trans, and Trans Media Watch. And for the last three years, the UK has had an annual Trans, Non-Binary and Intersex conference.
With this visibility has come a sense of permission for many more people to examine their gender identity and expression. It’s well worth reading this study by Joel et al from 2013: Queering gender: studying gender identity in ‘normative’ individuals. Over 35 percent of the 2000+ people studied felt their gender identity was other than that which they had been assigned at birth. As the researchers say: ‘We conclude that the current view of gender identity as binary and unitary does not reflect the experience of many individuals, and call for a new conceptualisation of gender, which relates to multiplicity and fluidity in the experience of gender.’ If you’d like to read further about this, How To Understand Your Gender by Alex Iantaffi and Meg-John Barker is a good place to start. Also Resources for Non-Binary Identities.
I highly recommend Trans Britain for a number of reasons, not least for recognising the sheer graft of everyone involved as they fought to live their best lives, and to ensure that others coming after them do too.
From Stephanie Hirst, who wrote the final chapter: ‘…’Generation Z’ […] are growing up with the normality of people of all genders, sexuality and ethnic backgrounds. This new generation will see fluidity in all people, and look back in total horror at how trans people were discriminated against during the late twentieth and early twenty-first century.’
So what makes some people so angry about the existence of gender non-conforming people, and their right to self-determination being enshrined in law?
As a therapist working with gender, sexuality and relationship diverse clients, I reflect on this frequently. There seem to be a number of factors at work here.
‘Think of the children’
Much of the recent wave of anti-trans prejudice relates to the support and treatment of trans children. ‘Won’t someone think of the children’ is an often-used argument against the existence of anything that questions current sex, sexuality and gender norms. What is being said about trans people today was said about queer people 30 years ago. Remember Section 28 in 1988, that prevented the ‘promotion of homosexuality’ in schools, and that awful phrase ‘pretended family relationships’? The thinking seems to be that where there is freedom for a person to be congruent and authentic in their gender identity and expression, the world has ‘gone mad’ and the brainwashing and abuse of children must follow.
There is a lot of anger from some quarters about medical interventions for trans children, and yet often total silence from those same quarters about the non-consensual and traumatic surgeries done to Intersex children to give them the ‘correct’ gender.
People are hugely invested in a natal gender binary. Unfortunately, much trouble comes from looking at a baby’s genitals when it is born, (particularly if the child is Intersex), and deciding which of two genders it is going to be and therefore what sexuality the child is likely to have. From this at-birth assignment of labels comes everything from earning power to personal safety, to how much this person’s opinions will be taken seriously, to medical treatment, to everything else.
It takes a lot of reflective work and uprooting of ancient beliefs to realise that neither genitals not perceived biological sex have to define gender. And some people do not define as either of the binary genders at all, as neither feels congruent for them.
I cannot say this is just something specifically about British culture, but as that is the one I grew up in, I will use it as a baseline. When I was growing up, it was much more normalised for parents and teachers to tell a child what they are, particularly when it was something negative. ‘You are bad. You are fundamentally inadequate. You are a disgrace.’ It wasn’t about the child’s actions in that moment, but something much deeper – about their entire being. So the opposing idea, that someone might respond, ‘No, you don’t get to define me – I do,’ feels positively revolutionary.
Unfortunately this drive to normalise through criticism is sometimes still mirrored in the psychotherapy world; the idea that anything that deviates from the [eg cisgender heterosexual monogamous vanilla] norm is a pathology that must be uprooted. These attitudes have not gone away, and may be echoed in the interaction when a client says ‘But it’s not like that’ and the therapist insists that they know better. At worst this becomes conversion therapy, a practice which the profession is increasingly distancing itself from.
Envy of someone who is living as their authentic self
Some (many) people grow up letting themselves be what other people define them as – this path of least resistance may be the safest path at the time. But when they realise that the norms they have conformed to do not reflect their true selves, it may feel as if it is too late. This may bring out deep envy of those who appear to be demanding and getting more from life, and this envy may manifest as a desire to attack. (And of course children can be harmed by unhappy parents who are not living as their true selves.)
A fixation with the purity of womanhood
There is a lot of frightened and at times Victorian-sounding rhetoric around who is allowed to self-declare as a woman. Some of it veers dangerously close to white nationalism, implying that somehow the classification ‘woman’ will be forever dirtied by allowing trans women to enter it.
A deflection of something much bigger, all-encompassing, and harder to challenge: how boys and men are raised
A widely expressed anti-trans fear (specifically in relation to trans women and the revision of the Gender Recognition Act) is that cis men are suddenly going to self-define as trans and start invading toilets and assaulting women. In fact, men can and do already invade toilets and harass people – which is already illegal. And of course, a woman entering a toilet and harassing people would also be committing a crime.
From what I observe, many objections to trans women’s existence involve things that men actually do (or might do), and I see a lot of fear expressed around this. It would therefore seem beneficial to campaign about better education for boys, better sex education in schools, and dismantling patriarchal structures in general. If campaigners put their considerable resources towards this instead of attacking a small minority of human beings, they might get a lot more support.
I have just spent an extraordinary two days at the Pink Therapy ‘Sex Works!’ conference, about the intersection of mental health and sexuality professionals.
Every year the Pink Therapy conference covers a different GSRD (Gender, Sexual and Relationship Diversity) topic. Created by Pink Therapy founder Dominic Davies, in recent years they have featured gay men, trans, bisexuality, and kink, non-monogamies and other sexualities/orientations beyond LGBTQ.
The purpose of the Sex Works! conference was multiple: to look at sex worker mental health and how the system could better support sex workers; to look at the experience of psychotherapists/counsellors (and trainees) who are also sex workers; and to look at the various forms of somatic sexology that may include genital touch, and how a dual trained counsellor/somatic sexologist may be protected within the psychotherapy system; and the ethical issues relating to all the above.
The conference was a potent reminder of the enormous variety of what might be called sexuality work. As well as an opportunity to speak to dual-trained practitioners, there was a lot of vital, and courageous, testimony from speakers who are both psychotherapists and sex workers.
What became rapidly clear was just how badly people who do sex work can be treated as trainees of psychotherapy – and this mirrors the experience that many sex workers have as clients trying to access counselling.
Many sex workers are not out to their therapists, because it is just not worth it, due to the judgements and pathologisation they are likely to experience. Importantly, very often the reason someone might want to go for therapy has nothing to do with their life in sex work, but they need to know they won’t have to endure projections, rescue or confused hostility.
The bottom line is that therapy clients who do sex work are often being harmed – by therapy.
What was especially disappointing was the way the therapy registration bodies represented, BACP and COSRT – (sadly we lost the official UKCP representative at the last minute) – seemed to have provided those speaking with very little relevant research and opinions for the conference, even though they were invited to participate six months ago. Contrast this with how, after the presenter of the session that preceded the final panel discussion was absent at the last minute, two psychotherapist sex workers created an excellent workshop at two minutes’ notice.
It was particularly saddening to see how the psychotherapy establishment continues to conflate sex work with abuse.
It seemed impossible to discuss the ethics of being a dual trained practitioner, or a sex worker being a psychotherapist, without the discussion leaning further and further into complaints, abuse, and the nebulous and highly politicised concept of ‘disrepute’. It was pointed out that sex work is actually legal in the UK – and yet there is a persistent lack of clarity on this in the psychotherapy world.This is part of a bigger picture, of a generalised lack of understanding of GSRD clients and identities that is consistently displayed in mainstream psychotherapy and, as a consequence, in training organisations. I find this issue especially disturbing.
From the many personal stories I have heard, a trainee therapist with a minority identity may well be expected to educate their peers about this identity, and may also endure endless questioning, assumptions, microaggressions and invalidating ‘debate’, even from tutors. The lack of understanding of minority stress, in organisations supposedly training people in how to support others, and how it can contribute to trauma, is mind boggling.
Of course, the excuse might be that by marginalising sex workers and sexuality practitioners, they are simply mirroring public life and the media.
Sexual pleasure in all but its most regimented, prescribed forms is othered and kept in darkness in a society where attention is not paid to sexual competence, and we are educated neither in negotiation nor consent, let alone in giving attention to our true desires. Apparently there is a perfect way to be a human, and that is to be monogamous, vanilla, cisgender and heterosexual, and the further away you go from that, the more deviant and in need of fixing you are. If you sell sex and do therapeutic or educational sexual touch, you are seen as almost beyond repair.
Counselling students who do sex work may be told that there are grey areas that may cause them to fail their course. This despite that, as was pointed out repeatedly, one of the skillsets necessary to survive as a sex worker – (intuition and trusting your gut, negotiation, establishing consent and boundaries, working with the client’s needs) – goes far beyond anything taught on counselling courses.
There was a lot of anger in the room towards the end, particularly when one panel member suggested the audience give them more information. It was pointed out that marginalised groups get very tired of doing the labour of explaining.
I and a couple of my colleagues have a list of queries that have been left hanging:
Can you be a sex worker while training as a psychotherapist? (Still unclear)
How are the registration bodies going to look out for dual-trained practitioners? (Still unclear)
What is the legal reason for COSRT’s two ethical issues, that a COSRT member therapist cannot refer a client to a sex surrogate because it constitutes a form of ‘pimping’ (scare quotes mine), and that a member cannot signpost a client towards doing sex surrogacy work as this apparently constitutes coercion?
And here are some thoughts about how we can all move forward:
There needs to be a basic CPD training for therapists around competency in working with sex workers.
There needs to be a directory of sex work friendly therapists, a bit like the kink and poly ones that already exist, with a badge to go on the practitioner’s website.
The main counselling and psychotherapy bodies would do well to reflect on why there is increasing frustration among therapists who work with GSRD clients, and who may well be GSRD identified themselves. There is a great opportunity here for these organisations to offer better support to all these client groups. Currently, too many minority clients are being harmed by a lack of understanding of their needs, judgement and pathologisation, and unhelpful use of therapeutic techniques and theories.
Led by the registration bodies, training organisations need to focus on diversity as the baseline, not an extra – and actual identity-based diversity rather than just ‘theories of diversity’ or relying on the students to provide the topics. The same goes for sex – this also needs to be a baseline subject. I have encountered many clients who are not sure whether they are allowed to mention sex at all in sessions.
Training organisations need to find ways to make trainings accessible to less well off students. Important minority voices are being lost due to this. Actually, many people do sex work because it is the only way to make a reasonable living (often on top of parenting and working around health issues) – for many people it would be the only way to make the kind of money needed to pay for counselling training.
Dual-trained practitioners are crying out for a membership organisation that can respect them and cater for all their needs. When one becomes visible, I suspect many will leave their existing registration bodies.
Several participants were reminded of the American Psychiatric Association conference in 1972, when being gay was still designated a mental illness. John Fryer, a gay psychiatrist, spoke on the stand while heavily disguised in a mask. This was an act of great courage, and we saw similar courage over the last two days.
This was a groundbreaking event that I was incredibly privileged to attend. Huge thanks to everyone who organised, presented and participated.
The next Pink Therapy conference, where I may be speaking, is ‘Contemporary Issues in BDSM and Therapy’ on 6 October 2018.
For many people, the idea of voluntarily cutting off contact from a family member is unimaginable – especially during the holidays.
In this way of thinking, blood ties are immutable and sacred, so making such a decision at this time of year feels doubly taboo. No matter how toxic the home environment, there is pressure to remain in it because ‘it’s family’.
I once wrote a proposal for a non-fiction book about people who estrange from their parents. It was going to have interviews, case histories, advice and self help. I pitched it to several agents – and received bemusement and confusion in response. One sent me a very strongly worded letter telling me that, as a parent herself, she was horrified and could not think why anyone would want to read such a book. (She actually rang me up the next morning to apologise – the subject had clearly affected her very deeply.)
I experienced similar elsewhere. Another agent said that it might help the book if I spent some time with ‘the perfect family’. Apparently, if only the misguided folks I wanted to write about could see that no family is perfect, everything would miraculously be okay again. I had a very strong sense of othering – that this topic really should not be aired publicly and was best quietly put away.
Shadow Daughter: A Memoir of Estrangement was published in 2018. (I’ve linked to Amazon because of the Kindle edition – there is a hardback but there still seems to be no paperback available in UK.) It’s well worth a read.
Update on 1/12/20: I wrote this piece long before the Covid-19 pandemic happened. It has changed the rules of how we live. During the holiday season it is creating increased pressure, but it can also be a protective factor in how we choose whether to spend time with people. Due to the many social changes and confusing public messages, some may become estranged against their will, and others may find it harder to get away.
Update on 23/12/22: Despite endless and ongoing misinformation about it, the pandemic is still here. On top of this, other pressures – chiefly rising fascism and climate change – feel more and more present and urgent. This will affect your decision making processes, whatever you do.
An increasing reality for many
In fact, as I have noted before on this blog, you only have to read the comments below a problem page about going no contact from family to know that there are a number of people who actively want to do this or – especially heartbreaking from older commenters – wish they had but felt it was too late.
While writing this, I felt an increasing sense of taboo, and a strong temptation not to continue. Generally when I feel this, I know something needs to be spoken aloud.
I also found this post getting longer and longer, so now’s the time to make a cup of tea.
Standalone charity survey of estranged adults
The charity Standalone, set up several years ago to offer support to adults who are estranged from their families, in 2015 published a report Hidden Voices – Family Estrangement in Adulthood. Carried out in collaboration with the Centre for Family Research at Cambridge, Hidden Voices is a survey of the estrangement experiences of just over 800 people. Three things stand out from the results:
Emotional abuse, clashes of personality and mismatched expectations were particularly common reasons for going no contact.
Most of those who were estranged from a parent felt strongly that they could never have a functional relationship again.
90 percent of respondents found the Christmas period ‘challenging’.
Standalone have published their own very thorough festive survival guide which is available here. For more on how to stand back and figure out Christmas the way you want it, try Rewriting the rules of the festive season.
You’ve gone no contact – what now?
What if it’s your first holiday period since the estrangement started? The particular pressures during this time (I’ve written more about this here) mean that you may need to do some extra self care.
Deciding to go no contact is never taken lightly, and may only happen after years of putting up with, but the decision itself can be made in an instant. And now it’s the holidays, and unless you live without an internet connection at all, you will be in some way exposed to advertising that encourages you to connect with people at all cost, especially ‘loved ones’ which generally, in media-speak, means blood family.
The social nature of holiday periods means that unless you spend time in communities who are sensitive to this, you may well have to give an account of yourself. There are a number of issues to reflect on:
Who to tell? Are you prepared for when someone offers you the usual invitation to join them for the festivities, or expects you to offer yours? Are you prepared for the response, and sides being taken?
How to tell them? Are you telling people in person, or by some other means which allows for more distance? (Bearing in mind your own safety when doing so.) Are you taking people aside individually, or contacting them as a group?
How will you deal with questions from others about where/how you are spending the holidays? If a friend has taken you in for the holidays, you may find their relatives (if they have a more traditional mindset) genuinely curious as to why you are there: ‘Why aren’t you with your own family?’ Do you have a story prepared which, while not factually true, may be enough to get you through the day? Do you feel safe enough testify and tell your truth, no matter what the response? I’ve written more here about strategies for getting through this time.
If you are alone, have you got a plan for the day itself? Solo Christmas day can be wonderful if that is what you want. If you’re not sure about that, see who you can round up to share the day with you. Or make plans for the day before and the day after. It’s amazing how many people you will find in a similar situation.
The period after going no contact can be heady, as if a cork has popped, but there can also be a hangover, an exhaustion that may lead to self-questioning and wondering if you did the right thing.
There are a number of stories you might be telling yourself:
‘Should I have waited a bit longer? This time of year is supposed to be about love and closeness, isn’t it?’
Such is the frog-in-a-pot nature of harmful family relationships, it’s far easier to put up with another year of difficult interactions than rock the boat. Perhaps you are wavering about things you have said, and wondering if it would be better if you just shut up and let everything go back to normal for a while. There are many ways to defer a decision like this, all of which can be made to sound entirely legitimate. Maybe you’ve been wondering whether it would be better to apologise to everyone and wait until:
After the summer / new year
After term starts / ends
After you’ve got fit / lost weight / given up smoking / had surgery
After you’ve moved house
After you’ve been in the new job for a while / left the old one
After you’ve paid off your debts
After the kids (if you have them) are older
You’re single / you’re in a stable relationship
A million time markers – like Christmas – can be enlisted in the cause of preventing us being true to ourselves.
‘But family’s family. Am I a terrible person?’
We are socially conditioned to put up with behaviours from blood relations that we would rarely tolerate in friends, colleagues, or partners.
You may be telling yourself that whatever happened wasn’t really that bad, and maybe you should just step back into line and apologise to everyone and let things go back to how they were. In all the cultural fog around this, it is easy to forget to give yourself permission not to live under conditions where you are not treated as an equal.
You may have spoken your intentions out loud, or written an email or letter. You might have ghosted (disappeared without warning), which some find to be an immature and selfish way to behave. ‘Can’t you just talk about it?’ they say. Which is, on the surface, a fair question. But if ‘just talking about it’ actually fixed these sorts of situations, they would not happen in the first place. There is a world of communication beyond talking. And all too often equal communication was never part of the relationship’s culture in the first place. With blood family, the problems are far older and run far deeper.
This is a good question. If you have young children and are estranging from your own parent/s, it’s important to ask yourself about the impact this will have on them, particularly during the holidays. What are you going to tell them? Do they need to be kept away from their grandparents for their own safety? In the future your child may wish to exercise a choice over whether they see that person. Obvious abuse aside, do you want to deprive them of a grandparent? And you may find yourself doing a balancing act – the more you paint the person as a monster, the more curious your children may become. And obvious family secrets can put heat into a situation which can be carried down through generations.
‘Shouldn’t I have been able to sort this out when I was a teenager?’
It might be helpful to think about this in terms of the Attachment Escalator. I find this analogy incredibly useful. (See more on the Relationship Escalator, and the Sex Escalator on this blog.) It’s a really effective way to critique the supposed gold standard of sex and relationships that causes people to put such pressure on themselves – and each other – in the name of socially sanctioned relating.
So we are put on this attachment escalator when we are born and it becomes our default forward movement with those closest to us. For some, this works out fine. But for others this escalator is poorly constructed and frequently malfunctions. Instead of making changes, or even abandoning it, we instead find ourselves staying on it, blaming ourselves for what just keeps on not working, even if we find the situation intolerable, because it is easier to just let ourselves be carried forwards. The longer we stay on it, the more habituated we become to being undermined, bullied, manipulated or threatened (as, of course, can anyone who is the perpetrator of those things). Eventually this will impact your other relationships and ultimately your enjoyment of life.
But not everyone, for a million reasons, finds themselves able to separate from family when young. It can take years, and sometimes years of therapy, to make the necessary connections, and feel ready to do so. So please don’t blame yourself for not having fixed everything before.
If you’re a young person or student: Standalone has a student section. Albert Kennedy Trust works with homeless LGBTQIA+ youth in the UK. Your Holiday Mom offers online support to LGBTQIA+ youth during the holidays.
‘I’m getting away from a narcissist, so it’s okay isn’t it?’
There is an increasing number of sites devoted to narcissists, or ‘narcs’. Lots of people have apparently become experts at clinical diagnosis and are eager to provide checklists of things to watch out for. I am also wondering about all the personal experiences that get dumped into this category, and about the nature of all the people who are labelled narcissistic.
As a therapist I feel torn here. On one hand, ‘narcissist’ has become a buzzword, a catch-all for anyone who seems to be a bit selfish and self-obsessed. There is a lot of quite objectifying advice on how to spot them, and I wonder how many people suffering from depression or anxiety or another mental illness may have been labelled this way after a difficult interaction.
On the other hand, certain patterns start to emerge in accounts of others’ behaviour, especially lack of empathy and apparently conscience-free cruelty. The Reddit Raised by Narcissists has many powerful stories. There are a number of problem page articles at the Guardian(search for parental or family estrangement) – the articles here tend to have a lot of comments, mostly supportive.
So I would say that you could see the person you have estranged from as a narcissist if it helps you validate your experience. My concern comes when people feel a need to diagnose the person who was abusive to them. Turning detective can sometimes be a way to rationalise someone’s treatment of you. What if you discover they were abused? Does this make their abuse of you less significant? Sometimes it can help, but sometimes you may gaslight yourself to the point of retreating into self-blame and inaction.
Finding your family of choice
I have noticed an increase in people talking about their Chosen Family, whatever their identity and even if their relationship with blood family is okay. (I have written more about creating Chosen Family here.) Queer communities in particular have a strong tradition of creating safe groups when society and/or family have failed. Many people eventually find themselves creating a parallel existence away from family of origin, even if they eventually remain in touch. Now may be your chance to surround yourself with people who want the best for you.
Seeing a therapist may be helpful. Choose carefully – this subject can stir up even an experienced practitioner, so it’s important you feel able to ask the right questions at the start.
If this is your first holiday season having gone no contact, I applaud your courage and wish you the best at what may be a challenging time.
If you would like to talk further about what’s going on for you, please contact mehere.
An increasing number of people refer to their ‘Chosen Family’. These are the close people we’ve gathered around us who we are not related to by blood or by law.
While anyone might create such a group while having a perfectly OK relationship with their Family of Origin, Chosen Family is often about putting distance between yourself and your Family of Origin as the only way to stay sane or safe. For this reason, it is often used in a queer context.
Whether you are escaping violence, prejudice, sexual abuse, bullying or neglect, you may put a lot of time and energy into gathering specific people around you.
Essentially, Chosen Family is a group of people who you believe will treat you as an equal, who you might rely on in a crisis, and who you hope will stay close to you, even when one of you has a major life change.
This applies on a societal level as well as a personal one – if you are queer, gender variant, kinky, consensually non-monogamous or a sex worker, for example, mainstream society likely sees your relationships – and your life – as less valid than those enjoyed by the majority. So it makes sense to band together and create something that works for you.
Created over years
I’m aware that my talking about ‘creating a family’ might imply that this is something done quite rapidly, like picking sports teams at school. ‘I’ll take this one and that one… oh and they look nice, but not that one…’ To be clear, we make these choices over years, during which time the desire to bond and create connection with others may override the quieter messages we may be getting that something is, despite our best hopes and intentions, not quite working.
Added to this is the fact that we may replicate behaviours that were modelled to us from a very young age. Remember, your family is the first group you know. That is where you first learned to navigate other people and
We may, in our eagerness to create the perfect safe zone, forget that it takes two people to form a friendship, and more than two to form a group. We may forget that consent and boundaries here need to be negotiated, as much as in any sexual scenario, and assume agreements that have not in fact been made.
Below is a range of issues you may come across when navigating chosen family:
(1) Letting shiny new people in much too quickly
As a young person you may have been told you had to ‘take what you’re given and be grateful’. So it can feel very exciting, even intoxicating, to realise that you have choices – particularly if this realisation has come to you later in life.
At the same time, it can also feel quite isolating and frightening to reflect on your own situation when ‘everyone’ around you appears to have so much support from blood relatives, partners and an array of incredible people they seem to have known for years. (Social media really doesn’t help here.)
So when you meet a new person and things seem to click, the temptation can be to grab them and not let go. ‘This person is fun and we have lots in common and we’ve talked so much already – this must mean we’re destined to be really close!’ And there may be a sense of relief that counteracts the feelings of isolation, and you may stop monitoring the situation because at last you’re home safe.
But having some things in common does not mean everything will match up. NRE (New Relationship Energy) is a phrase usually used to describe the intense feelings at the start of a romantic relationship, but it also serves to describe feelings at the start of any new association. It’s okay to enjoy this feeling – but it’s also good to wait until it dies down and re-evaluate whether this exciting new friend is right for you as a long-term close person. And it’s worth reflecting before jumping in and sharing your deepest darkest self.
(2) Ignoring warning signs
I have long found it to be the case that when you look back after any kind of breakup or rupture, you realise you actually saw the seeds of it very early on. It was likely a tiny thing the person said or did, which you ignored because it seemed too minor to be worth mentioning. And who wants to look mean-spirited or critical with the shiny new person?
It’s those little moments when the Lovely New (or not so new) Friend suddenly looks at you and says something that is – apparently – totally out of character. Or sends a message that makes you inwardly go ‘WTF?!’ Something a little bit tactless, jarring or controlling that is out of your comfort zone but you don’t have a rudder to navigate it – and you don’t want to scare them away by questioning them on it. It’s that that feeling where your stomach drops into your shoes and you can’t quite believe what you just heard – so you discount it. Such is the fear of abandonment.
Don’t ignore these little messages. They are tiny tells and they are important. For an exploration of the more extreme aspects of this, read Gavin de Becker’s excellent The Gift Of Fear.
(3) Getting sucked into other people’s stuff
When other people are friendly to you and invite you into their group, you may quickly lose a sense of yourself, particularly if you were excluded or othered as a child. If you aren’t used to it, it can feel amazing to be included in a ready made group whose members appear to be welcoming you and inviting you to things. It’s intoxicating when you are the Shiny New Person. Be aware of your feelings around this. You may feel excess gratitude for this inclusion that may eclipse other more realistic – and accurate – feelings.
Reflect on who is really in control in this new group – the person/couple at the centre may not have your best interests at heart once the fun dies down. Are you there to prop up their glory? Are they really trying to recruit you to go to their workshops or parties (monetised or not)? Or for sex? Are there lifestyle issues, like drugs or alcohol, where you are not on the same page? Are you being increasingly weighed down by a lot of gossip and expected to take sides?
You might want to ask yourself why you want to come in at the edges of someone else’s group rather than starting with yourself and people you yourself have chosen.
(4) Trying so hard to be acceptable that you hide the real you
If your Family of Origin message was that you are unacceptable in some way, you may attempt to hide aspects of yourself from new people, in case they find you similarly unacceptable. The trouble is, the Real You is going to leak out somewhere. If you sense that your outrageous true self is disapproved of in your chosen group, wonder about it. What exactly is it that you are needing to conceal from your chosen people? Are you actually avoiding the fact that, while they may be lovely, they may just not quite be the right people for you?
(5) Doing the opposite of whatever people did at home
Remember – your Family of Origin is the first group you know. This may be hard to hear, but it will inevitably influence how you respond to your role in the groups you create or join as you go through life.
This feels unfair, but until we have sufficiently understood our own dynamics and patterns, we may continue to replicate the harmful structures we are trying to get away from. Simply doing the opposite of whatever a parent did is reactive and may cause harm. If, for example, you vow never to shout at anyone the way you were shouted at, you may go too far the other way and become a quiet doormat who never gets their needs met.
(6) Sacrificing yourself for the sake of the friendship or group
Something’s not working but you’re not going to say anything in case the whole thing falls apart. It’s cold when the fire goes out and you know how that feels. It’s horrible and you’ll do anything not to feel that again. Similarly, when you feel that if you don’t do it, it won’t get done – such as organising meetups, for example. If you couldn’t rely on your childhood family for the reinforcement and validation you needed, you may understandably find yourself seeking this in others, and this is where problems can arise.
One good way to check the temperature of things is to stop initiating. If you are always the one who suggests meeting up, just stop doing it and see how long it takes for others to realise. It can provide a harsh but fruitful lesson. It doesn’t mean the friendship is over – but it means you likely need to state your needs and decide how much more to invest in this person or group.
(7) Your priorities clashing with the priorities of others
This is where you need to decide how aligned you need to be with your chosen family. About having or not having kids. And about politics. Being of a different political persuasion can be exhausting, no matter how much you feel you can put these things to the side. Endlessly explaining things, or being hooked into debate, is not sustainable.
You may find that some people prioritise romantic partners over friendships, putting you further down a hierarchy than you realised you were. (You may not have realised you were in one.) You may also be sad when you have a child and so few of your Chosen Family are still around a year later.
(8) Feeling as if you matter less than others
This is hard because there may be so many echoes from childhood here – some of them are your mind playing tricks on you, and some are real.
Example: when your Friend X mentions their other Friend Y a lot, who perhaps lives abroad and you have never met, and keeps on going on about how amazing this person is. Months or years pass, and you are finally introduced to Friend Y. You greet them with enthusiasm – ‘I’ve heard so much about you!’ – and they look a bit embarrassed and say ‘Oh, um, what did you say your name was? Oh, I don’t think they’ve ever mentioned you.’ This hurts, but is worth knowing.
And sometimes people really love you but cannot prioritise you for a huge and complex number of reasons.
(9) Guilting yourself into not acting on your feelings
You may have found yourself staying in friendships that are not working any more out of fear. One sure way of telling this is if you find yourself wondering what on earth your life would be like if this person wasn’t in it. If it seems unimaginable, it’s worth wondering why you have come to rely on this person (or group) for so much, even when they are making you unhappy.
You may have been told as a child that you were not allowed to have feelings, or you were ‘mean’ or even ‘selfish’ when you said you didn’t like someone or didn’t want to do something. Perhaps you were told you were inherently defective or just ‘bad’. As a result, you may have found yourself letting others take advantage of you because you just don’t think you have the right to refuse, and you must continually atone for your ‘badness’ by letting people push you around. Needless to say, you are doing all the work here, and this is not healthy.
If it’s not working – it’s not working.
You cannot make something work if it isn’t. You can try, but at some point you will need to find a way to go your separate ways. The relief you feel when this association is broken will be tremendous and tangible.
(10) Not being able to discuss the difficulties in a friendship – or end it
So much public advice is about romantic relationships: getting together and breaking up. We are not encouraged to have much emotional literacy about that, and with friendships even less. Are you able to sit one of your Chosen Family down and explain how things are not working out between you? Do you fear their anger? (Perhaps like that of a parent?) Can you find a way to hold a course with them, or is it time to move on?
Dealing with ending friendships is a whole post in itself. And while not everyone is into Relationship Anarchy, disrupting the presumed hierarchies among friends, romantic partners, (and bio family too), by treating them all with more equality is something many could benefit from.
If any of what you have read feels familiar and challenging and you would like to talk about it in therapy, please contact me here.
Need some CPD? Would you like to to update your skills and knowledge?
In 2017, as part of London Sex and Relationships Therapy, I am offering trainings on Gender and Sexuality in the therapy room, and other related subjects.
In January I will be in Cambridge and Edinburgh, facilitating:
Gender and Sexual Diversity in the Therapy Room
Drawing on the book Sexuality and gender for mental health professionals: A practical guide(Richards & Barker, 2013), this training provides a basic outline of good practice when working with issues of gender and sexuality. Attendees will be encouraged to reflect upon their own ideas and assumptions about gender and sexuality, and those implicit in their therapeutic approaches. We will consider various ways of understanding sexuality and gender, and their implications for therapy across client groups. Specifically we will focus on the issues which can be faced by those who fit into normative genders, sexualities and relationship structures, as well as for those who are positioned outside the norm.
If you would like to attend, please follow the links below for bookings:
Relate Cambridge – Saturday 14th January 2017 (10-4pm)
London Central Counselling 