I was at a gay bar with some friends to watch this year’s Super Bowl. Up until the halftime show, most of us had not been paying close attention to the game. Rather, most everyone (including myself) was talking and dancing. And then it was time.
The announcer introduced the halftime show and excitement filled the bar. And there she was.
Lady Gaga appeared on the screen in a silver sequined outfit with matching combat boots, looking fierce as fuck, belting God Bless America. The bar fell silent. Every man’s eyes were transfixed. No one had given a shit about the game that had preceded, but now no one dared look away from the screen.
She finished her performance (and it was stunning I must say), and the room erupted in cheers. I actually saw one guy with tears in his eyes.
Ask any gay man who some of his idols are, and it’s likely that a few iconic divas will be at the top of the list: Whitney, Cher, Beyonce, Mariah...I myself have a “prayer candle” with Dolly Parton’s face on it that sits on my nightstand among my succulents because I refer to Dolly as my patron saint.
No one completely understands why a badass performance from a queen can elicit so much joy and emotion from a gay guy. I suspect that we feel akin to the struggle that many of these divas have experienced. Women like Whitney, Britney, and Mariah portray a vulnerability that’s often wrapped up in glitzy strength. They shine brightly in front of the spotlight, but when they walk off the stage, their life is often littered with addiction, tragedy, and mental illness.
This narrative sounds familiar to many gay men. Almost too familiar. Like their tragic heroines, they too are often suffering behind the scenes, masking their pain with performance.
May 2, 2017 marks Eating Recovery Center’s second annual Eating Recovery Day. As a therapist with Eating Recovery Center, I’m excited to work with my colleagues to educate and bring awareness to the public about the signs and dangers of eating disorders. As a gay man and therapist, I am uniquely aware of how these illnesses affect our community. Of the men who enter treatment for an eating disorder, 42% of them are gay. That is a shockingly high statistic considering that gay men only constitute about 5% of the general population.
Despite this overrepresentation, there is still resistance among our community to the fact that gay men battle eating disorders and body dysmorphia in such large numbers. I suspect one of the reasons for this is how normative it is for us to count calories, excessively exercise, and make disparaging remarks about each other’s bodies. As my colleagues and I planned this year’s Eating Recovery Day, we wanted to make the focus clear. We themed our day “Don’t Miss It”—don’t miss the warning signs, don’t miss the chance to come out and share your story, and don’t miss having that difficult conversation with a loved one you know is suffering.
Maybe you’re a gay man reading this and relating to the struggle. Or maybe you’re worried about a man you love and feel a need to intervene. Many shirk from having these difficult conversations because they fear upsetting the person (and there is a chance that will happen). But difficult conversations are important. Many of our clients have reported to us that it was because of a loved one’s concern and intervention that pushed them to enter treatment. In my time as a therapist, I have learned a couple of helpful things that make conversations with gay men about the prevalence of mental illness and eating disorders go more smoothly.
Respect the defenses. You’ve probably heard about defense mechanisms, but many people do not have an actual understanding of what these powerful defenses are and how they serve us. In short, defense mechanisms are mental processes we initiate to avoid a conflict or anxiety. We don’t like conflict, so when faced with it, we implement defenses to take away the anxiety that conflict produces.
If we don’t know how to act when something makes us feel sad or vulnerable, then we might elicit the use of humor to lighten the situation. When someone that we care deeply about hurts us, we deny they meant anything to us to keep from feeling the pain of their betrayal. Or maybe someone has confronted us about some of our own hurtful actions and we flip the script and project onto them how they are hurtful so we don’t have to face the shame of our own faults and failures. Defenses are everywhere, and gay men are masters at using them.
Most of us have lived our entire lives employing defenses to manage our anxiety about being in the closet. During adolescence, we meticulously monitored every behavior to defend against someone finding out our “secret.” We were cautious of our hands so we didn’t let our wrists go limp. We tried to talk as deeply as possible. Anytime we let our guard down to check out another guy, we would quickly divert our eyes in fear that someone saw us. Defense mechanisms protected us, and we’ve been perfecting them for most of our lives.
Defenses aren’t necessarily bad—but they can sometimes prevent us from improving our mental health. When encountering defensiveness, it’s important to respect that defense. I have learned this lesson several times. Earlier in my career I would often interpret and prematurely expose a gay man’s defenses when he would come in for therapy. I was left curious why some of these men never returned to my office. Then it dawned on me: I had taken away their way of coping in my presence without giving them a different, more helpful coping skill in replacement.
An eating disorder serves an important function for a gay man. It usually gives him a sense of control over his world and body, and if he still experiences the illusion of that control, then he will not be likely to give it up easily.
I recall one man whom I was desperately trying to persuade to enter treatment. He was 75 pounds and had a litany of medical problems and complications. I was truly afraid for his life. He had battled his eating disorder for over thirty years, and his husband and loved ones had desperately tried, without success, to convince him he had a problem. He remained resolute in his stance: he did not have an eating disorder and he was perfectly in control.
He and I talked at length about his medical problems and the discomforts he was experiencing with his body. We also talked about his recent lab work and the abnormalities on it. I asked, “What was that like for you to see your abnormal lab results?”
His voice began to tremor and I could hear panic come up in his throat. I knew that sound. It was his awareness of his defense beginning to break down. For many gay men, that’s their worst fear.
Focus on connection. If you do decide to have a difficult conversation with a gay man who you suspect is struggling, focus on connecting to him in a meaningful way. At Eating Recovery Center, we often provide education to concerned friends and family members about how to talk to a resistant loved one about their eating disorder. To many, it might seem logical to comment on the person’s appearance and how they look. Please don’t. Don’t comment positively or negatively on your loved one’s weight or appearance. This is ineffective and the defense will dig its heels in. Rather, consider framing your conversation around how you see the eating disorder affecting your loved one.
When people speak from a perspective of what they are seeing and how it’s making them feel, a more effective interaction occurs. For someone’s defenses to come down, they need to feel a connection. According to nursing scholar Theresa Wiseman, effective connection happens when a person:
1. Takes the other person’s perspective
2. Refrains from judgment
3. Recognizes emotion
4. Communicates emotion
Wiseman’s framework can act as a powerful way to frame a conversation around eating disorders. For example, if you’re a gay person talking to another gay person about your concerns, pull on your common understanding of the difficulties the two of you might share. Dig deep to find that understanding of why they are engaging in their disordered eating. If you’re not sure how someone can find functionality and respite in an eating disorder, do your research to educate yourself so you can understand your loved one better.
Most importantly, keep your judgment to yourself. Judgement encourages shame more than almost anything else. We all like to judge, but there’s no place for it in conversations like these. Remember that it’s hard to judge if you’re asking questions and being curious about another person. Rely on that when feeling the judgment temptation.
Finally, recognize your loved one’s pain and gently comment on it. When people are assholes or rigid, it’s usually because they’re scared. It’s okay to acknowledge that fear.
A start to this conversation might sound something like: “It seems like you’ve been going through a lot lately. I’ve been concerned because I see all the energy you’re using to focus on your eating and appearance and I hate the toll it seems to be taking on you. It makes me think you’re pretty scared and anxious—I’ve been there before. How are things going for you?”
The wording isn’t as important as your demeanor and sincerity. Sincerity covers a multitude of verbal sins. Focus on your connection with the person so the defense can come down. Then go for it. Don’t manipulate. Don’t give an ultimatum. Don’t control. Just connect and let the person make their own choices. Words and interventions don’t matter as much as our connections do. If you or your loved one need help figuring out the next steps, give us a call at 877-711-1878. We will be happy to talk with you. But, please don’t miss it. Don’t miss the chance to be a powerful instrument in the life of someone you care about and love.