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The Short Version: Some psychologists and clinicians may find it difficult to help clients overcome anxieties and issues related to gender identity and sexual interests like kink, BDSM, and polyamory. These people may feel judged or misunderstood by professionals who don’t have expertise and experience in these areas. However, Dr. Keely Kolmes, who is based in San Francisco and Oakland, does have this knowledge. Dr. Kolmes, who identifies as nonbinary, strives to teach people how to work through stress, depression, and other problems with expertise in working with gender expansive clients and people of many different sexual identities, so people work towards personal growth in their lives.
When Dr. Keely Kolmes was growing up in New York City, they said they would often see men walking around dressed in full leather outfits. Sometimes these men wore chaps and harnesses, but Dr. Kolmes never paid much attention to them. Dr. Kolmes had no awareness of the kink or BDSM communities back then, but that changed when they went to college and started volunteering at an independent bookstore.
“I discovered ‘The Lesbian S/M Safety Manual,’ and I was intrigued, so I read it. What I learned surprised me. I had no idea how much knowledge, skill, and care went into BDSM,” they said.
Dr. Kolmes’ interest and knowledge base grew with the rise of the internet in the early 1990s when they could read posts on polyamory groups on Usenet. That was when they began to understand more about how polyamory could create feelings of both freedom and safety in a relationship. It became clear to Dr. Kolmes that, even though their diversity classes and presentations shed light on gay and lesbian culture, many other communities related to sexual identity and preferences remained unmentioned in their graduate school studies.
“I was interested in consensual non-monogamy, BDSM, transgender, bisexual, and pansexual individuals,” Kolmes said. “But my school only addressed gay and lesbian identities in our multicultural awareness class. Now I feel like I am in a unique position to educate other mental health professionals about the range of consensual sexual behaviors and diverse identities.”
Today, Dr. Kolmes runs a thriving private psychology practice in California where they explore many of those subjects with their clients. In their San Francisco and Oakland offices, they meet with individuals who fall into many categories, including heterosexual, LGBTQQA, alt-sex, monogamous, polyamorous, BDSM, kinky, and they provide therapy to sex workers and their partners, in their practice as well.
Dr. Kolmes’s goal is to help people understand the issues they face, and to help them develop skills to address those issues. Dr. Kolmes is committed to helping people of all genders and orientations.
Dr. Kolmes works with individuals, couples, and those engaged in multiple-partner relationships. They use their graduate training, clinical sensitivity, and expertise to ensure people feel comfortable discussing their alternative desires and identities.
More than 50% of Kolmes’s clients identify as kinky, meaning they’re interested in power dynamics as part of their sexual (or non-sexual) relationships, or they are consensually nonmonogamous, which is having an ethical open relationship. Dr. Kolmes also works with many transgender and non-binary individuals. Many of the clients they see are immigrants or tech industry workers who consider themselves members of the queer community — gay, lesbian, bisexual, or pansexual.
Given the cost barriers to finding a therapist with whom a client feels a good fit, Dr. Kolmes offers a free 45-minute consultation to help people experience what it’s like to engage in therapy with them.
Dr. Kolmes said many commonly face concerns related to anxiety, sexuality, body image, career transitions, depression, gender identity, and relationships with partners or family members. Their clinical practice also helps parents respond to teens and young adults who approach them about their gender and sexual identities.
Another one of their specialties is helping couples with conscious uncoupling, or ending relationships in a way that keeps the friendship intact.
If clients decide to move forward, the results can be transformational.
“It has been heartwarming to get cards from clients who credit our work together for their happiness,” they said. “I’ve received cards with wedding photos from people who worked through a difficult period to move forward harmoniously, and I’ve also received some with pictures of children they’ve had since our work together. It makes me so happy to see people thriving after our work together.”
As a trained psychologist doing relationship therapy, Dr. Kolmes often works using a style known as the Gottman Method, an approach to couples therapy that involves assessments. They also use Emotionally Focused Therapy, which they have also studied. They consider their style to be integrative, direct, and evidence-based.
“I see the problems people in relationships bring to therapy as a combination of needing support in having difficult conversations, and, sometimes, useful teaching about conflict management skills goes a long way,” they said. “But, often, attachment issues are involved that need to be addressed, so people have to understand the needs, wants, and longing that lies beneath what their partner is saying (and what they are saying).”
Dr. Kolmes uses an array of evidence-based treatments with their sex therapy clients. Couples therapy begins with all partners coming in together for a 75-minute intake session. If they wish to continue meeting, individual sessions with each partner will follow. Each client completes a Gottman assessment and attachment questionnaires are completed, which helps Dr. Kolmes understand their attachment styles.
“After this, we create the treatment plan which typically includes a session once a week. However, some folks in crisis have opted for two meetings a week. Once the conflict management and communication skills are working well, we may move to every other week or once a month,” Dr. Kolmes said. “Sometimes, people finish therapy and return later when an issue arises for a tune-up.”
Dr. Kolmes’s clients aren’t the only ones who are learning from their expertise in the alternative sexual and gender identified communities. They also provide continuing education for fellow therapists.
“For seven years now, I have been offering a four-hour training course with two of my colleagues called ‘Fifty Shades of Grey in Therapy: Working with BDSM/Kink Sexualities and Communities,’” they said. “This course is also available on my website, and people can purchase it there for continuing education credits.”
Dr. Kolmes also teaches clinicians about the importance of digital and social media ethics — a timely topic for clinicians using the Internet who struggle with questions about the ethics of Googling patients, or whether or not to friend or follow them on social media sites.
In addition, Dr. Kolmes is co-writing a book for clinicians on how to work with kinky and BDSM individuals and communities.
“I also dream of teaching relationship skills to people around the world who are engaged in consensual non-monogamy or consensual kink since those relationships are often excluded from research and workshops, and people may not feel welcome attending workshops if their relationships will be considered unusual,” they said.
The results Dr. Kolmes has seen, so far, motivate them to continue their specialized work.
“I feel very fortunate to have a job that both challenges me, but is also emotionally moving on a daily basis,” they said. “It is very rewarding to see people heal and reconnect.”