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Friday, April 18th, 2014

The Real Treatment Issues for Transgender and Gender Non-conforming Kids

by Margie Nichols

A nuanced, flexible, and tailored treatment approach to gender identity issues in childhood and adolescence is the prudent approach. Read Margie's latest blog HERE: http://www.goodtherapy.org/blog/transgender-and-gender-nonconforming-you...

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Friday, March 21st, 2014

The Phony Debate About Treatment for Transgender and Gender Non-Conforming Kids

 

Recent published reports woefully miss the mark with regard to treatment pertaining to transgender and gender-nonconforming children.  Read Margie's latest GoodTherapy.org blog here:

 

http://www.goodtherapy.org/blog/phony-debate-about-transgender-and-gender-nonconforming-youth-0306144

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Tuesday, January 28th, 2014

What My Grief Has Taught Me About Psychotherapy

by Margie Nichols, Ph.D.

     In 2004 I lost my daughter Jesse four days before her tenth birthday.   For reasons of sheer survival, I went back into counseling right after Jesse died, after a hiatus of a number of years, with New York -based therapist Bruce Wood.  Among his many skills, Bruce has a great deal of experience with post-traumatic stress, which I guarantee you ensues upon the loss of a child. My own process of stumbling back to semi- normalcy (one forever has a piece of themselves missing after an loss like this) has helped my practice and informed my beliefs about psychological theory in ways I’m just beginning to understand.

   More than anything it has confirmed, or re-confirmed, the value of psychotherapy. I can’t imagine getting through this without Bruce.  I have renewed appreciation for how important it is to have someone in your life who listens to you talk about yourself and your experience without wanting reciprocal attention; who is not affected by your decisions or behavior and therefore has no stake in your direction other than to help you attain your own goals; who does not judge you, but will also tell you the truth about yourself, in a compassionate way; who doesn’t nag you but doesn’t let you run away from reality, either; who is smart enough and competent enough for you to trust their guidance; and who above all makes you feel they care about you and that they will always be in your corner.

   A lot of times, that’s all you need to heal – a supportive environment within which you can process your own experience and recover from your wounds.  But it also helps to have a therapist skilled in specific techniques and knowledge – sex therapy, for example, is heavily dependent on certain behavioral interventions and upon medical knowledge, some conditions, like OCD, really do require specific CBT protocols.  All therapists, in my opinion, need to have at their disposal some methods for changing thoughts and behaviors, some for helping process people trauma and emotionally charged issues, and some that help with affect, mood, and behavior regulation.  I suspect the wave of the future also includes body oriented work, as we learn more about physical ways of healing emotional disorder.  In my case Bruce is an experienced EMDR practicioner and this really helped the PTSD  I experienced from  witnessing my daughter endure three months’ hospitalization and a rather horrible death.

   But the other thing I’ve learned through my own grief healing is the immense power of the unconscious mind, of stored memories, associations, and processes that have a primitive, symbolic logic rather than a rational one. We don’t understand much about the operations of this mind, although psychologists since Sigmund Freud have been speculating  Certain sounds, smells, even colors were connected to memories of my daughter, and as I untangled the web of my grief I found threads that led from her and her death back to earlier losses, childhood fears, little and big traumas suffered throughout my life.  I have gained a profound respect for grieving rituals because I understand that they allow the brain to engage in a primal undoing and re-doing that seems to heal pain and allow a future-orientation in the person who has experienced loss.  For example,  I have yet to meet a mother who does not  feel blame for the loss of her child, no matter how illogical. As the mother of someone who died in the 9/11 attacks said, “I’m his mother.  I’m supposed to keep him safe. I failed.”  And I know that no amount of rational thought dispels that feeling – but sometimes acts that can only be construed as making reparation, doing penance, or symbolically undoing and redoing the past can heal some of the self-blame.  Often the ‘reparation’ involved a certain period of mourning under circumstances of self-deprivation.   Not long ago I was working with a client who was overcome with grief over the loss of a beloved dog about eighteen months prior.  When I asked her why she hadn’t gotten a new dog, something I knew she wanted, she replied, “Cassie wants two years.”  My client’s unconscious mind told her she needed to grieve two years for her dog before she could ‘move on’ enough to enjoy another puppy, that respecting the bond she had with Cassie meant ‘depriving’ herself for a certain amount of time.

    My own process has also taught me that there is an inner wisdom most of us have that guides us, and the best therapists respect that wisdom and try not to have preconceived judgments about the ‘right’ ways to heal.   I’ve found no theories of psychotherapy or prescriptions for mental health that can adequately explain some of the things that were most helpful to my recovery, and some of these things seemed doubtful at the time.  For example, within four months of Jesse’s death I knew I needed to adopt another child and that it should be an older child from Guatemala (I eventually adopted two). Although many people warned me about a ‘replacement child,’ my therapist supported me – and it turned out to be the best thing I could have done for myself and my family.  For a long time after my daughter’s death it was extremely helpful for me to keep a public internet journal, through which I exposed my grief in excruciating detail. My LiveJournal was very important - until eventually it wasn’t, and I have no idea why I needed to start it and why it was okay to stop. Periodically I need to play Billie Holiday’s  ‘Good Morning Heartache’ and sob my heart out.  Why do I need this? And why not every day?  I have a little garden that is a tribute to Jesse, and tending the garden feels like a way of maintaining a connection to my child. These things are not ‘rational’ but they are critically important.

   We know so little about healing.  We know it requires love, trust and safety, but we’re pretty clueless about everything else.  Current psychotherapy research is very much focused upon comparing different theories and techniques, eg. CBT vs. antidepressant medication, exposure protocols versus insight techniques. Yet the only therapy outcome findings that are consistently replicated over time highlight the importance of therapist characteristics like empathy and active listening skills and the quality of the therapist-client bind.  In part from my own healing I’ve learned to hold all theories lightly and focus on their common underpinnings instead of their differences.   The longer I practice therapy and the more I contemplate my own growth, not only through my grief but over a lifetime, I realize I need to cultivate what the Buddhists call ‘don’t- know mind’ – ‘beginners mind’, one free of preconceptions and assumptions, one that can recognize and follow the lead of the mysterious healing process of my client’s unconscious.

 

  

 

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Saturday, January 11th, 2014

Sex Is Queerer Than We Can Imagine—Really

by Margie Nichols

The neatly categorized notions most people apply to sexual orientation, expression, and gender identity may not be inclusive enough.

Read the full blog, published on GoodTherapy.org, here!

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Friday, December 20th, 2013

Losing Lou Reed: It Takes A Busload Of Faith To Get By

by Dr. Margie Nichols

My blog on the loss of the incomparable Lou Reed has been published on Out In New Jersey. 

'When Lou Reed's New York album came out in 1989, many friends and I related instantly. It was hard, harsh and gritty. It expressed the anger, cynicism and mistrust of the government that we all felt. Although only one song, 'Halloween Parade,' explicity referenced gay people and AIDS, it was easy for us queers who were surrounded by the disease and faced with society's hatred of gay men and the government's homicidal negligence to identify with Reed's polemical songs about classism, racism, xenophobia and environmental plunder. They also expressed pain, hopelessness, despair – and yet, in addition, a shred of hope and mysticism. And some songs did all of this in one, like 'Busload of Faith.' One of my most vivid memories of that era, one that makes me smile and cry at the same time, is of IPG therapist Curt Schulze and me singing that song together at the top of our lungs. Curt died a couple of years later, of AIDS.'

Read the full blog here.

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Friday, October 18th, 2013

BISEXUALITY - STILL A HOTLY DEBATED ISSUE - BY STRAIGHT AND GAY PEOPLE ALIKE

by Margie Nichols

The blog I wrote for Goodtherapy.org about bisexuality must have touched a nerve - more people have commented than any other blog I've written.  Who knew, more than 20 years after I came out as 'bi' in the 1980's, that it would still be such a hot-button topic?

 

Read it HERE

 

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Friday, October 18th, 2013

LGBT YOUTH SUICIDE

by Margie Nichols

 

Check out Margie's blog on Goodtherapy.org about the problem of suicide among LGBT teens and young adults.  Gay, lesbian, bi and trans and gender non-conforming kids make more suicide attempts than other adolescents - but we can do something about this!

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Wednesday, August 28th, 2013

HOW SAME-SEX RELATIONSHIPS CAN INFORM THE 'OPTING OUT FOR MOTHERHOOD' DISCOURSE

by Margie Nichols, Ph.D. 

 

On August 11 2013, The New York Times published an article by Judith Warner in its Sunday Magazine, entitled “The Opt-Out Generation Wants Back In,” a revisiting of the women interviewed in Lisa Belkin’s 2003 Times article “The Opt-Out Revolution.”  The women, who had all given up high-powered jobs to be full-time mothers, now were working - or wanted to be.  Sixty percent had returned to work, and some others were trying unsuccessfully.  Not surprisingly, given that Warner’s sample is upper middle class, some had re-entered the work force with ease.  But others could not find paying jobs and still others had to take whatever they could find because they had to bring in money after divorce or because husbands lost jobs.  After the publication of the article, some reporters focused on the clear class bias and how working class and many middle class families cannot afford the choice to ‘opt-out.’   Some commentary focused on another problem highlighted by the account:  none of the women wanted to return to the 50-70 hour work week  they left, but there are still few employers who take part-time workers seriously.

      As a feminist, I resonate with this second critique.  The original goals of the second wave of feminism, at least the more radical branch, did not include simply succeeding in traditionally male workplaces, but instead, when we attained power ourselves, to  transform the game itself into something more family-friendly, balanced and fair.  We were all about day care, employment opportunities for women, job-sharing and becoming an active participant in the marketplace, knowing that in order to change the rules of the male-dominated business world, you needed power and money.  

      Instead, we got women ‘opting-out.’

      As a white-collar, educated professional, I have a privilege and freedom most of my working sisters don’t have.  But I also have a perspective that comes from a different place, informed by the fact that I am a queer Mom who, together with her female partner, chose to mother and raise a child who is now nearly 30.  I’ve lived and worked my whole life in the LGBT community, where I’ve raised and shared in the raising of four kids, three still living, and worked soon after the birth or adoption of all of them. 

      Thirty years ago, when pregnant with our son, an older and wiser working mom gave me invaluable advice:  “Never make friends with a stay at home mom,”.  She was referring to the fact that many full time mothers look down on working mothers, subtly and not so subtly.  The judgment can be particularly harsh for women who chose to work even though, with some lifestyle adjustments, they could afford to stay home fulltime.  The upper middle class heterosexually married ‘opting out’ moms portrayed by Lisa Belkin and now Warner are not the poor and working class women who stay home because childcare is too expensive and/or of low quality, but the ones who have a personal choice.  These "opting out" moms often seem to believe that their choice is the one more virtuous, the one made ‘for the children.’  And their husbands believe it too.  As does the whole culture, really.

      The myth, rarely articulated but widely shared, is that women are ‘naturally’ more skilled at parenting and that children need a full-time mother at home with them.  Most men and women accept this myth despite decades of research showing that it makes no difference to kids’ well-being whether they are in raised in quality daycare or with a full time parent.  Being a stay at home Mom can be hard work when there are several kids and a large household to run.  For upper middle class women who have housekeepers and nannies – not so much.  But because of the myth,  straight women feel entitled to more options than their husbands, so they are invested in actually believing that their children need them to stay home.  Women who consciously and willingly choose to go back to work and utilize daycare and childcare are seen somehow as selfish or at least as less adequate mothers.  This post-modern version of the belief in the sanctity of motherhood has morphed into a ‘women’s choice and freedom’ issue.  The practice of ‘opting out’ seems to blend traditional values with more modern notions of egalitarianism.  The Opt-Out women feel entitled to choose work or home life while their husbands continue to work, and at the same time they maintain the feminist expectation that Dad share housework and childcare.

      But according to Warner, the choice to stay home didn’t turn out as well as they had expected.  Over time, some women experienced a loss of personal self-confidence and self-esteem, and some began to feel like they really were inferior to their husbands.  For some, conflicts arose when husbands resented having to share household chores they expected be done by their wives during the day, or resented that they never had the choices that their wives had to incorporate better work-life balance into their lives.  It seemed that Opting-Out had as many problems as Leaning In.

      How can the study of same-sex relationships inform the discourse about work versus full-time motherhood?  How can we queers help the heterosexual family?  We can learn a lot from the research on how same sex couples function relative to straight marriages, most aptly summarized in Liza Mundy’s June 2013 Atlantic piece titled ‘The Gay Guide to Wedded Bliss.’  Gay and lesbian couples with children do it differently than straight ones.  First, lesbian families are the most egalitarian and least ‘specialized’ of all – there is less likely to be an arrangement where one parent stays home and the other is the sole breadwinner.  It is more likely that both make modifications to their work schedules, or they take turns – one stays home a year or two then they switch.  Lesbian moms share chores and child care more than other couples, and they even frequently ‘blend’ their incomes, both to mirror straight relationships and to neutralize the power that comes with one making more money than the other.  Observational studies comparing lesbian moms to heterosexual parent pairs show that when interacting with kids together, two women tend to reinforce and support each other's parenting while straight couples often obstruct each other.  Lesbian parents seem to have more inherent respect for each other’s abilities – and the right to share in parenting decisions.  Gay Dads are egalitarian as well, but they tend to ‘specialize.’  In contrast to heterosexual couples, gay men argue over who ‘gets to’ work, not who ‘gets to’ stay home. 

      What can same-sex couples teach us?  First, that no parent is ‘entitled’ to decide for both parents who will work and whether to work, and who will stay home.  This is something I rarely hear broached in the ‘Opt Out’ vs. ‘Lean In’ discourse.  Second, that money equals power.  The partner who is the sole breadwinner may make you feel, perhaps unwittingly, like you are inferior – and you may feel that you are as well, deferring to the one who earns the money.  Whether because of lack of social recognition for the importance of homemakers, having a husband who equates earnings with privilege, or something inherent in the role itself – it’s hard to maintain self-confidence and self-esteem when you are solely a stay-at-home mom for an extended period.  For many women, it gets to be a boring and thankless role in life, especially when housework is a big part of it.  There’s a reason gay Dads who ‘specialize’ fight to be the one to go to work – they recognize the inherent boredom in much of the routine of childcare as well as the power that money brings.  Note I’m not denigrating ‘specialized’ households, as long as decisions are reached fairly by two partners with equal power.  And as long as it is done with understanding that though this may the best choice for your particular household, it is not the best choice for all children, and this arrangement is no more inherently structured to raise healthy children than any other quality arrangement.  There are pluses and minuses to all childcare and parenting options.

      One negative to the stay-at-home option that people rarely discuss:  the things you can’t do for your kids because you may not have the money.  Kids are expensive, and some kids more expensive than others.  While research doesn’t show any superiority of constant mother presence, it does show the superiority of better schools, better health care, better mental health care and the ability to pay for college.  Because I’ve worked as hard as I have, my three surviving children have had tremendous educational resources, special services for their learning disabilities, life-broadening experiences – and all will graduate from college with zero student debt.  Which is more important parenting?  Being always physically close by when Junior is young?  Or being there when it matters, giving her unconditional love and guidance as needed, as well as giving her the education, life experiences and a financial head start when she is in her twenties?  I imagine it is different for different children and families; people have different values and beliefs about child-rearing priorities.

      I think straight couples should take a lesson from this.  For starters, I’d like to see women give up the sole privilege of choice, and start assuming that their spouses have equal footing when it comes to work-life balance and choice issues.  At the same time, men have to give up the sometimes unconscious tendency to dominate their spouses through financial power, using their stay-at-home wife as a 'status symbol' or expecting they will be ‘taken care of’ by women. 

      In gay and lesbian couples, there are no inherent gender divisions because both partners are the same sex.  So when responsibilities are divided, they can be portioned according to guidelines more rational than gender stereotypes.  And there's more fluidity.  The partner who seems ‘butch’ may do the cooking and the ‘femme’ change the oil in the car, because two women or two men aren’t locked into behavior based on appearance.  The assumption of equality in same sex relationships automatically leads to more mutual respect and more balanced power relationships, eliminating a major source of relationship strife.  Same sex couples interact better as a team than straight couples when parenting - because they have better teamwork in general.  Isn’t that better for the kids, to see cooperation between parents and not discord?  And getting a uniform message from both their parents?

      Another way same sex parents can serve as role models is in how they tend to stay friends with ex-partners.  I have seen nasty divorces in gay families, usually when one partner experiences a religious conversion and comes to believe their gay partner will corrupt their children.  And the LGBT community has its fair share of insane and immature people who care more about revenge for hurt feelings than they do for their children’s welfare.  But queer life has long normalized friendships among exes.  It is the norm rather than the exception, so new partners are usually accommodating.  When children are involved, this means that children do not experience being ripped apart between battling parents.  The transition to blended households and step-parenting is made easier, and children have a resulting  extended support system of relatives that care for them. 

      Heterosexual men and women have to give up the fiction that stay-at-home mothers are better for children.  That assumption may seem to privilege women with choice, but once assumed, it chains women to domesticity.  Feminists dating back to the 1960’s were aware of the dangers attached to the pedestal of motherhood, and some heterosexual women are learning it again in the 21st century.  Heterosexuals have to stop pretending they are engaging in work/homelife specialization because it is for the good of the children.  It’s a choice – like all parenting decisions – based partly on self-interest.  It’s not inherently more child-friendly than many others.

      There is nothing radical about opting out of the work world to be a full time mother.  What will be more radical is if heterosexual men and women are inspired by the egalitarian nature of same sex relationships to fully share decisions about who does what with housework, childcare and working.  Only if both men and women, gay and straight, are involved in a cultural push for more human work ethics, more European, less classically American lifestyles,  do we have a chance of radically changing a culture that makes work/life balance next to impossible.  Now THAT will be a movement.

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Tuesday, August 13th, 2013

What Same Sex Couples Teach Us All

 by Margie Nichols  

   Starting in the 1980's a small handful of social science researchers began to study same sex couples, mostly to see their relationships lasted as long as straight folk and whether kids raised in gay households grew up to be 'normal.'  Along the way, the studies have revealed a lot more about similarities and differences of heterosexual versus gay and lesbian relationships. Read the blog article I wrote for GoodTherapy.org:  

 

 

 

http://www.goodtherapy.org/blog/what-same-sex-couples-can-teach-heterosexuals-about-marriage-0812135

  

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Thursday, June 27th, 2013

'What Do Women Want?': Maybe Not Monogamy

 

by Margie Nichols

 

 

- From this feminist's perspective, Dan Bergner's new book, What Do Women Want? is an intriguing and important look at female sexuality.  Read my blog about it, and why it validates a theory proposed by Dr. Mary Jane Sherfey in the 1970's.

 

http://www.goodtherapy.org/blog/feminist-sexologist-review-of-dan-bergners-what-do-women-want-0627134

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