ABSTRACT
Five years ago, almost to the day of writing this, Michael walked into my office and took his usual place on the couch. Forty years old, handsome, personable, gay, and perpetually single, Michael first came to see me about six years before this to address longstanding feelings of depression and anxiety. At the time, he felt stuck financially and professionally, and found himself in constant conflict with his parents and many in his wide family and social circle. It soon came to light that drinking and substance use would also need to be addressed, and now, sober for about the last three years and more comfortable with himself and others, Michael felt ready, probably for the first time in his life, to meet and date men with the potential to become long-term partners rather than merely discardable sexual objects. Deeply longing for, but yet afraid and unsure of how to navigate intimacy, loneliness and its sometimes seemingly impossible antidotes now consumed our therapeutic hours. Narcissistic defenses were no longer as effective as they used to be; sadness, the pain of aloneness, often permeated. As is the paradox in these situations, we felt more good than not about having arrived at this difficult place. Still, we struggled.
