Charles Koehler 0:00 Hi, I'm Charles Koehler, and this is Lambda Reports, a weekly program by and for the St. Louis lesbian and gay community. You know, our world is filled with stress and daily challenges to our well being. Dealing with these problems is tough enough for the general population. At times, it can be overwhelming. But what happens when you're a lesbian or a gay or you're just not sure? What happens when you discover you are HIV positive or have AIDS? Who can you turn to that you can trust? Who can you trust that that will understand? Dr Barbara Lokitz is the head of a unique service in Metro St. Louis. It's called Delta Mental Health, and we welcome her to Lambda Reports. Good morning, Barbara. Barbara Lokitz 0:54 Good morning Charles Koehler 0:55 Barbara. Just what are some of the issues facing someone who's looking for help and as lesbian, gay or is HIV positive, and how are these things unique? Barbara Lokitz 1:06 Well, first, I think it's really important that anyone who is gay or lesbian, bisexual or who is HIV affected, find someone who understands that they do not have to educate or defend themselves. You know, it's like there's nothing to apologize about being gay or lesbian or bisexual. It's not a phase, as many clinicians believe. Just because someone is gay or lesbian doesn't mean they're going to come on to their therapist, so the therapist doesn't have to defend themselves or interpret themselves out of Charles Koehler 1:44 even on a subconscious basis, Barbara Lokitz 1:45 even on a subconscious basis, right? You just might not be their type. And someone who's HIV infected or affected, I mean, it's such a complex disease, there's so much stigma attached to it that it's bad enough to have to deal with the profound change in one's own identity to then be in seeking help from someone who needs to be educated about HIV and about the stigma and about the whole world in which someone who's affected ends up living in. That's a burden on a client. That is unnecessary, in my opinion, Charles Koehler 2:28 and is a burden enough without having to, in essence, educate the person who's giving you help. Barbara Lokitz 2:36 Right. I think any clinician needs to educate themselves. Some states, not Missouri, Washington State, for example, anyone who gets licensed or has a contract with the State Department of Mental Health or is licensed has to have coursework in HIV AIDS and get in, they call it sexual minorities, gay, lesbian, bisexual, transsexual, transvestite, so that the client isn't the one who has to do the educating or defend that who they are is not a pathology. And even though the American Psychiatric and the American Psychological Associations have decreed that being gay or lesbian is not a mental illness, that stigma and that belief holds true with too many practitioners. There are some practitioners who are really educated and if not gay or lesbian or bisexual, they certainly are sensitive and have gotten their acts together and do not hear what clients say out of this framework of arrested development or reverse Oedipal complex, or, you know, that kind of stuff. Charles Koehler 4:03 All of those things that have been disproven. You know, they were interesting theories, but that's they don't hold true. Barbara Lokitz 4:10 They don't hold true, and they're not a good explanation. Charles Koehler 4:13 Yeah, they, they, they lack real credibility, and in the experience of the world, right. The organization Delta Mental Health. And sounds like it was formed in in response to a need that was out there. How long ago was it founded, and and what are, what are some of the goals and missions of Delta? Barbara Lokitz 4:35 Okay, Delta was formed by in 1988 there were a group of us who got together, who had been working in the field of AIDS services and client services, and were aware that mental health, the field of mental health, was really ignorant about the dilemmas faced by someone who became HIV infected or had family member or a lover or partner become infected. Charles Koehler 5:03 We're talking about some very unique issues that are talking about later. Barbara Lokitz 5:07 Right. And so we put together a training, and in this 20 hours of training, we did a mailing. This was in the fall of 88. Thirteen mental health professionals signed up for the training, and in exchange for the training and the supervision, they agreed to see Delta clients, and with no advertising. In the early 1989 we started getting calls, and by April, we had 50 calls, and we had requests for us to do training for the Bureau of AIDS Prevention statewide care coordination team, and we did training in Springfield, Missouri. And so in June of 89 Board of Directors met, and in August of 89 we opened our offices at 4300 Laclede. We now have, everyone sees clients. I see, I have a caseload. The Associate Director has a caseload. We have two other full time clinicians. One is a woman who specializes in programs for women and people of color who are HIV affected, and we have an administrative assistant and a psychiatrist quarter time. And we started out with two paid staff, and we now have five and a quarter so we've grown a lot in two years, a little over two years, that's Charles Koehler 6:44 That's amazing. Barbara Lokitz 6:45 Our mission is to provide quality, that means short term or long term, group, individual, family, mental health, care that's accessible. That means economically as well as physically, or we have a parking lot or wheelchair accessible, that kind of thing, to people who are HIV affected, and to gay men and lesbians and bisexuals, that's our mission, and to educate in the area of our expertise. So Charles Koehler 7:18 Sounds like the need is growing out there, and St. Louis is very fortunate to have Delta as a as a resource. Now, how is Delta funded? Because we're talking about, I believe you mentioned sometime earlier about a sliding scale and that sort of thing. Barbara Lokitz 7:37 Yeah, our scale ranges, we like people to pay something, although we have had clients come in who didn't even have bus fare. So but our scale is basically from $1 to $70. We are funded with Ryan B White money right now. So if someone is HIV affected and is seen, has this part of the state system with a care coordinator, either through the Bureau of AIDS Prevention or through St. Louis Effort for AIDS or North Side Aids Outreach or Metro AIDS, and they meet the eligibility criteria, their mental health services are paid for. We also have third party payment for people who have group insurance. But about a third to a little bit more than a third of our income is client fees, whether that's through, you know, Ryan White, or through insurance or private pay. We have a grant from the State. We receive monies from the AIDS Foundation and private donations and some fundraisers, and we're always writing grants. I mean, any age service organization or any community based organization is always writing grants. Charles Koehler 9:10 At grant writing with particularly with times being as hard as they as they are financially. And I would imagine that there's a direct correlation between hard times economically and also the increase in need of services, Barbara Lokitz 9:27 Right. When we opened, like really got established like in 1990, we averaged about 15 intakes a month, you know, Depending, it fluctuates through the year, sure and now in 91 I would say our average is between 25 and 30, and takes a month. So we've just about doubled the number of incoming calls that we have. Charles Koehler 9:57 That's that's significant. Barbara Lokitz 9:59 That's significant. It right? Charles Koehler 10:01 And perhaps, after this program, you might get more people going, What are some of the most common reasons that people seek Delta's services? Well, problems that people come to Delta with? Barbara Lokitz 10:18 Problems with living. We, I'd like to, like, divide things between people who are dealing with mental health issues that are not HIV related and those who are dealing with mental health issues that are HIV related, because they are different. Charles Koehler 10:37 And then there's overlap. Barbara Lokitz 10:38 There's overlap categories for someone who's HIV infected are a family member or partner, there's a profound change in one's identity and how they see themselves. Charles Koehler 10:53 Now, how does this Barbara Lokitz 10:54 experience themselves. Charles Koehler 10:54 How does this manifest itself? Barbara Lokitz 10:56 Well, people can either, all kinds of ways of coping with it, extreme anxiety, depression, denial, not being able to concentrate. I mean, there are lots of, it's like, why me? What did I do to deserve this? How do I go on living? These are some general life issues. The other thing that have, the other thing that happens is that whatever it was that someone was struggling with before just gets, like, amplified and well, you know, I'll figure out what I want to do career wise when I turn 30. Well, for someone who's 23 who's sick, turning 30 is not much of a probability. So how do I give meaning to my life? A question we all address for people who are fortunate, they have decades of experience of living before they retire, to try to kind of make sense out of their life if they're not doing it as they go along. For someone who's infected, especially for someone who's been diagnosed with AIDS and is on disability, it's like they're on retirement, but they haven't had the intervening decades of life experience to put that in perspective; there's a contradiction between being 30 years old and and finding your place in the world and establishing your identity professionally and dealing with issues of imminent retirement and decline and death. Mean, it doesn't Charles Koehler 12:43 that's a lot to deal with. Barbara Lokitz 12:46 That's right. And and giving meaning, you know, if we make contact with other people, if we educate, if we share some part of ourself with another person that, for me, is giving life meaning. It's not by the standards of this culture, making a lot of money or or having a an advanced degree or being a quote, a professional. I mean, it's relationships, having worked with people with AIDS and HIV for over five years. It's like you get down to the essentials of what life is about, and that's people being able to love and make contact with each other in a real way, not defended, not with all our personas out, you know, make ourselves look good. But honestly, I mean, that takes courage. Charles Koehler 13:44 Indeed, it does, and it sounds like you've had several lifetimes worth of experiences so far, and we'll have many more to come, for better or for worse, yes. Gee. There's a lot of misinformation in the general population and in the lesbian and gay community about homosexuality, and just what it is, is it, Some people still believe that homosexuality is is a mental illness, and they firmly, firmly believe that it can be treated or cured. And why isn't that so, you know.One, one way of measuring something that that would indicate an illness is, devil's advocate, is that people behave in a different manner. And certainly, lesbians and gays in certain areas of their life do behave different than persons that are not lesbian or gay. So how do you explain that this really isn't a mental illness, something that can't be cured? Barbara Lokitz 14:45 Well, Charles, you've asked a question that's like central part of all of our training and our philosophy, and that sexual orientation, whether someone is gay or lesbian or bisexual or heterosexual is a core part of their identity, and is formed when we're just little guys and girls, you know, like by then we're five or six or seven. The standards set by the dominant culture, which are white, heterosexual male, Christian middle class, anyone, if someone falls into all of those categories, like a white, heterosexual male, Protestant middle-class man, that's redundant. Doesn't have to struggle to claim their identity as being okay. It's just a given. But for those of us who deviate in any way from that standard that's set by the dominant culture, we have to claim our identity. So women in the women's movement was process of saying, Look, you know, just because my gender is not male doesn't mean I'm a second class citizen or deserve to be discriminated against. The same is true in the civil rights movement, and with African Americans saying, you know, black is beautiful. Because our cultural standards are white, blonde, blue eyed, you know, this is the standard, and anyone who deviates is not, doesn't quite measure up, you know, it's like comparing apples and oranges. We also, in this culture, of course, assume heterosexuality and that there's no questions about what causes heterosexuality, but sexual orientation is as central to a person's identity as their race and as their gender. And develop that kind of awareness of family, race or tribal identity means the family we were born into. That's the, that's where our roots are. And someone who's male or female becomes aware of that when they're about two or three years old, at the same period in development, we believe, substantiated by research, is that sexual orientation also becomes a part of the identity. What happens then for a gay son or a lesbian daughter? Is that How that that, the best example I have to illustrate this is what's really culturally accepted is for a little girl who's four years old, three or four or five years old, flirting with her daddy and crawling up with her on her daddy's lap and being in love with her daddy, or for a little boy saying, I'm going to marry mommy. Well, Charles Koehler 17:56 That's the norm. Barbara Lokitz 17:57 That's the norm for a gay son, he wants to marry daddy, and for a lesbian daughter, she wants to carry your mom off, you know. What happens then, when parents pick up that energy from their kids is they pull away. So what happens for gay sons and for lesbian daughters is even more isolation, even more alienation, lack of that connection that's so important, because their parents are afraid of the feelings that are being directed towards them, and the parents don't know how to deal with it. Charles Koehler 18:33 Parents not might not be consciously even aware of what's happening. Barbara Lokitz 18:37 Oh no, they're not. Charles Koehler 18:39 And so how do you deal with something that you're not even aware that exists? Barbara Lokitz 18:42 And everyone's homophobic. We live in a homophobic world. Our language is homophobic. I mean, it's internalized. Charles Koehler 18:50 One of the the criticisms that I've heard of expressed is from some straight individuals, is that they say, Well, I don't see that there's this problem with homophobia, or what do you mean by heterosexist? And it's sort of like, how do you explain? How do you see the forest for the trees? It's, it's, it's part of the very fabric of our culture, and not being a judgment on it, it's just a statement of fact. Barbara Lokitz 19:20 That's right. There are no civil rights, Yeah. And I mean, it's so insulting when someone says, Well, you know, if you're gay or you're lesbian or you're bisexual, you can pass. You know, you don't have to flaunt it, and without realizing what passing does to one's self-esteem, what it says about who one is, if I have to pass for and hide who I am, that means there's something about me that I should be ashamed of, and that's not true, Charles Koehler 19:57 Something that's defective Barbara Lokitz 19:58 That's right, is. Right. Charles Koehler 20:00 inherently broken, wrong, , Barbara Lokitz 20:04 right and so far as one little treatment or cure this, you know, there are people who say, Well, we can cure homosexuality. Well, probably those cases, if really understood, because, I think we think, again, supported by other research, is that we are born with a predisposition, genetic, hormonal predisposition around sexual orientation to either be monosexual, which is either homosexual or heterosexual or bisexual, and that then environment interacts with that predisposition, if someone has lived primarily, say, as a gay man, and they get saved like somebody like this Nicolosi, who's written this book recently on reparative therapy with a male homosexual Charles Koehler 20:04 through religion or whatever, Barbara Lokitz 20:09 or psychotherapy or whatever, whatever means the person was probably bisexual. And culturally, we're really pushed be one or the other. I mean, you're, I mean, we, our world, is kind of binary, Charles Koehler 21:25 to be either this category or that category Barbara Lokitz 21:27 Right. Let's not confuse things, you know, Charles Koehler 21:29 it's too confusing, Barbara Lokitz 21:30 Right. And so this that they the potential, the structural potential for bisexuality was probably there for people who have been, quote, saved. Charles Koehler 21:41 But one of the questions that comes up, though, is, how do you explain to someone that feels that that sexual orientation is is is chosen? You know, they ask you, well, why did you choose to be gay? Barbara Lokitz 21:58 Well, I mean, if you try to answer a illogical question, which is very Charles Koehler 22:04 it's very logical. They hear sexual choice, Barbara Lokitz 22:07 and I guess Charles Koehler 22:08 sexual preference. Barbara Lokitz 22:10 Right. And that those are kind of moralistic and erroneous ways that dominant culture has had of defining someone else's experience and out of their own, and Charles Koehler 22:27 it might be very true for them, Barbara Lokitz 22:28 Sure, Charles Koehler 22:29 but not for the other person. Barbara Lokitz 22:31 Right. And I mean, I tend to answer questions like that with another question. I'm a therapist, right? Questions? Well, you know, how come you chose to be a man, or how come you chose to be Caucasian, or how come you chose to be middle class? I mean, come on, this is who I am. I don't have to explain to you anymore. If you want to understand it, you know, here's a good book to read. I mean, it depends on how antagonistic I'm being. Charles Koehler 23:07 If you've had a particularly bad day Barbara Lokitz 23:09 Right. If I want to educate, I will. Charles Koehler 23:14 What about some of the the myths about lesbians and gays and and how does, how do these myths affect how their family members or society as a whole interact with them? Barbara Lokitz 23:31 Not quite sure I understand it. Charles Koehler 23:32 Well, if we take a look at many of the myths that are out there, I was in a discussion group recently in which we we did a list of how, what, what images are of, of gay men, for instance, are projected by the media as a whole? What did they learn from the media as a whole about gay? Yeah, and you know, you come up with things such as, gay men are are promiscuous. All of them aren't promiscuous, that they're child molesters. Barbara Lokitz 24:02 Promiscuous is anyone who's getting more than you are. Charles Koehler 24:07 It's an interesting definition, but in all of these things that are inherently untrue, I mean, we know from our experience, and we know from research and everything else that they're just untrue, they might be true. Small minority is, as can be said from for almost any group of people, bisexual, straight, whatever, whatever race, whatever, whatever. But, but when the society as a whole, or when family members believe these myths, as is often the case, how does that inter how does that affect the interaction with a member who's lesbian or gay or bisexual? Barbara Lokitz 24:45 I mean, there are lots of ways. I mean, we as a culture use stereotypes as a kind of a shorthand to try to understand or put people in and cubby holes. I think what happens as a result of looking at stereotypes like gay men are effeminate, or lesbians are butch, you know, or masculine, is that the person is not seen and the relationship has to be, is confined. I don't exactly know how to respond other than that what gay men, lesbians, bisexuals need to move towards is to normalize their relationship with their families. To say, look, this is the person I love. How I love this person is not a whole lot different than how you love your partner, mom or dad, and to constantly push towards what Betty Berzon, in her book Permanent Partners, writes as normalizing the relationship, and like parents, especially of gay men who are in a partner relationship, tend not to take that relationship seriously, as if, if, if he were in involved with a woman, then she would be invited to things. She would be given gifts at Christmas, she they could sleep together if they were married or whatever. But Charles Koehler 26:36 in their house, Barbara Lokitz 26:37 in their house, Charles Koehler 26:37 it isn't Barbara Lokitz 26:38 Right. In a comparable relationship between two men, the families tend to discount the lover and exclude the lover and have hostility towards the lover. This comes out of ignorance, stereotypes come out of ignorance, and all we can do is constantly, if we really care about someone, is to take the risk in order to have an honest relationship with them, so that we can be who we are, not, without apology. I think for anyone who doesn't meet the standard, and even those who externally meet the standards, are probably really unsure of their place, that when we no longer apologize for who we are, but are, then it puts the burden of trying to figure things out on the other person and not on us. And I I think that's like overall would be, is a goal of therapy is for for each of us to work through those conflicts and insecurities and the shame and the shame for someone whose sexual orientation doesn't meet the norm, gay, lesbian, bisexual, transsexual, transvestite. I mean, that's part of who I am, you know, and I don't have to apologize to you, and I don't have to be ashamed. And when there's that kind of, when you're able to feel that way about yourself truly, then other people respond differently. But if we go through life with some kind of an apology that we're not quite as good as other people, straight people or men or or Caucasians, then they pick that up and respond Charles Koehler 28:40 And also as a whole society as a whole suffers because of that. Barbara Lokitz 28:44 That's righ., Charles Koehler 28:46 Barbara, unfortunately, that's all the time we have for this week. I'd like to thank you for being with us and sharing your expertise. And we've been talking with Dr Barbara Lokitz of Delta Mental Health. And if you our listeners would like more information about this organization or the resources available. You can call Delta Mental Health at 531-4566, or write them at 4300 Laclede, St Louis, Missouri, 63, 108. Until next week, this is Charles Koehler for Lambda Reports. Join us again next week, ame time, same station. Transcribed by https://otter.ai