Getting to Know: Robert Ischinger, Michael’s House Primary Therapist

Interviewer: Robert, you have gone through a lot in your life between struggling with substance abuse and coming out to now being a therapist. Can you tell us a little about your journey?

Robert Ischinger: So, well, I grew up obviously at a time when being gay was still considered to be a mental illness. It didn’t get taken out of the DSM until 1973. And so, there was a lot of shame and a lot of just hiding with that, and I ended up getting married. I had a daughter. I was married for 13 years. And I finally just figured out, [that] I can’t live like this. I have to live my truth. I have to be who I am. So I came out, my marriage ended, and I started living my life as a gay man.

I realized I still wasn’t really happy. I would go from job to job. I had never really had a job that lasted more than five years. I think this is the fourth career that I’ve had in my lifetime.

I also started playing around with substances after my divorce, and I ended up finding a person who became my partner. I was with him for 11 years until he passed away from AIDS in 1996. At that point is when I really went strong in drugs. My drug of choice was methamphetamine. I used it daily for about eight years. I started injecting it for the last five years and I lost everything.

I had no insurance. I hadn’t worked for two years and all that I could do was to go to a 12-Step meeting. At one point I finally decided either I’m going to die with a needle in my arm or I have to get sober, one or the other.

So I decided to get sober, and when into a 12-Step meeting. It was a Friday night. I was scared. I didn’t know what was going to happen. I didn’t know how I could live my life without the substance and all that. I went home, I used up the rest of my drugs and the next day – which was February 22, 2004, I started my journey in recovery.

Shortly after I got sober. I started thinking, what am I going to do with the rest of my life, you know? I talked to my sponsor and I said, “I think I want to become a drug and alcohol counselor.” He just laughed at me and he said, “Everybody in early recovery wants to be a drug and alcohol counselor. Give it a break. We’ll talk about it in a couple of years.”

So I waited and I ended up getting a job. A friend of mine was program director at a program called McIntyre House in Hollywood. It was a 16-bed nonprofit facility for men, and he offered me a job of working part-time there as a weekend manager. So I had to be on the property from Friday night until Sunday night.

At that point I decided, maybe this would be a good time for me to go back to school. I graduated with a bachelor’s degree back in like 1970. So it had been a number of years, obviously, since I had been in school. I was just going to go to LA community college and get a [counseling] certificate and my sponsor, this guy I was working for, and a couple of other people said, “Well, you already have a bachelor’s degree. It doesn’t make sense for you to go to a community college for two years to get a counseling certificate when you could go to graduate school and get a master’s degree in psychology and be a therapist.”

Well, my first reaction to that was “No. I can’t do that. I’ve been out of school for so long.” My grades were okay, but they weren’t great. I certainly couldn’t take or didn’t feel as though I could take the GRE and I didn’t have any money. My sponsor said, “All of those things are excuses and you need to try.”

So I did. I applied. I was very fearful. I thought for sure they were going to laugh at me. I went to Antioch University, which didn’t require the GRE, so I was happy about that. I got accepted and I started school. I loved it. I had a really great time and one of the things at Antioch – they had just started the year that I started there – what they had was an LGBT specialization program. So I took an extra quarter of classes and was able to have this extra coursework in LGBT-affirmative psychotherapy.

On Starting at Michael’s House and its LGBTQ+ Roots

Robert: It took me a while to find a job, but I did at Michael’s house. I’ve been here now for 10 years. I love it, and it’s just very rewarding. [As for] the LGBTQ+ program we started here, we had a CEO come in I think it was in 2010,* Allen Downs, who wrote The Velvet Rage, which is a really great book about growing up gay in a heterosexual world, the trauma that causes and some of the things that came in to compensate for that trauma and the feelings and so forth. So because of his affiliation with Michael’s house, I believe we always had sort of a trickling of gay men coming in.

After Allen left and Krista [Gilbert] was here, she said, “You know, this is a population that is underserved in substance abuse treatment. It is a population that, that seeks out a lot of substance abuse treatments. So we should develop something extra for these people coming in.” So we had, I’m going to say one to three gay men and two lesbian women who were working at the time. So we all got together and we worked out a program.

On How the LGBTQ+ Groups Operate

Robert: It’s basically two groups a week, and for the past five years, we’ve been taking all of the LGBTQ+ people out to the Palm Springs gay and lesbian center for a 12-Step meeting. It’s basically a process group, and that group, we try to keep it, as I’m going to say, gender-specific. We have a process group for the women and a process group for the men.

We also have an information or lecture study where I talk about things like LGBTQ+ history. We have talked about the trauma of coming out and what was that like, and what’s it like being in a mixed treatment community and being out; what are the problems or the feelings about that?

We also talk about what is it going to be like living in a sober community as part of a community that is very much – I hate to use the word “entrenched,” but, you know, a lot of substance use and substance abuse in the LGBTQ+ community – and what’s that going to be like living in that as a sober? And then also talk about dealing with shame and how do you navigate those waters, and how does it present?

So that’s the LGBTQ+ program and it’s been going really, really successfully now since, I’m going to say, probably mid-2010.

Interviewer: What do you do as a primary therapist at Michael’s House and once someone is admitted to Michael’s House, and how does your role fit into the patient-journey?

Robert: As a primary therapist, I view my job as just [one of] many aspects of what goes on here in the treatment community. It’s the kind of thing that every day is different. Every caseload is different. Our caseloads are constantly changing because we have people coming in and discharging and so on.

It’s sort of a constantly changing group, and some of the people that come in need extra attention, extra help, and others are pretty stable and kind of get along.

What is that going to look like? What are you going to have to do to maintain recovery? But also I think it’s really important for the patients to begin to look at their life, look at the underlying causes that lead to substance abuse. I have a very, very firm belief that substance abuse is just a symptom of other things going on.

I will say that directly to my patients, and so we need to figure out what are those other things going on? Why did you [need] to escape your life with substance abuse? And, you know, most of the guys that I’ve worked with have been very open to that kind of an exploration, but there’s some who [say], “I don’t have anything, I’ve got no problems, I’m fine.”

Those guys are resistant and yet if they were able to stop for a second and take a look, they might discover something. But for the most part, I think the men that I’ve worked with are really sort of anxious to try to figure it out because they’re here.

Interviewer: Right. I’m sure people just resonate with you really well in that journey.

Robert: Well, I’d say one of the things that I find is [that] the guys that I work with believe me and they trust me because I’ve been there.

I can tell them what my journey was like and why I had to do certain things and what my life is like without the drugs. I don’t have any problem telling them about my life today. I’m 15 and a half years sober. If somebody had told me say, 16 years ago, what my life would be like today, I would have laughed at him and said, “You’re absolutely crazy. It’s just never gonna happen.” And I try to convey that. I tell every single one of them, “If you get sobriety, you get true recovery. You have no idea how wonderful your life can become.”

Interviewer: What are some of the clinical therapeutic approaches you see patients respond well to? What have you seen the LGBTQ community respond well to?

Robert: We’re trained here in Motivational Interviewing, so that really works well. You sort of automatically use that constantly. Nothing happens unless you create a solid, therapeutic relationship. That starts with honesty and also respect for the patient. Those are the kinds of things that I try to do all the time and let them know that I understand what they’re telling me and have been there and gone through it. And so it’s that idea that using those kinds of approaches, of always meeting the person where they’re at.

I had a guy a while back who came in and in my opinion, he was a meth addict who was injecting meth daily. In his opinion, he only used it so that he could go to work. So I listened to him said, “I understand why you feel that way, but it’s not normal for somebody to inject meth on a daily basis just so that you can go to work and [that] you go at it that way.” To understand that I know that that’s how he was feeling and that’s what he thought, it was my position to say, “I understand that, but you have to look at it this way too,” instead of just shutting the door saying, “Hey, you’re an addict, you gotta change.” I just sort of have that empathy going back and forth.

Interviewer: What have you seen the LGBTQ community respond differently to?

Robert: One of the things that we see constantly here – and I’m going to say this probably happened more – Well, no, it’s even happening now. When we have a lot of gay men who have sort of been afraid of straight men. Afraid to be around straight men because of bullying and being beaten up and all sorts of other things growing up in their world, you know, going through high school and so forth. So coming into a very mixed community of both gay and straight, it can be very intimidating for them at first.

I had a guy here recently who had been severely beaten has had terrible PTSD over it. Beaten up, bullied in high school, it was to the point where he was constantly vigilant. If a guy was walking down the street towards him, he would cross the street to walk on the other side of the street. And he was here with obviously several straight men, some of them who were very athletic looking – big, tall, masculine.

And he said, probably two-thirds of the way through his treatment session, that he was able to understand that he did not have to be afraid of every man that walked near him. And these guys gave him a lot of support and love and understanding and he knew that he didn’t have to fear them. I thought that was a huge turnaround for him.

Interviewer: What is the most rewarding part of doing what you do?

Robert: Being able to see change happen. Being able to see somebody come in who is detoxing badly and is having trouble communicating their thoughts and ideas and seeing them go through the process. One of the phrases that we use as a common phrase is that we get to see the lights come on. When you get to see somebody who goes through that change and to be able to get to the point of being able to sort of thrive in what they’re doing is amazing.

I also occasionally, it doesn’t happen very often, but an example is that I have a guy who came through here, I’m going to say maybe nine years ago now. He calls me every day on his sober birthday to just let me know that he’s doing well and to thank me for helping him. That sort of thing is so humbling and it creates gratitude in me and I am grateful that I get to do what I do.

There are times where I could be sitting in doing a process group or community groups and things are going just really well and the patients are engaged in what’s going on. And I have this thought that runs through my head that says, “I can’t believe I’m getting paid to do this.” Because it’s an amazing thing to see people change. And I want to stay humble to the idea that it’s not just me, but to know that I’ve had an effect on people. It’s just –I can’t even describe it. That’s, I think, the best part of my job.

Interviewer: Is there anything else you’d like to add?

Robert: You know, I’m grateful. I’ve told this to Alan Downs who hired me years and years ago – I see him occasionally and I always like to tell him how grateful I am that he hired me to do what I get to do. Something that people say to me is, “Don’t you wish you had done this earlier in your life?” And my answer always is, I can wish anything I want, but I did it when I did it. I wouldn’t be sitting where I am if I hadn’t been a drug addict. I wouldn’t be sitting here today if I hadn’t gone through my coming out process.

*Allen Downs wrote The Velvet Rage in 2005