EP 3:43 Three Types of Chemsex User Profiles with Dr. Lockwood

worked with directly who they started out like connector types where they're mostly doing euphoric things, not numbing as much. And then with, in a couple of cases I'm thinking of specifically, they experienced some pretty drastic traumas and then they shifted gears away from the connecting type to more of the dissociator because the trauma was just too much for them. It kind of really affected their—

Chemsex, sexualized drug use among men who have sex with men, typically involving methamphetamine, mephedrone, and GHB, among others. Chemsex misuse is a worldwide epidemic that needs attention, dialogue, and hope for those lost in it, which is the purpose of The Aftermath Podcast. Please note the views expressed by the host and guests on this podcast are not to be taken as medical advice, and the content around sex and drug use can be triggering. All right, welcome back to The Aftermath Podcast. Thank you for coming today. Thank you for listening in. We appreciate you continuing to support the show. Don't forget though to like, subscribe, all the good stuff, rate, review the podcast. We want to get it— the algorithm to get it into the eyes and ears of those who need it. Also, AI is picking up on the podcast quite a bit. I hear a lot of people saying they found the podcast through AI, like everything else, I guess. But the more you get it moving, I guess the more AI Picks it up. I don't know. I don't know how these things work. I just know that ChatGPT, Claude, and the rest are saying, have you listened to this podcast? And so keep doing the thing. We really appreciate it. So today we have a return guest in the same season. We liked him so much. Dr. Patrick Lockwood was here and we did a podcast on meth-induced psychosis and paranoia. If you have not watched that episode or listened to that episode, Please do. It's very good. I got so much feedback from that, Dr. Patrick Lockwood. I got so much feedback from that.

Good.

People feeling seen, people feeling heard, people understanding more about what's happening. It really was the way that you described it, the way that you presented it yourself, it was very easy to understand as well.

Okay. Nice. Good. I'm happy to hear that. And thank you for allowing me to come back.

Well, I had to have you back. Had to have you back because we had so many side conversations that day on and off the air. And so, and, um, I just really like you as a person too. Um, I like Patrick. Patrick sends me a text every Monday, just about.

I try. Yeah, I try. I'm trying to, I'm trying to do the right thing and be more connected with people because it's easy for me to get lost in all the things that I'm doing. So I have to remember that people are the most important thing and stop working, you know? Yeah.

Yeah, I like that. I want to follow suit. And, you know, I've been growing this business for 3 and a half years now.

Yeah.

And as an entrepreneur, entrepreneur, it's easy to put blinders on. And I've had a lot of people in my life say, where have you been? Right? Yeah. Yeah.

Yeah.

Yeah.

It's hard. It's, it's really hard. I think my, one of my biggest struggles as a professional is remembering that the people are the most important thing because I get so caught up in all the things I have to do and all the tasks in my life and teaching and all these things. And, you know, I just, my life is better when I just try to connect with people and it's so, it's so obvious, but it's so like productive, be productive, don't connect, you know, like it's, it's terrible, you know?

Yeah. Yeah.

Yeah.

You know, and for me, I will say, and this is not a therapy session, but there's this common mistrust I have and this common like skepticism of what does this person Why are they being nice to me?

Yeah, sure.

Yeah. You know, it's like, why is this person— why is he texting me on a Monday asking me how I— how I— my weekend was? What, what does he want?

Yeah. Yeah, that's valid. And I think I'm, I'm built differently, so I have the opposite reaction, I think, which is, oh my God, I'm so grateful they're actually talking to me.

Well, yeah, I have that too. Yeah. You know, interesting. Yeah.

Yeah. I mean, it's, it's amazing the opportunity to actually connect with people. Like I remember when I was in undergrad and a much younger person and I took every relationship, professional or personal, for granted. I was just a mess in so many ways. And after a series of growing up moments and some therapy and things like that in the last 15 or so years, I would say I've tried to refocus on what's important. And I forget so easily every 6 months or so. It's like, ah, why are you not remembering people? What's going on with you? You know, like, you know, I've had some good stretches where I'm super involved with people. And then I have some stretches where I'm just like in my own head and neurotic and I have to make this plate spin and that plate spin and this and that. And it's just like, it's It's ego and it's selfish. And the more I get out of my head and into the lives of other people, my life gets better. You know, and sending a text message is not, as you know, it's not like a drastic, you know, heavyweight, but my brain is like, I don't have the time to spend that 30 seconds right now, which is so stupid because like people are far more important than whatever thing I'm supposed to be, you know?

Yeah.

Yeah.

This is good. Good. This is good for me to hear. I'm sure, I'm sure someone else that's listening, it's good for them to hear also. Um, 'cause you know, I mean, there's that, there's that whole phrase, the opposite of addiction is connection.

Yeah.

Right. It's really connecting, really connecting with people. And it's hard to do. It's difficult to do in this day and age, even though we are so connected.

Yeah. Yeah. There's just so many good excuses to like not connect. And I, I am so guilty of doing all the things to be busy and not connect with people. So that's why I have my Monday habit, you know? Yeah.

I like that. I like that. I should get a— well, I'm going to, yeah, next time. Well, next Monday when you text me, I'm also going to text a couple of people in response. So it'll be like you're paying it forward.

Yeah, I love that. I love that. I hope it makes your life better. It's made my life better so far.

Yeah.

You know? Yeah.

Well, knowing you has made my life better and we have, we have never met. It really has. I mean, because yes, it may just be a text, but so many people don't. And it's also made me reflect on, oh, and there's people not getting texts from me either. So, yeah.

Yeah.

Yeah.

It's easy to. misunderstand how important we can be to each other. And I, you know, I'm like you in that regard. I don't know how big of a deal it is to people. And then occasionally I'll get one of my friends from NorCal or other places who's like, you know, it really means a lot that you say hi to me. I'm like, that feels great. 'Cause like, it means a lot that you're responding, you know? Yeah. Yeah. I love it. Yeah. Wow.

Well, thank you. Thank you for being here. Thank you for being you. Yeah, of course. Already having a positive impact on my life. And I think a lot of people's lives with the podcast we had together. So, well, one thing that we talked about last time was you have a tremendous amount of experience in the recovery world and a tremendous amount of experience with chemsex.

Mm-hmm.

And you've noticed some trends, and you mentioned that you kind of could categorize chemsex users into different aspects or segments. And I thought about that after, and we haven't talked about it since. Um, you know, by the way, anyone who's listening, like, if you can't tell, I don't edit these, uh, podcasts. I don't prepare for them. I just sit down. We have a, you know, you sometimes have a topic, sometimes we don't, and we just go with it.

Yeah.

Um, and so we haven't talked about that, but I thought I was thinking about it and I thought, you know, if I was having a, a, if, if I was having a problematic, uh, relationship with chemsex and somebody had taken the time to kind of categorize me, not to pigeonhole me, but, you know, to take time to, to study. me and my, my, I don't know, the way that I, the reasons I'm doing it, the reasons that I can't stop and this kind of things, it could help me crack the code and find a way out. So that's what I'm hoping today will do.

Yeah.

Yeah.

I hope the same thing actually, because this idea of mine, which was kind of created when I was hanging out with our friend Mel.

Mm-hmm.

And, you know, the, the two of us being very different creatures, but also having a very similar passion for this topic and this group of people. Um, we were sitting down for coffee one day and talking about like, what are our experiences? And if we're going to do supervision about this, what we want to talk about with people, countertransference, whatever it is. And it struck both of us that, you know, there are different kinds of people. who use drugs and have sex in particular kinds of ways, right? So like you said, not to pathologize people or to make people pigeonholed in a, in a, in a separating kind of way, but sometimes we feel more seen when our core motivations are revealed, right? It's like, if I feel lonely and I do this behavior, well, it's the loneliness that matters more than the behavior to some degree. Obviously the behavior does matter. But really it's that core loneliness that's driving the behavior. So if we can talk about that, you know, especially as clinicians and things like that, we can, we can get to the root of things and start to not just change behavior patterns, which is important, but also start to help the person feel understood in a way that maybe they haven't before in their life. You know, because, you know, I don't know about you, but my experience in the world is when people really get me, I feel And when they don't, when they don't get me, when they have a superficial view of me or when they have a misunderstanding of me, I feel less safe. And it's not that, you know, that's, it's normal for people to misunderstand us, but I think in a helping relationship like you have with people and like I have with people, the more we can really help people feel understood by trying to kind of really target the core things that are happening, I think it's easier to work with people to build trust and keep trust and, So that's why, that's why when I was talking with Mel, we were thinking out loud about these ideas because it seems to be fundamentally true that there are different types of people in the chemsex community that have different motivations for their patterns of, you know, sexual behavior and drug use, both separately and combined.

Hmm.

You know?

Yeah. Yeah. So let me. Let me give an example that's coming up for me, if you don't mind. And tell me if this fits in what you're saying. So there's a, there's a client, uh, let's just say this is a fictitious client. So there's a client who I noticed right away a pattern of emotional relapse first, like some, something would happen.

Mm-hmm.

Usually a mild inconvenience compared to, you know, subjectively, I guess for me, it's a mild inconvenience. The response is pretty exaggerated by him.

Okay.

So then, then that sort of primes his emotional dysregulation a little bit. Then some other things may happen. And then he gets cravings. And then he, then he wants to use. And so things might happen, like he might drive by a house he used to use with. Or he may, you know, I don't know, something, something will remind him, but the cravings start to build. And so then he, then he would use. So it occurred to me, okay, not any time during that did he mention he was horny or that he, or that he wanted to have sex.

Mm.

There was no mention of that. But what I noticed was he's trying to find a way To cope and numb his emotions. Now, when he used, did he have sex?

Sure.

So, so sex became what he did while on it.

Yep.

But it was plain to me that it wasn't why he did it.

Correct.

So is this kind of what you're talking about?

That's 100% what I'm talking about. In fact, you use the word numb, and that's one of the 3 categories of types of use. So that's That's, you know, and again, these are just like concepts we came up with over coffee. This isn't like some, like in the literature for 50 years kind of thing.

Yeah.

To be clear, we were just talking about our experiences talking to people and treating people and things like that. And like, okay, so what are, what are the basic, if you want to call them stereotypes, you know, or loose clusterings of behaviors and symptoms, right? So like, you know, the 3 types that we, or I mean, My, I did, and we did kind of both came up with is, uh, we have people that use drugs and have sex for numbing purposes. So you can call them nummers. And then you have, you have people who, uh, engage in chemsex behaviors because they're really trying to connect. They're connectors. Right?

Okay.

Because they're, they're, they're chasing a sense of euphoria in connection. Okay. You know what I mean?

Yep.

Yep. And, and then there's a, a third category, which are the dissociators.

Hmm. Okay.

And so it might be a bit of an oversimplification to say that there's common behavior patterns and drug use patterns. However, I think just kind of, if you think about it off the top of your head, it kind of makes sense, these 3 types, because A lot of these drugs that people consume and that I consumed and consumed and things like that, like they do serve specific purposes, right? It's not a secret that alcohol, for instance, is a pain reliever. It's been used as a pain reliever across societies for thousands, basically thousands of years. You know, it was used in surgeries and anesthesia and things like that. So A lot of people do drink to numb various types of psychological pain when they're depressed, when they're feeling hurt and rejected and all these things, right? So based upon my experience at different programs and working with different people, I see that there is a subset of people in the chemsex world who their sexual behavior and their drug use behavior is psychologically kind of focused on the experience of numbing whatever is intolerable. Okay. Now, for people that, you know, don't use these words more technically, sometimes it's easy to confuse dissociating and numbing.

Yes.

And, and in reality, numbing is not the same thing at all as dissociating, because when you're numbing something, you're still engaging and in contact with the experience you want to avoid, right? So when you numb pain, you don't get rid of it. You just make it more dull. Hmm. Right. Okay. Whereas if you're dissociating, you're trying to completely escape from it.

Okay.

If that makes sense.

Yeah.

So a lot of people in the chemsex world that use drugs like alcohol in combination with probably, um, cannabis and things like that, they're probably more numbing and putting a positive spin on a negative experience. They have shame about their sexuality. They have shame about their sexual interests and urges. They have shame about this, that, and the other. So that shame is pain, psychological pain.

Mm-hmm.

And so they're using various substances to numb their pain. But the, the pain could be anything. It could be shame about, I got broken up with, shame about where I'm at in my career. My family doesn't accept me. Just pick, pick the topic. Whatever's causing that psychological pain or shame.

Mm-hmm.

Mm-hmm. You know, it's, it's perfectly, I mean, think about all the normal places that LGBT folks hang out. It's mostly bars and clubs.

Mm-hmm.

And it's mostly people that are numbing themselves to some degree.

Yeah.

You know, they're quote unquote loosening up, right? But I, I think that's fundamentally different than people who dissociate. You know, the people who use lots of sedative drugs like Xanax and Ativan and benzos, or the people who use a lot of GHB, or the people who use a lot of, um, ketamine. You know, ketamine is literally a dissociative drug. GHB is literally a dissociative drug. Right. So with the people who use these substances to dissociate while they're having sex, there's something intolerable, right, in their life psychologically. It could be themselves. It could be the experience. It could be, it could be shame. It could be any number of things, but their goal is not to numb and make something that's difficult fun. Their goal is to make something that is difficult, not real. Right? So if you're all G'd out at some party, or if you're all high on ketamine at the club and you're barely there, right? That's very different than being numb enough and having fun to compensate with how bad you feel. Hmm. Does that difference make sense?

Mm-hmm. I'm getting it. I'm getting it. I guess when you named the 3, that's my, what's gonna be my first question is what's the difference between numbing and dissociating?

What's your question?

Yeah. Well, that was my question when you first said it was, what's the difference? But you're telling me here.

Yeah.

So this is, okay. So to numb it, we mentioned the, the escaping the emotional dysregulation or escaping the emotions. You named, you named that, that client as a number.

Yeah.

Because he's just numbing that, what seems intolerable is his, he doesn't know how to process his emotions.

Right.

Right.

It doesn't feel safe to you usually. And so I need to numb it, but also probably get some euphoria out of it so I don't feel miserable.

Okay. Gotcha. But a dissociator doesn't want to feel at all.

Anything.

Right. Okay. Yeah.

And in fact, they don't even want to be here.

I would go so far as to say in many cases they don't want to even be in their life. Yeah. Okay.

And I don't mean that in the suicidal sense. I mean that in the, if I could be a ghost and not have to deal with the pressures of being a person and the trauma of my life and the shame of my life and the chaos of my life, you know?

Yeah. Yeah. Yeah. It reminds me. Of when I was, uh, in the closet, married, 2 kids.

Yeah.

Just the misery that I was living in. I did call myself a ghost.

Wow.

You know, like I was having an out-of-body experience all the time because I didn't, I didn't know who I was and I was in this life that confused me and I didn't want to be there.

Yeah.

And that did lead to some suicidal ideations. Wow. But I'm guessing it doesn't always. But that sounds like if I were to get into drugs at the time, I would want something to completely take me out of my life for, yeah, for a while. Okay.

Yeah. Yeah. That makes perfect sense.

Yeah. Um, okay. So what about connectors? Yeah.

So again, these might be more like stereotypes than real scientific reality.

Sure.

Yeah.

Yeah. Which is, you know, we love that here. We love that here.

But for the sake of, just for the sake of argument, and if, and if you don't want to try on these concepts at home, you know, it's okay. Um, we're just, we're experimenting with the model and hopefully the model evolves the more we talk to people like you and David and Mel and so on and so forth.

Yeah.

So, um, You know, the connectors are interesting because their behavior usually is very different in public and private. And for instance, a lot of people that are numbers will probably engage in chemsex behavior both alone and in public, whereas dissociators, believe it or not, will probably do a lot of chemsex behavior in public. They'll be dissociated. They'll be high on G at the club looking to hook up with someone.

Okay.

But But the people who are connectors are almost exclusively the kinds of people who do chemsex only in, in like public settings, like bathhouses and raves and so on and so forth. Whereas like in the rest of their life, they don't feel a strong need, comparatively speaking, to disengage from their normal conscious mind with drugs and sex.

Okay.

So They might use a lot of stimulants compared to the other 2. Not that the other 2 types don't use meth or anything like that, but you might also see these connector types using more of the traditional club drugs like Molly and MDMA. And they're trying to have lots of collective shared euphoric experiences.

Okay.

Now they, they still might be coping with pain and shame and things like that. Shame about sexuality or their Whatever. But they're, they more exclusively are out and about doing the behavior and less exclusively doing it by themselves in secret, watching porn by themselves for hours on end kind of thing.

Mm-hmm. Okay. Connectors are at the chill outs as they call them in Europe.

Yeah.

Or the PNP parties, the, the orgies, the saunas. They're connecting. Yeah.

Yeah. Yeah.

They want the collective experience.

It's the collective euphoria and the rush. Yeah.

Yeah.

Yeah.

Okay. For those who lock themselves up in a bedroom for 3 days by themselves with their porn and toys and, and their drugs, disassociate, would that be a disassociate?

I think it could be, I think it could be either. I think it depends upon the type of drugs they're using and the type of like sexual behavior they're interested in. Because at least in my experience, again, it's just my experience for what it's worth.

Yeah.

There are people who are numbers who will happily sit in front of a laptop and, you know, sniff poppers and smoke weed and jerk off for hours, you know, or edge or whatever. Yeah. And like that group of people is definitely in the numb category for me because They're still trying to quote unquote get high to compensate for how bad they feel. And they still want to be here because they're not getting so high that they're not in touch with their body anymore.

Okay.

So they're, they're chasing a euphoria that gets bigger and bigger and bigger. So they edge for longer and longer and longer, or they chat or video chat or whatever it is. And they're doing more and more and more of it because they're trying to compensate for more and more and more Shame, and the more they do the behavior, the more shame they feel, even if they can't consciously recognize it. And so that could be a number, whereas there are some people, I think, who certainly are dissociators and they spend time in private and they're super high on G or ketamine or something like that. And maybe they're not even fantasizing and maybe they're not even having sex to some degree, but they might consider porn. They might start with porn, but then they might give up on it or they might pass out. And it might be their goal to pass out for some, some people do have a goal to pass out, you know?

Yeah. Yeah.

Yeah.

Interesting. Interesting on that one. Okay. So I'm thinking of, so there's a, so for those who, let's say they're, they're fundamentally lonely, they feel lonely, right? Um, they can't stand to be a Friday night alone. This was, this was kind of what I couldn't stand to be alone on a Friday night. Like, I, I, it would just drive me crazy, the FOMO, and I need to get, reach out and all that kind of thing. When I, when they use, instead of feeling the loneliness, instead of facing it and asking questions of it, they're going to go use. That's a, that would be numbing that, correct? That would be a number.

I think so. Yeah, I think so. Yeah.

Okay. Because they're, you're, they're not trying to obliterate, like they're not trying to To completely leave themselves. They just want to feel better.

Yeah. You know, I think, you know, this might be a ridiculous reference, so please forgive me. However, I think, you know, if you've ever watched the popular TV show, The Simpsons, you can kind of see essentially what I'm talking about when they go to Moe's Tavern and get drunk. So you got Homer, who's the main character, right? And, you know, he's working this job, he's got this family and he's getting drunk. 'Cause he wants to avoid his family. But then you got other people at the bar, if you know who I'm talking about. But there's this character at the bar named Barney. He's this big fat dude who is always perpetually wasted. I mean, he is, he is so wasted that he can barely speak essentially.

Ah, okay.

Right? And so that guy is dissociated, but Homer and his friends from the nuclear power plant, they're just, you know, they're just, they're numbing.

Right.

They're numbing because their lives are, you know, difficult in a way that they can't accept and all these things.

Yeah. Right. Okay. Well, let me ask you about this. What about those who use based on inflationary experiences? Like life is going really well. I get a, I get a promotion at work. Um, I meet a guy that seems to be like the best, boyfriend material, like things, things start to go really well and they use.

Yeah.

Yeah.

Yeah.

Where do you think they fall?

That's a really good question because for a lot of people, as you probably well know from your work with people too, like when things start to go well, self-sabotage is kind of lurking in the back somewhere for a lot of people in the back of our minds usually. And so where does self-sabotage generally come from? It generally comes from shame. Right? I don't deserve, I am universally bad, you know? Um, and so when people are trying to compensate with shame, right? Because for a lot of people, shame isn't always a conscious experience. Sometimes shame is more of a background noise experience. It's, it's like the devil, it whispers in your ear quietly.

Yep.

Kind of thing. And so it might be the case that you get a promotion or you fall in love with someone and You know, there's a piece of you, maybe a large piece or maybe a smaller piece that's like, you don't deserve that, right? That shame voice is there. And so that might be the attempt to like overcompensate and numb your natural positive experience. So if you're, if you're naturally just kind of happy and joyous because you just got a promotion or you just fell in love with someone, it's interesting that you want to alter that.

Mm-hmm.

You know, so what are we altering? Are we really trying to accentuate it? You know, are we using like, uh, like a psychedelic kind of substance, like an MDMA or Molly, or are we using other substances and we're, we're rationalizing, we're making an excuse that we're trying to enhance it. Yeah. But the truth of the matter is you're trying to blunt it in some way, right? It's the classic, I'm going to go to the bar and celebrate with my friends. It's like, well, Yes, you're celebrating, but really you're not celebrating. You're actually numbing yourself when you get wasted, you know? So I'd always be curious about what the specific behavior is, because if it's specifically like, again, I keep coming back to the easy example like Molly, but if it's like, because that's more of a mood and euphoria enhancer than it is a number comparatively speaking.

Right.

You know, like 50/50, 40/60, something like that. You know what I mean? I don't know if that—

Yeah. No. Yeah. I, I'm thinking of specific clients here, but, you know, um, somebody who I noticed, you know, it's always easier for somebody else to notice, but I noticed each time they had a great date, they would relapse.

That sounds like a number to me.

Yeah. Because there's a, there's, there is a question of, I don't deserve this. I'm going to fuck it up anyway. Isn't that right? Or I'm not worthy. I'm not worthy of a healthy, giving man, boyfriend material.

And, and to me, I don't deserve this is the exact same thing as I am not worthy. Yeah. You know, they're all the same thing. It's all shame.

Yeah.

Right.

Yeah.

And that always leads me to believe it's probably more of a numbing experience than anything.

Yep. Yeah. Mm-hmm. Okay. Okay. So if, if I'm listening and I kind of see myself in one, maybe, maybe more than one. I mean, could, could I fall in more than one category?

Yeah. It's, yeah. Mel and I had this very conversation, like, how, what does the overlap look like?

Right. Right.

And I think it's true. I think it's totally true that there are some people that have kind of a bipolar experience with this where it's like, maybe they have moments in their life where they're more of a connector and then maybe they have moments in their life where they become more of a dissociator. Like I've had a couple of people I've worked with directly who they started out like connector types where they're mostly doing euphoric things, not numbing as much. And then with, in a couple of cases I'm thinking of specifically, They experienced some pretty drastic traumas and then they shifted gears away from the connecting type to more of the dissociator because the trauma was just too much for them. It kind of really affected their sense of self. And so they really wanted to leave their sense of self. It became intolerable, I think, for them. So I've seen that before. I've also seen some people shift back and forth between like being a number. And connector, because like, if you just take the average stereotype in the gay community in particular, if there's like a bar or a club or a rave or whatever, like a lot of people there are in the connector mindset, but they also have the capacity to be numbers. And so I think you might start out the night thinking you're one thing when in reality you're kind of your unconscious mind has a real wish for you to be numb.

Yeah.

You know?

Sure. Sure. I mean, you know, it happens when you're drunk, but it happens with, with meth too, is maybe you start out, maybe you start out as connector and then the veil is, the veil is lifted and you're reminded of what you've done or what your life is, or, you know, your trauma starts coming up, you get emotional, and then you want to dive into, let me disassociate here.

Yeah, absolutely. Absolutely. Yeah.

Yeah. Yeah. I mean, in my own trajectory, I started out certainly as a connector, you know, because when I first started, because I was looking for connection in the gay community, um, this was my ticket, right?

Yeah. Yeah.

And so it was on and on. I wanted to connect, to connect. And then as time went on and I started slamming regularly, My life started falling apart and I lost my car, then I lost my job and all this kind of stuff. Then it turned into, I'm going to put enough drugs in my veins that I don't have to face the destruction that's happening around me. I need to leave this.

That's right.

Yeah. That's right.

Yeah.

I didn't care for the pain of other people. That's a pretty common story. Yeah. Yeah.

Yeah. Yeah. Yeah. And to me, that's, that's how tricky this is because, you know, as I said last time I was on here, I'm not, anti-drugs at all. The problem that I face is, especially in our community where we have this minority status that keeps us separate from the world, from the people who don't understand us, the people who hate us, I think there's a layer there of, well, we have an extra added pressure perhaps to go a little further than the average person. You know, so if the, if the average straight person doesn't feel as much pressure to escape or connect because they feel more accepted by society, you know, then we might be slightly more at risk, comparatively speaking, especially given how insidious these norms are. It's perfectly normal, I think, in many of these, you know, commonly frequented settings, you know, like bars and clubs and things like that, for people to drink too much or to do a line of blow in the bathroom and so on and so forth. And that's not, it's not just a stereotype, it's a reality. You can go to any of the gay meccas, so to speak, and see it all the time. Every many nights of the week. You know what I mean?

Yeah.

And like between that set of cultural norms and the, I think the potential vulnerabilities of being a minority, I think we're at greater risk compared to other people. So I think it's always important to be clear that Drugs in and of themselves aren't the problem, but they can easily become a problem if we're not mindful of the type of relationship we have with them and why we use them in the first place.

Mm-hmm. Yeah. Yeah. I heard somebody say drugs, drugs aren't the problem. There's, they're the solution. Right. Yeah.

And, um, they're super effective.

Yeah.

Right. Yeah. Drugs are, drugs are more reliable than people.

Mm-hmm. Yeah. They do what they're supposed to do every time.

Every time. You know, a shot of tequila is the same thing every time, right? Yeah.

Yeah.

And so that's more reliable, you know?

Yeah. Yeah. Yeah. Yeah. And I'm thinking that you're talking about minority stress and cultural norms and what it, what it's like to be a gay person in today's world. So if you, If you wanna take a macro look at this, a whole culture, really a whole community, a whole demographic is trying to numb. Yeah. Is, is trying to connect and is trying to disassociate, which is, which is where I think the whole chemsex, the, the chemsex problem is rooted, right?

Yeah.

Is it?

Yeah.

We're, we're getting, we're getting ran into and crammed into this whole world. Based on a macro, a macro effect really of what we're talking about here on a micro level.

Yeah, absolutely. I mean, I think there's this really unfortunate relationship between, you know, all these external social forces, especially, you know, marginalization and the fact that we also choose to self-select. We choose, we make conscious choices to spend all this money and time and energy on these activities as opposed to creating more gay gyms, gay coffee shops, so on and so forth. And so like, we also bear some of the responsibility, at least half in my opinion, because we could certainly be doing things to create other businesses and other venues to relate to each other and have fun with each other and hang out and like not feel ashamed. You know, like there's, Tons of opportunities, I think, you know?

Yeah. Yes. Well, that's a good, a good charge for you listening and for me, right? Is to continue to work on alternatives to the answer to the, an answer to these problems. Um, so you mentioned when your core motivation is revealed, right? What, what's driving the behavior? And so I, I think in chemsex recovery, isn't that what we're trying to do?

Mm-hmm.

Is what is your motivation? So if I'm listening to this, do I don't, I don't know if you want to, if you have an answer for this. I know there isn't a, a, a set answer or a, a one-size-fits-all, but if I'm a number, what does that, how does that help me get started? down the recovery route? How does that inform me?

Yeah.

Yeah.

That's a great question. Obviously, like you said, everyone is an individual, so their path is going to be different. I would argue that the average person who mostly uses their drugs and sexual behavior to numb, I would argue that if that's your primary thing, Then, you know, learning to tolerate pain is a process, right? And so obviously we want to try to identify if we can the sources of the pain, right? And so just like physical pain can have multiple causes and consequences, psychological pain can too. You know, stubbing your toe is one thing, but having a sore, you know, leg or something, is that from the gym? Is it because I twisted my ankle? Is it because my shoes suck? Like, what's going on here? Right. And I think it's the kind of the same thing for psychological pain and shame. It's like, is it just because of these social things that I feel shame? Is it because of my behavior? Right. Because like, there's a really tricky balancing act we all have to do as human beings, which is we have to recognize that there's A 50-50 interchange or balance of there's societal pressures, and then there's my behavior and my values. And so our behavior and our values sometimes conflict with society, but sometimes our behavior just conflicts with our values, right? So, and anytime that we violate our values as a person, we're going to be anxious and upset. You know, that's not weird. There's an entire branch of psychotherapy called Acceptance and Commitment Therapy that talks about that. And, you know, ACT is the acronym. And so ACT is great because, you know, once people start to align their behavior with their values more, they tend to feel more motivated to do what's better for them, whatever that is for them. Right. So like, if one of my core values is grace, which it is, you know, so the way I grew up and how I've been shaped by the world and my personality and stuff, one of my core values is grace.

Mm-hmm.

Right. And so the more that my behavior aligns with that value, the more I'm like not holding things against people, not having resentments and grudges against people, right? The more I'm trying to be understanding and forgiving reasonably of people. the better my life goes because my behavior makes sense for who I am as a person. And I think that that's true for everybody. So if your shame, if, if you have some kind of shame, you know, and the shame is about your sexuality, the shame is about, um, just to pick an easy example in the chemsex community, a lot of people who engage in chemsex do not feel very important. In their real life. So they have this, they have like this, this double life that they live. Right. Right. So like in their regular life, they're a manager or marketing employee or whatever, or even in our community, they're, they're a healer of some kind.

Mm-hmm.

But because their professional life or their romantic life doesn't allow them to feel important, what they've done is they figured out a way to take all the shame about how unimportant they feel in their professional life and their romantic life. And they've kind of like cordoned it off and shoved it over here into chemsex. And so they'll go do, you know, sometimes ridiculous exhibitionistic things, or they'll try to, you know, as many of us do, like get in amazing shape so that we're the most sought after top or bottom or this or that or the other. You know what I mean?

Mm-hmm.

And so that sense that, that normal human need to feel important, which we all have. Which, if it's not getting met over here with your family and your friends, with your lovers, with your, your work, and it's, it's neglected over here. Well, what we can do is we can find it over here in our sexual behavior, in our drug-infused sexual behavior. We'll feel like those connector types. I'll feel maximally important because I'm the best guy at the orgy. I'm the nicest guy at the orgy, right?

Yeah.

And so that, that, that's that core need. I need to feel important and I don't know how to do that elsewhere. So our job, I think, is to figure out, okay, where does that shame around feeling important come from? Can we talk about it? And then can we do, perhaps the way I like to phrase it to my patients is, can we do little experiments? Because I think little experiments makes it seem like it's a more manageable task as opposed to like, you know, Go be social in the real world. It's like, no, no, no, no, no. Like, I couldn't do that if you asked me to do that.

Yeah.

You know?

Yeah. Yeah. Don't feel important and not feeling seen is similar too, right? I see that a lot.

Yes. Yeah. And we all need to feel seen. These are natural needs that we have from the moment we're born to the moment we die. It's just if they're not getting met appropriately in our regular life, They're going to come out sideways somehow. And that happens in chemsex all the time.

Yeah. Yeah. So back to the numbers and back to what you said earlier, tolerating pain. Yes. So we've had several guests on the podcast who come back to this healing, feeling is healing. It, you know, is that there for, for a lot of men, you're avoiding feeling something. Right? You're avoiding that loneliness or you are avoiding that unworthiness. You're avoiding whatever it is that you have to face, the rejection, like for me, right? Like you're avoiding feeling that way. And the best way to bypass it is to numb it, right? To numb yourself out with the drug. So tolerating, feeling the pain, it sounds so simple. to tell people to sit in that uncomfortable feeling and just be with it. You know, for one thing, it sounds too simple and men are like, it can't be that simple. And then the other thing is, how do I do that? Right. And so there's a lot of questions around that, but I really think this inability to tolerate the pain at least gives me as a listener some direction. Of there's, what am I avoiding feeling? And if it's a Friday night and I'm by myself and I'm anxious and I can't, I can't sit there or, or I numb, I replaced meth. I numb out on TV or I numb out on my phone at least. Right? Like, what can you do to face it head on and sit with it? Is that right?

I think sitting with it is very important. However, as you said, You said it perfectly. Saying it and doing it are not the same thing. Wildly simple to say, but nearly impossible to do if you feel overwhelmed.

Yeah. Yeah.

And the terrible thing is for a lot of us, the overwhelmed is, again, it's like the devil's voice. It's like, it's in our ear quietly. It's not always screaming at us.

You know? Yeah.

And so if it's back, if it's background noise, but it's insidious and toxic background noise, it's just perfectly understandable to just look at the phone more, watch more movies, whatever it is. You know what I mean? And so I always think starting small, whatever it is, like if we can start small and get good at starting small, then we can work our way up to bigger stuff. So like maybe you don't have to sit there and think about your childhood for an hour. That sounds torturous even to me. And I do this for a living.

You know, right, right.

But like, maybe it's like we start small with like, can I sit with this feeling for 5 minutes? And the feeling doesn't have to be the end of the world. You know, just as an easy example, it's like, just give myself 5 minutes to feel it, not run away from it that way. By the way, for everyone who's listening, if they've never had this experience, once you realize you can do something for 5 minutes, Then 10 minutes doesn't seem like much of a big deal, comparatively speaking. Right? And then the, the beautiful, like, side benefit of that is you start to feel more empowered.

Mm-hmm. Yes.

Because you learn to negotiate with yourself.

Mm-hmm. Right. Because you're in control. You're not at the whim of your subconscious urges, right? Yeah. Okay, good. Yeah, because there's some clients I'll say, you know, okay, like you said, 5 minutes. So feel— I feel lonely. The first thing I feel myself do is my hand goes to the phone or my hand goes to the remote. Okay. Could you put it back down and wait 5 minutes and feel what that feels like?

Yeah.

Yeah. So, so that's You're valid. I just want, I need validation that I'm right on that. But yeah, that's what you're saying, right?

Yeah, 100%. I couldn't agree more strongly because 5 minutes can be an eternity, especially if you're very early in the work.

Yeah.

But sometimes it's hard for me. Sometimes it's hard for me to sit there for 5 minutes and just be at peace because I, I should be doing something. You know what I mean?

Yeah.

Which is obviously BS, you know?

Yeah. Right. Yes.

Okay.

Um, connectors, I think the If, if we were going to give them a direction, I think the obvious answer is, well, make new connections, right? But what would you say to a connector in terms of what would be some of the first things we could do? What would be some little experiments?

Yeah, I think for a lot of people, again, I kind of outlined this a few minutes ago with like a stereotype of someone who doesn't feel very important at work or in their relationship or with their friends or family. And so the thing I'd be curious about with that kind of person is, okay, so where can we do a little experiment at work? Or where can we do a little experiment with your friends or with your family? Like stupid idea. Could, like, could you host a dinner? You know, could you, could you start a game night? You know what I mean? Like, these are obviously kind of low-hanging fruit things, but like, will that, will the game night replace the euphoria of like going to the orgy and being the talk of the town? Probably not. However, you know, harm reduction, is that a better choice? Probably, you know.

Yeah. Yeah. Yeah. I like that. Actually, I don't know. Starting game night sounds pretty scary to me. But so, yeah.

Yeah.

Yeah.

And that, that might be too big of a task. So it might be like, uh, easy example. I had this person I worked with who was definitely a connector. And he was very good at his job, but he never took credit for anything that he did. And so in the public chats and the company and the email chains, it was always one of his bosses who was taking credit for his stuff. And so what we talked about is like, what would it look like to just actually assert yourself in a group message or in an email chain about like, this was my idea.

Hmm.

And so on and so forth.

Yeah.

Proactively, not reactively, proactively.

Okay.

And now that didn't, that didn't cure anything, but it allowed him to, it allowed him to feel more important.

Yeah. Yeah. Yeah. And it, it feels like to me, boundaries is going to fall into this category too, right? Somebody who could set some boundaries. Um, in terms of what they tolerate, who they hang around with, what they, you know, saying, saying no when they mean, or saying yes when they mean no, or, you know, this kind of things.

Oh yeah, 100%.

Yeah.

Yeah.

Yeah. Okay. Okay. So a disassociator, a disassociate, or whatever we want to call it, dissociator, maybe. Um, what are we, what are we doing there? What do we, what do we start if that's, if we see ourselves in this what we're describing as?

You know, it's tough because there, there could be in many cases more complexity here. Like I said, with one example, some people have a lot of trauma and so they just do not want to be here. Right.

Yeah. Right.

And so obviously I always want to make sure they're not suicidal or there's no, nothing like that and just make sure they're okay in that regard first. But after that is done, Then I want to understand what is so unbearable about being here. That's the thing I'm very curious about because it could be that life has no meaning anymore. That happens for some people. For other people, like I said, they're so traumatized that their, their body has no more value anymore, or they were in such an abusive relationship that their mind has no value anymore. Maybe their body still does, so they're happy to abuse their body in some way, shape, or form, or use their body to feel pleasure in some way, but their mind is meaningless. So they're happy to be G'd out or, uh, you know, you know, barred out or whatever it is. You know what I mean? And so I always want to recognize that it could be complicated, number one. And number two, there's something that no longer has any, uh, value anymore. It could be their mind, could be their body, could be both.

Okay.

Okay.

Yeah. Or their life. Yeah.

Or just generally. Yeah.

Yeah. So for someone who has lost a very close loved one, they could feel like their life has no meaning or value anymore. I've seen that.

Well, yeah, me too.

Right. Um, somebody, so, uh, talk about going through from one to another. I see oftentimes they may start as a number or connector. They contract, or they, uh, contract? Why am I, what am I, they, they get HIV. They, yeah, yeah.

Contract. Yeah.

Contract. I don't know why that doesn't sound right. They, they contract HIV, then they become a dissociator because now my life is over. My body has no meaning. I have no meaning. I'm damaged goods, right? Yep. Yeah.

Yep.

Yeah. Yep. Yeah. And so anyone who falls in that category, I would definitely suggest some therapy. Sorry, some trauma therapy. I would say that's not, you know, those are, there are certain clients that come to me when I know right away it's above my pay grade. You know, and it's like, I can at least maybe point out this, this could be something to help me like, Do you fall in this category? Is this your motivation? Now let's take that information to a therapist, right? Because it's usually pretty deep, pretty deep traumatic injury, I would say.

Yeah, likely. Yeah.

Likely. But again, not everybody's the same, or we can't just stereotype at all. Um, yeah. Interesting. Very interesting. And I really thought that maybe I could stump you and come up with an example that didn't fit these 3, but I didn't.

Go ahead. Yeah.

Yeah.

I couldn't. Yeah, it's to, for, for us, it's an evolving conversation. So we're going to keep exploring and maybe eventually come up with like a test or something like that if we can, to see if we can figure it out.

Yeah, I think that'd be great. Like an assessment of, you know, why you come up. And then once you know, again, once you kind of know, then you could get a more tailored plan, right? Um, and know kind of what little, I like that you said little experiments. These, these little experiments we can do. Because I've always said, like, whatever I ask people, you know, what are you getting from the chemsex experience? And once you know what you're getting, then you need to give that to yourself.

Mm-hmm.

It sounds again too simplified, like just feel it, right? But at least it gives you, if you're feeling overwhelmed about like, How can I ever stop? Or how can I ever get through this? At least having some little like, oh, this is why I'm doing it. And just because you figure out why you're doing it doesn't solve it.

Right.

But it can give you some kind of hope or some kind of direction or light at the end of the tunnel, I would say. Yeah.

Yeah. Yeah.

So what did I miss today? I don't know, Patrick.

I, I don't know.

Is there something I, you, that we didn't cover that you think would be important in this discussion?

I mean, I don't know. I don't, I don't think so. I just, you know, just to reiterate a couple of things that we both said.

Yeah.

It's like everyone's an individual. So it may not be the case that any of these things like perfectly fit you or something. And the other thing to reiterate from the very beginning of this conversation is what you said, which is, you know, with full respect to people being individuals, these ideas are not meant to pigeonhole you and like typecast you. It's just perhaps if one of these 3 models or more fit you, maybe that's a sign of something that's going on inside of you, perhaps, you know, so just worth being curious about because for a lot of people, shame is a big part of it, but shame doesn't manifest the same for everybody, you know?

Yeah. Yes. And I really love the, uh, I mean, you haven't said this. I just got the idea, but I really love the idea of having Case study scenarios. And so I can read that and see myself in it, right? And then in that case study scenario, it revealed that this person is a number. This is what this person did. Not to say you have to follow it, but maybe you get some ideas. Maybe you get some direction. Maybe it gives you a starting point to say, at least I can, I can feel seen. and understood by someone else's story. So if you could, you know, if this evolves and you could come up with little case studies and, you know, little stories to read or something, you know, it can pretty more illustrate too, kind of what the types look like.

Yeah, absolutely. I think that's very doable between you and Mel and David and me. We could probably come up with dozens and dozens and dozens of—

Sure.

You know?

Yeah. Yeah.

Yeah.

Yes. Yeah. Yeah. I'm, I'm trying to, I'm thinking about starting a different podcast called, uh, Chemsex Client Case Studies, where I bring actual case studies to a professional like yourself and ask, what would you tell this person? Right. Um, it has to, you know, it's going to have to be general— generalized.

Yeah.

Obviously. Um, But in these case studies, I know that because what you're saying here is that a lot of people fall into similar categories. If I'm, if you're listening and you hear a case study, to me, I think you could latch onto that easier and say, oh, that's me. I see myself in that. And then getting the idea from a therapist, a clinician, a counselor, a treatment center director or something like that to say, In that case, this is what, you know, this is my advice to that, that person. So I'm thinking that that might be helpful.

Yeah, could be cool.

And helpful for clinicians too that are new to, that are new to Chemsex, right?

Agree. Completely agree. Yeah.

Yeah. Well, thank you so much for coming back, Patrick. Really appreciate it. And I appreciate you. This was, this was really enlightening for me. I wasn't sure what to expect. Um, and I like it. I like it. It's going to inform my work as well, which is helpful, helpful for me and helpful for my clients.

Awesome. Well, I really appreciate the chance to come here and have a conversation with you and explore things together, you know?

Yeah. Yeah. It was fun. It was fun. All right. Well, I'm going to let you go. And for you all listening, if you have one joining the conversation, you can comment on Spotify. You can comment on YouTube. You can also DM me on any social media platform anywhere. I'm everywhere out there. And if Patrick has contact information he wants to share, we'll put that on— we'll put that in the show notes as well. And don't forget, there is a supplemental study guide that goes along with every episode. The link will be in the show notes. It'll be a summary of the episode and some suggested journal prompts, actionable exercise, and reflective questions. All right. That being said, we will see you next week. Bye.