Chemsex in the therapy room

Up in my little room in the centre of Soho, I run a private therapy practice where I work a lot with ChemSex. From here I feel that I have gained an insight into the lives of men who have become involved in the world of apps, drugs and sex. While many out there are having fun with it, the men I speak to feel that they are not happy anymore and are looking to make a change. Over my time with clients, I have started to see some of the causes that lie beneath ChemSex. Of course this article won’t cover everything as we are talking about people, and what makes us fascinating beings is how beautifully complex and different we all are, these are just some common issues that can be worked with in counselling.
First of all I think two of the most important things are intimacy and a desire for connection; who doesn’t want to feel that closeness with people? But it can be so tricky. Chemsex can create a real escape from feelings of loneliness and isolation, it might be the only time that you feel like you belong. This is the thing to remember, that for all the risks that ChemSex brings, at the time it may feel like it fills a gap in your life. With the nature of these drugs and all that physical contact, it can feel very close. We live in a culture in which we can be connected with somebody in seconds online, however, without deeper relationships with people we can still feel alone. While ChemSex provides the fast-track to being with others, that feeling may not last.
There may even be an opportunity to open up and share with someone who might understand, or to be cared for; this in itself can be addictive. The feeling of being looked after in your drug use, or the moments between when stories can be shared. It’s not just physical but also emotional inhibitions that can be lowered with drug use, though this can feel very different the next day. See, intimacy is something that may be greatly desired, but not fully understood. It may feel like if you have sex then you are being intimate; or that to be intimate, you have to have sex. But where you really find it is in deeper connections with those who truly know you.
Part of this difficulty with intimacy may be due to the fact that relationships can sometimes be really hard to figure out; it can feel like you are out in the world without the manual. Many of the men that I speak to have talked about difficult early relationships or sexual experiences. They have been hurt by another either physically or emotionally and this can affect the way you see yourself. Sadly many feel that they are not worthy of being wanted, loved or cared for.
This may even reach back to the first man in your life, your father. Now this might sound a bit weird I know, but as a child our parents are our entire world so if this relationship is difficult then we can feel like it is something to do with us. It may be anything from a distant or absent father, to those who are abusive or struggle with their own addiction. This is the first way that we start to learn about relationships and if this is hard for you then you may grow up not trusting others, or not feeling like you are worthy of love. As an adult we can replicate difficult early relationships over and over again, or perhaps it might seem safer to avoid them all together.

And it’s not just single men who struggle with relationships. While some couples may enjoy sex and drugs together, other men describe how they got into ChemSex in an attempt to feel closer to their partner. Though as time has gone by they are left feeling uncomfortable, resentment or hurt. It may feel like without being involved their partner would not really want them, that alone they are not enough.

Then there can be those horrid feelings of shame. We all feel shame sometimes if we think that we might have done something wrong or embarrassing, we’ve all been there the morning after, however toxic shame is when you feel that your entire being is somehow wrong. If you feel that you are ‘bad’ inside then it may seem easier to isolate yourself from others, keep an emotional distance or try and escape through drug use. If you really don’t like what you feel inside, then it can be really difficult to believe that others would like you too. This also ties in with the idea of ‘internalised homophobia’ that we see spoken about in so many articles on the subject.

Internalised homophobia is when you grow up seeing that the societal ‘norm’ is heterosexuality and so to be anything other sets you apart. Negative comments and opinions may be absorbed and turned in on yourself. For a man who grows up in a community that doesn’t accept homosexuality, or perhaps hears others making negative comments about gay men, all of this might stick with you. It may lead to feelings of self-hatred, more risk taking, an anger inside or hiding behind a front to protect yourself. Chemsex can provide both a place to get away from all of these hurtful thoughts, but also takes people back to that sometimes all too familiar feeling of shame.
As you can see, the way that we view ourselves can have a huge effect on our lives and if we don’t like ourselves very much then it may be that we just want to escape and be somebody else for a bit. It would make perfect sense, particularly when it can seem like you are surrounded by unrealistic images of popular, fun, hot guys. If you can take something that makes you feel equally sexy and care-free, then that will be so seductive. Many men describe low self-esteem and lack of confidence and apps like Grindr, combined with drugs that make you feel like a pornstar, seem to play right into this. It may feel so difficult to approach someone in a bar if there is a fear of criticism, and an internet app seems much easier. In just a few clicks you can find yourself a hook up and be on your way. You don’t even really have to open up much or get to know each other. However, it comes with its own risks of being blocked and judged.

This can begin a new cycle of looking for more attention, more apps and finding somebody for sex. Ultimately it comes down to feeling attractive and feeling wanted, two things we can probably all relate too. It may seem like a quick fix, but since it’s based mainly on image it does not provide what is really needed. It can also perhaps lead you into situations that you do not feel comfortable with or are unsafe.
This article is merely to act as a brief overview of what I have seen in my time working with ChemSex clients, and there is such a huge range of reasons why people get involved. However, there seems to be a connecting desire for intimacy and to be wanted, but not knowing how to get it or not feeling good enough. I believe that to understand ChemSex we need to see that alongside all the risks, there is something about the whole process that plays into people’s needs. The aim of therapy is to provide a space to talk openly without judgement, to connect and to discover the real you. It may be that ChemSex has become a part of your identity or a way to deal with any difficult events or feelings, however it could be holding you in that trauma.

By sharing these feelings with another you can move past any shame and accept yourself for all that you are. You can learn what your needs are and how to connect in a relationship without drugs and sex, then take this forward into the rest of the world. It may be that all of your interactions with people are based on looks, sex and the physical while emotional connections are kept at a safe distance, but there is so much more to you than that. Whether you talk to a counsellor, a peer or allow yourself to open up to somebody in a sexual health or drug service, it is all making the first step towards sharing. Seek help with feelings of depression and paranoia and get the support that you need. You are worthy of care and kindness.


Katie Evans is a private practice counsellor based in Soho and Kings Cross.  She also runs workshops on working with ChemSex therapeutically.

Visit Katie’s website.