Inching Toward Health
Frank was diagnosed with bi-polar disorder, and he abused alcohol for decades. He is homosexual and was significantly overweight. He is gainfully employed with good job security. His adult sexual life has been largely defined by an unapologetic sexually promiscuous lifestyle. He had some relationships that lasted for a period, but those were relatively short lived and never monogamous.
When he came to counseling his mental health was unstable, and during the early and middle stages of our working relationship it would improve for a short while, but it would not last. His stated goal at the outset of counseling was to get into a committed relationship.
Several years passed and then he found someone, named Henry. Henry is also heavyset, prone to depression, and underemployed with minimal income. Henry has a low libido with little interest in sex, and that has been a major point of contention and frustration for Frank. It is the primary reason the relationship has been difficult to maintain. At times, a breakup seemed inevitable, but they remained together.
Frank has been seeing me for individual counseling, and Henry sees someone else for that type of counseling, and they see a third therapist for sex therapy/couples counseling.
Now here is the really interesting part; while Frank’s main complaint has been the lack of sex; and that condition is a major threat to the relationship, it is remarkable that since Frank and Henry have lived together, Frank’s overall well-being has improved markedly. He has not needed any psychotropic medication for about 1.5 years, he has not had any serious bouts of depression, he is no longer abusing alcohol, and he lost 25 lbs. through smarter eating.
In other words, Frank’s companionship with Henry, which entails a dramatic drop-off in sexual activity, has correlated with vastly improved overall health. At the same time Henry has also gotten healthier. His depression and irritability are much less pronounced, and he has returned to a nearly full-time work schedule.
Despite these positives, Frank says he is deeply dissatisfied with the relationship; and he is not willing to question the idea that his happiness is dependent upon having frequent homosexual encounters.
I have gently pointed out to Frank about the remarkable improvement in his health since he has been with Henry. He acknowledges this, but he is committed to his view.
At one point I suggested to Frank that his relationship with Henry may be intended, in a spiritual sense. Frank seemed puzzled by the “intended” comment. I do not think he agreed, and in the next session he sought to reaffirm that the lack of sex with Henry was a major threat to the relationship.
I do not take a judgmental stance with any of my patients. As guided by the patient, my role is to help them to become healthier and to achieve their life goals. On rare occasions people can make sudden remarkable progress, but most times it is a gradual process. It is important that one feels accepted as they are; but also assisted with inching toward becoming an improved version of themselves.
Frank is committed to the very active homosexual lifestyle, but it has not correlated with lasting health and happiness. He told me of a recent occasion when he had sex with a woman, but he expressed regret because he felt he betrayed other homosexuals by doing so. He has a close friend who is homosexual and celibate, but Frank says that he has too much interest in sex for that to apply to him. The problem is that he cannot find the formula that works for him.
In a recent session Frank recounted how offended he was when the sex therapist/couple’s counselor suggested that something may be amiss; not with Henry, but with him. Frank was wounded by the inference.
We are now at a point where Frank is getting depressed. He initially thought it was because of the lack of sex, but now he thinks it is because his relationship with Henry is leading to a breakup. He knows, on a certain level, that a loss of the relationship would have a dramatic negative effect on him. His focus on the sexual particulars; and his willingness to abandon the relationship is causing his personhood to react with depression. His healthy side is telling him to value the relationship over the sex, but he is unable to hear that point.
Frank is a nice man; he is seemingly a good employee, and a loved member of his family. I believe I have been effective in supporting him, in guiding him toward health, and in reaffirming his worth. It is just unfortunate that his focus on sex remains the dominant concern in his adult life. The evidence indicates that it was not meant to be that way.