Drugs / Mental Health / Relationship Advice / Sex & Hooking Up

Gay Therapy: Questions for an LGBTQ Psychotherapist – Pt. 2, Drugs in Relationships, PnP/Chemsex, Emotional Abuse


Nick Fager (@gaytherapy)

It’s no surprise that I regularly receive some intense questions from my followers.  While I do my best to answer, I think we could all benefit from a professional!  I reached out to Nick Fager over at @gaytherapy for some help.  Nick is an LGBTQ psychotherapist based in NYC.  Some of you may already follow Nick on Instagram!  Along with his great content there, he founded a startup last year that matches LGBTQ people with nearby LGBTQ-specialized therapists and doctors. Launched in NYC but expanding soon, check it out at lighthouse.lgbt.

In this two part series, I asked Nick to answer some popular questions I have received from followers over the past several months.  Please check it out and share with anyone who may need this advice!

Question 1:  I’m in a relationship and my partner likes to use drugs but I don’t.  I try to be ok with it and accepting because I really do love him, but it’s starting to wear me down.  What can I do to stop him or do I just need to move on?

This is always a tough situation to be in and varies case by case. Of course there is a big difference between occasional substance use and addiction. What constitutes addiction can be subjective, but you want to look out for how much the drug use is interfering with their daily life – are they missing work or school? Are they still functioning the way they were before the addiction? Has their behavior changed?

You don’t want to shame or judge your partner but you also don’t want to enable, which means taking away the natural consequences of someone’s actions. It is healthy to target the behavior, not the person as a whole. Labeling someone as an addict in a critical way can often exacerbate the situation as opposed to opening up a conversation about their behavior and how it is affecting you.

Often what I see is men wanting to save their partner from addiction, or believing that they are going to change or get over it. In reality, the motivation to get sober has to come from the person who is using the substance. You can guide him there, even open up the door, but he has to be the one to step through it otherwise you will just be placing a band-aid on the situation.

One this that is absolutely necessary is communication. A lot of people stand by and watch someone they love lose control or struggle with addiction without actually saying anything because they are worried about the consequences of bringing it up. If you can’t have a serious conversation about substance use, then the relationship doesn’t have a strong enough foundation to get through it.

If you sense that your partner is dealing with addiction, you have to remember to protect yourself. This is not to say run away as soon as you realize your partner is struggling, but if repeated conversations and attempts to intervene are unsuccessful, and the situation is escalating, it is often necessary to leave for self-protection, as painful as that might be.

Question 2: It seems like PnP and Chemsex (click for definition) is so normal in gay culture even though it has harmful effects.  I can’t decide if I’m missing out on better sex and fun or if I should just stay away from all of it?  How can I decide.

STAY AWAY! I cannot reiterate this enough, party drugs like meth are the most addictive and most harmful substances out there. Everyone that I see in therapy who has tried these drugs has had a very hard time getting off them and for many, it has ruined their lives.

I believe that most people turn to these drugs because sex and relating to others intimately is a very difficult experience without them. Growing up gay, we develop a lot of shame, a need to protect ourselves, and a constant fear of being revealed or exposed. On a deep level, we might believe that we are bad, ugly, even disgusting, and this makes opening up to someone, sexually or emotionally, very anxiety-provoking. To bypass all that shame and discomfort, we take a drug and connect openly, but by doing so we miss the opportunity to actually look inside and see what’s going on.

Choosing to do the work on ourselves is a harder and longer journey than taking a drug, but it is absolutely one million percent the right choice. Drugs give us a brief break from our reality but then deliver us right back to it feeling even worse than before, and so we take more and more to get back to where we were. If we choose to look inside instead and work through all the shame, fear, anger, sadness, or whatever is in there, with the help of a therapist or supportive other, we eventually can feel that freedom that the drugs bring on a moment to moment basis in our sober lives. We can live authentically without shame and relate to others without excessive fear. We can enjoy sex and intimacy. We have enormous potential for love and happiness once we get over that emotional hump, but we have to commit to the road of introspection and vulnerability and not take shortcuts.

Check out my blog post on meth here.

Question 3: What are some common signs of an emotionally abusive relationship in the gay community?  How do I know if I’m in one and when it’s time to leave?

There are a lot of signs to look for if you think you might be in an emotionally abusive relationship. Generally a lack of respect is a good starting point. Is your partner constantly criticizing you, belittling you, humiliating you, name calling or ignoring you? Control is another red flag. Does you partner control your daily activities to an excessive degree? Tell you what to wear or how to behave? Control how you engage with others?

Violating boundaries is another area to check in with. Does your partner respect the boundaries that you have laid down. Maybe there is one night a week you don’t want to sleep together, or one possession you don’t want them to touch. Does your partner violate your privacy online? Access your facebook, email, text etc? These boundary violations are often excused but are massive violations of privacy.

Finally, threats. Does your partner threaten you in any way? This might mean threatening to hurt you or themselves, or it might be something different. They might threaten to out you to someone, or threaten to reveal your HIV status. Threats are a form of abuse even if the abuser doesn’t actually follow through on the threat.

Abusive relationships are generally underreported in the gay community, which usually comes back to masculinity. Men can feel like it is weak or feminine to report being abused in their relationship which holds them back from taking action. It’s important to be aware of how your own ideas of masculinity might be holding you back from acknowledging or sharing the situation you are in, and to challenge those ideas in order to protect yourself. There is never anything to be ashamed of when it comes to protecting yourself from abuse and seeking help.

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