Don Clark on Psychotherapy with Gay Clients

Don Clark: Well, I am delighted to be your interviewee.

DC: Yes.

DC: That would be the book Someone Gay: Memoirs that I wrote, which is about 350 pages long. But I assume what you want is a thumbnail sketch of what my life as a therapist has been like?

DC: It wasn't relative poverty. It was poverty. As in, we moved frequently because we couldn't pay the rent. And my parents really were basically illiterate. My father could not read or write. My mother was able to do some reading and she was the writer. My father's writing was limited to signing his name to things, which he did very meticulously. But there were fortuitous events. Perhaps everyone has them, I don't know. Like when I was in the eighth grade, I hated school, because of course being socially at the bottom of the totem pole you get picked on by other kids. Recess was a nightmare.

But in the eighth grade, bless her heart, my teacher must have seen something, and pulled me from the back row up to the front row of the class, and started smiling at me. And I don't remember a teacher ever having done that before. So I started paying attention to her. And her passion seemed to be diagramming sentences in English. Instantly I became the best diagrammer of sentences in the class. Since that had to do with words, which I had been playing with all by myself unbeknownst to other people-trying to decipher Shakespeare, for instance, which I had decided was a secret code like the ones being used by the Allies and the Nazis. I was already enamored with words, and I had already tried writing poetry, but all of this was unknown to any teacher. So we were in this together, now, the teacher and I. We were doing words. And I became her darling and she became my darling, and when it came time to do the eighth-grade yearbook, she appointed me chairman of the committee. I ended up writing the whole yearbook, and I did it in poetry!

DC: Oh, god, teachers, absolutely. That one teacher in eighth grade saved my life, I'm sure. I would have been working in a factory like my siblings.

DC: Well, I always had to work, of course. Money was always needed in the family. And so one of the jobs I took when I was in high school was an usher in the fanciest movie theater in town. In the beginning I was only allowed to work days, but when I became sixteen I was able to work evenings. And I remember one of the first evening programs I saw was Spellbound with Gregory Peck and Ingrid Bergman. Of course, I fell in love with both of them immediately. I fell in love with a lot of movie stars during that period, male and female. And the males were silent; the females I could talk about. And I wanted to be just like her. She was a psychologist, interestingly. She was acting as a psychoanalyst in the film, but she was called a psychologist. So, duly noted, I thought I would be a psychologist, so that I can save young handsome men like Gregory Peck who have had these awful things happen to them that they can't remember, but I'll help them remember and they will be cured.

So when I got to college, at Antioch in Yellow Springs, Ohio, I started out as a business major, then I became an art major. Then, I took a couple of hospital jobs in the Antioch work-study program. The first one was hideous. The second one was wonderful, at Chestnut Lodge, which was the mental hospital in Maryland that Harry Stack Sullivan had been the control analyst in when he did his writing, and he was followed by Frieda Fromm-Reichmann, who was still there at the time. I had a chance encounter with one patient who had been mute for years. I was nineteen or twenty years old at the time. For whatever reasons, I think she fell in love with me, and I was able to get her to talk and to move and to ambulate, to the point where I was able to take her on a train trip to visit her mother in New York City, which everyone considered to be a total miracle. Frieda Fromm-Reichmann offered me an analysis at fifteen dollars an hour, which of course I could ill afford, but I understood it was a bargain, if I would stay and work with this patient, which I was delighted to do. By the way, Morrie Schwartz--the sociologist at Harvard, who became known for Tuesdays with Morrie-- got fascinated by it and he recorded a meeting with me every week a about this. Everybody was trying to figure out why it was working, how this was happening. Now I know why it was working, but then I didn't.

DC: I really cared about what she had to say, and I cared about her. She had not had that before. Even in her analysis there, her presumed analysis, which was a joke since she was totally mute, no one was giving her any warmth. So the first time we met was when she raised herself up off the floor and threw herself at me, literally, and I caught her in mid-air. Her legs were wrapped around my waist, her arms were wrapped around my neck, she was grunting and salivating, and she was kind of a mess. But I said, like a well-trained twenty-year-old on the staff, I said, "Mary, I think you're trying to tell me something."

DC: I cared about her, and I came back at night on my own time when I was off duty to sit with her and draw little boxes and ask her questions and say, "If the answer to this is yes, just put a mark here. If it's no, put a mark there." I'm laughing and almost on the verge of tears, because it sort of reminds me of Ann Sullivan with Helen Keller. No one had taken the trouble to do this with her. And I wouldn't have either, had it not been that she had thrown herself at me.

DC: I guess that makes me a sucker for people who throw themselves at me.

DC: Yes.

DC: Empathy and warmth. Showing that you really care.

DC: Yes.

DC: God, I don't know. I mean, in a way, in the writings of Harry Stack Sullivan you see some of it because, as far as I know, he was the first person saying, "Look, there are two people in the room. And it's not just this cold analytic idea about the patient, and you sit behind the patient with a pad and paper and write things down. There are two of you there. There's an interaction going on between the two of you. Pay attention to it. Pay attention to what you're feeling, pay attention to what the patient is feeling, and to what the interaction is between you. Be real."

DC: Yes! Carl Rogers, absolutely.

DC: Well, in terms of the analytic school, that was it,Stack Sullivan, Frieda Fromm-Reichmann. Gosh, Carl Rogers played a big part. I was already very interested in what he was doing while I was an undergraduate student. I remember going to the library, I think he had one book published so far, and everybody was making fun of him...

DC: Oh, I spent some time at Esalen in its heyday in the early '70s, when I was on a Carnegie grant mission studying the new human potential movement. I really paid attention to what the Esalen staff were doing. I was permitted into the royal presence of Fritz Perls, who was the reigning diva there at the time. And of all the people I studied on my Carnegie sabbatical from university teaching, he put more fear into me about what was being done with all these new things than anybody else. I named in my report Marion Saltman, who was a woman who did play therapy with adults on a houseboat in Sausalito, as the person guaranteed to do no harm, and often did a lot of good. I named Fritz Perls as the person who was most likely to do harm while sometimes doing a lot of good. He was very good at what he did and very smug. He was like a surgeon who went into the operating room, did everything exactly right, laid the guts out on the table, and then smiled at the young residents and said, "Okay, you take over now," and pulled off his scrubs and left. And I witnessed one, and know about another one, where following his dramatic interventions, the people went into psychotic episodes. Now, I'm sure he rationalized that as saying, "Well, that was what they needed to do." One of them was the wife of a colleague in the university where I taught. I don't think that's what she needed to do. And it brought a lot of grief into that family for both of them. So, I have mixed feelings about his diva behavior.

DC: Right.

DC: Oh, boy. Well, the roots of this are back at Antioch when I was an undergraduate there, because it was, and apparently is going to be again, a very social activist school. I think within the first weeks that I was there as a naive eighteen-year-old freshman from New Jersey, we were picketing the barbershop in downtown Yellow Springs, Ohio, population 2,000, because the one barber in town would not cut black people's hair, saying he did not know how, because they have different hair. Well, that was just a small example. Actively advocating for disempowered people permeated the school, and during the time that I was there, people took it really, really seriously. So, going back to Mary, the woman at Chestnut Lodge, perhaps I wouldn't have been smart enough to do what I did.

DC: If I had not already been immersed in that very well.

DC: June '69. But I was already rolling before that.

DC: Oh, god. I think I started writing letters to the editor. I know I wrote a letter to the editor of Time magazine, when they did a big expose about gay people, and my father-in-law at the time was devoted to Time magazine. And I was beginning to get it, that if I said, "Hey, I'm the expert in this field because I am gay," that's where I was going, that's what was beginning to happen, other therapists backed off. They had no credentials. But Time magazine, lo and behold they printed my letter as the lead letter two issues later. My father-in-law called my wife and said, "Hey, Don's letter is the lead letter in Time magazine this week. I don't know what he's talking about, but isn't that great?" And I wrote letters to the APA (American Psychological Association) too. I was beginning to get in touch with other gay therapists, mostly not out yet, but it was happening. The groundswell was beginning to happen, when I moved back to California, in January, 1971.

DC: Oh, absolutely. Absolutely. And I could lose my license. I had a license in California, one in New York, and I could lose them in both places for "moral turpitude."

DC: Guaranteed, if you're homosexual, because the law describes homosexuality as criminal, the church describes it as sinful, and psychology describes it as a mental illness, you're going to be tossed out because it's moral turpitude.

DC: I think the first public appearance about it, per se, was here in San Francisco at a Western States Psychology conference, and I was the new kid in town, but the word got around fast, I had come out, and I had left the university and come to San Francisco specifically because I had decided to start a full-time private practice devoted to gay people.

DC: Absolutely. Or anywhere. I was the first one to say, "I'm gay. I'm devoting my practice to helping gay people, their families, and their friends in any way I can."

DC: I certainly was. So at the Western States meeting, there were four of us presenting on a panel on homosexuality, organized by John Neumeyer. I think all of us were gay, but I was the only one that was going to say it. I didn't know I was going to say it actually, until I got up, and as I stood in front of the microphone, before I had said anything, I looked at the audience, and what I saw was a big room, packed with about 250 people who were very interested in what homosexual people might be like.

DC: Well attended. Very well attended. I stood there, I looked, and I just opened my mouth and said what I was thinking and feeling, which is, "You know, as I look out at you people, I'm sorry to tell you, I think I see the same smug faces that I've gotten used to seeing at psychological meetings. People who either think they know all about homosexuality and have decided that it really is sick, or people who are in some way or another just beyond this. You don't even have to think about it. You can just come and be amused. Well, okay. Here's what I want you to do, for your amusement and mine. I would like every man in the audience to reach out with his right hand and put it in the crotch of the man seated nearest you."

At which point there was a standing ovation, and I think John Neumeyer nudged over close to me and said, "There are no laps out there now." But that did a lot for me. I realized if I could stand up there and call them out on their prejudice and their smugness, all I had to do was talk about what I was thinking and feeling, and people were going to listen. And they did. So from there on, I kept using my slightly false pretense in saying, "Hey, I'm the expert on this. I know about it. I'm gay." And what are you going to say to that? If a black person says, "Hey, I know about being black. I'm black," and you're white, what are you going to say?

DC: Yes. But I didn't care and it truly didn't matter. Everybody said, the friends that I interned with out here, said, "Oh my god, you're committing professional suicide. Never mind losing your license, you're never going to be able to have a full-time private practice. You're going to be persona non grata." Au contraire. I had started a little practice in Menlo Park and one here in the city, seeing which would work better. Both of them were filled immediately.

DC: No problem getting customers. Both of them were filled, and filled with gay people who wanted to talk to someone who would understand what they were talking about.

DC: Absolutely.

DC: Well, you see, as soon as a few psychologists started to be visible and probably gay, and then visible and gay, and then some more thought it might be safe to put a toe out of the closet... as soon as we started to be visible, gay psychologists' organizations formed. All the liberation movements were happening at one time. And the time was right. People could smell it. It was going to be okay.

DC: Yes. During that time, I joined a committee that was working with the San Francisco mental health association, or the county mental health association I think, working on this problem, trying to figure out if homosexuality might possibly be considered not a mental illness. It was amazing. From this committee, Sally Gearhart, Rick Stokes and I became the feared trio on the speaking circuit, because Sally knew the bible inside out and she would come wearing a dress or a suit and stockings and high heels. Rick was a lawyer, knew the law inside out, and he had been hospitalized for this mental illness by his parents as a youngster, and I think given shock treatment, as I recall. I was the psychologist, I was out. So all three of us were out: law, religion, psychology.

DC: You know, it was actually the American Psychiatric Association.

DC: Well, because they move faster. They were just working on it at the same time. And there was actually only a thirteen-month difference between the two associations. But it looks like there's a longer time-span because the American Psychiatric Association did it in December of 1973, and then not a month later but the following January of 1975, the American Psychological Association did it. The American Psychological Association's change was much, much more comprehensive. The ones that lagged far behind, of course, no surprise to anybody, were the psychoanalytic people who didn't come out for another five years, I think. But wanted to make sure they wouldn't get shot. So then the book.

DC: I wrote it in '75. At first, nobody would touch it with a ten-foot pole. I got a scolding letter from the Editor in Chief of Basic Books, saying, "Doesn't this man, he calls himself a psychologist, and doesn't he understand these people are sick and they need help? And this is not going to help them, it's going to help them deny their sickness." Finally, after a year of many refusals, when Celestial Arts agreed to publish it, they sold out the initial five thousand copies before the publication date, which was January of '77. We were really happy. But soon it collided with Anita Bryant**, so I was suddenly wanted on television and radio all over the country. Being basically an introvert, I hated the idea. But I knew... where would this kind of publicity ever come from again? So I did that. I spent about a year doing that.

DC: Beyond count, I mean, truly there were many printings, many different editions, in many languages. It was in two different kinds of paperbacks, mass-market editions, which was where the count got lost because nobody could figure out how many copies Bantam or New American Libraries sold. But that was why I was getting fan mail from people all over the country. Also hate mail. The ones that moved me the most were exactly, exactly the ones I wanted-the kids who had been able to sneak into a little drugstore in Podunk nowhere and get a paperback copy of this. And they suddenly knew there was another gay person somewhere out there in the world, saying, "It's okay, it's okay." Now I get emails from all over the world.

DC: Well, we have to get into the psychodynamics of what does it mean to be gay. And, not in the interest of selling more copies of Loving Someone Gay, I really would encourage those who are interested to pick up the 5th Edition, the new one, and read it, because I can only give a few words here. The main special dynamic for a therapist to understand is that a gay person goes through a different maturational process than a straight person does. We actually go through two at the same time. We get matured through the steps as if we were straight people, and also as gay people.

The different dynamics in development of the gay childhood, young person, adolescent, and so on, is that even today, let there be no mistake, most gay people are growing up invisible. They are having to learn how to become adult as straight people do. They're also having to learn at the same time what to do with being invisible, with having nobody know who they really are, with being terrified of what would happen if they were known. Black people grow up in black families, usually. Jewish people grow up in Jewish families. Gay people do not grow up in gay families. The vast majority of the time, they do not have any support around who they are. There is nothing comparable in the human experience. It is as if the gay child is the result of having an egg from outer space planted in the uterus of the mother, and then appears looking just like the people who live on this planet, and grows up, develops, but all that time something different is happening inside this person; and he or she understands early not to let it show, or not to let it show enough that he or she will get into trouble because of it. And trouble, is indeed, what awaits most of them. So, you live two lives. You hide the life of your true self.

DC: An alien, who has these strange and different feelings about other people of the same gender, which you dare not reveal; and you learn to live as if you were having all the same feelings that your parents, and the preachers, and the teachers, and the police, etc., are having.

DC: And that the therapist needs to go back with them and visit through every level, every age level, every stage of that development. How has it affected them as they grew up? If they knew when they were five years old, what was like that? If they still knew when they were fifteen and were maybe even experimenting with having sex and nobody knew, what was that doing to them? How did they feel? What did that tell them about themselves? Because it affects people differently.

DC: And you always have to be on their side. It doesn't matter how it looks to you. It matters how it looks to them. The biggest mistake is for therapists to think or say: "I've been studying this for years, I know what you're thinking. I know what you're feeling." No, you don't.

DC: Well, there are a few things I put into Loving Someone Gay, aimed at everybody who wants to help gay people:

• Number one: The gay person probably has learned to feel different. Keep that in mind.
• Two: A gay person may have learned to distrust her or his feelings. Very important for a therapist.
• Three: A gay person may have a higher degree of self-consciousness.
• Four: A gay person may have decreased awareness of feelings, such as anger generated in response to a punitive environment.
• Five: A gay person, often invisible, as such to others, is assaulted frequently with attacks on character and ability.
• Six: A gay person is more likely to fall victim to depression.
• Seven: A gay person may be tempted to dull the pain that surfaces, by making use and misuse of alcohol and other drugs.
• Eight: A gay person who is respected and loved, but who is hiding his or her true gay identity and facing what she or he believes would be a ruined life, if the truth were to be discovered, is at a high risk for a fatal accident, or a seemingly inexplicable suicide.
• And, nine: A gay person usually has lived in two worlds simultaneously.

This is why I believe it usually is much better for gays to see a gay therapist than a straight therapist, and the therapist must never, ever hold back on revealing that they're gay. Otherwise they're acting like they're ashamed of it. They have to be able to be supportive, and the first thing that I tell young trainees is you always say something positive and affirmative when the person says anything about sexual desires, sexual fantasies, sexual whatever. If it's homosexual, you're there. You're on it, you're with it, you smile, you sit forward in your chair-

DC: If a gay person walks into your office with a seemingly small or large problem, you may make the mistake or thinking that you can deal with it just as you would for any other person. Well, that's not true. Maybe if they just want advice on whether they should contact a lawyer because they're getting a divorce, yeah, you can deal with that just as you would with a straight person. However, if you're talking about psychodynamic issues, from day one, everything is different. They are very eagerly watching you to see if you might have any idea of what their life is like. And chances are, unless you have been through it yourself, unless you, too, were born gay and had some decent therapy yourself, so that you could explore your own internalized homophobia, which comes with the course for gay people and for not gay people.

We all have internalized homophobia because we live in a homophobic culture, which is not that unusual. Most cultures on this planet are homophobic, which is a term that was created by George Weinberg, who was a statistically oriented psychologist in New York City. He hit on exactly the right word. If you're phobic about snakes or spiders--two familiar phobias that people have--it doesn't necessarily ruin your life, but you certainly don't want to go near them, and anything that hints of them is going to make you a little uncomfortable, to the extent that for many people, with snakes for instance, seeing a picture of a snake in a book makes them consciously and/or unconsciously uncomfortable. It's just, "I'm not sure I want to go there."

Okay, so now you have a homosexually inclined client in your office, and you, as far as you know, have never had any of those feelings yourself. Or maybe you did and well, you took care of it. You're all grown up now. You've had your therapy. What are you going to do? You know, how are you going to let this person know that you really understand what he or she is feeling? My opinion, I don't think you can, unless you've been down that road yourself. And even then, unless you've had some expert help from other people like you, who have been down that road before you, who can help you to see that it really is okay to be you. Whatever the presenting problem is, you don't go anywhere with your client unless you have that magic thing called rapport. And you're not going to have that rapport unless you can illustrate that you have genuine, genuine empathy. And you can't have genuine empathy if you don't know anything about the world this person came from.

DC: Well, if I had my druthers, that would be true. I don't think it's possible, of course, because there are not enough gay therapists to see all the gay people who need to be helped. There is another solution. I don't think we're anywhere near doing it yet, but if therapists who are not themselves gay, and have not confronted their own internalized homophobia, were willing to become really, really, really familiar with the experience; to immerse themselves in it. A one-day, continuing ed course, or lots of reading about it doesn't quite do it. It doesn't give you the feel of what it's like to be such a person.

DC: So, if you're a therapist who is not gay oriented, not gay yourself, and you want to really familiarize yourself with what it's like to be in this world, to be one of these people, go where they go. Do what they do. Have lots of them as friends. Have lots of them in your home. Have your children be familiar with them. You know, if you're not that comfortable, you're not there.

DC: I think it's possible if you are willing to learn. That when that person sits down in your office, someone is sitting there that you have to assume you don't understand.

DC: Yeah.

DC: Get out into the community. Get to know gay people. Get to appreciate what is better about the life they are living than the one you are living. Be honest. Find out something you're envious about. If you can't find envy in another world, you're not open to that world. So, maybe that's enough about that. Get out, read about it. You know, meet people, go. Eleanor Roosevelt used to immerse herself in black culture. She didn't sit home and read a book about it, she got out there and did it.

DC: The quote, which is on the one monument that exists on Antioch's Yellow Springs campus, is Horace Mann famously saying, "Be ashamed to die until you have won some victory for humanity."

DC: Well, I've tried. And I think I have. Probably through the book, since it has reached so many people and obviously done a lot of good, or they wouldn't be writing me and telling me that. It's certainly more of a contribution than I ever thought I was capable of making. And I'm still stunned that it happened, that I was blessed with being able to do this.

DC: Any time.