Bathtubs, Boosters, and Bears, Omicron!! [A Holiday Update]

On November 24, 2021 I decided to get my fourth shot of the COVID19 vaccine.  The first two doses (Astra-Zeneca) were administered in a vaccine trial in November and December of 2020.  The next single shot (Johnson & Johnson) was given in May, 2021.  Did I medically need a fourth shot in order to have the maximal protection from COVID and its variants?  The answer involved a lot of math, a lot of probabilities, and a lot of maybes.  Ultimately I opted to receive the next dose (Pfizer) because it removed uncertainty, cleared up my ambivalence, and helped me to feel in control over what happens to my body. 

When I made this pre-Thanksgiving announcement on Facebook I received much support from family and friends.  One person, however, whom I would describe as vaccine ambivalent, privately reached out and asked, “So what does this mean?  That you’re going to keep getting booster shots over and over?” My answer:  YEAH!!  I will happily get COVID booster shots as long as it takes.  You’re talking to the same guy who regularly uses PrEP to prevent HIV and doxycycline to prevent STIs.  The idea of utilizing biomedical interventions to enhance my quality of life and reduce harm is hardly an unusual concept for me.

About 24 hours later media headlines started swarming around the World Health Organizations’s announcement of Omicron as a “COVID variant of concern.”   At the time of this writing, there is no clear evidence that Omicron is more likely to lead to illness than the other variants, nor how well the current vaccines protect from this new strain.  But I do know that having an additional booster shot offers me a way to feel proactive, responsible, and empowered about my pleasure and protection, in the midst of more panic and uncertainty. 

Damon in Mike Enders' Tub

This theme of seeking medical and mental safety in times of turbulence and trauma has come up frequently in my new “Tub Talks” series.  The idea of doing naked interviews in a bathtub came to me years ago, when I saw my buddy Mike Enders, aka as “The Accidental Bear” holding court in his tub in San Francisco.  I begged him to let me be part of his show, and we filmed a very fun episode in early 2018.  Mike was already moving beyond his bathtub to focus on animal activism by that point, and I thought eventually I wanted to host a similar type of forum for discussions, dialogues, and deeper lessons about resilience and hope. 

After finishing my 50 Lessons of 50 Series last Spring, I began planning  “Tub Talks With Damon" -

Kareem McJagger In The Tub

...featuring naked conversations with thought leaders, artists, healers, creators, bears, and people who just fascinate me.  All have generously shared experiences of vulnerability, as well as lessons learned from surviving pain.  Everyone who has visited my Tub has deepened my appreciation for overcoming obstacles, fighting to gain a sense of safety and control after dealing with traumatic setbacks, and using their experiences of adversity to help improve the lives of others. 

Tub Talks With Damon Premieres Today

On this pilot episode of Tub Talks, Damon learns from Matt how he transitioned from occupational therapist to sex worker. What are the pros/cons of doing porn and sex work, and how can we celebrate the beauty of our bodies as we get older? 

 

Plus - Why the heck are we doing interviews in the bathtub? 

 

Please follow Matt at : https://allmylinks.com/thedudenextdoor

 

10 Years Of Taking PrEP

I began using PrEP 10 years ago today.  I'm clarifying some myths, fears, and inaccuracies in this statement.  Please take time to learn more at PrEP Facts: Rethinking HIV Prevention and Sex!

1. The Joy Of Aging: Power, Purpose, Pleasure

I was 14-years-old when The Breakfast Club was first released in theaters and I would end up seeing it many times during its original release.   As much as I enjoyed it, I did disagree with a central premise of the film, and seemingly all the John Hughes angst films in that genre.   In a scene where all five characters discuss their fears and vulnerabilities, Ally Sheedy’s character laments, “It’s unavoidable.  It just happens. When you grow up, your heart dies.”  I remember thinking, “No, it’s not unavoidable.  That doesn’t have to happen!” 

I am turning 50-years-old today as I'm writing this filled with more heart, more gratitude, more optimism than I’ve had before.  One of the benefits of living this long is knowing that when I feel hopeful it’s not coming from idealism or naivety.  I’ve seen good and bad, I’ve seen highs and lows, I’ve experienced the best and the worst.  I’ve seen beauty and miracles unfold in this world.  And in the last 14 months I believe I’ve seen the ugliest humanity has to offer.  Nevertheless, I write this carrying a strong rational faith that there is much joy ahead.  

About two decades ago I came to understand that most feelings aren’t about what happen to us, they are about the meaning we give to the events that happen to us.  If you don’t like the feeling, change the thinking.  So the faith I’m feeling today isn’t about things going well for me in my future, it’s about knowing that my reactions to what’s unfolding around me are largely guided by an energy of love, forgiveness, peace, and resilience.  I trust Damon now in a way I didn’t when I was younger, I like Damon now in a way I didn’t before. I’ve respect who I’ve been, I dig who I’m becoming.   This is very different from the scenario of adulthood described by the kids in The Breakfast Club. Over the past 49 days I’ve shared lessons I’ve learned that have helped me to reach fifty with my heart in check, my soul aligned, my body ready to take action.  All of the previous entries were building toward my “trifecta” of focusing on the power, purpose, and pleasure, that can help us to age with ascension, confidence, and lots of fun.   Here’s what each of these looks like to me:

POWER:  This is not power over others as it is typically described in capitalistic terms.   My concept of power here is about the true power that lies within us, our connection with that God or Spirit or Higher calling that is not contingent on another person’s validation or attention.  It is the connection we foster and maintain within ourselves, ways we tap into the abundant energy of love that is in us and around us.  This is basically the opposite of what we are conditioned to do in the United States, which is use blame, shame, criticism, and attack, to respond to fear or discomfort.  Our true empowerment is something we were born with, it is a beautiful force we already carry.  You don’t need therapy or a drug to find it, it’s already a part of who you are now.  

When we don’t cultivate and nurture our true power, we become a “leaf” that is reactive to the opinions and judgments of those around us.  This is especially in challenging for gay men who simultaneous crave attention, but perpetuate ageism.  If your sense of identity and confidence is contingent on men finding your desirable, then you are setting yourself up for much pain and suffering in the years ahead.  

There is an easier way!  Begin the process of decoupling the true self from the social self.  Actively nurture and maintain your love for your true self, knowing that that peace and confidence will affect the attention you get with your social self, not the other way around.  These techniques and tools were covered in Lessons 48, 47, 43, 42, 40, 33, 27, 26, 22, 20, 19, 15, 13, 11, 9, 7, 5, and 3.  
   

PURPOSE:  We all need a reason to get out of bed in the morning.  Or in some cases, maybe the afternoon.  Either way, it is important in all stages of life that we feel our lives matter, our contributions are relevant, our hearts are included.  I believe we all have “Work” we do that helps us to feel like we’re contributing meaningfully in the world.  For me that Work has always been related to mental health and service, but people can experience this through their artistic achievements, their sports activities, volunteer work, their hobbies or recreational interests. It doesn’t matter as much what it its you are doing, just so long as it maintains that there is a reason we are living on this planet at this time in this body, and our energies are called upon at this point to help somehow make the world a better place .

Without purpose people often feel obsolete and irrelevant.  If they don’t feel like they have a reason to get out of bed then they may not get out of bed.  I have seen people falter at these times, sink into depression, escape into alcohol or drug abuse.  We are living in an ageist society that continues to tell people they become less relevant and have less to contribute as they get older.  I think that might be changing, as more and more people in their late 70s maintain positions of significant political significance in government.  

Nevertheless we are taught it is the goal to “retire” and slow down as we age.  If that feels right to you then that is a beautiful thing.  But if you feel you have something to share, something urgent to say, something relevant to express, then it will be incumbent on you to find ways to channel that message throughout the different stages of life.  Different suggestions about finding purpose and meaningful Work were covered in Lessons 46, 44, 41, 39, 38, 36, 35, 34, 30, 28, 24, 23, 18, 10, and 8.

  

PLEASURE:   This almost always gets left out of conversations about aging, especially when we’re talking about sex.  Especially when we’re talking about gay sex.  Especially when we’re talking about a lot of gay sex with a lot of different partners that doesn’t result in some horrible catastrophe, and instead leaves all participants with a sense of connection, fun, and some groovy oxytocin.  But “pleasure” is not limited to the sexual realm — in my opinion it involves anything fun on the tactile level. It might be sports, it might be hot air balloons, it might mean riding horses, it might mean traveling to a new country.  Anything that heightens sensation and affirms your life experience can be pleasurable.

We know that babies need a consistent amount of affectionate touch and holding in order to physically and cognitive thrive.  At what age does that stop?  I don’t think it ever does, but I do think American culture discourages us from asking for physical touch, intimate connection, sexual vulnerability, especially as we get older.  When people are involuntarily celibate they often feel loneliness, depression, and express irritability and rage.  This need not be!

What if we normalized consensual touch and sensuality as a regular part of human connection at all stages of life?  What if we respected the role of human contact and oxytocin as an integral part of healthy aging?  What happens when we nurture curiosity to seek out fun and playful connections with others?  How would we feel if  we used our agency to clearly articulate our “Yes,” or “no,” and our “mmm, maybe.”  I explored these themes in great depth in Lessons 50, 49, 45, 37, 32, 31, 29, 25, 21, 17, 16, 14, 12, 6, 4, and 2.  

 [Thank you Adam's Nest]

I believe we have an unprecedented moment here.  As a gay man I have never lived in a time with this level of social acceptance, legal protections, medical advancements.  I am starting a new decade of life with the U.S. starting a new decade with great potential for recovery, healing, and growth. When we put together power, purpose, and pleasure we develop the limitless opportunities of expansion, enlightenment, and connection that lie before us as we get older.  I’m so glad to be on this journey, and continuing these ideas and conversations in the years and decades ahead.  

 

*Thank you Adam Singer for all the graphics developed for this series, and proofreading my typos!! 💜 

** I made a Facebook Live video about these Lessons last night, available here. 

 Damon L. Jacobs is a Licensed Marriage and Family Therapist helping individuals and couples enjoy life with peace, purpose, and pleasure. His books "Absolutely Should-less" and "Rational Relating" help people experience connection with joy, serenity, and meaning. His work has been featured on CNN Health, The New York Times, MSNBC, USA Today and more. He can be reached at Damon@DamonLJacobs.com or 347-227-7707

 

 

2. Now Is Our Time For Fun

I am a part of one of the fiercest and most resilient generation of queer folks that has ever existed.  Most LGBTQ individuals my age and older had to grow up in a time when society directed hostility and violence toward people who aren’t straight. We often had to compartmentalize our personalities, lower our voices, make sure we didn’t shine too bright as to draw suspicious attention.  We had to be afraid that our bodies could be deadly vectors of disease that could harm others. We had to grow up in communities, churches, and schools, that constantly instructed, “be less than you are.”  Not a lot of fun.

I had no queer role models growing up, no one to look up to or follow.  The gay and lesbian teachers in my high school had to remain closeted and couldn’t be a direct source of support or information even if they had wanted to be.  There were no representations on television that I can recall which portrayed an LGBT person as happy or successful.  I do recall an occasional movie here or there but they were mostly limited to the “Monty” stereotype in the movie Fame.  He was not as tragic as the doomed protagonists of Suddenly Last Summer or The Children's Hour, but not exactly someone you aspired to emulate either.  The insidious message was if your gay you’re doomed to be depressed, ostracized, lonely, and potentially a victim of violence.  

Those who overcame these obstacles in the 1970s befell another tragedy in the 1980s:  The AIDS crisis.  From seemingly out of nowhere, a cruel and deadly virus struck the U.S. hitting gay communities significantly harder than other populations.  The association was made clear to all of us:  sex can result in death, pleasure may lead to disease, vulnerability can give you a virus.  I came out during this time only knowing sexuality as something dangerous that must be protected by a latex barrier.

 

Sodomy laws in the U.S. made anal and oral sex a crime, and were enforced almost exclusively against gay men.  The Supreme Court upheld state rights to prosecute gay men for sodomy in 1986, and these were used to threaten, intimidate, and criminalize sex between consenting adults in many states up until 2003.  The message was clear:  Hide who you are, be ashamed of your sexuality, and if you don't you may face exploitation and  jail time. 

    

Many who were in a emotionally bonded relationships during these years faced an additional trauma: being separated by their partner’s family during and after their death.  There were no legal unions then, so even if you had been in a committed relationship for years, you had no legal right to stay by your partner’s side in the hospital.  Healthcare institutions could legally remove you from caring for your loved one without any cause whatsoever.  Their families could easily ban you from visiting as well.  After their death, there were no protections promising you would still have a place to live or any of the financial benefits that legal heterosexual marriages enjoyed, even if the deceased had made a legal will.  Every clinic I worked and volunteered in had clients who were homeless and destitute after their partner’s homophobic family had exiled them.  They simply had no legal claim on their beloved’s property or financial gains if the family disputed them.

In other words, things were rough.

3. Someday I Will Die

When I was in tenth grade I played a forest ranger in what perhaps might be the silliest musical ever produced titled, “Little Mary Sunshine.”  I can’t even remember what the show was about, but I do remember an important lyric from the showstopper “Mata Hari”: 

“As she died she said, ‘What fun! It’s the only thing I haven’t done!'”

At 16-years-old I vividly recall saying, “Yes that’s how I want to go out too.”  

At 50-years-old I am well aware I am in my second act.  I don’t think I’ve had my showstopper yet, but I’ve had a hell of a soundtrack.  I know that I have less time in front of me than I do behind me.  At the same time I see gun violence escalating which reminds me I may not get as much time as I would like.  Every day in the United States there are mass shootings and there is no clear end in sight.  I am not at all afraid of dying, I’m just afraid of not living while I’m still alive.  

Even as a teenager I was cognizant of the fact that it was more important for me to live a life of variety, curiosity, and adventure rather than to stay in one place, only have one partner, only do one thing for work.  I wanted to live a life that was filled with highs and lows, joys and sorrows, victories and setbacks.  I didn’t mind losing a game or getting hurt, just so long as I played hard and gave it my best.  So when all was said and done on my death bed I could sing the Mata Hari song and mean it. [FYI — the version of the song that has this verse is on the 1962 soundtrack, not the 1959 rendition, because the world needed two distinct versions of Little Mary Sunshine].  
  

One of the many things I am grateful to have learned on this journey is the relevance of balance.  The Buddhist yin yang symbol represents perfect symmetry and respect for all energies.  It illustrates that we cannot have true joy without true sorrow.  We cannot really laugh unless we can really cry.  We can’t truly celebrate until we can truly grieve.  We can’t appreciate health if we can’t respect sickness.  And we can’t fully embrace life unless we can fully embrace death.  Our ability to feel one is directly proportional to the ability to feel the other.  My life would not be fulfilling, meaningful, and really fun in the now, if I didn’t fully recognize and respect the fact that my body will someday die.  

4. Great Sex = Safety + Agency + Discovery

Talking with people around the world about sex and pleasure has been one of the greatest rewards of my personal and professional career. It is also so different from the world I grew up in where people did not talk about sex openly or casually.  I knew whatever Doug and Julie were doing under the covers on Days Or Our Lives looked like fun, I just didn't understand what it was. Yes, I learned about reproduction and "birds and bees" but not about connection and gratification.  Yes, my high school played a video with Whoopi Goldberg telling us to use condoms to prevent AIDS but no one actually talked about enhancing pleasure or intimacy.  Gay men love to share explicit pictures and porn but rarely ever communicate how they'd like to be touched or held.  Much of my Work is about changing the paradigms of fear and shame that keep sex depersonalized and separated from joyful aging.  I have been doing that in recent years by focusing on the model: Great Sex = Safety + Agency + Discovery .   I will explain each  below. 

SAFETY - This means having an experience of protection from imminent risk.   It is an understanding that sex, like every physically playful activity on earth, involves negotiating a modicum of harm-reduction and risk reduction.  This operates on several different levels:

 

Physical:  In order to enjoy sex we must believe that our partners are not going to physically harm or do something gravely painful to our bodies.  We must have reason to believe we will not be traumatized or permanently injured during this encounter. 

 

Medical:  This is the confidence that sexual pleasure won’t result in a life-changing medical event.  I never had sex completely free of fear of HIV until I started using PrEP at forty-years-old.  The science of U=U has since proven that someone who is living with HIV and undetectable cannot sexually transmit HIV to their partner.  Put these together and we have two significant ways of improving safety in sexual connections.  However, in spite of these biomedical advancements, people may still hold back from experiencing pleasure if they remain consumed by fear, and/or still struggling with trauma, as described in Lesson 50. 

 

Emotional:  In order to enjoy sex we need to know our partners will not willingly nor maliciously try to harm our emotional or mental health.  Feelings by their very nature can sometimes result in pain and loss.  But we have to also believe our partner is not intending to cause harm or damage, or seeking to use sex to cause mental pain or exploitation.  

None of this is to be confused with consensual risk or danger.  Many people are stimulated by intentionally creating a scenario that involves a level of physical pain, emotional exploitation, legal jeopardy. But again, that is an entirely different experience from the risks of being physically, medically, or emotionally in peril without agreement or negotiation.  

AGENCY - I define "agency" as the feeling that you can make things happen.  It means that on many or most occasions, if you’re interested in having sex, then you will have sex.  Whether that is with a primary partner, multiple people in your pod, or completely random hook-ups, you are aware that with genuine effort, the odds are in your favor.

With agency you have the ability to practice essentials like consent and communication. If you know that sex is available and abundant for you, then it’s much easier to say “yes” when your answer is yes, say “no” when your answer is no, and “maybe” when your answer is maybe.  It’s much easier with a sense of agency to clearly communicate your boundaries, consent, and what you prefer sexually.  It’s knowing you’ll have plenty of options to enjoy sex in your lifetime, so you need not shame people, coerce them, or react viciously, when you hear “no."

5. Lose The Should To Feel Good

If everyone removed their "shoulds" then my career would be over tomorrow.  People could immediately experience relief from guilt, shame, low self esteem, body dysmorphia, loneliness, superfluous disputes, impulsive rage, conflict on social media, and emotional suffering.  So please, whatever you do, don’t share this Lesson with anyone you know.  I love my job.  

 

Yes that is sarcasm.  If there happened to be a radical shift in thinking and connecting, and people stopped using “should” against themselves and others, and a subsequent revolution of love, compassion, and connection happened to follow, then I wouldn't complain.  I would happily drive trucks or deliver pizza in such a utopian world.  I would still find a way do my “Work."

I don’t think this is likely to happen in my lifetime, however.  In fifty years I have consistently seen people identify with their depression, defend their anxiety, retell unhealthy narratives, polish the glass ceiling on the limitations they place on their joy.  When someone asks for my help changing this, the first step I recommend is changing their “should” in order to feel good.

“Shoulds” are rigid and inflexible beliefs that cause great pain suffering when they conflict with immediate reality.  Examples include, “I should lose weight,"  “I should make more money,” “My penis should get erect anytime I tell it to,” or “He should vote the same way I do,” "She shouldn't leave me," or “They should wear a fucking mask.”  Shoulds are insidious, meaning they are often subtle, gradual, and usually not recognized until they have become problem.  If you they don't conflict with reality, then there's no stress, no problem.  If I say, "A pizza should appear when I order one," and then it does, then there's no strain. But if you're investing in a rigid and inflexible idea that is NOT being reflected in reality,  then you are likely to feel guilt, shame, lack of control of your anger, contempt for your body, have arguments with people who aren’t there, repetitive fights with people who are there, regret your life decisions, and then some. 

“So What’s the big deal about the word should?  Isn’t it just a common word people use every day to express themselves?” 

 

Yes, it is used every day.  But that doesn’t make it healthy or productive, especially not in a country where suicide rates have increased by 30% in the past twenty years, drug overdoses have tripled in the same time frame and most Americans felt lonely before  COVID19 hit.  Clearly “normal” does not translate into “joyful.”  Living life and getting older doesn’t have to be this difficult.

I go about joy in an entirely different way.  I believe we were born into this world already carrying an abundant sense of love.  We often can see in babies and small children an infinite capacity to give and receive limitless joy.  They just want to be held, fed, changed, touched.  They don’t lie around thinking, “How much weight am I going to gain if I drink that bottle tonight?”

6. I Stay Up At Night (And Other Space Oddities)

I was born fifty years ago at 1:12 in the afternoon, and I haven’t wanted do anything before 1:12 in the afternoon ever since.  For as long as I can remember, I have had a proclivity for staying up late at night.  I have always felt better, thought clearer, been more productive, experienced more meaning and purpose, in the later night hours.  Pretty much every word of these 50 Lessons of 50 was written between 12am-5am.  Most of my two books were written during the same hours.  

This used to be a source of great struggle.  While growing up I thought I “should” be like other kids who went to sleep at 10pm and woke up 7am but I couldn't sleep when I tried.  Getting up in the morning has always been an uphill battle and when I had to do it in school, and the early days of my career, I felt constantly at odds with my body’s natural circadian rhythms.  This however, came to be of great benefit when I opened my private psychotherapy practice  in 2010.  I could lay claim to being the only shrink in Manhattan who saw clients until midnight, and that helped position my business from others.  When my clients expressed surprise I worked that late I told them, “You’ll find me here at 11pm but you’ll never see me here at 11am.” 

In other words, I took something that was different about me, something I often felt made me “wrong,” and turned into a strength.  I realized there was no shame being who I am, just struggle in trying to be someone I’m not.  I’m not a morning person, I doubt I ever will be.  But even just ten years ago that is not a fact I ever would have admitted publicly. 

The night before I “came out” on the Huffington Post Live about using PrEP, I was scared.  Although I had talked about HIV prevention publicly before, I had never talked about my HIV prevention before.  Could I really tell the world that I was using a pill to have sex without condoms?  Would I ever be able to work as a healthcare provider after saying such a thing? I had been quite slutty in my time, but this was not something I could readily admit publicly.  But once again, my proclivities came in handy, given that talking and teaching about PrEP, using my own personal experiences,  ended up becoming one of my more successful endeavors and certainly one of the more meaningful chapters of my career. 

The older I get the “less fucks I have to give” (thank you, Amy).  The longer I live in the world the more I realize there are certain things that are true for me that aren’t true for others, and vice-versa.  I no longer have any attachment or shame about this, I no longer think there is anything “wrong” with me for thinking and feeling this way:

 

— I absolutely hate talking on the phone (this was true before Internet)

7. Joyfulizing vs. Catastrophizing

I think American Psychology is destructive in many ways.  When you create an industry that is funded on people’s “diagnosis” or “disorder,” then you inadvertently create a system where providers are trained to focus on problems, scan for symptoms,  perceive limitations instead of strengths, document what’s wrong instead of what’s right.  These perceptions then contribute to a culture which makes diagnosis an identity, problems a personality, sexual expresson a stigma.  Consequently, people are more likely to say, “I’m depressed,” instead of, “I’m a resilient person who feels a lot of pain.”  They are more likely to report, “I’m borderline,” instead of, “I’m a human being who has developed some problematic coping skills while surviving trauma.”  They report, "I'm a sex addict" instead of, "I live in a society that taught me how to have an unhealthy relationship with sex."  Or they’ll say, “I’m anxious,” instead of “My brain’s neurons are currently firing in a way that is causing me to focus inordinately on fears.”  

In Lessons 31 and 15 I talked about internalizing fears when I was growing up.  I worried a lot. For the first three decades of my life I was stressed out about everything from earthquakes, to burglars breaking into my house, to academic failures, to not having friends, to the Energy Crisis, to the threat of nuclear war, to the AIDS pandemic, to not getting into college, to not getting my psychotherapy license, to not having enough money, to being rejected by men, to more earthquakes, my mind spent a great deal of time anticipating disastrous doomsday scenarios.  

After I turned thirty I had a revelation:  My life was pretty good.  I was living in Palm Springs, making some great friends, had a very rewarding job, owned my home, was earning good money, receiving first rate supervision toward my clinical hours, getting to see my family frequently, and felt very physically healthy.  And yet — I still felt ubiquitous worry.  My mind’s default setting was to constantly scan for something that could go wrong.  It was around that time I came to consciously understand, “OH - wait - my worry has little to do with externals.  It’s just a bad habit my neurons have locked into.”  

When I began studying A Course In Miracles, and the practice of Rational Emotional Behavioral Therapy, I came to get gain a better model for how I could direct my neurons differently.  Both these models offer ways to change thinking to change feeling.  They focus on changing the cognitive cause to alter the emotional effect.  So if you’re regularly anxious for no real reason, you can change that by exercising your mind differently.  In essence, they involve shifting fear to love;  irrational distortions to rational truths.     

I took these theories to heart and began practicing them throughout my thirties.  Just like any muscle in your body, the mind muscles take awhile to get in shape.  But with persistence and patience, those synaptic connections can be changed.  So when my default setting of worrying for no reason would creep in, I became more accustomed to returning to love, pushing away panic, breathing in peace, making clear and healthier decisions.  So far, so good.

But then something even better happened.

8. Compassionate Conversations Are Critical

Yesterday I wrote about the ways hurt people hurt people and my intention to be part of changing this perpetual cycle of pain.  I want to live in a democracy that prioritizes human rights, maintains social justice, corrects systemic errors, repairs historical travesties, and creates communities where love, family, and friendship, can flourish.  I don’t think any of this is possible if we can’t have reasonable, rational, and compassionate conversations with people who think differently and carry divergent values.     

Social media allows us a historically unprecedented opportunity to share ideas, exchange opinions and engage in riveting debates. Unfortunately, it also allows anyone with a Wi-Fi connection to express stigma, spew hatred, and claim unscientific and unfounded opinions as “facts.” How does one cope productively with irrational and vitriolic aggression? And when given an opportunity, how do we open people’s minds?

Most people are not taught the skills to partake in these types of respectful conversations and discussions. I learned a lot of these tools from my father, who became a political figure in Culver City when I was four-years-old, and remained at the center of civic debates for the next sixteen years. During that time, I watched him field attacks, navigate irrational aggression, and delicately handle irate voters who claimed that his efforts to protect public safety was impinging on their civil rights (sound familiar?). Case in point:  He was the “lone vote” in banning the sales of fireworks for many years, and I remember him getting a lot of angry phone calls for that.  But ultimately caution and safety won out, showing that people are capable of prioritizing human lives over righteousness when given an opportunity.  I never saw my father shame anyone in this process, he actively engaged them in compassionate conversation instead.
 

I have used many similar methods for engaging with doctors and healthcare professionals when I’ve taught and about PrEP and U=U over this past decade.  I’ve continued to practice the lesson that no one opens their minds or hearts or changes their behavior when they feel shamed or attacked.  But how do you engage people who hold medical and scientific views that oppose facts and rationality?  I’d like to propose some methods I’ve practiced on the front lines with a (mostly) fictional opponent named "Larry": 

Method #1:  Find some agreement in what the other person says: Find a kernel of truth in something your opponent expresses in order to demonstrate respect and understanding.

Larry:  Everyone should just use condoms.
Damon: For some people, condoms are a very effective and satisfying way of preventing HIV. Others who take PrEP continue to use condoms and appreciate the peace of mind that the combination gives them. At the same time, condom usage is not a preferable nor realistic option for many people.  Just like birth control, PrEP is an umbrella term that describes a "toolkit" of biomedical options to prevent HIV transmission.  

Method #2:  Use “I” statements: Preface opinions with “I” statements, “I think,” or “In my opinion.” 

Larry: It’s stupid and reckless to use a pill to prevent HIV.
Damon: I have found people who use to PrEP to be intelligent, resourceful, and quite methodical in their planning. I think using PrEP requires one to make a series of complicated decisions - from speaking to their doctors, to navigating insurance, to deciding how (or if) to come out and discuss their usage to their communities. In my opnion, these conundrums require a level of cognitive reasoning. For me, taking PrEP was well thought out, and was the most responsible and loving choice I could make for myself and for my sexual partners. 

9. Hurt People Hurt People

I received my first real death threat on July 16, 2014. I was taping a segment with Joel Rose of NPR that day following the World Health Organization’s endorsement of PrEP as a preferred strategy to prevent HIV.  It was a dream come true: Guy moves to New York from California, works his ass off, gets briefly famous, receives an invitation to do an interview at NPR in Times Square on a beautiful summer day.  I left the studio, turned on my Samsung Android only to see notifications from several friends alerting me that a person in the Act-Up New York Facebook group had announced his intention to stab me to death and “march his head on a stick up sixth avenue.”  For the record, I would have preferred being marched up ninth avenue,  but it seemed we were long past the point of concessions or negotiations.

This was before I had a smartphone, and I did not know back then how to take a screen shot on a Samsung.  But I knew how to take one on my office laptop.  So I raced down to my office on 26th street from 42nd to capture the threat and report it to the police.  By the time I got to the Flatiron the post had been deleted.  I tried contacting Facebook to get a copy of the evidence, but, good luck with that.  The words were gone, the person blocked me, and well, I’m still alive today.  

Why would someone be so enraged as to make a viable threat against me in public?  Fortunately, I had a pretty solid clinical background in working with violent offenders, trauma survivors, and impulsive rage from people in a chemically imbalanced state.  What it ultimately comes down to is this: Hurt people hurt people.  Wounded people wound people.  If we don’t actively tend to the emotional scarring in life then we will re-enact pain and violence against others.  If we don't have a framework for handling rejection then we will lash out at others.  But where in the world are we ever taught or encouraged how to do this? 

Several months ago I watched a profound video on this subject from an unexpected source:  actor Will Smith.  As he gathered the cast of The Fresh Prince of Bel Air for a reunion, he came to an understanding of how much he had harmed his former cast mate Janet Hubert (“Aunt Viv”).  So he set up a therapeutic reckoning of sorts so he could understand her pain as well as his own reactions.  In this process he discussed the trauma of growing up in his own turbulent family home, learning that his physical and emotional safety rested in making other adults laugh. As long as his father was laughing, he didn’t hit his mother.  As long as adults laughed around him, he felt calm and in control.  But if someone didn’t like him, or didn't laugh with him, that for him was the danger zone, and called for his “dragon” to come out. When Janet Hubert did not laugh along with his jokes, nor appreciate his disruptions on set, he became more and more enraged. These tensions ultimately lead to her being dismissed from the show, being called a “difficult” Black actress by Will Smith in the press, thereby sinking her ability to find sustainable work in entertainment for most of the next thirty years.  In his desperate need for safety, a woman's career was destroyed. 

Watching these discussions and revelations unfold reminded me of the guy who wanted to put my head on a stick.  The only thing I knew about him then, and still know about him now, is that he is a long-term survivor living with HIV.  What had he been through to get to the point of making a murder threat?  What part of his “dragon” felt necessary to invoke in order to feel safe?  What part of me talking about PrEP and HIV prevention was so threatening?  

10. We Can Be Heroes: 12 People Over 50 Changing The HIV Epidemic

When I first starting speaking publicly about PrEP on November 8, 2012, I knew I had an opportunity to help people understand a new way to prevent HIV and enjoy sex without fear.  What I didn’t know was that it going to lead to meeting hundreds of inspiring activists, innovative educators, and compassionate leaders who have dedicated their entire careers to helping their communities lead happier and healthier lives.  Although I have been moved by so many of these individuals, there are twelve in particular whom I consider trusted friends not only because of their commitment to their service, but because of how they fully show up in their Work and jobs, year after year, with passion, purpose, and play. I have turned to all of these individuals for guidance and counsel at times during the past decade, and each and every one has been compassionate, wise, and generous with their wisdom and time.  As my own milestone gets closer, these folks (in alphabetical order) all show me paths to embrace life past age fifty while simultaneously fighting the HIV epidemic in unique and original ways: 
   

Tez Anderson:  When Tez was diagnosed with HIV/AIDS in 1983, the 26-year-old had no reason to think he’d live to see thirty.  But Tez fought back with meditation, humor, and a tendency to just be damned stubborn.  When he saw that service organizations were ignorant and oblivious to the needs of older long-term survivors, he took upon himself to start his own group called, “Let’s Kick ASS (Aids Survivor Symptoms)” so people around the word could be understood and validated.  His personal pilgrimage toward helping people living with HIV feel counted, heard, respected, and relevant is unrivaled in the HIV epidemic so far.  Now 61-years-old Tez says,  “The key to getting through it is being grateful, humble and happy, and those are not impossible things to do even in the worst of times. Aging is a privilege."
  

Dazon Diallo:  When Dazon came to realize that there were no service delivery system available for women living in the South throughout the 1980s, she left the traditional systems to start her own organization Sister Love.  Through her concentrated efforts the CDC began to count women in their HIV/AIDS statistics, and were subsequently able to distribute more funds to organizations that prioritized the medical and social needs of Black women living with HIV.  I have been humbled to share a stage with Dazon a few times and simply mesmorized by her passion, enthusiasm, commitment to serving, and damn funny sense of humor.  And on top of all this, she still manages to host her weekly radio show Sisters' Time/WomenSpeak on WRFG 89.3FM Atlanta.  She has been so very generous to me with her time, information, and friendship.  “What I’m clear about is that it will be the women who will close the door on this epidemic. Because once women own it we change things and when we change things we change things for everybody.”
  

Phil Joffe:  When Phil reached out to me in 2014 with the idea of helping all around the world access PrEP generics at reasonable prices, I thought “sure, why not.”  I wasn’t sure what to make of him.  I had already learned that any one in life can have a good idea, not everyone can see it through.  I came to soon learn that Phil not only can think outside of traditional limitations, but has the know-how and resilience to put plans into action.  He was soon operating an international pharmacy called Dynamix that would get PrEP in the hands of nearly 100,000 people around the globe at reasonable prices.  On a personal note, Phil has been a trusted friend, incredible travel companion, and supported me through many aggravating moments administering PrEP Facts.  At the heart of all this is a man who deeply cares about helping others, supporting his global community, giving people healthier ways to laugh, connect, celebrate, and have great sex.  He doesn’t like the limelight as much as others (okay, as much as me) but his innovative work deserves recognition and distinction.  

11. The Four Kingdoms Of Consciousness

I discussed the joyful opportunity to learn from Jacob Glass in Lessons 15, 27, and 43.  His lectures and teachings have helped me in countless over the past eighteen years to relax, find peace, and enjoy a quality of life I hadn’t appreciated before.

His framework for “The 4 Kingdoms Of Consciousness” has offered me a way of perceiving my own emotional reactions, and behavioral decisions.  I’m going to present Jacob’s diagram as it was originally shown to me, and still offer my own spin as I’ve come to understand its usefulness in terms of getting older, doing valuable Work, and  finding peace and play. [Tap the picture in order to enlarge size]

Kingdom one:  “I am a victim of the world.”  This is the playing field most people in this culture are operating on at most times of the day.  This is the realm in which we are an emotional “leaf”, i.e., we blame others for how we feel, expect others to make us feel “special”, become angry and resentful when others do not meet our “needs.”  I see people at this level complaining about being “ignored” and “invisible” when other people don’t deliver the attention and validation they think they need and deserve.  At its best playing the victim offers relief from being responsible for making poor decisions, engaging in toxic relationships, having agency in the outcomes of the world.  At worst it leads to severe depression, suicidal ideation, even violence.  

Kingdom two:  “I am in control of the world.”  This is the realm where people start to realize they have some agency and responsibility for their lived experience.  We see a lot of people in the self-help field on this level seeking to “manifest” external outcomes and “success.”  This is definitely a step up from the victim narrative in level one, but it’s still inherently problematic given it is the opposite side of the same coin. Both the “victim” and the “controller” are still practicing “leaf” energy, giving away their emotional energy to external forces.  I’ve seen many well-intended leaders crack under the pressure of constantly being in control, always having their sense of agency or joy threatened by the slightest outcome going wrong.  This is also the stage where I’ve seen many younger people get overwhelmed by career choices and potential life decisions.

12. Fearing Fat Is A Gay Rights Issue

 I first read “Fat Is a Feminist Issue” in 1989 in Bettina Aptheker’s Intro To Feminism course.  This monumental work remains seminal in it’s coneptualizing women’s complex relationship to their bodies.  One of the more notable points made was the correlation made between women’s financial, political, and sexual ascendance, and more limited and oppressive beauty standards.    As women gained power throughout the 1960s the cultural norms (or “shoulds” as I call them) pivoted from fuller body types like Marilyn Monroe to the impossibly thin models of Twiggy or Goldie Hawn.  The more women gained power, the higher incidence of eating disorders.  This was not an accident nor coincidence.

Since I started working with gay men in therapeutic settings nearly 25-years ago, many things have changed in the world.   We now enjoy greater social acceptance, legal protections such as Marriage Equality, and advancements in HIV treatment and prevention thanks to U=U and PrEP.  But the one thing that hasn’t changed is the profound terror so many gay men experience at the prospect of gaining weight.  This is also not an accident nor coincidence.  
 

You can’t stop progress but you can deter it when you condition any minority group to believe that their worth and value are contingent on:  (1) a man’s approval; (2) one's physical appearance; (3) standards that are nearly impossible for most people to maintain.  It is a very convenient way of making people believe, “Your contributions to the world are not as relevant as how much you weigh.  Your emotional wellness is not as important as how you body looks.  Your sense of wellness and joy are not as much of a priority as appearing thin.  And if you deviate from the program you will face a life sentence of shame, embarrassment, and loneliness."   

These messages are insidious, meaning they are so pervasive that we don’t always realize how normal they have become.  For example, “Will and Grace” was a groundbreaking TV show that arguably helped increased social support for LGBT individuals from 1998-2006.  At the same time, it repeatedly contained jokes about the two gay male lead characters terrified of getting older, gaining weight, and consequently being alone. Thinness is primarily the type used to advertise everything to the gay community from travel to soda, to drinking water to detergent to grooming products.  And while some dating apps have cracked down on hate speech and racist epithets, it is still accepted on most for people to write “no fats” into their profiles.

So why exactly are so many gay men so terrified of gaining weight?  In my experience, it comes down to four issues:      

(1) Fuckability.  Many men have a tremendous fear of not being desired or considered “fuckable” by other gay men.  This makes sense given that our identity of “gay” is inextricably tied to sex and it’s difficult for many men to think about their value and empowerment without being defined by a physical act.  In the United States gay men’s sexuality is directly tied to power and virility.  We are seen as strong, healthy, and worthwhile if someone finds us sexually desirable.  Ergo, if someone associates being thin with desirability, and desirability is key to feeling powerful and strong, then thinness will be perpetuated within the community ranks as a preferred standard or "should".    

How we change this:  (1) by recognizing that there is no universal standard of sexiness or desirability.  That all human bodies are attractive vessels of beauty, power and strength.  It doesn’t mean everyone finds everyone erotically desirable, it just means that every body of all ages, sizes, races, genders, has inherent worth and beauty.  From that baseline, we all have erotic preferences and attractions, and "types" with whom we prefer sexual intimacy.  Or to put it another way, there is a lid for every pot. 

13. Find Your Role In The Cycle Of Lonely

“Mark” had lunch with me at a Creating Change conference several years ago.  He shared his trepidation about being a gay man turning 40 in a certain major U.S. city.  Mark was (and still is) a person who is considered physically desirable by many if not most gay men.  Yet he feared, "Guys don’t want to date me anymore. Already they’ve stopped showing interest.  Once you’re a certain age they’re not interested anymore.”   I was surprised to hear Mark articulate these ideas, given I knew people were interested in him, I knew lots of men would date him if they could.  But I was also aware that Mark had a very stand-off quality to him, a non-verbal way he communicated “back off.”  I knew that the reason people weren’t paying attention to him in his area had nothing do with ageism, but everything to do with the way he discouraged and repelled human energy and romantic attraction.  

Unfortunately, Mark is not unusual in this regard, I have seen hundreds of men do the same thing.  I started coming out and socializing in the gay community in 1989, and in the 32 years since one thing has remained consistent:  The self-fulfilling prophesies men use to actively participate in cycles of isolation and loneliness.  Here’s the way it looks:

(1) Mark believes the myth that there is only one way to be desirable in the gay community: young and thin.  Perhaps he is attracted to that type himself, so he wrongfully assumes everyone else is attracted to the same type.  He chooses to ignore the fact there is no universal consensus on sexy.
(2) Mark looks at his naked body in the mirror with loathing and contempt.  All he can do is see fault and flaws.  He refuses to see the beauty of his body hair and natural curves.  He just perceives “gross, ugly, wrong.”
(3) Mark enters into social situations or goes on dating apps carrying this disdain and loathing for himself.  
(4) The self-disdain energy places an energetic partition around him and prevents any interested partners or dates from offering any attention.  The few who try to get through the barrier are summarily dismissed and discounted.   
(5) Mark ends his night alone with his “evidence” that he was correct all along — no one want to meet or get close to guy approaching 40, he is destined to be alone.   

This need not be!

14. Compersion Is Caring

The number one question I get asked by couples entering into equatable negotiations of ethical non-
monogamy and compassionate compromises is, “What do I do with my jealousy? How do I not feel insecure and afraid when my partner is having fun with someone else?”  Fortunately, there are several tools to help with easing fear and increasing confidence in these situations.   Many of them have already been discussed in Lessons 33, 27, and 21.

Although the term “compersion” was coined in the Bay Area around 1991, I had never heard of it until I opened my psychotherapy practice in New York City in late 2010.  It was explained to me by a couple I was working with as “the opposite of jealousy.”  I found that to be a very interesting concept, but only definitive in that it is the opposite of something, not affirmatively what it actually means.  So I turned to a friend at Open Love NYC who explained to me that compersion has complicated facets, but when it comes down to it, it is fundamentally “joy in someone else’s joy.” 

Now THAT rang very familiar to me.  After all, so many of the ideas I had learned in A Course Of Miracles over the previous seven years also encapsulated the concept of human ascension through interconnectivity.  As discussed in Lesson 43:   In the spirit world there is no separation -- there is just infinite loving energy.  There are no bodies, no vessels, no “others”, just abundance.  We are living on this thing called “earth” in separate vessels called “bodies” that give us the illusion that we are distinct from one another. In the Spirit world we recognize all living things contain the energy of God.  Perceiving the God that is in other beings strengthens the God [joy] that is in you. 

Anytime we replace a fearful thought with a loving thought we are creating “miracles.”  And so when we perceive the God in ourselves, and by extension the God in each other, we paradoxically experience the reality that there is no “self,” and there is no “other.”  It is in this discernment that we find moments of love, peace, and true connection.  It is in this zone that we can begin to consider the possibility of feeling joy in another person’s pleasure, even when we are not the direct source of it.

I know.  I know.  Most people who read this will think, “That’s just way too out there for me.”  I get it. 

But I also understand there are fundamental barriers to considering compersion as a viable relationship state.  It is neither an accident nor coincidence that this practice is so vehemently resisted in the United States.  I believe we are fighting an uphill battle here for the following reasons: 

(1) Capitalism instructs us to live in a perpetual state of scarcity.  We are constantly told there is not enough love, attention, affection, to go around in the world, like money.  Some people have more, some people have less. So you’d better hoard and protect what you can get and fight anyone who tries to “take” it from you.   Compersion runs contrary to this.  It’s says that there is abundance in the world, that there is enough loving energy to go around, and by sharing in a partner’s love and joy you are actually increasing more love and joy to go around for yourself and for others. 

Bonus: Doug Williams is 95-Years-Young!

On the March 25th episode of Days Of Our Lives, the character of Doug Williams shared with the new woman in town Paulina (played by Jackee Harris) that he is "95-years-young." 

To the best of my recollection, no character on daytime television has ever announced their age like this, especially not one that has been on our screens for 51 years.  Bill Hayes, who in real life is also proudly 95-years-young,  began playing Doug on February 18, 1970.  The strength of his dialogue not only speaks to Mr. Hayes's inspiring enthusiasm, but also to daytime's ability to positively impact their audience over a lifetime like no other medium.  

For someone who is turning 50-years-young, and wasn't even alive when Mr. Hayes started on the series, it is deeply gratifying to see someone 95-years-young who still emanates so much joy, so much zeal, and knows how to bust a move every now and then.  

Bill and Susan Hayes ("Doug and Julie")

Damon L. Jacobs is a Licensed Marriage and Family Therapist helping individuals and couples enjoy life with peace, purpose, and pleasure. His books "Absolutely Should-less" and "Rational Relating" help people experience connection with joy, serenity, and meaning. His work has been featured on CNN Health, The New York Times, MSNBC, USA Today and more. He can be reached at Damon@DamonLJacobs.com or 347-227-7707

15. Do You Want To Be The Leaf Or The Tree?

Madison Square Park

I have had the historically unique experience of living through two major hurricanes passing through New York City.  Both storms Irene (2011) and Sandy (2012) wreaked havoc on our metropolis.  Wind howled, electricity rattled on and off, there were leaves scattered everywhere.  But the older trees outside my office in Madison Square Park stayed upright, strong, and firm during both ordeals.  Sure, some bent it a bit, swayed a bit, but the trees that were firmly rooted in the ground remained standing tall and confident through the turbulent weather.  The leaves, however, were scattered everywhere.  I looked around and was reminded of one of my favorite spiritual metaphors: Do I want to be an emotionally reactive leaf (flying any which way the weather takes me) or a tree (stable, centered, able to withstand challenges).

Earlier in my life I was much more leaf-like then tree-like.  I was easily swayed by fears of the world, emotionally reactive to the words of others, stressed out by external events I had no control over.  I could start the morning feeling good and then have my whole day ruined by a boy who didn’t return a phone call.  I could start off feeling grumpy and then swept into a euphoria by a compliment from a boss, and then crash down again if a someone cut me off in traffic.  I could feel at ease and calm in my job but then easily triggered to get upset and scared about getting fired in the future.  My moods were up again, down again;  my anxiety was completely determined by people, places, things, outside my grasp of control.    

I was an emotional leaf in a hurricane of drama, often of my own making.  And although I wouldn’t admit it at the time, for much of my twenties I preferred it that way.  I liked creating conflict, having an uphill mountain to climb, facing an epic tidal wave of emotional obstacles like the heroines of the soap operas I loved so much.   It was existential in many ways, I didn’t know who I was or what my storyline would be without strife.  After all, it wasn’t Maggie Horton or Myrtle Fairgate getting the airtime, it was Marlena Evans,  Erica Kane, and Reva Shayne who were falling in love, having grand adventures, fighting adversaries, staring down bears, jumping naked into fountains, coming through one crisis after another, year after year, stronger than before with more glamor and higher hair.  

Stress, fear, and drama made for some interesting stories, but eventually the head writers in my mind ran out of stories.  By age 32 I was burnt out on drama and completely bored with my own narrative.  I just didn’t find chasing charismatic narcissists, getting into conflicts at work, and overcoming life crises very engaging anymore.  I was told you have to get sick and tired of being sick and tired in order to create real change.  I was ready.  

16. Coerced Monogamy Does Not Work

If there is one idea that could put a lot of therapists and lawyers out of business tomorrow, it would be accepting the reality behind an irrational and proprietary concept called “monogamy.”  Most humans on earth are not monogamous, nor have ever been so.  Anthropological and historical investigations have consistently demonstrated that human beings are not inclined to practice sexual monogamy their entire lives, yet Western societies traditionally pressure and coerce their members to do so. It is in the tension between expectations and reality there exists so much pain and shame.  This need not be.  

Before I offer my take on this, I want to strongly emphasize that there is nothing I’ve seen problematic about consensual monogamy in practice.  This is done when two people make an informed, empowered, and equatable decision to not have sex with other people (which also begets a negotiation of what the word “sex” means).  When this arrangement is arrived at with respect, agency, and compromise, without coercion or threats, it can work out very well.  Unfortunately this rarely happens in the United States, by virtue of the fact that it so unusual for couples to discuss monogamy before someone has “cheated.”  It’s typically not until after someone has gotten hurt that there is any serious attention or consideration given to this topic. 

As I enter my fiftieth year of life, and twenty-fifth year of practicing as a therapist, I’m going to share my take on this very sensitive, and often incendiary, topic. 

The Western concept of marriage was originally invented to join powerful families for financial and political gain.  Women were perceived as a literal piece of property to be owned and traded by men.  Men had full permission to police and control women’s bodies anyway they saw fit to do so.  There was absolutely no pretense for men to limit their sexual activities with one partner, but women were expected to be virginal before marriage and then chaste [ie. 'virtuous'] throughout her life.  If a woman was being abused, harmed, or assaulted by her legal spouse, there was absolutely no social or legal recourse. 

It wasn’t until the 19th century that marrying someone for romantic reasons began to find it’s way into 

society.  The tension between marriage for business relations and marriage for romantic reasons was recently illustrated in the popular series Bridgerton.  The main character and her peers are displayed like cattle to male suitors, expected to spend a socially and sexually monogamous life with a suitable partner whose union would be mutually advantageous to both families.  If a woman wasn’t attracted or cared for by her husband, then too bad.  She had no social or legal standing to resist, and she was only expected to live to 40-years-old anyway, so it was pretty much about learning to grin-and-bear-it.  

As Feminism started changing the way women perceived their values and expectations, they changed marital relations as well.  Throughout the twentieth century women fought and began to win rights to vote, to work, to own property, and later to access to safe birth control and reproductive rights.  At this point monogamy could have gone a different way:   The movement could have said, “We want sexual equality with men, we want to right to screw around whenever we want with whomever we want just the way men have been doing for eons.”  Instead the movement chose to go a more reactionary route by saying, “We have been expected to be sexually chaste, now men should be too.”  This expectation did not change men’s sexual practices, it simply changed the ways they practiced deceit and deception.  Men generally kept doing what they were already doing, women generally kept suffering.  Hence my own Marriage and Family Therapy profession was born! 

17. Humans Need Touch

Photo courtesy of MMX

It has been medically well established that babies need to be touched in order to physically and
cognitively thrive.  Throughout the early part of the 20th century there began to be more observational and clinical trials that revealed the devastating and often fatal effects of not adequately holding and nurturing infants.  Consequently, hospital programs started hiring staff and volunteers to cuddle babies for certain lengths of time if a parent or caretaker were unavailable.  My question has always been:  At what age does the need to be touched end?  

I don’t think it ever does.  And more and more research is showing that touch is a viable and necessary source of nurturence and growth throughout the lifespan.  Touch benefits us by reducing cortisol levels (reducing heart rate and blood pressure).  It increases oxytocin and dopamine levels in the brain, which generally result in a state of pleasure and happiness.  Emotionally it can increase a sense of meaning, connection, while reducing an experience of loneliness and separation. 

Conversely, the effects of touch deprivation or “starvation” in adults can be stark.  With COVID19 there is more and more research and anecdotal accounts of the impact on humans who do not have regular access to human contact.  Basically, its the opposite of above — they sometimes experience increased blood pressure, higher cortisol levels, as well as higher rates depression and loneliness. 

Gay men in particular can be impacted by touch starvation in several ways as we get older.  Often times when people are in a long-term relationships with a primary partner, they stop touching each other.  That may sound counter-intuitive, but it tends to happen when sexual desire has declined, as it usually does in most human relationships.  That is completely natural and universal.  However, it can be problematic for men who have been conditioned to exclusively associate touch and intimacy with goal-oriented sexual activity.  Intimate physical contact becomes an all-or-nothing scenario, i.e,,“If we’re not going to have sex then why touch each other at all?” I have seen many individuals and couples touch starved in scenarios where intimacy and affection are only offered in conjunction with sex and orgasms.