About Dr. Ken Carrington

Doctor working in developing nations for at risk populations, advocacy, protection and mental health; and home in the USA for equality and awareness.

Loyalty and Betrayal

An old quote about loyalty

If loyalty is, and always has been, perceived as obsolete, why do we continue to praise it? Because loyalty is essential to the most basic things that make life livable. Without loyalty there can be no love. Without loyalty there can be no family. Without loyalty there can be no friendship. Without loyalty there can be no commitment to community or country. And without those things, there can be no society. My loyalty is fading as to give it I must also receive it.

Loyalty has always been key to me in all aspects of my life and betrayal the means of totally tearing apart those relations and often my own sense of self.

I am a public figure on many levels and have recently gone through a difficult 4 months and a divorce that was widely publicized . I was hospitalized and told I would not survive. I did miraculously. Upon being discharged my husband filed a restraining order and a divorce without any conversation. I left the hospital and never went home.

He then disseminated my medical records with malicious intent via phone, email and social media to do nothing more than hurt me. This was true betrayal…something so strong that I had never felt before.

Why is it that someone who loves you one month can become so vindictive the next? The answer is not so simple. Often it us the build up of many things through the relationship, hurt, cheating, lack of communication or simply fading from each other’s hearts. Sometimes it is internalized anger and even fear.

Instead of communication to the person we are closest, we push them away and strike out. We hurt them with the pain that we are feeling. This is so destructive for both but more so for the one doing the hurting as their hurt is so much greater and will stay with them so much longer.

They need help.

Relations are never easy. They take effort, they take talking, they take sharing and caring. Once that is gone, so is loyalty and trust.

To finish my story, it was challenging but I am so much happier now. He, he is clearly still in pain. I hope he gets help before something worse happens

#lgbt #gay #love #betrayal


Gay Marriage | An Intimate and Social Perspective, by Armando Diaz

Gay Marriage | An Intimate and Social Perspective
by Armando Diaz

The issue of gay marriage has been a wondrous evolution
of principle, passion and polarization in this country. It has
evolved from something seemingly unattainable, to being
the single issue in American politics that has galvanized
more response from the people than that of melting ice
caps or the death penalty. We are certainly living in curious
times as Americans. As we continue to guide ourselves
through it all, regardless which side of the issue you might
find yourself on.

From its inception in 1987 during the third march on
Washington DC for LGBT rights to its current dance within
the the Supreme Court, gay marriage is now a very real
institution in and of itself.  However there is still much to
understand from both a personal and social point of view.

To assist us in this dialogue, we have employed the
opinions of (2) brilliant couples who navigated the waters
of this process. David & Marcelo, as well as Ken & Wes.

David is a Life Coach and Psychotherapist and Marcelo is
a visual artist and designer. Ken is a Doctor of Psychology
working in program development locally and worldwide, as
well as a passionate community activist. Wes has just
completed his studies at FIU in International Business, is
involved in his family’s businesses abroad and is a board
member of Unity Coalition|Coalicion Unida and an LGBT
community activist.

How long have you gentlemen been married now?

D&M – We have been married for two years

K&W – We were married March 30th 2013, thus making it
just over 2 years. Though we have been together for 7 years
beginning in Cambodia and then fighting to stay here in the
USA since 2011.

I’m a hopeless romantic on marriage proposals. Can you
tell me a little about yours?

D&M – We really did not have a traditional marriage proposal situation. We had been talking for a long time about getting married, and
mutually decided to go and do it after being together 18 years at that point.

K&W – Funny to think back to this. Originally I was going to propose to Wes over the New Year holiday in 2010 in Bangkok Thailand but I
suddenly had to leave SE Asia and return to the USA. Wes came to the states in the beginning of 2011 and our lives changed in many
ways of course. Marriage in Florida was not legal of course and being married could jeopardize his visa status so we held off until 2013
in hopes that DOMA would be overturned in June of the same year. Honestly I don’t think there was an official proposal but certainly a
sense of excitement as we planned our wedding at the Jefferson Memorial in DC with close friends joining us. A beautiful day on so
many levels; for us and historically.

What differences do you feel now that you are ‘legally’ married as opposed to when you were a domestic partnership?

D&M – The biggest difference is that we feel recognized in the eyes of the law and by society, which
makes us feel protected, more secure, and safer from discrimination.

K&W – Being in a binational relationship where only one person has security as a citizen is constantly
anxiety provoking and unsettling. Neither of us ever felt like we were permanent to Miami or to the USA
before DOMA was overturned, always knowing in the back of our heads that we might have to leave the
country again to be with each other. Ironic thinking that we had more rights in a war torn dictatorship of
Wes’ home country than we did in the USA.

Even after federal changes and Wes gaining his Green Card, we still did not feel settled in Florida.
FIU refused to recognize Wes as a citizen and give the benefits that go with that for tuition and other
purposes and Florida continued to discriminate in every possible way. We still could not feel accepted
in our state simply because we loved each other. It was additionally frustrating watching how hard our
State leaders fought against us. It hurt as an individual and made us both want to leave Florida.
All of these feelings were relieved once Florida also made changes and we finally decided to settle
and stay here in Miami. There was a sense of validation. Though in the back of our heads we do worry
that those basic legal rights could be stripped any time by our legislators.

This week North Carolina’s Republican-controlled state House passed a “Gay Marriage Exemption
Bill”. Basically it allows certain court officials the option to stop fulfilling their duties in relation to
gay marriages, due to their religious beliefs. The bill is now law in that state as of Thursday June
11th. Same-sex marriage became legal there last Fall. What are your thoughts on this?

D&M – This is a very sad development. While we have moved forward quite a bit, this was a big step backward.
Until this issue is settled once and for all on a Federal level, we will likely see bills like this passed in different states. This  turn of events
clearly speaks to the need for a federal law legalizing same sex marriage.

Also, once a worker or official of the court refuses to perform these duties, they cannot perform weddings for at least a period of
six months. What advice do you have for gay and lesbian couples in North Carolina seeking to get married, that run into this issue?

D&M – They need to do their research and make sure that anyone involved in their proceedings will follow through with all the legal
requirements. In this process, they will hopefully find  someone in the state of N. Carolina who will perform their marriage and related

I find a principal argument from the conservatives in this country, has been that gay marriage will destroy the thousands-year old
institution of holy matrimony. It’s been stated frequently that gay people cannot procreate, which is the reason that “marriage” and
“civil union” are two different things. Your thoughts on this now as a same-sex married couple?

D&M – The whole procreation
argument is ridiculous, and
it is used as a smokescreen
for the purposes of
discrimination. Procreation
and marriage are not
necessarily connected. For
example, in a heterosexual
couple, if a woman is unable
to conceive, or a man is not
fertile, is that couple
prevented from marrying?
No, they are not.  Other
examples : if a male-female
couple is not married, does
that mean that they cannot
procreate? No, it does not –
In fact, there are many
couples who have children
out of wedlock. Also, if a
couple chooses not to have
children, are they prevented
from marrying? No, they are
not. Based on all of the
above, it is clear that
marriage and procreation
are not inextricably connected,
and this is really a non-issue.

K&W – Well, we’re not so
sure that heterosexuals
have exactly done well
protecting that state of holy matrimony with any level of dignity or respect so have very little space to talk or judge. Marriage is about love
and commitment. It is about a bond between two people. And it is about the law in the end. Love has no restrictions and should be
embraced and celebrated as should the rituals of marriage no matter who is in love. And of course, we all deserve the same protection
under law and that includes the protections within marriage. Our world and certainly our love is not defined by a centuries old book
written in a different era and being used as a means of hate and judgment.

A few days ago  a straight married couple in Australia threatened to divorce, as a “matter of
conscience” if their government legalizes gay marriage.  Conversely, Ireland (one the most
Catholic nations on Earth), passed gay marriage into law based on popular vote by the people.
What would you say to Nick and Sarah Jensen of Australia? And what would you say to the
people of Ireland?

D&M – To the Jensens – what you do is your choice, and you need to stay out of other peoples’ lives.
Your actions and statements are evidence of your bigotry and hatred.
To Ireland – Kudos for such an evolved response despite your strongly religious conservative

background – you have done the right thing.

In your particular experience. What (legal, civic, bureaucratic) challenges did you face during
the process that led up to the day when you both said “I do”

D&M – There were many, including health insurance coverage not being extended to both despite
having lived together as a married couple for 18 years, dual property ownership not being legally
recognized pending our legal marriage, and fears of not being able to care for each other in the
event of a medical emergency re: Health Care Proxy, Will, etc…;

K&W – Our biggest hurdle was citizenship of course. Wes is from Cambodia and came to the USA
on an f1 via as a student. But, at the time under US Law we could not be married and protected under
the same laws that protected heterosexual couples. He would potentially face being deported or the
two of us leaving to be together.
Our later struggles with FIU’s discriminatory policies based on those policies of the State of Florida, were about financial on one large
level and on principles for another. We could not stand by and Wes became the first student to have his in state status recognized
through a gay marriage.

What advice do you have for our
own community, as far as what
hurdles they can expect if they

are seeking to get married.
What can they do to avoid any
serious setbacks?

D&M – First and foremost, if there
are any potential legal issues,
consult with an experienced
attorney before getting married.
Depending on your situation,
there may be issues that could
end up being barriers. This can
be prevented with sound advice
from an knowledgeable and
experienced attorney. This is
particularly true for bi-national
couples, and any other couple
dealing with immigration issues.

K&W – Couples are now very
lucky to have the ability to marry
in our State and across most
of this country. If one partner
is of a different nationality
I suggest strongly that they seek legal advice and guidance. The process of marriage and immigration is more complicated than most
know and moving forward without that guidance could jeopardize everything.
Other than that, simply fall in love, be good and kind to each other, get a license and make the wedding fabulous!

What effects do you feel marriage equality will have on our gay community and culture as we move forward? What effect do feel it
will bring to our civilization as a whole?

D&M – Marriage equality is a step toward greater acceptance, tolerance and compassion for others. Freedom and equality are not just for
select groups – they are for everyone. As our equal status is recognized on a federal level, we will have taken a big step out of the
‘shadows’. This “leveling of the playing field’ will allow us to get on with the business of living without the fear of the institutionalized
discrimination that we have been forced to live in. This can only help civilization move forward with more acceptance, compassion and

It is validation and acceptance. This fight for equality is not asking for any
special rights but simply the same rights and the same simple desire to
express our love and commit to the person we want to be with. Pretty
harmless and seems like something that should be celebrated and have a
wonderful impact on our community and humanity.
   Ambiente cover– Ken & Weslee

Determined to Defeat DOMA (featured from the DOMA Project)

Leaving Cambodia Behind, Ken & Wes Settle Down to Married Life in Florida, Determined to Defeat DOMA


We met in the summer of 2008 in beautiful and exotic Phnom Penh, Cambodia. I had been there since 2004 working in developing nations as a doctor for advocacy, child protection, LGBT and human rights, trauma, HIV/AIDS. I also worked in the development of mental health systems in Southeast Asia, India, and Africa. Wes was one of the top students for International Business as well as a part of the social elite in Cambodia. We met through Wes’ dean, who happened to be my best friend. She would bring Wes with her to events and meetings and even social outings as part of his role as University Ambassador. The attraction was clear; the spark ignited. After hours of phone calls going late into the night plus courting, teasing, and flirting, our feelings turned into a relationship. Years later, across oceans and hardship, we continue.

Wes quickly found his passion for advocacy and development, becoming a key member in my governmental and non-governmental organizations. Wes particularly focused on the development of protection and assistance for his own people who suffered greatly from past genocide and the current oppressive regime of the prime minister. At the same time, life was fabulous with glamorous events, dinners, royals, celebrities, parties, ceremonies, and exotic travels; but in reality it was not an easy endeavor to work with a government when it was the government that was responsible for the very problems we hoped to address. Nonetheless, our relationships and passion made the experience not just bearable but full of love and fun. Our work together was exciting, caring, compassionate, risky and frightening all at the same time. In spite of the dangers we faced in our work to bring about change, one of the biggest obstacles was having to hide our relationship from Wes’ family and from society for fear of being harmed and outcast. Though not ideal, it brought us even closer together and made our love and commitment that much stronger.

We found love, we grew, and thrived on the intrigue and challenge involved in our work. However, eventually our situation became too dangerous as our work placed us at odds with powerful leaders who did not wish to be exposed for their corruption and abuses. As the situation became unmanageable, I was forced to leave the country out of fear for my safety, leaving Wes behind in the protection of his family. We were both persecuted on many levels, but with the help of Wes’ wonderful family and hard work, a path was found for him to also escape to America six months later. It was a very long six months, but we had the happiest of reunions here in Miami – our new home.

Wes is now in school again and preparing to graduate while I continue my work as a human rights activist, an equality advocate, and as a private practice psychologist. In the meantime, the two of us are enjoying the beauty, culture, and life that is South Beach, a big change from our previous home. From the security of U.S., we were also able to pursue our dream of getting married. We married in D.C. on March 30th, 2013 with a reception here in Miami shortly thereafter.


Despite all our success and our love, we struggle with the fact that as a binational couple we are still feeling vulnerable because the Defense of Marriage Act prohibits the federal government from recognizing our marriage and allowing me to sponsor my husband for permanent residency. As a result, we feel threatened in our freedoms and our ability to stay together. After working in nations fraught with extreme oppression brutal regimes; it is sadly ironic that we may one day be forced to leave the “Land of the Free” in order to find a place that allows us to be able to spend the rest of our lives together.

We share our story and speak out in public as much as we can to help bring change and to help our fellow binational couples who have not had the good fortune to find a way to live together. Far too many live separated from their loved one, simply because DOMA prohibits them from sponsoring their spouse/fiancé(e) for residency. If we all get involved and share our stories, DOMA can be overturned and people can be with the ones they love. As The DOMA Project mission reminds us, we must ensure that the our elected officials, the Supreme Court, and the court of public opinion are aware that there are people, lives, and love behind these laws! Thank you for reading and sharing our story.

Love and Marriage

Gay Marriage

 So seriously, what is all the fuss? I mean isn’t the idea of getting married and settling down something that we all should support including those from the right politically. I mean, would they rather all those gay people continue to be out there sleeping around, spreading their diseases, and corrupting the straight people into a life of sin? Is that their preference? Yes, I know, the moral decline of America, the end of traditional marriage and families, the damning to hell by the Church and their hypocritical staff, and so many other reasons that gay marriage should be prevented. Yes, if we stop it, that is what will keep America safe and moral…sure!

So those to the right of this issue will continue to fight on these “moral” grounds while continuing to fight against exactly what this nation is supposed to stand for – freedom, liberty, EQUALITY.  It is not about the religious aspects of marriage that I would even argue, but about two other things. The first is law and discrimination within it. If someone is legally recognized as married, then by law they should have the same legal rights. Notice, I say “legal” rights and not human rights. Over 1000 laws and benefits are missing for gay marriage because of this discrimination including family protection, Immigration, hospital rights, tax, and so many others.  Hell, if I could have gotten married and had it legally recognized, I would have saved a good $30,000 last year in tuition, insurance and taxes.  Does that seem fair? I know, life isn’t fair.  I should just suck it up and deal with it. And I do! But we are “not a land of discrimination” despite our past and current drives to discriminate against anyone and everyone we can.  Hypocrisy at its best…

Don’t get me started on Immigration issues and other federal benefits. Personally, I met my partner while living overseas doing work in development and child protection, mental health, education, advocacy and health care. I worked under dictatorships, had my life in jeopardy more than I can count, but fought for their protection and freedoms. Only to come home to a country with the person I love and told that even the Great and Free Country of the United States of America will not protect some freedoms of equality and the person that I love.

Can you imagine the idea of having to LEAVE America to find MORE freedom? Really? This is what is faced by so many…myself included…

But the main reason I argue in favor is for the simple idea of love and family. Nothing is more human than that. So, some men like men, some women like women, and then there is that mix and match that we call heterosexuality. All seems pretty fabulous to me. They share, they protect, they comfort and they respect each other. They build families and help their communities. They are just people in the end trying to find love and happiness in a sometimes cruel little world.

Are we really fighting to stop this when we can focus our energy on trying to stop child trafficking, bullying, abuse, rape, terrorism, and so many other things that hurt people? Does my love for another really hurt you? Does it cause those types of violence and destruction? I think not and if you do, well then you need some time on a couch with a good therapist, or simply maybe need to find some love in your life as well as you clearly are suffering and angry.

So to all the Gay Marriage haters out there, I say relax a little, maybe have a drink or two and move all that energy and hate back to focusing on yourself and why you are so unhappy with who you are and your own state of being. Focus on things that really matter in your life, your community, and the world that you can impact and change for the good without spewing hate and ignorance. Hate and ignorance and even discrimination have been a hallmark of America and the world throughout history. In the end, most learn to accept and include others and change becomes inevitable.

I always place my bet on humanity and acceptance…and maybe LOVE really does always win out in the end!

It did for me!

And the world did not end…

Hate Hate and more Hate

Hate Hate and more Hate

I know this conversation has happened over and over but I feel the need to share my thoughts and experiences with it. I still sit back and am amazed over the amount of hate and intolerance in this world no matter to whom that hate is directed. Even my friends sometimes will say things in all seriousness that just takes me by surprise including comments about guns, gays, blacks, women, muslims…it doesn’t seem to matter to whom it is directed or to how ignorant and delusional they may sound in the process.

See, I DO feel I share a unique perspective having traveled to nearly 100 countries, surrounded myself with every culture, religion, and race there is. Enmeshed myself in those cultures and worked with those governments. Sure, I have had biases and lived by stereotypes as well, but at least have made an attempt to challenge them and grow verse being stifled by my own arrogance and living under the guise of God, religion, politics or money…

Why have I been spurred to write this?…well, many reasons, but one being that I have recently been criticized for all the work I do to bring equality to the LGBT community here in the United States. It is funny to me that I never get criticized for all the work I have done in 3rd world nations and in America for helping women who have been abused, children who are trafficked, poor people from having their land stolen in Cambodia, religious tribes from being exterminated in Africa and rape victims all over the world from being left to suffer, hated or punished for being victims themselves. But when it comes to gays, the same people who praise me for helping these others attain equality, safety, and assistance, are the first to criticize me for helping gay people achieve the SAME…and yet, they are unable to see their hypocrisy. “They deserve to suffer”, “they are evil”, “they are sinners”! Can people hear themselves? Seriously? “God says that it is wrong”…hmmmm, I think I have “heard” the same ignorant response for centuries used against every other possible minority or group…I would hate to be on the wrong side of this argument…again.

So we carry on with the Boy Scouts (and MANY other groups) continuing to question if they should be a role model and not discriminate (like this should even be a thought), for the Congress to continue to pledge to fight against allowing gays equality in marriage or immigration when America itself is based upon the idea of equality and fairness no matter who the person is. Shouts of religious freedom, as if there is only one religion and that one somehow delusionally states that all gays are sinners and SHOULD be hated and excluded. What kind of religion is that? What kind of government is that? What kind of people are we?

Can you imagine the thought of having to move to another nation than America to gain MORE freedom? I face that every day as I think about my future. Do you? Can you imagine thinking the only way out is suicide because you have been outcast by your society, bullied, beaten? I work with these people and help to save their lives and find hope in the world. They ARE people – sons, daughters, brothers and sister, friends and co-workers. Do you? The answer is likely no, you just continue to hate and base your experiences on a very sheltered life and very sheltered way of thinking. You don’t stop to think about what your hate does to people around you, to those that are part of your family, to those that are facing the ideas of suicide as a means of expressing their depression and sense of desperation.

I for one, will continue to fight for all of those in need and at-risk. I will continue to fight for EQUALITY and understanding and acceptance! Live your life and let people live theirs. Simple respect, kindness and a small amount of empathy can get us so much further than you can imagine. And everyone deserves to feel safe…to feel loved.

Equality is for all. Hate is for the weak.

Cambodia Youths and Mental Health (reprinted from the Globe Magazine)

In the west there is a cliché that refers to the fact that we can blame our parents for the way we have turned out.  This is especially true when it comes to the negative things:  the way we have adjusted to life, our failed marriages and relationships, financial mistakes, and even health and legal problems. Easier to blame and not be responsible.

But is there some truth to this?  How much are they to blame?  Aren’t they the ones who are suppose to guide us and direct us through those fragile young years of our life as we try to go out on our own and become independent?

What about these twenty-somethings  here in Cambodia who have often drastic differences and gaps between themselves and the multiple generations with whom they live and are influenced, and with whom they can be so far apart in culture, tradition, and even appearance, education and experience?

The young girl who is mocked for wearing sexy clothes, the young boy whose hair is too long, the young adult male who is in love, but must marry the woman who his family has chosen, or the woman who has been divorced and now told that she is “used goods and no man will want [her] again.”

The new generation, the ones who will someday run the country’s businesses and government, are left with few coping mechanisms in this modern world, with little social support, and even sometimes misguided education to adjust and develop in this rapidly changing Kingdom!

When we examine the difference in generations here in Cambodia it is important to consider the history in part.  There is small part of a missing generation due to the history of war and violence in this country, thus leaving a gap between the older generation, one that places its experience and functioning on tradition and culture; and a younger generation in their teens and twenties who are being dominated now by a global superculture that brings a great many influences, education, exposure, change, and different belief systems that conflict with the older methods and beliefs.  New things bring excitement but also challenges and conflict when this new way of being conflicts so strongly with the traditional belief systems of the older generation.  This external and internal conflict are what can lead to feelings of abandonment, lack of social acceptance, decreased self esteem, and often an internalization of strong feelings of guilt for rejecting the traditional culture, and thus their caretakers or parents.

What a struggle it must be for these twenty somethings to be exposed to modern technology, modern thinking about dating, sex and sexuality, education, socialization, and even family systems, but to feel guilty to partake and integrate some of those ways of thinking into their own sense of self and into their social lives.  Change is a powerful thing, but we have to be prepared to make changes and be accepted when those changes are in the end implemented.  For in the end, they impact who we are as individuals

This generational conflict, one that can be so divided and with so little buffer becomes a conflict for each young adult trying to grow up. He or she has no one they can share with, no one they can talk to and no one to go to when they have problems, questions, or are simply confused.  The older generation is not there to guide and the younger does not go to each other for support.

Take the example of a young man from a good family here in Cambodia, moderately wealthy, from divorced parents, and attending good schools but has come to terms that his sexuality is not of the mainstream – that he is gay.  He has struggled to find identity within that realm, to reach out to friends that for many years simply mocked him.

“I go to parties and my father and his friends laugh at me.  My friends don’t understand and think I want to be a girl. Even my teacher at school tells me that being gay is wrong and that gay men have no penis and cannot have sex. I don’t know who I am or what I can do.  I don’t know about my future.”

But more importantly are the strong conflicts within himself and his family, the rejection by his family, the pull of all financial supports for his education and living.  Where does this leave him?  “I feel lonely and have no one to talk to.”  Not only in a place of depression and abandonment, but strong rejection and potentially at risk for a self destructive lifestyle.

This may not differ too much than even a western family and their reaction to the same news that their son is gay, but again, the supports in place are different.  A young adult has access to better education and to an environment in which he can find the social supports necessary to go through this struggle, in the best of cases.  He has been taught to seek out others in a time of need, to talk to others and to share his fears and anxiety.  Instead, the older generation here has taught them to suppress, to save face, and to not open up to friends as that is weakness and will bring shame to himself and his family. This leads to guilt and to an even greater self destruction.  This is worrisome.

Where is this person or any other facing any problems to go?  Another client stated, “I have no one to talk to. My friends can’t understand and don’t want to talk about real things.  I would be laughed at if I went to therapy.”

To open to others is weak and shameful.  So where do they go?  Only inside themselves where they may not be well equipped to handle the pressure of this changing world? Or outwardly destructive where alcohol, violence, self harm, and drugs can easily become a coping means?

Why are we not teaching our kids?  Why are we not letting them understand society, the changes and how these influence us?  Are we afraid it may harm them?  How is this going to impact the future of them and this country?  Denial and lack of sharing/communication are so strong in this country that families hide everything. That is not protecting them from harm, but causing it.

Financial problems, as we know, are one of the largest causes of conflict, divorce, and domestic violence in the west.  What about when families begin to suffer in the new economy.  Do they talk to each other and share their stories? The sharing and knowledge that other people are dealing with the same issues is one of the most powerful means of coping with a problem.  But this is a culture where we are taught never to share, never to speak of problems, and never to open up to new ways of thinking.  Simply, we cannot.

I think of a recent case of a young girl who attempted suicide. She had a bright future and was from a good family, despite some family issues and now recent financial set backs.  She was understanding the pressures and stress that her family was under and her own stress trying to develop and understand a changing Cambodia and social status.  She even made attempts to talk to her friends about her plan, but even then her friends did nothing besides ignore it.

One of her friends at school told said she could not understand why no one helped.  “she told her friends it would be her last day alive, and they just said good bye.” They even went with her when she purchased the overdose she was planning to take.

Did they ask her anything, comfort her, talk to her? She had to save face for herself and for her family as she knew deep inside, although never communicated, that her family was facing a loss of status and that it would be terrible and shameful to her community.  She is now sitting in a coma on life support.  And her family is likely wondering how all of this could have happened. When her family was asked, they just said “when she gets better, we will have a big party to celebrate.”

Suppression.  This is modeled behaviour which is how we tend to learn the best.  This is copied from the older to the younger and reinforced by both generations.  It becomes a social construction and a major handicap to good development.  Supress!  Is this what the new generation is learning even when the problems that face them continue to grow at exponential rates and are far different than the ones that faced the traditional culture?

A strong woman with confidence, education, and determination comes to treatment as she is suffering from a loss of individual identity and feeling as if she is only that of the family system, of a woman, of a Cambodian, but not of herself.  She talks about new experiences she wishes to engage in or explore, new thoughts and ideas, a new sense of power and being outspoken, “but the fear of shaming my mom and the guilt is too much.”

“My mother wants to be close to me but does not understand boundaries.  She wants to know everything about me, but when I try to tell her about things, she tells me that young women should not discuss such things in private or public.  She looks at me with disapproval. I feel guilt, resentment and a burden to her”   –  a 27 year old female patient.


The outcome and potential dangers of this old school education and belief system is potentially devastating for the twenty somethings here.  Trying to cope in a rapidly changing country while being told not to change, to embrace old traditions, myths, and belief systems, without adapting them to this new world leads only to conflict inside.  The mental health risks and therefore social impact are considerable.

And it is not just suicide.  Look around at our society.  Mental Health disorders are on the rise.  Some estimate it to be near 50 percent of the population.  Admittedly this includes PTSD from the war, but there are more pressing and contemporary psychological issues developing in Cambodia and being emphasized by the superculture and exacerbated by lack of resources, education, simple guidance, and coping means.

Look and see how they are coping.  Substance abuse is on the increase, outward violence and self-harming behaviours are becoming more and more common. Marriage issues are on the rise as conflict occurs at home and we have no means of settling disputes beside the old ways of denial, alcohol, adultery, or worse, domestic violence.  Depression and anxiety developed from lifestyle and social or family issues with nowhere to go.  Fears and phobias and adjustment disorders, abandonment, social and developmental issues and even personality disorders.  Who is to blame?

But not is all so grim. As humans we are so capable of adapting, able to come through problems and to grow despite even the worse circumstances.  Cambodia suffers mostly from being exposed to the modern world and rapid exposure makes adaptation very complicated.  This change can lead to similar problems we see in the west as they will manifest in different mental health and physical health conditions.  It is through awareness and education, continued modeling behaviors that lead to acceptance and change, self-awareness and understanding of our own behaviors, and simply taking a chance to share and open up that are critical. Overcoming the fears, guilt, or shame that are associated is hard.

As a client made it clear, “no one understands how [I] feel and no one wants to listen.”


This is not something that is just part of Cambodia and its culture, it is something that is all over the world. My clients here are the same as back home, in some ways, but handicapped in others by this gap.

If we blame someone else for our problems, we don’t have to take responsibility.  But in the end, no matter who we can or want to blame, we are, in fact, the only ones left to deal with them – by ourselves, with our friends, support of our family, or of course a professional.  Assuming these simple resources are available to us and do not lead to further isolation or continue to increase the confusion, lack of trust, deception, and lack of intimacy between these generations. Yes, your children will have something or someone to blame!

As I see more clients with more contemporary issues it relieves me to see them get the help they feel they need, to fight the traditions and belief systems and social norms that they have learned, and to try something new.

But where does it leave the young gay man with a now developing sense of self, but still no acceptance and tolerance by his family or friends – things we need so badly.  Or of the young girl who sits in a coma, who, if she recovers, will be shed with a grand party for living, but what got her to her current place will never be discussed? Or to the countless other people out there who are not even seeking help but hiding it away, just like they have been taught to?


Fantasies, Fetishes and All Things Fun

Fantasies, Fetishes and all things Fun

So you have met this amazing guy and have been hitting it off for months. It has been full of great conversation, exciting adventures and of course great sex in bed.  One night as you make your way to bed, he heads to the bathroom for his nightly routine and comes out dressed in leather, whip in hand and handcuffs for you in the other…hot? Maybe…Or do you run?

People have all sorts of fantasies from simple threesomes; domination and submission;  incorporating certain objects, people, places or animals; diapers; fisting; bondage and pain. The list goes on and I certainly am not going to share my own, but we all have them whether they are vanilla or extreme.  One question always comes up – are they healthy?

The DSM-IV, the “Bible” for us Shrinks, categorizes possible such things within Sexual Dysfunctions to include Paraphilias and other Sexual Disorders and Dysfunctions.  Paraphilias or the ones we are more aware of and often the ones involved in fantasy play including exhibitionism, voyeurism, fetishism, sadism and masochism, and even pedophilia. The second category examines premature ejaculation, erectile disorders, gender identity disorder and others.

But if a pair of leather boots or being urinated on is part of your sexual fantasy world does that mean you should be booking some time on my couch? Not necessarily…

Most fantasies are normal and even healthy as they are a great release of our sexual desires and when played out in a safe fashion can be exciting, adventurous and fun. I mean, who doesn’t like a little role play or being tied up every so often? Incorporating toys or playing doctor (my personal favorite)?

But these can become problematic for some if they start to interfere with your life in some negative ways.  The DSM points out that they are not disorders unless these fantasies, urges, or behaviors occur for a significant period of time and interfere with either satisfactory sexual relations or everyday functioning. There must also be a sense of distress. In other words, the fetish or other behavior must negatively impact you and create a sense of distress in that you feel you are unable to control them.

Fantasies can come about in so many different ways from unresolved issues as a child, from pairing an ordinary stimulus with a sexual experience, or the carrying of a transitional object from infancy into adult sexual development. They can also arise from unusual or traumatic sexual experiences in which they are more likely to create problems and distress in adulthood. In the case of sexual trauma, either a reaction that includes fear of intimacy and inability to participate sexually; or a reaction formation in which the victim plays out sexually in order to “normalize” what has happened to them. Both cases are unhealthy and should be referred to for treatment and support.

Fantasy can also just come about by simple curiosity and wanting to push our limits and try new things. Our minds can be creative and fun for sure and it likes to push itself, so enjoy the ride. Pornography, for example, can often introduce us to such things this way and allow us to experience something vicariously through others before participating ourselves or maybe never doing, but just thinking about it!

We are sexually stimulated very easily and by so many different means, and for some that may make us uncomfortable but many times that is part of our social upbringing that seeps into our psychological self. Think about a straight man watching gay porn. It will still turn him on, but does that mean you can change him? No. Give it up, it will only cause more stress for him and for you!

So if it makes us uncomfortable and causes great impairment, then it needs to be examined and you should seek some advice, support or professional care.  If it is simply something new and different, we like it and it makes us feel good (and is legal, safe and healthy) then carry on doing it! And do it with conviction and vigor!

Sex is fun! Be safe! Be smart! And remember that healthy sexual development is key to overall growth and sense of self, especially in our “gay” world where there are so many extra turns to negotiate and conflicting messages along the way. Be true to yourself and do only what makes you comfortable!

Join me on my couch next week…I will be waiting…

Part II

Alright, so the fetish or paraphilia is causing you problems in developing relationships, being intimate in more “normal” ways, or is causing you other social, professional, or legal issues (pedophilia, exhibitionism, bestiality) in your life. Well then this so called fetish has gone from being fun and playful to being a psychological dysfunction and causing undo distress in your life. Now you need some couch time with the good doctor…

These erotic tendencies can be reshaped through many means so that you can go back to enjoying some good old vanilla sex with your boyfriend or whomever, while also spicing things up but not having to rely on specific behaviors or objects that are causing the distress to yourself or to them or worse, to unwanted recipients. Treatment approaches work around medications, psychoanalysis, hypnosis and cognitive behavioral treatments.

Don’t worry, none of these are too painful and will lead to a better sex life for all, not to mention a whole lot less stress in your life. 

The most common intervention is something called aversive conditioning which is just using a negative association to eliminate the behavior. The fetish developed often by the pairing of an object/situation with pleasure, now that process can be reversed and is sometimes done automatically through legal actions or shame. Other means can be more drastic including watching yourself commit the negative actions, watching more aversive consequences or by pairing other negative stimuli (nasty odors) with the behavior. It is just re teaching your brain in a simple form. We really aren’t as complicated as we might like to think we are.

More positive ways include social skills training, teaching empathy to victims (exhibitionism), or using a plethysmograph (machine attached to your penis to measure erection) to control your levels of stimulation. And even more fun, reconditioning the brain through masturbation techniques by learning how to associate the pleasure of masturbation and climax with more acceptable stimuli through repeated exposure and therapy.

Yes, my job can certainly be more than interesting at times. You know this all sounds so clinical in nature, but really it is built upon reversing so many things that we have learned in how we think and our associated behaviors. Remember, we developed the paraphilia by being turned on by something and then associating that feeling with a certain object or situation and making it so that we feel we MUST be in that situation or with that object to get off. We can unlearn that and often a key is in meeting a good and understanding partner that can help you learn to change those behaviors so that you will get off with him instead! You simply outgrow it. And hey, there is nothing more fun than enjoying good healthy sex with another hot guy!

Don’t think that it all has to be boring. Toys, cuffs, leather, outdoor (but discrete) sex and so many other things are fun and fabulous…unless it victimizes someone else or hurts yourself. Sex should be mixed up and fun and interesting, but a paraphilia often becomes compulsive and unhealthy. And our goal of course  is to keep sex healthy!

Go have fun and try out some masturbatory exercises! Or get someone to help you!

See you next time on the couch…