Sexual identity therapy and neutrality, Part one

Continuing the discussion about sexual identity therapy, I want to contrast our framework with both gay affirming and reparative therapies on the dimension of value neutrality in two posts. As a springboard for my thoughts, I want to quote from an article by Joseph Nicolosi on the NARTH website called, “Why I Am Not A Neutral Therapist.” He led with this explanation:

A Christian psychologist contacted me to discuss reorientation therapy for SSA men. Hoping to find a politically “safe” compromise with the APA, he was anxious to avoid value judgments and remain noncommittal about homosexuality. The solution, he thought, would be a simple behavior modification program. Speaking from my 25 years of experience in this field, I told him I found his approach na茂ve and ultimately unworkable.

Then he adds:

“Furthermore, why should I refuse to discuss philosophical issues with clients,” I told him, “when gay-affirmative therapists are working very hard as boosters of their philosophy? They tell clients that same-sex feelings are ‘sacred.’ They push them to revolutionize society’s and the church’s attitudes. Any client’s conviction that heterosexuality is the norm will be redefined by the therapist as a ‘psychological illness — homophobia.'”

“The fact is, neutrality fails for clinicians on both sides of this issue,” I told the psychologist. “Clinicians like you and me, who believe that humanity was designed for heterosexuality, must speak up about our philosophy. These men with unwanted SSA want boosters, allies, advocates, as they claim their masculine identity — someone who believes in them and stands strongly at their side.”

Dr. Nicolosi parallels his disclosure of reparative drive theory as an ideology to what he believes gay affirming therapists do with clients but from an opposing perspective. After all, if it is ethical for gay affirming therapists to promote homosexuality as a moral good, then why shouldn’t reparative therapists promote heterosexuality as God’s design?

Before I discuss this further, one might question whether gay affirming therapists or therapists in general really have a worldview on the matter. I cannot go into this exhaustively but a statement from the APA’s Clinton Anderson from a recent AP article by David Crary suggests there are favored and disfavored religious views on matters gay. Speaking about religious views which are at odds with homosexual behavior, Dr. Anderson said:

“We cannot take into account what are fundamentally negative religious perceptions of homosexuality — they don’t fit into our worldview,” Anderson said.

So can therapists be neutral?

In my view, not all therapists can practice in a neutral manner. In our sexual identity therapy framework, we have clear guidance which allows for referrals when value conflicts impair what therapy has to offer a client. In other situations, the role of the therapist is to assist clients clarify their own perspectives and work toward congruence. For clients who do not know what they believe, it can be very valuable for the therapist to refrain from imposing a religious worldview or stigmatizing conservative religious views.

Some people want a non-neutral therapist on either side of the worldview spectrum. Perhaps they would not be happy with sexual identity therapy. My investigations into this arena suggest that retrospective assessments of therapist helpfulness are associated with therapists not attempting to impose a contrary value position on to the client. And so, I continue to believe that SIT occupies a niche that offers something not available in ideologically-driven approaches. For those who are still figuring things out or have not felt successful with other approaches, our framework could provide something different.

Part two will explore where the sexual identity therapist isn’t neutral.