This article was written by Paul Flynn and Matthew Todd, for The Observer on Sunday 20th February 2011 00.05 UTC

The window of Alan Downs’s therapy practice overlooks Santa Monica Boulevard and the heart of Los Angeles’s glossy gay ghetto, West Hollywood. The psychologist can stare out at the gay gym he uses and the “very gay” restaurant he dined at the evening before we talk. In the distance is the Hollywood sign. Downs is at the heart of LA’s gay community, yet the book that has made his name completely reassesses the modern gay experience, holding up an unsparing mirror to it.

Downs’s spry self-help manual is called The Velvet Rage: Overcoming the Pain of Growing Up Gay in a Straight Man’s World. It is becoming a touchstone in gay culture just as Christopher Isherwood’s Goodbye to Berlin was in the 30s, Edmund White’s A Boy’s Own Story in the 60s and Larry Kramer‘s Faggots in the 70s. But The Velvet Rage is not fiction: it addresses the myth of gay pride and, after three decades of post-Aids concentration on gay men’s physical health, turns inward to their mental wellbeing.

Its snappy title is slipping, sometimes ironically, into the gay lexicon. Man orders fifth pint at the bar: “It’s OK, it’s just my velvet rage.” Boyfriend finds partner trawling through the thousands of profiles on sex-on-demand website Gaydar: “But it’s my velvet rage.”

Downs coined the phrase to refer to a very specific anger he encountered in his gay patients – whether it was manifested in drug abuse, promiscuity or alcoholism – and whose roots, the book argues, are found in childhood shame and parental rejection. “Velvet rage is the deep and abiding anger that results from growing up in an environment when I learn that who I am as a gay person is unacceptable, perhaps even unlovable,” he explains. “This anger pushes me at times to overcompensate and try to earn love and acceptance by being more, better, beautiful, more sexy – in short, to become something I believe will make me more acceptable and loved.”

It is a controversial theory, but for a book whose only marketing campaign has been word of mouth, it is having a profound impact. The Velvet Rage was first published in 2005, but it has been a slow-burn success – in each of his royalty statements Downs has noticed that sales have markedly increased. On the last, the figures doubled. And his appearance on The Oprah Winfrey Show hasn’t hurt his cause. Downs’s invitation, as he understands it, came after the boyfriend of one of the show’s producers left her for a man. She picked up a copy of the book in the aftermath and begged Oprah to put the author on the couch. Winfrey took the book home and became one of The Velvet Rage‘s first and most powerful advocates.

Downs’s argument is that feelings of worthlessness can be created in childhood quite unintentionally, and these lead gay adults to search for an unachievable perfection. “We have created a gay culture that is, in most senses, unlivable. The expectation is that you have the beautiful body, that you have lots of money, that you have a beautiful boyfriend with whom you have wonderful, toe-curling sex every night… none of us have that. To try to achieve that really makes us miserable. The next phase of gay history, I believe, is for us to come to terms with creating a culture that is livable and comfortable.”

Downs’s belief is shared by other mental-health professionals. Therapist David Smallwood, who is the former head of addiction treatment at the Priory, and a blunt-speaking recovering alcoholic, goes one step further. “Gay pride is an adaption,” he says, “a way of dealing with something we can’t deal with. We put on this TV picture and what we show is: ‘I’m proud to be gay.’ Underneath that, we might be dying inside.”

Downs identifies a litany of compulsions as adult manifestations of “velvet rage”. “If you give people in pain an anaesthetic they make use of it,” says Tim Franks, from the British gay charity Pace. “They may then become habitual users of that anaesthetic.”

Less problematic gay issues, but ones that struck a deep chord with me, include the unusually sophisticated knowledge of superficial cultures – pop music, fashion or film, for example – among many gay men. These can be seen as inauthentic compensations for the rejection we felt as children. Downs notes the high numbers of gay men working as stylists, hairdressers and fashion designers. “Because of our childhoods we’re good at these jobs. It is a specific gay talent because of invalidation. We are talented at stepping into something that’s a mess and cleaning it up and putting a fabulous facade on it.”

The Velvet Rage also deals with depression, self-harm and suicide, body dysmorphia and eating disorders – four times as likely in gay men as their straight counterparts. Conspicuous consumption and a culture of exhaustive gay acquisition – that absolute need to have the newest and shiniest and best of everything – is deconstructed. If Downs seems to penetrate to the centre of the modern gay condition with almost preternatural ease, it is because he’s writing from confessional as well as professional perspective. His research was drawn from treating patients in Santa Fe, New Mexico, and from his own upbringing in a small-town, conservative Pentecostal church family in Louisiana.

“Clearly, because I was Pentecostal, I was going straight to hell for being gay,” says Downs. “Hence my own experience with shame. I often say the God of my childhood had anger-management problems.” Churches are particularly culpable, believes Tim Franks, for velvet rage. “Some gay men grow up in cultures where they will be told in no uncertain terms that God hates them. That’s a very significant message to grow up with.” Educational establishments don’t acquit themselves too well, either, he adds. “Homophobic bullying in schools in this country is still epidemic. It’s absolutely rife. Most British schools are not safe places to be gay.”

By putting the more celebrated, creative aspects of gay culture in the spotlight, and suggesting that beneath them lurk serious psychological issues, the book has caused a stir, and Downs himself has drawn criticism. “It’s a minority of readers, but it’s a sizable minority,” he says. “Probably somewhere around 15% of readers will get quite angry. The question I get a lot is, ‘If I want to have as much sex as I want then what is the problem with that? Why pathologise that?’ I am not, in fact, pathologising that, but people have interpreted it as such. My response to that is if that’s working for you, if that’s bringing you lasting fulfilment and creating a life that you feel really is the life that you want to live, then go for it.”

Is this all about rebranding self-loathing for a new era? “Only if you buy the argument that the cause of our problems is being gay,” says Downs, “and not the invalidation we went through as children. I do fear that as the book becomes more popular those who would like to misinterpret it or to take some small piece of it and take it out of context could do so. But what I’m saying is that it’s invalidation – not being gay – that creates the problems.”

Everyone WHO I speak to about Velvet Rage insists it is important to remember, amid the hype around the book, that, as Franks puts it: “Many gay men are able to grow up and have happy, successful adult lives with meaningful relationships, friendships and sex. I don’t want us to get into this idea that we’re all broken.”

You imagine that if the book brings greater awareness of gay mental-health issues, that can only be a good thing. Franks began his work at Pace with a systematic review of National Institute for Mental Health research. “What they found was that lesbian and gay people were up to two-and-a-half times more likely to become alcohol or drug dependent, over two-and-a-half times more likely to suffer from anxiety or depression disorders. Gay men particularly were up to four times more likely to attempt suicide than their heterosexual counterparts. The report concludes by saying that ‘lesbian, gay and bisexual people are at significantly higher risk of mental disorder, suicide ideation, substance abuse and deliberate self-harm than heterosexual people.’ This is a very, very serious issue.”

The report further says: “It is likely that the social hostility, stigma and discriminations most LGB people experience is at least likely to be part of the reason for the higher rates of psychological morbidity observed. Prejudice against homosexuality is unlike other intolerance in that it can reach into families. Rejection by parents of their own children because of their sexual orientation is likely to have a severe emotional impact.”

The government welfare cuts are not good news here. “By default rather than by design we are going to be massacred,” says Franks. “We’re in deep trouble. Less than a third of mental-health services in this country monitor sexual orientation. Our needs are invisible. When mental-health charities are planning what to provide for we are not on the radar. Nobody is looking.”

Franks is setting up a research project in association with Brunel, Southbank, Aston and Greenwich Universities into mental-health issues for gay people. Working with David Smallwood, he is also in the planning stages for running velvet rage workshops around the country in conjunction with Attitude magazine. Editor Matthew Todd dedicated a whole issue to the subject last year “and received more mail from readers than we have had on any subject in the 15 years I have been here”.

If gay men are going to have to self-diagnose and treat their own mental-health issues, lending a well-thumbed copy of The Velvet Rage might present the first Elastoplast to the problem. “When you read it, it all seems so very obvious,” says therapist David Smallwood, “but no one had written it down before. I don’t want it to seem like I’m a single-issue fanatic. All I’m saying is that when I see someone that is troubled in this way I will bet my next 20 years’ salary on where it started. I start dealing with gay men that have issues around sex or drugs or alcohol and within five minutes I know that we are into their childhood. So I think that every gay man to some extent will have been affected by velvet rage.”

Downs has assumed an almost messianic place in the lives of those who have absorbed his thinking. He has broken the implicit language of half a century’s gay culture and flipped it on its head. The central axis of an individual’s gay narrative, one that used to concentrate on the coming-out story either as a teenager or later, has been shifted back into childhood. The result is that gayness appears to be a psychological as much as sexual condition. Historically, gay culture has been underpinned by the word “pride”. Now Downs has identified a clear relationship with shame.

“I do think that a lot of the issues in The Velvet Rage have pushed gay men and gay culture to create thoroughly wonderful things,” says Downs, “but the question that each of us must ask is: ‘Is this the life that I want for myself?’ When you read the biographies of most people who have been incredibly successful in the creative world, they haven’t always achieved a personal life that is satisfying and fulfilling. That is my concern as a psychologist.”

Downs is currently writing his follow-up book. It will be called Peter Pan Becomes a Man. “The subtitle is The Eternal Boy Grows Up. The new book really delves into our emotional adolescence and how we seem to be stuck in a cycle and how it stops us leading deeply attached and healthy relationships.”

For now, though, Downs is delighted he got his publishers to change the artwork on the paperback edition of The Velvet Rage from the original bland illustration of a man in a suit. It now features a black-and-white photograph of young schoolboys in a row – one standing out in his shocking-pink tie.

Was it a gay man exploring his own velvet rage who designed it? “I have no idea,” says Downs. “But I’m thrilled with it.”

Andy Goff, 48, pub owner, Surrey

I’m a tough butch guy, a geeza I suppose, and with the guys I was hanging around with, watching football, I couldn’t accept that I could be with a fella. It wasn’t an option. Sexually, I thought, fine, but not the kissing, cuddling, walking down the street side of things. It wasn’t that I thought it was disgusting I just couldn’t see that working for me.

I first had a sexual experience at school – boys just mucking around – and I didn’t think much of it. I dated some girls and even got engaged, but my life was just about hanging round with my mates drinking beer, going on stag nights, that kind of thing.

My first grown-up gay experience was in my 20s when I was working as a builder. I was painting some offices in Croydon at night because there was no one in them. I had to move the van and I went for a pee in a public toilet – no one believes me when I tell them that’s why I went in but it’s true – and there was a guy hanging around and one thing led to another. I didn’t get into it, it was seedy. I’ve got no shame about it, it’s not what I’d do now, it was just a need at the time.

After that I realised there was something going on inside me and from time to time I’d go to the underground clubs of the 80s. They weren’t out in the open like they are now, but that was better because I was getting to actually meet people. I didn’t tell anyone and didn’t really accept it. It wasn’t until my early 40s, a few years ago, that I actually thought, you know what, I’m gay and I need to do something about it.

I started going on dates, from the internet or with people I’d chat up in bars, trying to meet someone special. Then by coincidence I met Michael. After six months I knew he was the one. I still wasn’t out. And then one day someone from work saw me leaving Revenge, a gay club in Brighton – so the cat was out of the bag.

No one’s been bothered by it and I haven’t looked back. I never told my mum and dad. They both died years ago and I often wonder if they knew. But my brothers are completely accepting of it. I don’t care who knows now. I’m comfortable with who I am.

Michael and I have been together for four years and are getting a civil partnership in 18 months’ time on the sixth anniversary of when we met.

Les Pratt, 36, radio producer, Manchester

I was a late starter. I grew up in the 80s when the tabloids constantly portrayed gay men as paedophiles and freaks and so thinking you were gay was fairly horrifying. I wasn’t any of those things. I drank bitter and went to football matches and the two things didn’t seem to go together so I just pushed it into my subconscious. I didn’t tell anyone or do anything until my last year at university.

I did a degree in music at Leeds and spent my last year at a music college in Holland, where I gradually fell for a Turkish baritone. A bond developed, though I wasn’t sure what it was exactly. He was openly gay, but I hadn’t even admitted it to myself let alone anyone else, so nothing happened until a few days before I was due to come back to the UK. He said he was sad I was going and declared his undying love for me. It was incredible. I sensed it was coming and when it did I felt every part of me tingling. It was like a bomb going off.

We spent the night together and then I got the ferry back to Hull and that was the end of that. But it was the watershed moment. I thought OK, I’ve done this now, this is what I am and I felt ready to confront it and start to tell the people I cared about. It turned out my friends had all worked it out for themselves.

My brother was the most difficult. He was 13 years older than me and he was my hero growing up. He is a devout Baptist and I thought it might be difficult in case he thought any less of me or stopped me seeing my nephews. I told him in Pizza Hut. I just dropped it into conversation as though it was the most normal thing in the world rather than saying, “I’ve got this big thing to tell you.” I mentioned that I was going on a date with this guy, something as mundane as that. He flinched slightly and that was the biggest reaction I had. He had no issue at all with it.

My parents were the last to find out. My mum understood as she had a gay brother and my dad came round. I still go to football matches and drink bitter. When I’m with my dad at a game I show a different side of my personality than I do when I’m with gay friends. I’m not putting on an act; I’m just being me in whatever social setting I’m in.

Ian Drummond, 38, landscape garden designer, London

I realised I was different from the other boys when I was seven, but it wasn’t until I hit puberty at 12 that I understood I was actually gay. It was very isolating. I became anorexic, found it difficult to socialise and got bullied a lot.

I’d always known I wanted to work with flowers and plants so I left school at 16 and went to work for a large florist in Victoria. The company was mixed and there were a few older gay guys working there and we’d all often go out for drinks after work. One of those nights, when I was about 18, one of them suggested going to a gay pub up the road called the Vauxhall Tavern. I was nervous, but didn’t want to look homophobic so I went along. Inside, I tried to look comfortable, but I was terrified and couldn’t wait to leave.

I didn’t think about it again until a few months later when we had a work event in Soho. I knew that was where London’s gay bars were and, as I’d had a few drinks, I went for a walk to try and find one of them. I knew I couldn’t deny it forever. I went into a bar called the Yard on Rupert Street. The people inside were nearer my age and it felt a bit more relaxed and fun. I’m quite confident socially and I started chatting to people.

I struck up a conversation with a guy just a couple of years older then me. He was attractive and funny, and just a regular bloke like me. It felt natural and exciting, like it is when you’re 18. He became the first man I slept with. It was the start of a few years of socialising on the gay scene. I probably slept with too many people, but when you’ve been repressed for so long, coming out you feel like a kid in a sweet shop.

My life is great now. I have a rewarding job, great friends and family and a wonderful partner. I’m very close to my mother, but I have never said the words “I am gay” to her. I think she knows. I mention Allan a lot and she knows I do work for the Elton John Aids Foundation and other HIV charities and she’s very proud of me.

Fiez Mughal, 30, dentist, London

I announced to my dad that I was gay when I was nine. He laughed at first then took me to see a child psychologist. That made me realise it was considered wrong and I played it down and never spoke of it for another 12 years. I grew up thinking I had to prepare for the future more than others – work harder, get a better job, be financially secure and independent so if I was rejected I could cope.

When I eventually told my parents at 25 my dad sighed and said, “But why are you like this?” My mum was crying. I let them say what they wanted, with my dad saying it was disgusting and my mum saying it was against Islam, because I wanted them to get it off their chests. My mum said anal sex was considered wrong in our religion. I’m glad she was so direct rather than pretending there was no issue, but I explained that being gay was about love and relationships, not about sexual mechanics. My father was concerned about our community finding out, but he said that if anyone was to challenge him he’d say, “Yes, he’s gay, so what! Mind your own business!”

I was brought up to be religious. At school I did have feelings of shame regarding being gay and my religion, but I’ve realised that God made me the way I am and that it can never be a sin to love someone. People seem to expect the Muslim community to be very homophobic, but if you talk to people about it they realise it is not a big deal.

I had a boyfriend when I came out to my parents, someone I ended up being with for more than seven years. My dad didn’t really want to meet him, but Mum did. When he announced he was converting to Islam it opened the floodgates for her. She got some books for him and would always ask how he was.

Three years ago she died very unexpectedly, which knocked me for six. My partner came to her funeral and it forced my dad to put it into perspective. I am so glad I was honest with her and we had made peace. It isn’t easy for anyone’s parents. My mum brought me up to be happy and comfortable with being Muslim and British and her teachings have helped me to be comfortable with being gay as well.

Matthew Cavan, 21, actor, Northern Ireland

Queer As Folk made me realise I was gay. I watched it aged nine in my bedroom with the sound turned down so my parents didn’t know. I started to get bullied at secondary school, not because I told anyone, but because I wasn’t into sports and preferred drama and music. I was called queer, beaten up and had death letters and gay porn sent to my house. The boys wouldn’t let me change for PE in the same room. They said I’d like it too much.

I found the dating site Gaydar when I was 14 and I met up with a local lad who was 15 and we messed about a couple of times. I came out when I was 16. I used to go to a group called Christianity Explored. The youth leader talked about how you shouldn’t hide anything about who you are because God knows everything. I thought, “Well now’s the time” and came out to him. He was a family friend and he was great about it. My parents were, too. My mum cried, but said she was just worried about me “having a harder life”. I wanted a more dramatic reaction, but they’ve always been brilliant. I started going out on the gay scene in Belfast when I was 16 and really enjoyed it. It gave me a sense of being normal.

On 9 September 2009 I got really drunk and went to a gay sauna. I can’t remember what happened apart from that I knew I had unsafe sex. Six weeks later I got a bad flu, I had an HIV test and it was positive. I didn’t know how to tell my mum. I was crying and crying, but she knew what was going on because she’s a midwife. It’s frustrating because I have negative feelings about sex and I very rarely have it.

I went into a deep depression earlier this year. I’ve only met one other person who is positive. People seem to not want to talk about it. I want to help show it’s something that people can talk about. I don’t hate being gay, but it annoys me when people say it’s a choice. I’ve had to go through a lot and I wouldn’t have chosen all this. My family and friends have rallied round me and I’m hoping things will get better.

Paul Flynn is a freelance journalist. Matthew Todd is editor of Attitude

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