The psychological roots of chemsex and how understanding the full picture can help create meaningful support

Chemsex or Party n Play (PnP) is the sexualized use of substances by GBMSM. It is often viewed as dangerous, problematic and users are reprimanded for using substances during sex. While some users want to stop or reduce their use, some GBMSM derives pleasure and manages their use of substances. For service providers, it is essential to see the complete picture of the pros and cons.     

The author is an Integrative Therapist whose focus is the psychodynamic approach and elements of person-centered approach.  Over the years of providing therapy to GBMSM clients who use chemsex, the author found a common link. While each client may have their issues, many of their themes are common. For many clients, drugs were not the main appeal, but the drug helped them achieve or do as these needs were not available in the community. Predominantly starting with loneliness, which is not how many people are in your circle of friends. But the ability to connect and the depth of connections.  

Some of the reasons are the challenges of coming out in the early years, inability to socialize, fear of vulnerability, self-esteem, and shame. The expectations to be desirable, perfect, masculine, and top or bottom place an unnecessary burden on GBMSM to achieve the impossible. The pressure to conform is tied to shame, internalized homophobia, and traumatic experiences of being perceived as gay and fitting into a heteronormative world and toxic masculinity. Traumatic experiences and toxic shame can be overwhelming for many GBMSM.   

Chemsex offers an escape to a different world pleasure, intense highs, acceptability, bonding, and great sex.  The author describes that when men tend to relapse is due to the sex, not the drugs.  It is crucial to know about the drugs used, GHB/GBL, mephedrone, crystal meth, and the drugs and sex connection.   

These drugs affect serotonin, dopamine levels, and neurotransmitters and affect emotions, feelings, and intimacy. Many GBMSM has learned early on to hide their emotions, feelings, and desires of “gay sex,” which has created shame. The shame and unrealistic expectations of body image and sexual performance often learned from gay magazines and pornography set an impossible end goal.   

For many GBMSM, chemsex allows a space for the men to be connected to other men without judgment in an authentic caring, sharing, and self-acceptance of each other without censoring parts of themselves. To build a therapeutic alliance with GBMSM, service providers must be aware of the history of criminalization and pathologizing of homosexuality.  

These isms have a burden on self-esteem, shame, and discomfort for many GBMSM to connect with themselves as sexual beings. Ultimately, service providers must hold space and allow GBMSM to be accepted and listen to them speak about their needs and provide appropriate support and toolkits. In conclusion, “Pleasure is an important part of life, and it is important to hold it in therapy too” to build a therapeutic approach with clients.  

Source: The psychological roots of chemsex and how understanding the full picture can help us create meaningful support | Emerald Insight

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