Gay Psychotherapist - San Francisco / East Bay

Psychotherapy with Gay and Bisexual Men
Dr. Karr identifies himself as a gay man and has for over twenty-eight years has had a clinical practice with primarily gay and bisexual men and their issues (approximately 75% of clients). Dr. Karr has extensive experience facilitating gay men's groups and gay couples therapy as well as short and long-term individual psychotherapy. He has extensive experience working with common gay/bisexual men's issues such as intimacy, commitment, sex addiction, alcoholism, drug addiction, depression, identity issues, low self-esteem, guilt and shame, religious issues, body identity issues, workaholism and over-achievement issues.

He utilizes his extensive personal history and experience as a gay man to help with coming-out issues, relationship issues, addiction issues, and others. He employs his extensive connections with gay organizations and resources in the Bay Area for client referrals. He also has extensive experience working with lesbian clients in mixed gay lesbian groups, lesbian couples therapy and individual psychotherapy.

"Don't ask Don't Tell" - 1920's gay boys

Rodney's Father's best buddy, with whom he spent many joyful hours alone in a duck-blind. Same gentlemen appears in the photo above at an earlier age.

Valentine's card from Rodney's boyfriend in the first grade, saved for him by his father, Rex

Cross Cultural

Dr. Karr has a good deal of experience working with clients from diverse ethnic and cultural backgrounds. These include South Asian (Indian), African-American, Chinese, Japanese, European, and Latino peoples. He studied Hinduism for five years with a Hindu teacher; and has worked extensively with South Asian clients. He has especially worked with South Asian women who are well educated and successful, such as PhDs, MDs, business executives, etc. These women present issues concerning dating, marriage and family. They experience a good deal of conflict of role and identity as powerful women vs. their culturally defined role where such power is not understood or recognized. They often feel pushed in the direction of dating American or European men who are more accepting of them.

Dr. Karr has a good deal of experience and comfort working with African-American clients. He grew up in an inner city neighborhood, which was 80%, African-American. Most of his friends while growing up were African-American. As a result, he has a good deal more first hand experience, familiarity and knowledge of African-American culture than most non-black therapists. This aids him with sensitivity and understanding in his psychology practice with African-American clients.

Dr. Karr has had 28 years of clinical experience in San Francisco with multi-cultural demography. He has worked with diverse Asian populations including Japanese, Chinese, Thai, and others. His experience includes work with Latinos from various cultures including Mexico, as well as South and Central American. He has also worked with a number of clients from Europe including Ireland, France, Germany, Spain and Eastern Europe.

Dr. Karr's personal family background provides him experience to understand and identify with clients coming from traditional extended family backgrounds, as opposed to the modern American nuclear family model. Dr. Karr was raised in a traditional Scots-Irish extended family. He grew up in a large house with a multi-generational family composed of his grandparents, parents, aunts, uncles, cousins and siblings. This traditional extended family more closely resembles many families who have immigrated to the US, such as South Asian, Chinese, East Europeans, and others. This extended family system is more typical of Latino and African-American families as well. Dr. Karr, having grown up in an extended family system, has a greater empathy and understanding of how important the extended family is to ethnically identified clients.

Dr. Karr has a clearly defined sense of his Scots-Irish ethnicity and culture. He has engaged in a good deal of study of Celtic culture and history as well as his own personal genealogy. He is aware of his ancestors going back eight generations in the US, who have maintained their own family culture. He has studied extensively, as a Jungian therapist, the concept of collective consciousness and ancestral consciousness. He believes strongly in the Jungian idea that it is important to study one's genealogy and that one's ancestors greatly affect one's personal identity and behaviors. He, therefore, honors each client's ethnicity, cultural background and genealogy and encourages clients to rediscover their ancestry if they are not already aware.

Dr. Karr has recently agreed to supervise and include in his clinical practice Natalia A. Bolsheva, MD and PhD Candidate in Clinical Psychology. He will be supervising her as his psychological assistant and be involved on her dissertation committee. Dr. Bolsheva is from the Ukraine and is fluent in Ukrainian, Russian and Polish and plans to work with East European immigrants in their own language.

Dr. Karr also supervises Renee Hudgins-Lopez, MA, as an intern for her Marriage and Family Therapists license. She is fluent in English and Spanish and can work with clients who prefer to work in Spanish. Dr. Karr supports people in being bi-cultural and maintaining their language and culture along side their American cultural identity.

Kerr*
Crest Badge: The Sun in his splendor
Motto: Sero sed serio (Late but in earnest)
Gaelic Name: Cearr; MacGhillechaer.

Origin of Name: Gaelic MacAoidh (son of fire).
Plant Badge: Great balrush.
War Cry: Bratach Bhan Chlann Aoidh (The White Banner of MacKay).
Pipe Music: MacKay's March.

Real Men wear Dresses

[Mackay warrior's picture]

Gender Identity, Transgender, and Intersex Conditions

Like sexual orientation, gender identity is not always concrete or fixed. For some, gender identity may shift and change in a person's life from childhood through adolescence and into adulthood. Some people experience fragmentation of self due to undergoing a lifelong socialization process hostile to their gender identity.

For many gay men and lesbians, going through their adolescent development takes a longer time in some regards. Much of this has to do with sexual identity issues. In general, all GLBTI people continue developing some aspects of their adolescent phase well into their forties. Many gay men do not develop a strong masculine identity until their forties.

A positive aspect of this longer development includes, for many GLBTI people, a broader more whole male-female identity and awareness. In Native American cultures, frequently, GLBTI persons are referred to with what is considered a positive label: twin spirits, meaning that they are fully connected to their male and female spirits.

For transgender and inter-sexed people it is helpful for them to look at gender identity on several planes. The first is the emotional/spiritual level concerning the traits and qualities of one's emotional and spiritual being. The second aspect, which differentiates transsexual and inter-sexed persons from gay, lesbian and bisexual individuals, is the physical dimension. Most transsexual and inter-sexed persons are not made whole by the outward expression of their inner being's gender identity, including clothing, speech, body language and all gender traits expressible through one's behavior. Transsexual people have a deep need for their actual physical body and presence to conform wholly with their primary psycho-spiritual identity. This is also true for a great number of intersex individuals.

Dr. Karr has supported and facilitated transsexual-identified clients process through their transition, real life test, and sex reassignment surgery. With other people who experience gender confusion, Dr. Karr has facilitated them accepting their transgender identity without gender transition or surgeries.

Dr. Karr has worked extensively with transgender clients including male to female transsexuals, female to male transsexuals, heterosexual transvestites, homosexual transvestites and drag queens as well as inter-sexed individuals. He began his clinical experience with transgender clients doing assessment interviews at the gender identity clinic at the University of Washington in the early 1970's. Dr. Karr's Jungian philosophy which includes the concept that a whole person has both male and female traits and identities creates a helpful view of a transgender person. It is the Jungian philosophy that men have a feminine aspect which needs to be developed and made conscious called "the anima", and that women have a masculine aspect or identity which needs to be developed called "the animus." In regards to gay, lesbian, and transgender clients, often these aspects are reversed. Gay men for example may have a close identification with their feminine identity and have a poor relationship with their animus or masculine identity and need therapy to develop a better relationship with their animus. Lesbians have a closer relationship with their animus and need to develop more their anima. Sometimes for a post-operative transsexual person, they must come to terms in therapy with a new and radically different reorientation of their relationship with their anima and animus.

Dr. Karr has a deep honoring and respect for people's diverse gender identity. He supports clients exploring both their gender and sexual orientation/identities. He supports people coming to their own choice of gender identity or sexual orientation/identity.

Dr. Karr, as an openly gay person and psychologist, has for many years had many friends, clients, and colleagues of diverse gender/sexual identities and orientations. Dr. Karr supervises a male-to-female transsexual Marriage and Family Therapist intern who is available for counseling clients who would like to work with a transsexual therapist.

Honoring our gay ancestors and their humor
San Francisco - Gay and Lesbian marriage - 1920's style

Multiple Personalities
Dr. Karr has over twenty-five years of experience with clients who identify themselves as multiple personalities. A majority of these multiple personality clients that Dr. Karr has seen also identify as transgender persons. Most multiple personality persons have personalities, which are diverse in terms of age, gender, and sexual orientation. Many multiple personality persons with gender identity issues experience a good deal of pain concerning a conflict of genders among their personalities. A sex change operation would not resolve these conflicts because it might facilitate the happiness of one personality at the same time as creating pain and sadness for the other(s).

Therefore, sexual reassignment surgery is not a positive option for transgender multiple personalities. Dr. Karr takes a positive, accepting attitude towards multiple personalities. His therapeutic goal with multiple personality persons is to facilitate acceptance, communication, and dialogue between or among the different personalities, rather than attempt to destroy personalities and create one personality. He supports the process of creating a mediating personality who listens to the various personalities and is able to decide who is in the driver's seat, who is in the body at a particular time. Dr. Karr's experience of multiple personality persons is that they are often very intelligent, creative, and with a breadth of selves. Our English language is not designed to fully express, understand or accept people who are multiple personalities, or have a transgender or inter-sexed identity. It is important with transgender and multiple personality persons to develop their language and understanding of their unique and beautiful natures. Most multiple personality persons report histories of intense emotional, physical and sexual abuse. Classically in the research on multiple personalities, the splitting of personality characteristics has been the result of intense ongoing emotional, physical and sexual abuse. Therefore therapy with multiple personally persons as with other abuse survivors, requires long-term therapy to develop trust. Also helpful are hypnosis, age regression to recover lost memory, and the teaching of psychological tools to deal with stress and fear.

Mid-life Issues
Dr. Karr himself is fifty-six years old and has experienced his own mid-life issues concerning failure, loss, disillusionment, aging, etc. His twenty plus years of experience of the AIDS epidemic in San Francisco has provided him with the opportunity of dealing with various mid-life crises. When one has been diagnosed as HIV positive, or having AIDS, it catalyses a mid-life crisis for clients. Dr. Karr works with a number of clients forty plus, who enter therapy concerning mid life issues. These mid-life crisis issues may include dissatisfaction with professional or career life, dissatisfaction with a long term relationship or the lack thereof, spiritual crisis concerning the meaning or purpose of life, identity crisis concerning realizing that one has been leading one's life to please others, family, friends, or society, rather than one's self. Identity crises concern not knowing oneself or not liking one's self. Dr. Karr encourages people to embrace the idea of change, of changing self, and of experimenting with new identities and experiences. Dr. Karr's spiritual philosophy includes the idea that change is a necessary aspect of being alive. He believes, like other Jungian psychologists, that we can go through different reincarnations of ourselves in a given physical lifetime. Research in longevity and happiness has indicated that people who live to be over one hundred years have certain characteristics. These characteristics are associated with successfully going through mid-life crises. Such characteristics include embracing and enjoying change, having a positive attitude about pain in difficult situations, continuing to try new things and be active in the world, doing things that one enjoys for oneself, finding a higher purpose for one's life and contributing to the world, i.e. volunteering, community work, artistic work, having close and intimate relationships with other people, nature and animals. Dr. Karr encourages clients going through their mid-life crises to explore and embrace the maturing process of becoming an elder. This is particularly important and difficult for gay men, given that our sub-culture is youth, physical and perfection oriented. It has been a great challenge and difficulty for gay men in our fifties and sixties who are survivors of the AIDS pandemic and have lost many of our gay compatriots who we would have grown old with. It is difficult for many elder gay men to find a place of respect and acceptance within the very youth-oriented, beauty-oriented gay sub-culture. Dr. Karr's role is to facilitate middle-aged and elder gay men discovering their own worth, value, beauty and sexuality.

Anxiety/Stress Issues
Dr. Karr works with a number of clients who have anxiety and stress issues. He works with them using a number of cognitive behavioral methods aimed at reducing anxiety and stress. These include meditation, hypnosis and systematic relaxation. He also works with such clients in a holistic way to identify their lifestyle and thinking patterns, which may be contributing to their stress and anxiety. In addition to using teaching methods to reduce anxiety, other suggested methods include going to the gym, taking walks in nature, taking warm baths, etc. Dr. Karr encourages clients to begin to make choices in their lives which eliminate stressful relationships, jobs or ways of thought.

Vietnam Veterans and Others
Dr. Karr began his extensive experience with Death, Dying, Loss and Bereavement during his year-long internship in 1974-1975 at the VA hospital in Seattle, Washington. At that time he was working primarily with Vietnam Veterans who were heavily damaged physically and emotionally. Many of these men were dealing with issues related to lost limbs, lost self-worth, living with various disabilities including drug addictions and physical and emotional disabilities, as well as clients with Post Traumatic Stress Disorder (PTSD) and other related issues. Since that time, Dr. Karr has continued to work with veterans of other wars and also veterans who have had difficulty with being gay in the military.

Physical. Emotional, and Sexual Abuse Survivors
Since 1970, Dr. Karr has worked extensively with Gay, Lesbian, Bisexual and Transgender (GLBT) people who have experienced physical and emotional abuse as children and adults. He also has extensive experience with clients who have experienced sexual abuse and molestation as adults or as children within or outside their family of origin. People who have experienced physical, sexual, and emotional abuse often experience Post Traumatic Stress Disorder symptoms as do war veterans.

Dr. Karr takes a long, slow, and supportive approach with clients suffering from PTSD and abuse issues. Trust and the lack of trust are major issues for such clients, and it takes a long time for abused people to trust a therapist enough to share and remember their experiences. Dr. Karr works with a holistic approach with such clients that includes teaching relaxation methods, positive visualization, and positive shielding/imaging, He also works with hypnosis, age regression, and guided journeys in order to assist clients to remember, re-experience and catalyze the trauma. When appropriate, gestalt and psychodrama methods may be utilized in order to help the clients' body remember, re-experience and catalyze the trauma. This method is particularly useful when used in Dr. Karr's therapy groups.

Artistic and Exquisitely Sensitive People
Dr. Karr as a gay man, an artist, and sensitive person, has developed a good deal of expertise in therapy with other highly artistic and sensitive people. It is a common experience of artistic and sensitive people to be put down and told that they are over-sensitive. Dr. Karr over the years has developed methods of teaching artistic and exquisitely sensitively people how to deal better with their emotions and sensitivities. Dealing better with being an artistic or sensitive person includes developing a shield of protection and being self-confident and being proud rather than ashamed of one's emotions and sensitivities. Dr. Karr, as an artistic and sensitive person, has learned how to maintain proper boundaries with others and how to shield and protect his deepest inner feelings from insensitive people.

Dr. Karr worked with a number of visual artists, musicians, actors, writers, film artists and dancers. He is experienced in helping clients work through creative blockages and balancing their lives in terms of issues of money and personal relationships.

Mystic and Psychic Experiences

The Holy Grail

As a Jungian transpersonal therapist, Dr. Karr has worked extensively with people who identify themselves as being mystic and/or psychic. He is able in therapy to help mystic people cope with their subtle reality experiences and yet deal with the real material world. He helps people to differentiate between mystical visionary experience and a psychotic experience. He teaches mystics and very sensitive people methods of meditation and guided visualization in order to protect themselves and be more grounded in this material world. The difference between a visionary and a psychotic experience may be a thin line, but an important one

Mystics perceive that they have had a subtle or other world experience and know the difference between it and a "this-world" experience. A psychotic is unable to identify the difference between a psychotic experience and a "this-world" experience. Our modern American culture does not have an extensive language to identify different subtle or inner world experiences. It is the purpose of transpersonal therapy to help mystic clients to develop constructs and language to understand and better describe their subtle and other world experiences. Dr. Karr is experienced and adept at helping mystic clients explore their subtle experiences.