Tuesday, March 25, 2008

Conversations with Dr. Macari, Part One

Here is the first in a series of conversations with Dr. Macari about relationships and mental illness. The blog will regularly post entries based on our conversations. I encourage interested parties to subscribe to the blog to be notified when updates are posted...

Can people with an MI pursue a healthy sexual relationship?

Individuals with mental illness have the same sexual desires and concerns as those without a diagnosis. However, clinicians often fail to address these issues with their patients thereby implicitly communicating that they are unnatural or something in which to be ashamed. But nothing is farther from the truth. In fact, patients who have an active fantasy life and/or sex life often have a better prognosis than those that do not. Sex is one of the most powerful ways to bring pleasure into your life. By ignoring or denying its existence, you are actually depriving yourself of the world’s best anti-depressant! But just like Prozac, sex comes with its own set of side effects.

Sex always complicates any relationship whether serious or casual. It is important that if you are intimate with a partner that you practice safe sex to prevent unwanted pregnancies and sexually transmitted diseases. But beyond that, it is essential that both of you are ready to handle the emotions that follow such an encounter. Sex can trigger feelings of inadequacy, guilt, abandonment, and sadness. This is particularly true if you have a history of abuse or rocky relationships. If you are unsure, you should share your feelings with your partner and your therapist. This will enable you to clarify your emotions. You might also consider taking it slow so that you can build up your confidence with every encounter. Kissing, caressing, and mutual masturbation might be good alternatives to try before actual intercourse. Make sure you feel comfortable before progressing to the next step.

Of course, I must remind you that you do not need a partner to have a healthy sex life. Masturbation is a safe way to experience sexual pleasure without the anxiety of having to relate to another person. Erotic literature, pornography, and sex toys can also be incorporated into these sessions. The key point is that just because you have a mental illness does not mean that you cannot enjoy sex!

So, can a person with a mental illness have a healthy sexual relationship? Absolutely! Just be sure that you are ready to handle the potential consequences of such an encounter. Have fun!


Is there a good timetable for someone with mental illness to reveal to a potential partner that they have a diagnosed MI?

Unfortunately, society still continues to stigmatize against those with a mental illness. Therefore, it is no wonder that those diagnosed are reluctant to reveal their status to a potential partner. To disclose your diagnosis means making yourself vulnerable to rejection. And let’s face it, nobody enjoys being rejected!

However, it is important to remember that everyone in the dating scene is afraid of rejection. Some people are worried that they are too short or too overweight. Others are nervous that they don’t make enough money. The reality remains that everyone (including the person you are dating) is insecure of something. It is very likely that while you are panicking over whether to share your secret, your partner is debating the same thing. And given the prevalence of mental illness, it is very possible that their secret is the same as yours!

As a guideline, I recommend that patients share their status on the fourth date. My reasoning is that most dates don’t get past the three date anyway because of an overall lack of compatibility. Why put yourself through that stress if the relationship doesn’t seem like it could work anyway? So if the person passes your requirements for the first three dates, then I would consider sharing on the fourth because he has already proven himself to be a worthy potential partner. Waiting much longer than that can become awkward and appear as if you don’t trust him. Furthermore if the person is unwilling to date a person with a mental illness, then it is best to know early in the relationship. Why waste time kissing a frog when your real Prince or Princess is waiting for you to find them!

Of course, by using No Longer Lonely you are avoiding this issue entirely! This is the beauty of this website. Total disclosure from the beginning is a huge relief to many members. Although, it is important to believe that a mental illness is not a mark of shame but rather a source of what makes you special. Anyone who can’t recognize that is not worth dating anyway.

Dr. Andrea Macari is a licensed Clinical Psychologist in private practice in Great Neck, NY and a Psychology Instructor at Suffolk County Community College. A nationally known expert, her advice has appeared in the New York Times, Psychology Today, The New York Post, In Touch Weekly, and Parents Magazine and on Fox News Channel, CNN, MSNBC, and Court TV. Please visit her website at
www.DrMacari.com for more information.