Sexual identity therapy: Is neutrality a bad thing?

Last year, I wrote an article for my website called I Am Not a Reparative Therapist. In that article, I indicated that one of my problems with reparative therapy, as I understood it, was that the therapist promoted reparative drive theory to clients as the singular source of same-sex attractions.

It seems to me that if a therapist begins with this theory or any one-size-fits-all theory, confirmation bias will operate to find it in the histories of clients. It also seems to me that any theory of origins, whether it be developmental or pre-natal or a combination thereof, is bound to contain much speculation due to the inadequacy of current research and the biases inherent in the therapeutic uncovering process. However, such speculation and uncovering may be quite useful in setting a context for the pursuit of valued action and may indeed lead to powerful emotional catharsis and the formation of a new way of looking at one’s self. A new perspective can be powerful, even if it is incorrect on certain objective points. E.g., some people say they have been freed of emotional bondage by resolving issues of trauma in past lives (past life regression). I do not believe they are correct but I suspect they really do feel better. This is an extreme example, of course, but it serves to illustrate that one may be objectively incorrect about the meaning of historical events but still feel relief because one has a meaningful perspective to make sense of it all. A single pathway theory can make clients and therapists feel better because it enhances a sense of certainty but I remain skeptical that single pathway theories are correct.

Having expressed skepticism about the meaning of historical events, I also believe that clients and therapists are sometimes correct in their inferences and finding the truth may or may not have real impact in the present. However, being correct in our inferences some of the time does not mean we are correct all of the time, nor does the events that ring so true for one client mean that the next client with similar issues has the same history or makes the same meaning of a similar history.

My reactions to reparative therapy as a means of addressing conflicted people are based in part on the belief that therapists should be prepared to flex from their theoretical and cognitive mindsets to address individual clients – the facts on the ground, so to speak. Perhaps, however, this is my bias showing about how therapy should be conducted. Perhaps, on the other hand, it is defensible to offer a form of therapy (e.g., cognitive-behavioral, client-centered, or gestalt) and say to the client, “Here is how I think about problems and how I work with them. If my way of working does not seem right for you then you are free to move on to another therapist.” Taking the analogy further, client-centered therapists refrain from giving advice, or making interpretations and view problems as arising due to discrepancies between a person’s real self and their idealized self. A client who wanted an active, directive therapist might be frustrated by a non-directive therapist. However, a non-directive therapist might be so wed to his viewpoint that he would need to refer clients who wanted a differing theoretical and technical perspective.

Germane to this discussion of therapy approaches, Dr. Nicolosi recently published an article on the NARTH website titled “Why I Am Not a Neutral Therapist.” This article lays out his rationale for advancing a specific theory of homosexuality and resultant therapy for those who do not feel congruent with their beliefs.

The developmental model we suggest must deeply resonate with the men we work with, or they will (rightfully) leave our office and pursue a different therapeutic approach. We explain that our position differs from the American Psychological Association, which sees homosexuality and heterosexuality as equivalent, and along the way, we encourage them to clarify and re-clarify the direction of their identity commitment. Gay-affirmative therapy should, of course, be available for any such client.

A few gay-identified clients do decide to stay with us. Out of respect for diversity and autonomy, I affirm them in their right to define themselves as they wish, and I accept them in their gay self-label.

This article addresses some of the concerns I cited in my article about reparative therapy. On one hand, it does appear that Dr. Nicolosi offers a singular explanation for homosexual attractions that clients encounter early in reparative therapy. On the other hand, Dr. Nicolosi tells clients the theory must ring true for them to proceed. And he apparently affirms some small group of gay clients. This is probably surprising news for many observers.

I continue to believe the reparative developmental model is probably not operative for all people who are same-sex attracted. And my bias is to hold all such theories loosely and indeed to think that there are many factors, both pre-natal and environmental, that lead to different outcomes for different people. I do wonder what people do if they do not believe reparative drive theory fits them. Does the insistence on the theory drive some people toward a more deterministic “born gay” view since they do not agree with the singular developmental theory of origins? Inasmuch as evangelical faith is often bound to an environmental explanation, can such determinism create more conflict with faith? These are of course open questions but I have written about this before.

From the article about therapist neutrality, it appears that Dr. Nicolosi envisions an environment where gay affirming therapists can assert their beliefs to clients and reparative therapists can likewise assert their beliefs and then let clients choose which approach they like. In contrast, the sexual identity therapy framework calls for therapists to refrain from offering preconceived ideas about causation and change but to focus instead on the realization of objectives which align with the individual values and beliefs of clients. In practice, I suspect there are times when therapists using any of three mindsets would look very similar.

I am hopeful that our framework provides therapists of all ideologies with a map to help clients determine their path. I believe our framework can be valuable in helping clients clarify which broad way may be most suitable for their individual situation.

13 thoughts on “Sexual identity therapy: Is neutrality a bad thing?”

  1. Anon2

    If I understand you correctly, what you are saying is that you believe that certain claims and statements give you hope and are therefore valid and desireable – whether or not there is truth to them.

    I can understand the need for hope. And I can understand the desire to hear what gives you hope.

    But please realize that seeking to hear what is not true is, by definition, self-deluding. If you rejoice that NARTH tells you what you want to hear and don’t care if it is true, you are practicing self-delusion.

    I know that we all tell ourselves little fibs from time to time to inspire us or give us confidence. I look great today. If I buy this lottery ticket my life will change. I will get this promotion.

    But the difference is that these delusions generally don’t harm others and, as long as we don’t act on these fibs and act as though we are going to win the lottery, these hope-builders don’t harm us either.

    But the deceptions of NARTH and Cameron hurt others. And, Anon2, if you act on them as though they are true, they will hurt you too.

    If you want to seek the unlikely – but hope for its possibility – then by all means do so. I don’t fault you for hoping or trying. But if you are basing your life on the assumption that your orientation WILL change dramatically – and seeking confirmation from anyone who will affirm that assumption – then truly you are behaving no differently than if you were living as though you are planning on winning the lottery. “This ticket is a winner, and no one tell me otherwise”.

    I think that you would ultimately be happier if you sought more to craft a life consistent with your values and then hope that change occurs within that framework – without relying on false promises or fruadulent claims. Of course, it is your own life. But if you assume that the “change can happen” claims are always true and that the “orientation is pretty much fixed” statement are always just media bias, then I think you will always be in internal conflict – constantly seeking to deceive yourself.

    But then again – I’m not a mental health professional so don’t take my word for it.

  2. Anon2 said: “But on the other hand, saying that one cannot change at all is taking away hope of value driven change and creating a sense of hopelessness in the individual.”

    “Cannot change” what exactly? No one is saying that gays can’t change their BEHAVIOR or that they can’t learn to live more productive lives. What most well-informed persons are saying is that it appears that sexual orientation tends NOT to change from gay to straight. A person CAN, however, live in accordance with his or her values — which is what I believe Dr, Throckmoston is trying to say. Anon2 may have “a difficult time listening to some of the accusations being leveled against NARTH and Exodus” but perhaps that is because they are TRUE.

    NARTH (and EXODUS, by association with NARTH) have (1) repeatedly promoted religious and personal prejudice as “science”, (2) published the articles of adivisors (and still have as “expert advisors”) men who have advocated the ridiculing and teasing of children and who have suggested that “slaves had it better off”, (3) labeled those who disagree with them as “busybodies” and intellectually stunted “Marxists”, (4) stood by the unscientifc and hateful ramblings of folks like Cameron who insists that gays “live parasitic lives”, (5) engaged in an agressive right-wing political agenda rather than sticking to minstry. I could go on.

    To be fair, EXODUS has disavowed Cameron, but NARTH has not — and EXODUS has not disavowed NARTH for standing by Cameron. In terms of “deception”. EXODUS contuinues to use confusing, vexing, provocative and misleading terms like “ex-gay” and “former homosexual” — even though their leaders admit that “ex-gay” doesn’t mean “ex-homosexual” or “heterosexual”. In light of all this, I am curious. What “deception” has Anon2 “seen for so many years from the other side”?

  3. Warren,

    I think you are right about the country being divided. For myself I started feeling much better about myself and my relationship with my family when I started looking for balance in my own life. I believe that the extremes on either position are the real problem. Anyone who insists that someone must change or go to HELL is not being very compassionate. But one the other hand saying that one cannot change at all is taking away hope of value driven change and creating a sense of hopelessness in the individual.

    The problem as I have come to see it is that this is a political issue for many and those, like myself, who have struggled with SSA, are being used as pawns in a larger power struggle. I think instead of encouraging confrontation between the two sides it is time to look at where there is common ground and work toward cooperation to over power the real enemy.

    I for one have been very much helped by what NARTH has presented over the years. I have not felt it is all completely balanced, but it has helped to balance the very biased media reporting in opposition to change. Maybe this is not the case in the US but it has been the case north of the border.

    Balance is what I see you are offering, Warren and balance is what is needed. I have a difficult time listening to some of the accusations being leveled against NARTH and Exodus, in light of the deception I have seen for so many years from the other side

  4. Warren: I think the APA does respect sexual orentation diversity (I can’t comment on their stand or religion). What I think the APA does NOT respect are attempts to reclassify homosexuality as a mental illness, spurious claims of sexual reorientation or the right wing political agenda of most sp-called ex-gay or reparative therapy organizations. So far, the “we-can-change-you” camp has done little to warrant respect — and much to arouse suspicion.

  5. I agree it is a shame that therapists are divided. I don’t think Dr. Nicolosi deserves are the blame for that though. The culture is divided and it seems inevitable that therapists would reflect that. I think the APA has some culpability as well in that they made policy statements in advance of doing the research necessary to build solid policy that would include respect for religious diversity and sexual orientation diversity.

  6. I am disappointed that Dr. Nicolosi believes it necessary to divide the therapeutic community into political camps — he seems to be declaring, “Either you’re on my team or you’re my enemy.”

    I have not yet read the framework but I promise to do so. The summaries of it are most promising. Therapy should help clients to establish healthy and constructive values and to live according to those values. Therapy should not be about the therapist remaking clients in his own image and likeness.

  7. Throckmorton: “It seems to me that if a therapist begins with this theory or any one-size-fits-all theory, confirmation bias will operate to find it in the histories of clients.”

    I agree. The reparative therapy movement (and Nicolosi in particular) is famously guilty of this logical fallacy. They all begin with: If you are gay, you MUST have had a bad relationship with your dad – and if you can’t remember it, we’ll go moment by moment through your history until we find something to blame him for.

    Throckmorton: “On one hand, it does appear that Dr. Nicolosi offers a singular explanation for homosexual attractions that clients encounter early in reparative therapy. On the other hand, Dr. Nicolosi tells clients the theory must ring true for them to proceed.”

    Question: What does it take for his theory to “ring true”? Maybe just Nicolosi’s insistence that it IS true? Any unhappy homosexual, programmed by family, church and society to hate his gayness might very READILY accept the BAD DAD theory – just because an “expert” like Nicolosi insists the theory is true.

    Throckmorton: “From the article about therapist neutrality, it appears that Dr. Nicolosi envisions an environment where gay affirming therapists can assert their beliefs to clients and reparative therapists can likewise assert their beliefs and then let clients choose which approach they like.”

    This “let clients choose” makes it sound as though the client has enough unbiased information, informed consent and EMOTIONAL neutrality to make such an objective “choice” about which theoretical approach is the most appropriate and the most clinically sound. That’s assuming a LOT, isn’t it? The underlying message is clear: Choose the gay affirming therapist and you go to HELL for all eternity. Choose Nicolosi and heaven awaits…

  8. This part of the Nicolosi article is intriguing:

    “Our men do not come to us just to change their unwanted behavior. They come to us to change their sense of self — to be more heterosexual, not just to “act” heterosexually; to feel comfortable in relationships with straight men, to learn to hold onto their masculine autonomy with women — in short, to fulfill their latent heterosexual potential.”

    He assumes: (1) that we gay men are uncomfortable in straight relationships, (2) that we have relinquished our “masculine autonmy” (whatever THAT is) with (I suppose he means emasculating) women (most likely, our Moms), and (3) that we all really just “latent” homosexuals.

    It is interesting that he says he helps his “men” “to be MORE heterosexual, not “to BE heterosexual…

  9. I tried reparative therapy with someone who insisted that my relationship with my father was the source of my desire for strong masculine men. It seemed to make sense that this should have been the problem but I could not figure out what was wrong between my dad and me. The counsellor asked me if my dad wrestled with me (he did), told me he loved me (he did) and several other things. When I was in the third grade my dad missed my birthday party due to business travel. I mentioned this as I was racking my brain to think of things and then we spent several sessions on this. The man found his reason and he was going to make it stick. I did not last long with this guy.

  10. Minty – I think it would be good to reflect on NickC’s comment above. Calling Dr. Nicolosi dishonest in absence of evidence that he does not see gay identified clients is to create a straw man. I have no reason to think he does not do as he says and now some evidence that he does. I wrote that it seems surprising because of public statements such as Steve described.

  11. ” I affirm them in their right to define themselves as they wish, and I accept them in their gay self-label.”

    I question the honesty of this statement.

    Given Dr. Nicolosi’s strong history of opposing homosexual identity, I suspect he “affirms” and “accepts” gay clients in the same way he would affirm a kleptomaniac or a drug addict. And surely his underlying attitudes pervade the therapy sessions.

    Dishonesty of this sort is pervasive to the gay-reparative movement, demonstrating the amazing human capacity for self-deception. We are complicated creatures indeed…

  12. I appreciate Dr. Nicolosi’s objective of accepting clients who identify as gay. I didn’t get a message remotely resembling that when I heard him speak almost a year ago. Relevant quotes (paraphrased) included “You cannot be Christian and gay,” and (one message for clients needing to be) “You’re not a pervert and you know that gay sex does’t work.”

    As I summarized then, I came away from his talk convinced that he thought my masculinity was counterfeit.

  13. I did weekly therapy for about two years with one of Nicolosi’s associates, David Mattheson. Mattheson, who I believe was also a founder of Evergreen International, has since moved off on his own, but at that time he was part of Nicolosi’s Thomas Aquinas Psychological Clinic in Encino, CA. My sessions were mostly by phone since I lived in another state. I never met Nicolosi himself.

    I can confirm Nicolosi’s claim to serve some gay-identified clients to this extent: Mattheson told me at one point that he had another client who had decided to identify and live as gay, but was continuing therapy with him to deal with other issues. He told me this to emphasize that he did not demand, as a precondition for therapy, that I refuse to consider returning to a gay identity.

    I can make other complaints about my experience with Nicolosi’s practice. But I do believe him on this point.

Comments are closed.