Dear you,

It’s April, which means National Poetry Month, which means the weather does who knows, which means we’re out of Pisces season and into the more go-get-em Aries (thank god).

I spent March actively sitting with things that scare me. On a work trip to teach patient advocacy at a university in Las Vegas, I used my free time to confront the ways my brain creates problematic patternings that come from hurt, trauma, loss, and scarcity.

Obviously, changing the way one functions, copes, and metabolizes is not something that is done in just one month. Nor should it be. However, the last six months of my life have been full of grief, endless rain, physical pain, stress, anxiety, and sleeplessness; I was ready to work on the common denominator of myself.

So I approached it the way I approach everything: as a scholarly pursuit.

This decision to start actively sitting with wounds and things that frighten me isn’t an entirely new one; I first felt the need to move into another level of therapy and healing last May, while reading Yosa Buson on a park bench in Los Angeles. I was nearly at the end of my tour, I had lost two friends to unspeakable things (one to an accident, one to a long and painful illness), and my dream of having a book in the world had come true. I was strangely undone by the juxtaposition of those two things.

“Coolness – the sound of the bell as it leaves the bell.”

Reading this poem struck me, much like a large piece of resonant metal would, and I’ve never forgotten it. It is always the poem that starts and ends my meditation as I hear the bell chime. “If you ever find yourself wandering off in your practice,” Tara Brach once said, “Just follow the sound of the bell as long as you can.”

I started sitting with the things that scare me (abandonment, not being good enough, social anxiety, grief) because I had reached a place in my healing where it seemed possible to do so without damaging myself; through somatic therapy, talk therapy, EMDR, writing, books, and community (and yes, sometimes even medication) I’ve built a strong base.

I also started meditating because I wanted to be less afraid of dying.

While the death of my maternal grandmother seemed sudden, comparatively, the death of my paternal grandmother was a long, long goodbye. Visiting her was always a practice in sitting with death and dying. At a point, she had been dying for so long that I stopped seeing her hands as they were when I was a child; I gave manicures to nails brittle and aware of time passing.

I’m currently working on translating a collection of poems by an obscure-even-in-his-time Patagonian poet. Today, translating an epitaph on infancy, I came across this line he wrote:

“It is good to understand that we are made of memory,
that time grows without listening to us.
That there are many things we do not understand.”

I turned to a kind of spirituality known for practicing robust and sacred understandings of the rituals of loss and dying, and this was a wise instinct; despite my relatively young age, I’ve experienced more death than most I know who are in a similar station and generation and citizenship in life. It makes good sense to need something larger than our Western framework can hold — and our Western framework does poor work of containing the complex shadow lives of death, dying, aging, grieving.

The white static that happens for people who can’t bear children after they pass their child-bearing years. The solitude of a person who outlives their friends. What to do in the face of a long illness. What to do when your nicest friend is battling terminal illness way too young.

Things that helped change these confront my damaging patterns, my loss of people I love, my creeping self-doubt and bone-tiredness with grey:

• sound meditation (whatever you like, even music, but binaural beats and Tibetan singing bowls worked best for me) 
• visualization (my favorite included imagining being inside of a dirt devil of all of the things I am obligated to do, and then stepping through it to the other side, where a field — in my case, due to my upbringing, cotton — waited for me) 
• disrupting my thoughts with breath* 
• getting right with taking naps (and understanding just exactly how complicated sleep is — for example, we’re the only animals on the planet who force ourselves to get all of our sleep in one fell swoop) 
• active journaling 
• anything & everything by Tara Brach, who combines psychology with mindfulness better than most anyone I’ve seen (and whose voice sounds exactly like my therapist’s, which is comforting to me)

It’s true that your brain cannot be reprogrammed in a month. However, I just went to the same, massive writing conference I go to every year—I just returned last night. It’s 15,000 people who all extrude their loneliness and observative introversion and careful natures and breakup baggage and book deals into the bowels of convention centers at rotating cities every year. It’s a conference I need to go to for my career, and in the past it has filled me with all of the aforementioned toxins, but has also been a beautiful, overwhelming mix of seeing massive amounts of people I love all crammed into bars and coffee shops and libraries and public halls to hear just a few lines of their favorite authors. To click their tongues and shake their heads and say “damn”.

Going this year endowed with the ability to disrupt my body’s anxiety response with breath was life-saving. I felt like I imagine Kevin does in Home Alone, when he seeing the glowing red face of the furnace in the basement and yells I’M NOT AFRAID OF YOU ANYMORE!

It didn’t hurt that Portland was falling all over itself in magnolias, and the sun shone for three days straight at 70 degrees, that I had champagne in the sun with friends, that I got a few freckles and got my cheeks kissed by beloveds, that I overheard two young poets I’d never met before talking about my book in glowing ways, without knowing I could hear them. It didn’t hurt that I came home laden with books that I immediately dove into, and that this week, though it’s raining, I have Spring Break and I am only one day in and have felt so inspired that I’ve already written four new poems.

It doesn’t hurt that my life has been here, beautiful and shining, the whole time. When I need reminding, I can just follow the sound of the bell, leaving the bell.

I love you,
July

Content warning: Suicide, self-harm

I tried to throw myself in front of a train on my 30th birthday. It was the 1 train at 28th St. in New York, just a couple blocks from GLAAD (Gay and Lesbian Alliance Against Defamation) where I was an assistant. That was two decades ago. I came close to attempting it twice more—once in 2014 and again in 2016. I planned it for weeks, edging closer as I waited for the train to work. Felt the calm.

On jump day, I’d back up when I felt the rumble, get a running start—then stop short. I spent an hour, two—time was gauzy—trying to get myself airborne. A chain kept pulling me up short, the kind that allows backyard dogs just so close to the fence. At the time I thought it was God. Maybe I was more afraid than I’d thought. Whatever.

It pissed me off. I felt like even more of a failure—I couldn’t even end myself right. I wanted to take every pill in my house, but I couldn’t do it. I was too afraid I’d end up profoundly disabled, but still here. So I punked out. That’s what I told myself. I’d landed in my own purgatory; I‘d found a way to end my pain, but lacked the confidence to follow through.

More research was needed to assure my success.

Reasons to jump in front of a NYC subway on your 30th birthday:

• Being ostracized by your family after coming out

• Self-loathing for not becoming the Someone you were expected to be, what your Ivy League/Fulbright path foretold

Reasons to nearly take every pill over a decade later:

• Living with still unaccepting parents as my 50th birthday careens towards me

• Realizing that, desperate to restore the family friendship I lost, I sabotaged my success just to stay in that house

Foundational reason for either method:

• Taken down by an undertow of shame

Stigma is a silencing bully. World Mental Health Awareness Week (October 7th – 13th) aims to lift the stain suicide casts. Kate Spade. Anthony Bourdain. These are public deaths that have focused collective attention on depression’s brutality. Finally. More of us are sharing experiences, confronting myths. Hopefully, we’ll be heard, felt, understood. I was hospitalized after my near attempts. I’m stabler than I’ve been in two years, even if I’m not quite happy. Yet.

Here’s What helped // And Other Things to Try with Your Depressed Person

When others understood that being suicidal didn’t mean I wanted to die.
Sounds completely illogical, I get you. I’d attempted. I must’ve wanted out. Nope. Not really. Humans have or need ways of pushing through. Our methods aren’t always healthy. Suicidal thoughts were how I coped. Most, maybe even every time, when those thoughts sparked on, I wanted many things that weren’t death: to be invisible and free; to make everything just stop; to swipe right and change a bunch of past decisions. I detested myself. Hauled around bone-deep sadness while drowning in that shame tsunami. The app I needed doesn’t exist. And the world doesn’t pause. But I could fantasize about leaving it. And that was relief.

Compassionate listeners.
There’ve been a number of kindly homo sapiens who, hearing that I was depressed, listed the sparkly fantastic reasons I shouldn’t be: my long life ahead, people who’d miss me. I’d feel dismissed from my own story. That’s what they thought I needed. They didn’t know the certainty of my heart: I was garbage deserving of suffering. This life awaiting me sounded like a sentence to years of kicks in the face. My brain kept a ledger of how I’d failed those same people who’d mourn my death. Being reminded that they’d miss me layered on guilty pressure.

Being suicidal didn’t mean I wanted to die.
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I never wanted to hurt my people. But they weren’t living in my skin, in my torture. I couldn’t live for them. The most valuable listeners were capable of hearing the whole truth—they wanted details about my suicidal thoughts. They didn’t try to fix me. Without engulfing me in their worry, they’d ask what problem I envisioned solving by dying. They knew talking about suicide wasn’t the action.

Talking meant I was alive. Being alive kept open the possibility of creating a plan to keep me safe. Understandably, this commitment to listening is difficult. If you’re that listener, know your limits. Care for yourself while keeping your person well.

Just be there.
After my last hospitalization in 2016, a crew of friends encircled me. Together, they coordinated my post-discharge safety net: exchanged emails, checked if I’d gotten out of bed, encouraged me to try to leave my apartment. There were daily texts that made me laugh. Their efforts seemed irrational to me; I felt unworthy. But the messages and invites were soothing. Honestly, at times what I needed most was to just not be alone, to have another person near while I journaled, watched tv.

Helping through tough moments.
Suicide can be a slow building impulse, a moment of breaking the final straw. Depression warps and lies. It pulls me into spiraling webs of self-hatred. I’d lose my keys then get angry at my stupidity. That’s why I’m an embarrassment and I haven’t done anything with my life and I’m a fuck up and won’t ever be anything more and I don’t deserve to live. Multiple times, daily.

My every action was a test of my earthly value. Having someone gently walk me through my thoughts— “Gail, how did losing keys become a reason to die?”—dislodged me. Afterwards, I saw the loss for what it was. Knowing you’ll guide them through life’s hiccups can change a lot for your person.

Hugs. Seriously. Lots.
My best friend would text during her work day, asking if I needed a hug. We’d meet-up and she’d deliver! She’d check in before returning to work. She’d tell me she loved me. Just having those 15 minutes in my future could get me moving on days I preferred to hibernate and let my brain spin.

The world doesn’t pause. But I could fantasize about leaving it. And that was relief.
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Therapy and meds.
Drugs are good. They can be. Meds at least helped me begin functioning. Leaving my bed became slightly less onerous. I could shower, get to therapy. Think about this: It’s someone’s job to just listen to you. Finding the right fit might take time, which can suck. But, once I did, I felt safer. My darkness found a sheltered place with her, even those deeper thoughts I kept from friends. Most importantly, I got diagnoses explaining the ways that my illness bamboozles my mind.

Placed in a DBT (Dialectical Behavioral Therapy) group, I learned tools to manage my condition.

Maybe try gathering therapy resources for your person. Don’t push. Let them take time. Let them talk about any resistance they might have. Again, listen. Explore what might make it easier. Also, consider who your person is and how to make therapy comfortable. As a blacktina lesbian, a gay-friendly therapist of color was non-negotiable for me. Sometimes therapists without this background were unintentionally offensive, didn’t grasp the weight of particular issues. Therapy became stressful. Reach out for suggestions in seeking appropriate care.

An empathetic family is the greatest support. Unfortunately, my family wasn’t. The willingness to educate yourself for a relative is tremendously loving. There are dozens of useful sites and organizations. But one of the best sources is your person.

Consider who your person is and how to make therapy comfortable. As a blacktina lesbian, a gay-friendly therapist of color was non-negotiable for me.
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Ask. Listen: what’s needed, what would feel good, what might be helpful.
Sometimes they may not know. Depression numbs me. Making decisions becomes exhausting. It’s ok if your person is in that place. Just let them know you’re there. Maybe help with daily tasks. Support doesn’t have to be huge.

What’s not helpful: being a dick.
Listicles of statements to avoid are at your Googling fingertips.I even found a moving podcast by survivors of suicide attempts and losses about providing support. For me, labeling the act as selfish is the most damaging. Picture saying that about a person with cancer. Bizarre, right? Depression is cancer—a beastly, soul-chomping tumor, requiring Justice League strength to survive.

Remission, cure or death are the only outcomes from either illness. Calling a suicidal person selfish heaves on even more guilt. Focuses on the emotions of others, rather than the sufferer. Hearing this, your person could isolate instead of reaching out. And that could be tragic.

Since 2016, I’ve completed programs involving daily therapy—group and individual—plus meds management. I’m calmer, sleep better, am regaining some appetite. I’ve learned a lot. Yet, I’m not cured. I’m not drinking iced lattes, paddling my golden canoe while bluebirds pay off my grad school loans. With my therapist’s help, I see my depression as a manageable illness, like diabetes. I still struggle, just not from a bear trap in a grimy cell.

Labeling suicide as selfish is the most damaging. Picture saying that about a person with cancer.
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Working out, doing things I’m good at, making decisions slowly—these help me manage. The suicidal thoughts still spark, but now they’re signals that self-care is needed. I know people who’ll treat me well, tenderly before I sink. Ultimately they offer kindness, empathy and compassion.

And I’m sure you’ve got that in you, too.

If you or someone you know is in a mental health crisis…

National Suicide Prevention Lifeline – Call 800-273-TALK (8255) to speak with a trained crisis counselor 24/7 who will listen empathetically and without judgment. Your call is confidential and free.

Crisis Text Line – Text NAMI to 741-741
Connect with a trained crisis counselor to receive free, 24/7 crisis support via text message.

Therapists who identify as queer people of color, like me, are few and far between. As a result, women of color (WOC) and LGBTQ+ people of color (POC) often take a keen interest in my mental health advocacy. I am routinely asked for advice about how to find WOC and LGBTQ+ POC therapists, in particular, and many also inquire about my availability. In response to the latter question, I began to notice over time that sheer disappointment washed over some folks’ faces whenever I shared that I don’t currently practice therapy.

“Surely, I can’t be the only like-minded therapist out there,” I always think to myself. But for many, I am.

Findings from a 2013 study revealed that White Americans comprised 83% of psychologists, while representation of Black Americans stood at 5.4%, Latinxs at 5%, and Asian Americans at a mere 4.3%. Native Americans — a demographic that researchers routinely disregard because of cultural erasure — were not even accounted for (despite Native American youth having the highest rate of youth suicide, by ethnicity). Likewise, WOC and LGBTQ+ POC psychologists, as well as therapists of all types, are also underrepresented, both in research and in the field. This invisibility has alarming implications.

Findings from a 2013 study revealed that White Americans comprised 83% of psychologists.
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For one thing, research on race-matching in therapy suggests that for some clients, sharing a minoritized identity with a therapist may reduce guardedness, mistrust, and self-consciousness. Yet, the dearth of WOC and LGBTQ+ POC therapists means that clients from these backgrounds often face an uphill battle searching for a cultural match along the lines of race, gender, and sexuality. Add to this the fact that rates of depression are higher among WOC and LGBTQ+ POC, compared to cis-hetero (cisgender-heterosexual) men of color and White people who identify as LGBTQ+.

For these reasons, I created this resource about therapy, specifically for WOC and LGBTQ+ POC. My aim is to share the most frequent question asked of me: “How do I find a therapist who ‘gets it’?” These four simple questions can help you do just that.

1. Why do you do what you do?

Pro-tip: If you ask a therapist why they got into counseling, and they reply, “I just wanted to help people”…run.

The “I just wanted to help people” type of therapist is what I call a general practitioner. They can surely support you with one-size-fits-all interventions that aren’t culturally specific. But when it comes to addressing mental health stressors related to identity and oppression, they usually overpromise and underdeliver. Rarely, if ever, have these therapists demonstrated a strong, unwavering commitment to centering underserved communities in their work.

Furthermore, these “I just wanted to make a difference” therapists will sometimes subject you to their self-serving savior complex. Their motivation for working with minoritized communities is often not rooted in a genuine interest in social change, but in ego and pity, instead. As a result, many disregard a core principle of cultural humility: that impact trumps good intentions. Failing to recognize their own blind spots and implicit biases can lead to some very awkward and offensive interactions. Don’t be their “cultural competency guinea pig.”

2. How do you do what you do?

Pro-tip: If a therapist can’t cite the spiritual healers, philosophers, theorists, therapists, or even revolutionaries who inform their work…run.

Every therapist informs their work with one or more theoretical orientations (i.e. “standard interpretive frameworks” and “philosophical assumptions” that guide interventions). Cognitive behavioral therapy, or CBT, is probably most well-known. Feminist therapy, which is particularly affirming of WOC and LGBTQ+ POC, is much less mainstream, on the other hand.

The good news is that clients can exercise the right to request feminist therapy, or any other orientation. In fact, you could ask your therapist to get familiar with any school of thought or healing practice that supports your goals, no matter how “alternative,” non-Western, or unempirical. Simply ask, “How do you do what you do? Could you please describe your preferred theoretical orientation(s), as well as your willingness to consider other approaches? ”

WOC and LGBTQ+ POC rarely assert their needs in therapy, especially to White, cis-hetero therapists. But closed mouths don’t get fed.

3. Who and what informs your understanding of oppression?

Pro-tip: If a therapist can’t define intersectionality, or, at the very least, make an educated guess…run.

During therapy sessions, intersectional feminists often find ourselves pausing after every sentence to explain social justice terms like positionality and rape culture, and concepts like “the personal is political” and “prejudice plus power.” On top of that, we’re burdened with unpacking the historical context around myriad forms of internalized oppression, as well as nuanced intracommunity issues. WOC and LGBTQ+ POC get into these predicaments partly because no one encourages us to screen the politics of our therapists.

Often, we just take a chance on new therapists. We simply pray that they will share our awareness of structural intersectionality, and the language that we use to makes sense of it. But the only surefire way to gauge whether a therapist is equipped to meet you where you are, is to ask, “Who and what informs your understanding of oppression?”

Be sure not to settle for run-of-the-mill answers about cultural competency workshops, either. Ask what you really want to know, like whether they are familiar with the work of certain feminist scholars of color, or if they follow certain blogs, podcasts, or activists on social media. Only the most thorough and specific answers will clue you in to their learning curve.

If a therapist can’t define intersectionality…run.
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4. How will you hold space for me when we discuss my oppression?

Pro-tip: If your therapist isn’t willing to lean into discomfort…run.

According to author Heather Plett, “holding space for someone” means bringing your entire presence to them, and walking alongside them on their journey, without judgement. She suggests eight tips for holding space, including: “give people permission to trust their own intuition and wisdom,” “don’t take their power away,” “keep your ego out of it,” “give guidance with humility,” and “create a container for complex emotions, fear, trauma, etc.”

When you settle for therapists who can theorize about oppression, but not process the emotional texture of it, you settle for therapists who cannot hold space for you. Almost always, these therapists will shift the focus from your needs, to their countertransference of defensiveness and guilt. It often looks like being tone-policed, treated like a know-it-all, mocked as a “social justice warrior,” schooled about non-existent “reverse” -isms, or even pressured to apologize because of your therapist’s tears.

Moreover, a therapist who cannot separate their work from your work, especially your anger, is not mature or skilled enough to do engage with you about oppression in healthy and affirming ways. Holding space for you should always be a therapist’s first priority, even if leaning into the discomfort of their privilege means leaning into your rage.

As writer Amy Dentata penned, “People often say ‘stop being angry and educate us,’ not understanding that the anger is part of the education.”

When people ask me what I get out of gaming, trauma therapy, or kink activities, my answer to all three is the same: They each provide me with access to a contained emotional experience with a clear beginning, middle, and end that I control.

Whether I’m engaging in a role-playing game—my most recent favorite being Witch: The Road To Lindisfarne— wrapped in rope at the hands of a play partner, or sitting across from my therapist, similar needs are being met for me as a trauma survivor. And the access to the emotional spaces that those three experiences provide are essential to my growth and healing.

In his book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Dr. Bessel Van Der Kolk explains how trauma reshapes the body and brains of trauma survivors. In discussing the ways in which our minds are altered by the psychological contusions trauma creates, he cited a study wherein combat veterans were asked to submit to a standard pain test while watching scenes from movies.

Seven of the eight veterans kept their hands in painfully cold water 30% longer during graphically violent scenes than other media.

The reason that they were able to do so is that witnessing those fifteen minutes of a combat movie created a certain amount of analgesia — a blocking of the body’s response to pain — that was equivalent to an injection of eight milligrams of morphine.

The strong emotions created by exposure to violent content were able to block pain in the body, leading Van Der Kok to state that, “for many traumatized people, re-exposure to stress might provide a relief from anxiety.” When moderated well, the stressful scenarios brought about by gaming, trauma, and kink activities can make space for re-exposure to stress that feels safe, moderated, and contained.

CK* is a therapist working in the Philadelphia area who specializes in therapy dealing with, among other things, trauma and PTSD. Their approach to trauma therapy begins with neurobiological responses to trauma and focuses on rebuilding survivors’ trust in their bodies.

In talking with them about their thoughts on consensual kink and its usefulness to trauma survivors, they referenced the work of traumatologist Peter Levine, whose stated belief is that the moment of trauma happens when there is immobilization coupled with fear.

According to CK, this is why there is something powerful to be found in consensual kink for sexual trauma survivors:

“The physiological response in our brain toward the end of a really intense kink scene is a stress response. And the experience of having that response without the fear is something that, in terms of the neurological processing, is super powerful.”

The self-discovery and rebuilding of trust in ourselves to make decisions about our bodies and the process of finding humans with whom we can safely explore the depths of kink experiences are deeply powerful processes for survivors. Additionally, the language around consent and boundaries can be very healthy and self-affirming as we navigate our way through the shoals of healing from trauma.

It is believed that trauma happens when there is immobilization coupled with fear.
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Kink, gaming, and therapy all have tools at their disposal which facilitators can use to create potent emotional settings that in turn allow people to feel safe enough to bring forward their whole selves in those spaces—that element of facilitation is vital to trauma survivors who may be seeking out safe spaces in which to have emotionally intense experiences.

When it comes to facilitating emotionally intense role playing games (RPGs), Kate Bullock is an expert. As a person who has been facilitating RPGs for 18 years and specializes in creating games with high emotional impact play, Kate Bullock believes that choice and transparency are the ways in which gaming facilitators can get their players to buy into games with high emotional risk:

You have to play vulnerable. You have to be willing to be open yourself as the facilitator. And you have to get player buy-in at the start… being really honest and having integrity around our game space is important. You have to have tone conversations and content warnings and safety tools and say: “Look at how much we are caring for each other, here.”

In terms of safety tools, the gaming community has a lot of them at their disposal. It has become culturally normative in gaming spaces to use content warnings, but many gaming spaces also make use of mechanics such as lines and veils and the X-Card. The X-Card is a mechanic that allows players and facilitators to simply stop whatever is happening in a particular moment by placing their hand on the card. Like safe-words in kink, this stops whatever is happening in the game. Lines and veils allow players at the table (and facilitators) to state what themes or content they do not want to deal with at all (lines) and what they would like to deal with, but not see explicitly played out in front of them in a game (veils).

I sit down at a table to begin facilitating a game of Witch. To start, I address the players.

“This is a game about gendered oppression, violence, and making decisions concerning a woman’s life. That said, are there any themes or scenarios that you would prefer to not deal with at all during the time we are playing?”

Two players inform me that they would prefer that we not deal with sexual assault or animal abuse at all during the course of the game. I write those things down on a card in the middle of the table under the header “Lines.”

“Great! Now, are there any things which you don’t mind us dealing with, but would prefer not to touch on directly? In movie terms, these are themes or scenarios in which we will fade to black in game, but we will all know they are happening.”

One player lets me know that she would prefer we not see sexual activity directly. Another informs me he would like to have child abuse veiled off. I wrote those things on the card under the heading “Veils.”

These safety tools, when coupled with the skills and openness of a good facilitator, allow people to explore intense themes without fearing that players will have to keep going if they become uncomfortable and upset. For trauma survivors, this can provide us with the ability to experience the stress response associated with trauma without the fear coupled with it.

In therapy, there are also opportunities to experience stress response without the attendant fear. Through a process called titration, trauma therapists encourage their clients to add material “a drop at a time,” thus preventing their clients from re-traumatizing themselves while simultaneously building up their tolerances to the feelings that trauma creates. Therapists like CK are always aware that their clients may have to “tap out,” and rely on informed consent at the outset of their therapeutic relationships to allow both themselves and their clients to feel safe bringing their trauma into the room.

Kink, when done well, provides the same outlet. With warm ups and the natural rise and fall of a scene, tops can bring their bottoms to areas of deep physical and psychological endurance. Safewords and good negotiation give the bottom a sense of safety and trust that allow them to fully give themselves over to the scene and find anything from cathartic release to the depths of their ability to endure pain or obedience.

Through a process called titration, trauma therapists encourage their clients to add material 'a drop at a time.'
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Storytelling plays a large role in both gaming and therapy as a means for trauma survivors to find healing. CK focuses on walking their clients through the body’s responses to trauma in order to find a sense of trust in the body’s response and in our ability to protect ourselves:

“Because we are cognitive beings, we shame ourselves for not reacting in a way that is self-protective or that we feel we should act. Learning about what your body actually did in those moments is super powerful. Maybe you weren’t able to stop this person, but you made a little motion or something. That’s your body’s instinct to protect. You couldn’t do it, but the instinct was there.”

Through this process of discovery in therapy, survivors can be guided by their therapists to build up trust in their bodies and minds and re-narrate the story away from helplessness and defenselessness and towards a trust that we have the intelligence and the strength to defend ourselves.

In gaming, sometimes our characters are confronted with traumas that we ourselves have experienced. Like narrating our stories in therapy, this can give us the opportunity to experience those emotions again with the added impact of further storytelling.

According to Bullock, experiencing previous traumas in a game through the perspective of your character can give players a bird’s eye view of how they responded to that trauma themselves; it allows the space to process the situation in a new way.

Perhaps the character deals with the fallout better than you did, or at the very least, they offer a different path forward. Exploring trauma from this secondary level of distance and imagination can allow players and survivors to feel empowered in those moments in ways that weren’t when those events initially occurred.

It is important to remember as facilitators for both gaming and kink that we are not health care professionals and that our scope of care is not the same as that of a trained professional therapist. However, in tandem with therapy, good communication and boundaries in place, kink and gaming can be healthy outlets and places that foster safe exploration of trauma as we heal and grow on the other side of our traumas.

*Due to the nature of their work, CK asked that I use a pseudonym for them in this article.

By Renee Fabian

On a typical night, my brain races with anxiety, worried about everything from getting fired to being kicked out of therapy to whether or not my air conditioner will fall out of my window. For hours, I lie awake — until I feel two small, warm bodies cozy up next to me. My cats. As a sexual abuse survivor with PTSD, more often than not my mental health is somewhere between jumping out of my skin or unable to get off the couch. In these moments, it’s the comforting presence of my cats that helps anchor me to reality.

Mine is hardly a unique experience. Many cat owners who deal with mental illness have found cats to be of enormous help as well — and a surprising amount of empirical research backs up the particular role cats can play in providing mental-health therapy.

This is, of course, in part because animals in general are often of therapeutic use. “Cats, like any other animal, can help people from experiencing isolation or loneliness,” says Charlotte, North Carolina-based psychologist Lisa Long. “Animals can serve as a buffer to being alone. Animals boost serotonin and can significantly improve mood.”

A National Center for Biotechnology Information study found that spending time with an animal can increase the hormone oxytocin. Sometimes called the “cuddle chemical,” oxytocin increases pet owners’ sense of well-being. In addition, playing with a pet can increase serotonin and dopamine levels, two chemicals key in regulating mood disorders such as depression.

But while many animals have documented mental health benefits, it’s dogs that seem to get all the attention. A quick Google search for emotional support dogs yields nearly 5 million results, while emotional support cats get only 2.4 million hits, with a link to a dog-specific site on the first page of results. Animal-assisted therapy providers also tend to favor dogs; among many examples, Therapet in Tyler, Texas, has more than 90 dogs on their roster and only five cats. Therapy animal provider Paws Patrol in Albany, Georgia, features more than 25 dogs and two cats. The University of California, Los Angeles’ People-Animal Connection therapy program works exclusively with dogs.

The popularity of dogs in the role of therapy and emotional support may have something to do with the fact that cats are commonly viewed as anti-social, aloof, or independent. But not only is this partly rooted in widespread misconception (more on this later), the fact that cats are more independent and individual than dogs is actually the very reason they make for such valuable therapy animals.

“We actually find dogs kind of limiting. The fact that dogs are so accepting and non-judgemental is really good and helpful in the beginning of therapy,” says Linda Chassman, co-founder and executive director of Animal Assisted Therapy Programs of Colorado. “But it’s not very realistic when you’re trying to help a client who has social skills issues or who has anxiety, problems in the family, communication issues, [or] boundary issues. The dog just kind of puts up with bad behavior, whereas the cat won’t.”

The fact that cats are more independent and individual than dogs is actually the very reason they make for such valuable therapy animals.
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Chassman practices animal-assisted psychotherapy, where animals serve as an integral part of a client’s mental health treatment plan. While Chassman works with a variety of animals in her practice, including dogs, horses, and goats, it was a cat who first turned her on to the idea of working with animals more than 20 years ago.

While working with severely traumatized children, Chassman’s cat Norman got involved in the process. Through learning what behaviors Norman wouldn’t tolerate — such as rough housing or yelling — the children began to understand how to interact in a healthy relationship. Like humans, cats won’t tolerate all behavior, making them useful mirrors to human interaction.

“They have enough interest in people, but can also assert themselves. And they have quiet dignity,” Chassman says. “They won’t let people walk on them. … I just think they’re wonderful role models for good relationships.”

According to Chassman, relationship role modeling can play out in couples and family therapy when clients observe how the cat reacts to what’s happening in the room:

Cats aren’t just helpful for mirroring couple and family dynamics; they are also critical in helping people who struggle with mental illnesses such as post-traumatic stress disorder or anxiety learn about emotional regulation.

“The emotional regulation is something we deal with a lot because we get a lot of kids and adults who don’t have the ability to calm themselves down,” Chassman says. “Being able to rhythmically pet the cat and just kind of focus on stroking the cat’s back, or seeing how the cat responds, can be really helpful.”

Though most animals respond favorably to being pet, having clients strive to get a cat to purr can make all the difference. Unique to cats, not only does purring provide a tangible goal for emotional regulation, it has its own health benefits as well.

Cats aren’t just helpful for mirroring couple and family dynamics; they are also critical in helping people who struggle with mental illnesses such as post-traumatic stress disorder or anxiety learn about emotional regulation.
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“[Scientists] discovered that the purring frequency of cats is a hertz rate that is equal to what they call the gamma waves, which are the meditation waves,” says Shawn Simons, headmistress of Kitty Bungalow: Charm School for Wayward Cats in Los Angeles. “So the purring of your cat actually helps to incite additional gamma rays for you. It helps to slow down your breathing. [It helps] with anxiety [and] high blood pressure. It has a meditative quality, which has extremely positive health ramifications.”

Other studies, too, have illuminated the benefits of having a cat by your side.

A study by the Cats Protection agency in the UK surveyed 600 participants, half of whom struggled with their mental health. They discovered that 87% of cat owners found their cats to have a positive effect on their well-being. In addition, 76% reported cats made regular stressors easier to manage.

Cornwell College student Filipa Denis studied the benefit of human attachment with cats, and found that humans who were attached to their cats experienced great calming effects from the relationship. Cats also fulfill the human need for touch, especially for those whose mental illness prevents them from easily forming attachments with other people. Contrary to popular belief, cats can be affectionate and attached to their humans as well.

“There’s kind of a misnomer that cats are not social creatures. They’ve proven through studying feral colonies that cats are actually very social and they choose to live in social groups,” says Charlottesville, Virginia-based cat behaviorist, Ami Somers. “Cats have a similar connection with people, especially when they’ve been socialized with people early on in life. They want to be with you and they want to connect with you. The truth is cats are very social and they’re very trainable and they do enjoy living with people.”

For forming attachments, providing companionship, and easing mental health symptoms, cats can be an ideal emotional support animal for at-home companionship as well.

“A few years ago, after I was shot, I went through hell, physically, emotionally, mentally, and socially,” says Becky Cole. “I was diagnosed with PTSD and depression. It was my cat, Simon, who got me through it all. There were nights where I wouldn’t realize I was crying in my sleep and I would wake up to him licking my tears. He was my bridge back into the human world, because he kept me from shutting down altogether. It was almost like he was forcing his paw in the door, so I couldn’t shut it completely on everything.”

Though only dogs and miniature horses qualify as service animals, cats can be considered emotional support animals, designated as “comfort animals” to those with mental illnesses. Accommodations for ESAs are not as extensive as service animals, but they do qualify for protections under the Fair Housing Act. For example, ESAs must be permitted in housing with a “no pet policy,” as landlords are required to provide “reasonable accommodation” for those who rely on an animal for support. To qualify for an ESA, a mental health professional must supply an official letter.

“Similar to a person who needs glasses in order to be able to see, the animal serves a function to improve the psychological functioning of the person,” Long says. “In order to have [an emotional support] animal, a mental health provider would have to deem it as a necessary accommodation to help the individual through everyday life.”

Cats may be often overlooked, but whether serving as a critical companion at home, an official emotional support animal, or a part of the healing process in therapy, they can greatly improve our mental health.

“I have dealt with depression, anxiety, and panic attacks for over 20 years,” says Alyssa Heller. “My mental health has improved tremendously since [my cat] Shadow came into my life. … I am definitely happier, I don’t cry nearly as often, and the anxiety is much more manageable. … On the days I’m having a rough mental health episode, her presence enables me to work through the symptoms and I rarely have to call on family or friends for assistance anymore. I highly recommend a cat as a companion animal to anyone who deals with mental health issues.”

Cats may be often overlooked, but whether serving as a critical companion at home, an official emotional support animal, or a part of the healing process in therapy, they can greatly improve our mental health.
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My cats have become integral to my own mental health — and I wouldn’t have it any other way. They make sure I get out of bed in the morning and keep me moving forward. Their playful antics bring me joy and their warm presence at night helps me fall asleep.

Most importantly, their constant companionship reminds me that I have value and purpose.