The new resident Gawker therapist, Anonymous, is a licensed therapist who treats many different patients, but specializes in teens and couples therapy. After many years in the field, Anonymous has lots of stories and insight to share. We'll be publishing some of them here. Today: when sexuality impacts treatment.

If you have any questions you'd like to ask our therapist, send them to gawkertherapist@gmail.com with the subject line "Therapist." We'll use the most relevant ones for publication.

Have you ever had a patient come out to you?

I once had a patient come out to me, and it had taken place two years after I began to see him. I began to see him during his junior year of high school, when he was involved in a heterosexual relationship. The kid had come from a well-to-do family where he was the second oldest of five children. His siblings were all athletic; he performed in the school play and was a member of the choir. He was originally referred to me by his parents for depression, and he attributed his depression to all factors except for his sexuality. He was still a virgin and complained of a general lack of intimacy in the relationship, but attributed this to the girlfriend's anxiety issues and the fact that she had been a victim of a sexual assault.

A few years later, he revealed to me that he had chosen her as a partner in part because he knew about her victimization, and what it meant about her hesitation and issues of trust relating to other men—specifically in a sexual nature. He thought that her background would allow him to maintain his hetero facade without ever being confronted about his lack of sexual attraction or action. During his senior year, he began to self-mutilate, which occurs far less frequently in males than in females. He felt like an outcast in his family because he had such dissimilar interests, and he felt that nobody had understood him. But in the few times his family was involved in his treatment, they appeared very supportive and were consistent in reiterating that his different interests were something the family celebrated and admired him for. He terminated the relationship with the girlfriend mid-way through his senior year, and all seemed right as rain until he went to college.

He attended college in a major city, and we continued bi-monthly appointments. He fell in love with his new environment, but always said it was due to its artistic open-mindedness. At this point he began to discuss an attraction to men, but not in a physical manner—more in an emotional or sense of connectedness manner. He would gauge my response as momentum to move forward in his quest for personal and social acceptance. He soon revealed that he had hooked up with a fellow male student, and we processed the associated feelings with taking that step within the constructs of how he wanted to define himself. He admitted that who he was becoming was getting closer to who he wanted to be.

At this point, his anxiety was increasing, but his depression was almost nonexistent. We spent a great deal of time assessing his sexuality in his own terms, on a continuum, and not in terms of social mores or the need to pigeonhole himself into a specific sexual category. A few months after this, he "officially" told me he was gay and said he no longer felt attracted to women. This became a catch-22, though: He had vindicated his own life but was carrying a burden of leading a double life with his family and friends.

In time, he agreed to tell his family in my office, and needless to say, they were very supportive and not the least bit surprised. After coming out to his family, the rest fell in place and I don't remember him being rejected by anyone close to him. After that, the major therapeutic work came in how to maintain his core being and not fall into the trap of being "stereotypically gay"—a big fear of his—and how to not allow his sexuality to define him. He also had to learn, simultaneously, to not attribute all rejection in other venues to his sexuality, and to allow his partner (who was mostly still in the closet) to undertake the same patient process he did. In my experience, coming out is a process that breeds empowerment, as the decision is rightfully perceived as a difficult thing to endure.

Do you consider bisexuality to be a myth?

I have treated people that had an equal, almost unbiased emotional and physical attraction for both sexes, so I think it can exist. I feel that we get clouded by society's perception of bisexuality. First, I ask myself why people feel it is OK for women to be attracted to women, but not for men to be attracted to men. Isn't it one in the same? Men use lesbianism as a defense to exude some level of acceptance with regard to homosexual behavior. Men also approve of sex between two guys and one girl, but deny any factotum of homo-eroticism in that. Bisexuality has become among women has become a perpetuation of the fucked up standards our society holds for what is desirable and edgy. A drunken make-out with another girl in college does not denote bisexuality. That is what females have ingested as what a man wants; a sexually expressive girl who is not afraid to get wild and to give a big fuck you to society.

But instead of the desired purpose of being different, you become just like everyone else if many are doing it. In my opinion, bisexuality encompasses more than just physicality. It is emotional and psychological in nature as well, and, in reality, you must be prepared to take on all the subsidiary issues related to bisexuality—especially in relationships. Bisexuality, I think, can only exist if a love or the potential of love is there.

Do you find that females who "experiment" are prone to self-destruction?

A resounding yes. Forget about the spoon-fed knowledge that promiscuity and experimentation lead to a higher risk of sexual assault, STDs, and unplanned children. Women that experiment—both heterosexually and homosexually—have, in my experience, faced higher levels of guilt and a lack of identity as their lives begin to settle down. Understand that this is a chicken-or-egg scenario, because sexual promiscuity in women in is one of the three major symptoms of internal anger and self-hatred, along with substance abuse and self-mutilation.

That seems harsh. How so?

I had a female patient once. She was very attractive, had three kids and was married to a prominent figure around town. She admitted to me that as a teen, she was extremely sexually active due to some feelings of unattractiveness and abandonment. Once she had kids, she felt guilty that her kids would one day—and I'm quoting here—"realize that they were birthed from a 'whore,'" and that there was no special physical connection between her and her husband because he was like, the 70th man she'd been with. She felt unworthy of her social prominence because no one knew who she truly was. Since she could not separate from her past and never truly dealt with the core issues of her inadequacies, she began to self-destruct with substances, a spending addiction, and oftentimes engaging in communications that would jeopardize her husband's career.

Self-destruction stems from guilt or a sense of unworthiness, and if you are not punished by someone else then, in your mind, you must punish yourself. Experimentation is also socially driven: It is now commendable in our society to be promiscuous. For both men and women, any type of promiscuity or experimentation, what you feel at the time is not always how you will feel about it later. In my opinion, any type of promiscuity or "phase" is fulfilling some type of need or emptiness inside that person at that specific time. Later on, that need may be fulfilled, but the behavior has occurred and the person may not be able to intellectualize the rationale or forgive themselves for fulfilling that need in that venue.

So do you think couples should reveal how many people they've had sex with in order to alleviate guilt?

Absolutely not! Once you know that number, you begin to dwell on it and then the mind begins to go places it shouldn't go and then start to rationalize and over-think the numbers—i.e., how many were one-night stands? How often were feelings shared? Does that make it better or worse? And so on. It's just a useless piece of information that tends to eventually, more often than not, impact the relationship either on a conscious or subconscious level. So keep it to yourself.

From a reader:

Hello,

I read the gawker post with great interest. My fiancee, who is estranged from her family, has previously told me that her mother abused her and then falsely claimed "elder abuse" and threatened to have her arrested. Fast forward to my situation and over the past weekend, she punched me in the face, kicked me repeatedly and repeatedly was name-calling me. All because she felt that I have not done enough to help prepare for her wedding. I told her I doubt her story about her mother abusing her, because she is the one initiating violence with me.

Having grown up in a fairly comfortable family, I have not experienced the duress that she has in her life. Should I confront her about what I suspect are lies? Why should I trust her on anything? And what do I do to make her stop hitting me? Shortly after punching me, she took out a bottle of spray bleach and threatened to spray me in the face with it. Yes, she's that loving.

How fucked up is my situation?

Thanks

Pretty fucked up. To minimize the situation, though, weddings are a time of tremendous stress and often bring out the worst in a couple. They are more focused on the perfection of the day and pleasing the guests than the meaning of the union. However, this is more than that. Whether the accusation is true or not, her behavior towards you is real, and thoroughly unacceptable. Since abuse is cyclical, often times the victim becomes the abuser, as physical expression is learned. I would give serious consideration about whether or not to go through with the marriage. Trust is so important, and it is dismaying that you are questioning it at this juncture. Once married, that kind of stress will only intensify, and my guess is that her behavior will worsen as well. What makes you think she will change? In essence, you are telling me you are going to spend your life with a lying, explosive woman.

Previously:
 The Patient Who ‘Tried to Insert His Penis Into His Dog,' and Other Confessions of a Therapist
Here's Why Your Relationship is Doomed, and Other Confessions of a Therapist

Illustration by Jim Cooke.