LONDONDERRY — A New York City therapist wants to provide affordable and accessible mental health care in southern Vermont.
To further that goal, Michael DeMarco, Ph.D., founder and executive director of Our Collective Mental Health Inc. in New York, is opening branch offices this month in Londonderry and Bellows Falls.
The Bellows Falls practice will operate in the same block as the Chamber of Commerce, at 49 The Square.
Because his practice is organized as a nonprofit with access to social services grants, DeMarco says his sliding scale prices will range according to his client's ability to pay.
Why a nonprofit practice? Writing on his blog, NYC Therapist tells all...okay some (drdemarco.tumblr.com), DeMarco said he was getting frustrated with the health insurance industry's approach to mental illness.
“Everything is pathologized. Everything is illness. Everything is addiction. Everything has a pill touted as the cure,” he wrote. “I'm supposed to fix the marital patterns of a 10 year marriage in six to eight 45-minute sessions of counseling, once a week. ... Why would I, as a therapist, want to be paid weeks to months after the sessions actually take place, be rushed through my work by insurance companies who tell me how many sessions I am allowed to have for whatever given diagnosis, and offer less-than-stellar results with a couple in crisis? It just doesn't make sense!”
DeMarco concluded that he would “rather just offer my services at an affordable rate based on the financial situations of the client and make therapy a right, not a privilege, and part of normal life, not something used by 'crazy people.'”
A cozy retreat
The Londonderry office is really a house where DeMarco will be offering couples retreats - both one-on-one and group therapy - in a safe and homey atmosphere. DeMarco said it was “the first house I looked at. I told the agent we didn't need to look any further. This was home. I didn't even take a look inside.”
The “Little Wolf Cottage” is located on a knoll in a rural area a few minutes outside Londonderry. The drive to the rambling two-story house is serene, and you're first sight on arrival is naturally stained wood and pink and purple window sashes nestled in a copse of evergreens. Just seeing the house from the outside makes one smile and think, “What fun!”
“Clients will love it,” DeMarco said.
A kit house built in the 1960s, it features stained glass windows from a local church, iron railings and a red cone fireplace in the comfortable living area opposite a large open kitchen.
“It's an old hippie house,” DeMarco said with a laugh.
Several floors and rooms offer privacy, so several different sessions can go on at the same time.
DeMarco said his style of therapy was a natural evolution from grandmothers who would invite him in, sit him down at the kitchen table, feed him, and then proceed to listen to whatever he wanted to talk about. He said the listening part, and having food there to help him be at ease, are at the heart of how he has learned to help people.
“Whether its art, having a dog to pet, a cat in your lap, or food on the table to eat if you wish, I just found it easier for people to feel relaxed enough to open up and talk about what's really on their minds,” DeMarco said. “When people have something to do with their hands, they are free to let the mind open up.”
A different approach
DeMarco got his master's degree in psychology, with a concentration on marriage and family therapy. He went on to focus his Ph.D. on clinical sexology, specifically “gender role and sexual compulsivity.” He was also an adjunct assistant professor at Long Island University's mental health counseling program, and was the mental health coordinator for the Staten Island (N.Y.) Lesbian and Gay Community Center.
He has been a psychotherapist since 2002, but he has also done much work with the public and the media. DeMarco has done segments for MTV, VH1, HBO and SpikeTV, has been quoted in Esquire and Details magazines, wrote a regular column called “Head Case” for the newspaper Camp, and speaks frequently on issues related to mental health and human sexuality at schools, churches, and community groups.
Through his clinical work with the lesbian, bisexual, gay and transgender (LGBT) population, DeMarco is passionate about increasing access to mental health and wellness services for anyone, regardless of identity.
Over time, DeMarco has said he has found every other couple he sees has sex problems, whether it's compulsive sexual behavior or something else.
“Everyone has sex problems at some point or another,” he said, adding that he gradually began to focus more on treating those clients.
While he does help individuals and couples with sex issues, he said that “we can talk about anything. I'll listen and see how I can help. There are often other issues at the heart of the problem.”
DeMarco's history of offering mental health therapy to individuals and couples from the LGBT community is a first in the area. The Brattleboro Retreat offers a LGBT in-patient treatment program for members of the LGBT community with acute or chronic mental health issues.
But, as DeMarco emphasizes, “I like to say we're straight-friendly too.”
DeMarco also works with “gender identity non-conformists,” what the DSM-IV calls “gender identity disorder” - men and women who have made the choice to transition from male to female, or female to male, “to make their outside match the inside,” as DeMarco puts it.
“I'm here to help them transition,” he said.
DeMarco explains that a standard of care has been established by the World Professional Association of Transgender Health [WPATH] that “is not a bible, but is generally followed by the medical and mental health community.” DeMarco has helped transgendered clients through the lengthy process to the ultimate goal, “of having them feel comfortable with who they are, inside and out.”
A person who decides to go through a sex change operation must begin by taking hormone therapy, but not until after having seen a therapist and getting two recommendations based on “gender identity disorder” diagnosis, to do so.
DeMarco explains, “… to be sure there isn't some other disorder, like schizophrenia, at work, and there rarely is.”
DeMarco says when a male starts taking female hormones prior to sexual reassignment surgery, “They essentially go through puberty again. They get the mood swings, bad skin, and hot flashes. We help them through that.”
He explained that once the client gets to the point of presenting themselves to the community, he is there to help them find a way to do so that conforms to how they see themselves. He also helps with the legal process of name changes by providing referrals to whatever agencies handle that, among other things.
“It's about an 18 month relationship with mental health therapy,” DeMarco explained. “It doesn't happen overnight.”
He also said that in the LGBT community and among therapists who see them, “It's kind of controversial to be required to see a therapist just to be who you are, to “cure” how you are most comfortable with yourself.”
At an open house last month in the “Little Wolf Cottage” in Londonderry, DeMarco found a welcoming community and “the networking was amazing. Even neighbors down the road said to just bring a pail and they would send me home with fresh milk.”
DeMarco's OCMH practice will be staffed by volunteers, as well interns who need practicums to complete their psychology degree requirements. This is one of the ways he says he is able to operate as a nonprofit.
He said he all ready has a waiting list of clients. DeMarco said he will be directing the practices, but not necessarily doing the counseling himself.
Our Collective Mental Health is also in the middle of a fundraising drive, with a goal of raising $10,000 by March 1
For more information about DeMarco and his practice, visit www.ourcollectivementalhealth.org, or contact DeMarco at [email protected] or 212-343-7008.