A BFC counselor tells the story about two high risk clients who came in to get tested.
C: This one client who had a problem with binge drinking and having unprotected sex and his way of dealing with it, it was interesting, I mean this was a client who you know, I spent about an hour with, in the session because he was at a place that was really accessible, you know a lot of times clients come in and uh any effort to get below the surface is defense, so it's I know that, you know, can we get on with it, uh, you know, I really need to , I'm kind of in a hurry. HHH.
N: And the body language here is key.
C: Yeah. And so trying to be this supportive helpful person you're kind of put in a position saying Ok well let's don't do this intervention and you know, you have to make an assessment as a counselor to say you know, if the guy's really defensive you're just put on all those defenses and you're just gonna increase them and I don't have the opportunity to have an ongoing therapeutic relationship where we can chisel away at this, so, when I start hitting those walls, just to say ok, we got to, this is I'm not ready to go there, and to try and take another tack on it, so I was getting this client to talk about his experience and he was very guarded about what the issues were, and you know he kind of came out, well I don't go to bars anymore, and I was like so why is that? Well I just don't like it, what goes on there, it's just dadadadada you know. Well in fact he really likes it but what happened was he went on this date with a guy that he met through an HIV prevention program for youth, so here he is doing the thing that we'd say, you know building a social network, dealing with coming out and all this kind of stuff, so he goes to an under 21 or 25 group for gay men, you know that's HIV prevention oriented, so he meets another guy same age and everything and they go on a date to this gay bar and cafe and the guy's having a great time, you know, and slams down whatever, more than his limit, and goes back and has unprotected sex with this guy, totally freaks out, you know, loved it but hated it. So, he's got these unstoppable feelings with unmoveable feelings, you know, that's the unmovable feeling being the only way to be a good homosexual is to have protected sex and anything less than that you deserve to die, and the unstoppable feeling being that that was a peak experience. HHH. You know, and so, these two hit and it's just, he was presenting with a clinical level of anxiety, so the guy could have been treated just on this so, his way of dealing with that was I don't go to bars anymore. OK. He also doesn't go/ cause I worked with him on trying to build a social network because my goal for him in the session, my goal, something that I thought would be helpful was uhm, finding ways for him to connect as a gay man that weren't sexual. Uhm, so that it could be more diversified emotionally and not always be operating at the highest most intense setting which going to a sex club is you know high, it's the maximum, it's 11, it's one louder. HHH. And so, you know that's the appeal of it. And, particularly for him, so anyway, because he had this one experience his way of dealing with these collisions was to say well ok I'm not going to anymore of these groups because they're not safe, and I'm not going to gay bars, because I drink.
N: I'm gonna become a monk.
C: Well no, nono he was more creative than that. Cause he was still in touch with, he's trying to reconcile the unstoppable force with the immoveable object problem so he decides sex clubs are the solution, they're ideal from his perspective because they don't serve alcohol in sex clubs so you can go sober and he would report going sober and not using drugs or anything like that, so you can go completely sober, so you don't have to worry about losing control that way, and he reasoned in him mind that it was much easier to be safe, that it was much better thing for him because it doesn't have the alcohol, there's condoms everywhere and there's more of a sense of we're here to have hot sex and so let's have condoms cause we want to have a lot of sex. All of that. So his experience in going to the clubs, and he goes twice a week to the SW and twice a week to Eros, so this becomes his social life, and you know he's constructed something that reconciles these forces and it's working for him and it seems logical. What brought him in though, and it took/we were 2/3 the way through the thing, because what he was coming for was closing the window on this one night stand with this guy, so that's what brought him in, he was closing the window and this was going to be the end of the dark cloud of anxiety that he was living under, so it was like, praise jesus, that was in July, and this was whatever, June, and it was six months, it was like December whatever, so he was closing his window and you know everything was going to be great and his HIV negative plan was sex clubs only, safe sex,
N: [ ] just like oral sex?
C: No, receptive anal, that's what he does.
N: At sex clubs.
C: Yeah, well that's the kind of sex he likes.
N: So that's protected and he's [ ].
C: Uh hm. And so that was his strategy so anyway, we're going through, well 2/3 of the way through this session it becomes clear that he had another little slip problem that was in October, and it was in a sex club, this sex club however is another place called the Black house and so, I was like, well tell me about this experience, and he said, well I don't go there anymore, yeah ok, well what was it like? And he's like, oh, it's not good, it's not good. And I said, well what do you mean? He said, nobody was being safe there. Nobody was being safe. And it was just everything was going on. And I said so how did you handle that, he said, well, this guy was fucking me with a condom and you know it was great and uhm, then he pulled out and he took the condom off and then he continued to fuck me til he came and uh, so, here's this next thing uh, which he was totally sublimating to not deal with you know, try to focus on closing the window and being out of this. But my take on this is you see that he has a strategy that one level sounds like it works for him,but here's an example of where that's closing down and his way of handling that was well I'm never gonna go back there again, that place is bad. I've got my routine, SW is working for me. { ] but my sense, my assessment has nothing to do with where he is, I mean of the problem he's carrying around with him, you know, his demon is his own it's not related to whether he's at sex club x or y and it has to do with being able to exert some sort of power in a sexual relationship and for him, being passive is part of the sexual thing for him, that's the role that he likes, it's satisfying, that's the way that he sees himself and uh, you know, he seemed very happy with his sex life and all that so, but here's the deal where slowly his life's chipping away, so let's say that then he has a slip sometime at Eros and he's gonna have, on average, he has about six to ten partners a night, and of course being a receptive bottom he can have as many as he wants. And being 20 years old,
N: He's a commodity?
C: Uh, yeah, everybody's a high commodity but young
N: But you could feel like a big fish
C: Yeah, young, well I think youth is attractive and we live in a culture that really glamorizes it, and the other thing about young bodies are, they're just, they don't show any of the signs of aging,you know, but the other thing is uh, that naivete and that sense of innocence that's very seductive.
N: So the men fucking him are older generally.
C: Yeah. Yeah. Oh yeah, definately. I mean I don't think it's all about age but it's a dynamic that's going on. Ane there's nothing wrong with that but the thing is his strategy for staying negative is dealing with this unstoppable force but it's such a limited strategy and he's having so many tries that if there's any one problem you can have this collision again. So then let's say he takes out the eros and puts all his energy into them, what happens when there's no place that's safe for him, he's out of places, he's out of tools in his tool kit, uh, this is a guy who I think would be a very high risk for suicide, uh, just because of the tremendous amount of hatred directed toward himself because of not being to manage this, sense of loss of control and the sense of hopelessness and you know the anxiety was so great I was even having to have boundaries to not pick it up myself, and his level of, his lack of awareness about other options was so big
N: You mean other kinds of sexual practises?
C: Uh hm. Cause we talked about, what about blow jobs and that/it's just like that just isn't gonna work for him, so spending more time selling the unsellable is not, cause that's not the issue here, you know, we talked about all those things but when he came back. So, and there was somebody observing me in that session and we talked about it and she was like , man that was amazing the way you were able to get in and what he was able to share and then that big disclosure dadada and what was interesting was, at the beginning he came in, was one of these you know, I know all about it, I've got it all I'm just closing my window, stamp my card and let me get out of here, and uh, and so that's always a red flag when somebody like generally, there are cases where people really are
N: That's the thing that's hardest for a novice counselor to deal with cause they don't have those skills, body language, to get someone who'se amped up like that on speed to actually sit down and stay and talk to you.
C: Uh huh. And so the time it came time to leave he was laughing, he was incredibly relaxed, he was asking questions, we were able to play with some ideas and so what I left him with was this idea of hay there are other things going on and see if you can't diversify them and find other ways of connecting, just so that all of your needs don't. because that just adds momentum to this unstoppable thing you know, and so if there are other ways, because this is somebody who I think is very emotionally needy, and having six to seven hundred sex partners isn't just about enjoying sex, that he was having a lot of it for more, you know, trying to get something, you know, he's trying to scratch an itch with, in the wrong place and that became, that was an intuitive thing and it became obvious and so we were talking about that and he was talking about why he didn't want to go to this or that but then he said well you know I'm gonna start with a gay man's chorus in SF, and he became so animated talking about the possibilities of that and the whole thing, and so that was really kind of confirmation that he was one on this but that he was scared shitless about how to do it, and he had this sense of, anytime we'd talk about condoms or how to intervene in situations like this, it doesn't feel natural, doesn't feel natural, doesn't feel natural, doesn't feel natural, and by feeling natural he wasn't talking about the way it feels inside of him because he can't tell the difference whether you have a condom or not, uh, yeah you can't tell the difference, so the, it was that sense of I don't want to change the dynamics of what's going on here, this guy's in charge and he's handling me and all of that and really it's a powerful moment and so I was trying to help him see you know, this isn't about being natural, you know sex is natural, but how to have sex and how to interact is social and it's learned you know and no sex education class really talks about those things. Sex in our culture is constantly, we're obsessed with it, but we never discuss it in real context. We discuss it in health context, we discuss it in death context, we discuss it in a moral context, we don't discuss it in the context in which it happens and from the myriad of ways that people do it, and I'm not talking about positions you know but the whole routine and ritual that leads up to it and how that plays in, and how it's used to meet so many needs, and so to help him maybe move to someplace to say hey, there's a way that I can make this work for me, and that it's ok, you know, I'm not supposed to know it all, you know, and have that all figured out, So it was amazing to see the transition and so just talking about all these things and being able to for example talk about that negative, that other kind of hidden period, because see if we hadn't got that to the session, once we dealt with close the window on that one, then this would have been the same. So it would have just been a rotating window.
N: There's the long hallway of windows opening and closing.
C: Right, and not jumping on him and saying well you didn't tell me about that or you know, this is a whole new picture, or you know, and I just casually toward the end wrapping up, I said ok so, and we talked a little bit about what if it was positive and all that, and then, cause I had the sense that this guy may really be positive I mean you know this may be it, and it, later that night, I mean I actually thought, generally I don't think about clients after [ ] but it was like this guy struck me because he seemed so vulnerable in that this juncture and the opportunity was right for mentoring and to see what was missing here, what you have in so many families, are people that you can go and talk to in your family, parents, friends, or something that you have access to people that you can talk to about these things, uh, you know, and he didn't have that. There was nobody for him to talk to who he could talk to, I mean what got him so animated and engaged was that I knew where he was coming from, you know, in being a gay man myself, being able to say oh so then how is this, you know, so we started the session kind of changed, cause I didn't want to recreate this dynamic of where I'm the top and he's the bottom or I'm the expert and he's passive and I need to fill him up kind of thing, which would have been just recreating the same dynamic that he has in his sex life, and to change it around to more like a peer thing, which he didn't have at all, was someone to say wow, you know, this was really hot and the person to go yeah, boy, I know that is hot, not to say are you crazy, are you suicidal, is there something wrong with you, you know, to say boy, yeah, I really know but you know that doesn't work, here's how I do that, and to be able to access it several times with him cause this is such a high anxiety thing you can't bring it up. I mean he's got so much at stake, and what he's slowly eroding away is all of his access to his identity and sense of connection cause he's getting his world smaller and smaller and smaller and smaller and smaller, and the frequency of his sex is just going up up up. So it's inversely, it's like he can't get enough because what he wants isn't all there, you know, and so trying to deal with that, so what was helpful to be able to be able to relate in that way and say hey you know we can talk about this without having to go to this unmoveable problem thing. Uh, rather than trying to move this let's talk about how to work on your unstoppable force here, and to not see things in such black or white. See, he couldn't give up with the black and white because that was his defense, that was his way of coping. By keeping it so high and tense, that was the way he could make his world smaller and smaller and more controllable. But that's a limited strategy, you know, in life rarely does one strategy work in all circumstances, it's just, I would say it's never, maybe there is sometimes but it's just rare that one sex strategy is going to work in all sex situations, you know, particularly as you're learning, see he's in an active learning stage.
N: Twenty?
C: Yeah, and he had only been out for a very short time.
N: How many tests did he have?
C: Uh, three or four I think.
N: Oh ok, now what do you think the testing process, how was that contributing to this whole dynamic?
C: Four tests
N: At probably regular intervals right?
C: Right. Well the way the test works is it's a time to recharge the anxiety in this unstoppable/moveable force thing that he has going on, so the test serves the function of reinforcing his coping strategy which is fear and anxiety, so it forces him, I mean generally how he deals with his anxiety is through sex, ok, so he deals with his anxiety by doing what makes him anxious, so you can see how that's a short term fix. Kind of like, being anxious about drinking because you have a drinking problem but then the only way to deal with it is to drink, because nothing else will make you stop thinking about the fact that you shouldn't be doing it. HHH. And so that was where he was at, right, so he's in a closed loop, and the testing serves the function of reinforcing that and what he came into the session wanting and setting up is uh, you know, ok, dominant person, I'm a bad person.
N: THis is the guy who came in and announced that he was stupid
C: Yeah, both these clients had that. I see parallels, they're two different guys but same behavioral patterns, some of the same/the other one did not have the closed down world approach.
N: Uh hm.
C: The other guy is somebody whose dealt with a lot of religious baggage.
N: The 18 year old guy?
C: Yeah.
N: He's one of the new [ ] at the [].
C: I met him at [ ] and uh, his thing is that he came from this very intense trying to be the perfect catholic, and his personality structure in general is just vulnerable. And very needy but very black and white, and so he has a lot of that black and white thinking, same as this other guy does about what the problem is, you know, the problem is the place, the problem is who I was with, the problem is drinking, the problem is this, so he keeps trying to bring his world down. This other guy has a much bigger issue, or a different issue that presents I think in the same kind of framework is was religious, so, he lives in a family and is very dependent and very attached to his family, uh, is younger than his age, so he's even younger than 18, and his thing was about religion and about his soul. ANd he really believes that the soul's lost. He even said that AIDS was God's punishment. So he's internalized, he's got this other religious abuse thing going on, he presents to somebody you know based on my years of experience working with survivors of sexual abuse, he presents as somebody who was severely sexually abused.
N: Probably by a priest.
C: Or maybe his father. Or some other authority figure. Uh, not necessarily a priest but probably an authority figure. Maybe a priest and this is the kind of guy who'se a magnet for that.
N: And look where he's working.
C: Uh hm. He's a magnet because he's the type of person that you'd want to hold in your lap kind of thing, you know what I mean, kind of like, treat him like he's acting, which is ten or nine, and I don't mean that in a negative way but just like that's where he's at, and he can't move beyond that because he has this really rigid and firmly planted cognitive structure about good and evil and right and wrong and all of that, so that presents him with a real dilema.
N: So according to the psychological model he would have been abused right about that age. Right? [ ]
C: THis other client, I didn't have the sense, he may have been abused but I didn't have a strong sense and I didn't present on that or you know pursue that but it was interesting, so I was trying to think alright, well what could help, what's something that I can give this guy to take home, cause he knows all about condoms, that's not the problem, using them, dadada but it's just this power control thing and so getting the idea that well let's try to get your needs met in other ways so that you can hook up with other people who are successfully dealing with this and you can get some emotional support and all of that, and build some peer relationships where you can talk about sex in a non-having it sort of environment, cause it's too hard to learn how to do that when you're at the maximum intensity level, you know, you're being cruised and this guy is so unbelievably hot you can't imagine that he's attracted to you, wants to put his cock inside you, that's the wrong time to say you know my therapist has said I really need to work on control...... HHHHHH... and I'm just exerting myself, I mean that's just unreasonable.
N: And the drinking is a kind of way of making it so that things can happen and you're not responsible.
C: Right, so I was thinking what can I do, what can I do? Well I finally came up with the idea, what's another strategy and tip you know, and so I actually engaged him and said, well are some things that you think might work for you?
N: Which guy are you talking to right now?
C: Now I'm talking, I'm back to the guy who was making his world smaller and smaller and he was in a better place to make change, this other guy who was ten years old, he needs a whole support, I mean, he needs an active therapist and case manager, I mean he needs a long term therapeutic relationship with ongoing support, hotline, you know, being able to call leave messages. This other guy, the one at the sex club, has some needs for some serious therapeutic work with a lot of ongoing relationship with his cause it's so multiproblem, multifaceted and goes so much the core of his identity and spirituality and his whole framework for why he's on the earth that uhm, this is a much bigger, that was a much bigger project, uhm, but this particular one was more, I think this is more containable and approachable, and something that might be able to make a difference. This other guy you know, uh, there's just not much opportunity and you know that's one of the frustrations you have to deal with is to say, you're not going to be able to help everyone, you know and that's so, and I don't mean that in a defeatist kind of way, because maybe the best you can do is just comfort them, listen to them, give them an opportunity, and that's worthwhile, but in terms of really making change is just the scale of the problem is too big for the scope of the session so
N: Now did either of them have the resources to get the kind of counseling or somekind of counseling that would help them, in terms of money or
C: Well one was a [] student, so would just be entitled to ten sessions at []. and was real resistent to doing any of that cause he's real resistent to anything that would disrupt his coping strategy. See you know, cause the way to help him cope is to open up and expand his world, and to him that's the most threatening thing, so it's gonna be tough to get this guy to go into access that. He didn't have any independent source of income and he didn't have a relationship with his parents where he could say hey you know, I'm having trouble, there's a risk that I might be getting AIDS.
N: [ ] to father.
C: Yeah, hey dad, I'm really having a problem. Yeah and the other, the
younger guy lives at home with his parents and they don't even know that
he's gay, so, that'd be a problem. With the other guy the other idea that
I hit on was the reality condom, so I was describing that to him and I wish
we had had one or had the instruction sheet on how to do it, but it was
interesting even on this, he was like, oh yeah, I tried that, and I said
well, cause what I was thinking was hey, this is something he could put
on before he goes out and it'd be in place so then he wouldn't even, it
wouldn't even have to come up, you know, in terms of his negotiation
This conversation continues: Reality Condom
Index of test counselor narratives
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