Page 6 HIGH GEAR JULY 1981

Finding gay mental health

Editor's note: The company which publishes Christopher Street has been reorganizing financially, and ' distribution of the magazine has been cut back. Since last December · the only distribution of Christopher Street has been to subscribers. It seemed more reasonable to give HIGH GEAR readers a summary of an article we thought was important than recommend that they try to get a hold of an issue of the publication that has not been sold on any newstands.

Appearing in the March/April issue of Christopher Street is an article by Brian Karsh, entitled "Stuart Berger: A New Iconoclast."

Berger, a young psychiatrist (27 years old), recently served as the Medical Director of Project Return, a drug rehabilitation and human services program located in Manhattan.

Project Return has been in existence for nine years, but only during the past couple of years has it shown any notable success in treating drug abuse among gays.

The program's original lack of success, says Berger, was due to regarding homosexuality as being the underlying illness, and seeing drug abuse as being its outgrowth and symptoms.

The gay people using the facility were regarded as being untreatable.

Says Berger, "We therefore had to abandon institutional psychiatry with its homophobia and therapeutic communities with their anti-homosexuality to develop a mode of treatment for gay men and women who suffered from heroin, barbiturate, or

cocaine addiction.

"Through a long series of political manipulations, lobbying, and calling on favors from influential people, we started the first gay environmental drug treatment center, called Pyramid House."

"The forty-odd beds were always filled. The need was amazing."

"The success rate for treating gay men's addictive problems in an environment that was not hostile to gay men (as all other therapeutic communities had been) was astonishing."

"For those who graduate from the program, there was less than fifteen percent recidivism rate."

"What that meant to me was that in order to treat drug addition among gay people, the recognition that there was a gay culture and community which could provide the support required in the treatment was fundamental to the program's success."

The success of Pyramid House, says Berger, led to the establishment of Sappho, a drug

rehabilitation program specifically for lesbians. Within weeks its facilities were operating at full capacity.

"There even more." says Berger. The sense and spirit of a community has been crucial in helping people whose lives weren't working and who felt disconnected from society into becoming functional, happy people who could relate to one another and help one another get better."

Healthy sexuality

Healthy sexuality, says Berger, has "everything to do with the mutuality of the experience" and "nothing to do with the gender of either partner."

Pointing out that what is right or wrong sexually is not something you learn "from physiology. cardiac disease, or hematology." Berger says that the power to do such deciding is something that psychiatry has assumed "without the training or insight."

Psychiatrists, says Berger. "crave power."

If you need therapy

Asked if psychiatry can be of any benefit to men and women who are gay. Berger replies at some length

"People who are repressed are most likely to become extremely depressed in a society that is already tremendously depres-

sive."

psychiatrist to begin at any

"Why shouldn't a group of point." people who are constantly open to violent attack be depressed?"

"The problem for gay people is that there is such ready access for relief of depression through self-destructive behavior--which includes destroying brains with synthetic chemicals, not allow ing intimacy and warmth inside, but instead focusing on immediate, quaalude-like gratification."

"A therapeutic relationship can be enormously helpful in recognizing and coming to terms. with depression, instead of acting it out with consciously or unconsciously suicidal behavior."

The trick is...

"The trick is to screen the ther-

apist very carefully. Don't be intimidated by his or her position. Ask direct questions about anything you need to know about your therapist before you engage in the relationship."

"It's perfectly reasonable, for example, to ask, 'Do you think homosexuality is an illness?' and expect a forthright answer."

"Realize that they, too, are chock full of psychopathology based on their own criteria of their own lifestyles."

"A number of different therapists should be interviewed until you feel comfortable, until you feel that the person you're working with is someone who fits your biochemistry."

"Even then there should be a trial period, after which the therapist should be reevaluated in terms of how and why you're benefiting from the relationship." Reactive depression

Berger argues that feeling depressed might very well mean a realistic appreciation of what is going on in the world.

"Reactive depression," he says, "is completely comprehensible. It's based on real things--it's not self-indulgence. nor is it due to some hidden biochemical mishap."

"It's fairly easy to understand why people living a gay lifestyle can become depressed frequently-and even chronically."

"But that doesn't mean it has to be that way. It's not hopeless in any way."

"There's no reason in the world to begin a therapeutic relationship with someone who thinks "I believe that gay people can. you're sick because of your sexif they so desire, lead extremely ual preference." fulfilling and.gratifying lives as "Don't allow deification of a openly gay people."

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