Decades of walking alongside men like you.
Not from a distance. But in the room, present, through the hardest stretches — the diagnosis that rearranged everything, the grief that arrived out of order, the heaviness that has no obvious source, the 3 a.m. question of what the coming years are actually for.
I have spent thousands of hours sitting with men just like you in those places, listening and understanding.
Not to fix what's happening. Not to reframe it into something easier. But to be there — steadily, without flinching — while you find your way through it.
There's no performance required here. No version of yourself you have to show up as. Whatever is true right now — the anger, the grief, the fear or the flatness you keep tucked away so others won't worry — there's room for all of it.
Many men say they feel something shift, simply from having a place where they can speak without a filter. Where nothing has to be managed or softened.
That matters.
What I hope for, as we work together, is that you come to know more clearly what you value — and that you find a way to live closer to those things, even now.
Especially now.
What’s it like to work with me?
This is a private, focused practice.
Not one-size-fits-all therapy, but thoughtful, individualized work that makes space for nuance, uncertainty, and the realities that often go unspoken.
Over time, I've developed a focused practice around the intersection of health, aging, and the lived experience of gay men — areas that are often overlooked or insufficiently understood in more general therapy settings.
Part of this work is recognizing that not everything can be solved or neatly resolved. At certain points, the work becomes less about finding clear answers and more about learning how to live with important questions — about identity, meaning, relationship, and what lies ahead. Therapy offers a space to approach those questions with steadiness, honesty, and support.
It's not about quick solutions. It's about doing the kind of work that actually holds up over time — work that can support you not just in the immediate moment, but as your life continues to unfold in complex and unexpected ways.
If you're at a point where you're ready for that kind of attention and depth, you're welcome to reach out to schedule a brief consultation and see whether this feels like the right fit.
A Different Kind of Therapy.
Where This Began.
How I came to this work
I'm a fourth-generation Californian. My family came west in a covered wagon and farmed in the Central Valley. I was a boy in the late sixties and seventies, and I knew something about myself before I had a word for it: that I was different from the other boys, and that it was supposed to be shameful. Nobody had to tell me.
Then, just as I was emerging from adolescence into young adulthood, reports of a new virus began to surface in the gay community — and so the years when I was becoming a man were the same years when everything around me was becoming frightening.
What I remember most is not knowing. Nobody could tell us what this was, or how it moved, or who would be taken next. And then young gay men I knew began to get sick, and then they began to die, and after a while, it stopped being extraordinary. I became acquainted with illness and death at an age when most people are only beginning to think about their lives. Wellness was the abnormal thing.
I went to therapy because I was frightened. I was in my early twenties and grappling with death — my own possible death, and the deaths of people I loved — and I had nowhere to put any of it. The therapists I found were kind and skilled, and they were willing to stay with me in what was hardest rather than hurry me past it. That changed the course of my life. I found my footing in the work itself — volunteering with HIV organizations, learning the clinical skills this particular kind of suffering asks for, and discovering that I could actually help. Over time, I stopped thinking of it as a phase. It was just what I did, and what I wanted to keep doing.
So I became a psychotherapist, and I built my practice here, in my own community. Part of what I'm doing is trying to turn the difficulty of those years — the 1980s and 1990s and everything they cost us — into something useful. I can offer resilience where there's some to be had, and honesty about hope. And if you're facing a serious illness — including one that isn't going to get better — I'll stay with you.
Maybe it's depression that arrived late, or anxiety. Grief, a relationship, a retirement, or the question of what the rest of your life is supposed to be. Those years taught me how to stay with a man when the outcome isn't certain, and there's nothing obvious to fix — and how much it means just to be heard by someone who isn't going anywhere.
About the Practice
Bob Basque, LCSW, is a psychotherapist in private practice in San Diego, California. He earned his Master of Social Work from Arizona State University. Starfish Mental Health is his solo practice, serving gay men in the second half of life.
Office — 1901 First Avenue, San Diego, CA 92101 (Bankers Hill)
Telehealth — Available to clients anywhere in California
Who I work with — Gay men, generally 50 and older, individually and with partners
Specialties — Depression and anxiety, serious and chronic illness, living with HIV, grief and loss, caregiving and partner support, alcohol use
Approach — Depth-oriented psychotherapy, integrating ACT, DBT, motivational interviewing, and harm reduction
Payment — Participating traditional Medicare provider; otherwise private pay, with out-of-network claims filed through Mentaya (a professional insurance biller). Please note: unable to accept Medicare Advantage.
Fees (when not using insurance) — $250 per 50-minute individual session; $350 per 80-minute couples session
Contact — 760-523-9000 · hello@starfishmentalhealth.com
Training & Education.
Master of Social Work, Arizona State University
Licensed Clinical Social Worker - State of California - 110772
Mental Health and Aging Specialist
Gottman Method Training (Couples Therapy)
Certified Clinical Supervisor - providing guidance and mentorship to less experienced psychotherapists or graduate-level students