Reparative therapy and confirmation bias: An illustration

One of the biggest problems I have with reparative therapy is the self-fulfilling nature of the approach. Reparative therapists assume that the existence of same-sex attraction means a person has suffered gender based trauma during a specific period of childhood.

Reparative therapist David Pickup has commented on another post that straight men may have wounds but, from his point of view, they are not as deep as those which haunt gay men. In other words, if a straight man says he was traumatized in the same way, the reparative therapist’s answer is that the trauma wasn’t deep enough to trigger the reparative drive leading to same-sex attraction. If the gay man says he does not recall any such trauma, then the reparative drive theory posits that the gay man has repressed it and needs to uncover it. It seems to me the powerful effects of confirmation bias are at work.

The assumptions necessary to work as a reparative therapist remind me of the assumptions often associated with the repressed memory movement. Especially during the decade of the 1990s, many therapists assumed that negative moods such as depression or relational problems were due to childhood abuse of some kind that had been forgotten via the defense mechanism of repression. Some therapists harbored a belief that clients who could not remember trauma from the past were in a state of denial. This belief  led some therapists to repeatedly ask about recollections of trauma and hold out the possibility to their clients that they were simply unable to remember.

By questioning the mechanism of repression, I am not questioning the reality of gender based trauma. I am not questioning that some gay people had very impoverished childhoods. Of course that is true. But so did many straight people. In his recent comment, Mr. Pickup proposed that gay people have experienced deeper trauma than straight people experienced. This seems circular to me. How can you tell which experiences are worse? As far as I can tell, the way reparative therapists answer this question iss by knowing the sexual orientation of the client. Straight people have deep wounds; gay people, by definition according to the reparative approach, have deeper wounds.

As an illustration of how clients can adapt themselves to the theories of their therapists, I offer the experience of Carol Diament. Ms. Diament initially thought she would not need to detach from her family, as the other clients at Genesis Associates did. However, after awhile, “memories of abuse came up” and she detached from her parents (over three years), husband and even small children (at least 8 months and maybe longer).

Eventually Carol got away from Genesis, sought another therapist and came to realize that her memories were reconstructed with the help of her therapists at Genesis. By then, the damage was done. She had lost years of her life and had even lost her immediate family.

The clip is just over nine minutes long, but I hope you will watch it all the way through. Then, I hope you will discuss this and let me know what you think. Am I seeing a parallel with reparative theory that is valid or not?

Over the years, I have worked with many clients, gay and straight, who have experience significant trauma with parents. However, I have not been able to differentiate them based on the severity of their experiences. Furthermore, I know and have worked with many gay men and women who recall no deep trauma relating to their parents or peers. I also know gay men who experienced trauma after they came out to their parents because of the tension surrounding homosexuality. However, prior to the disclosure, the relationship was on par with any comparable straight person’s home life.

I also want to be clear that I am not closed to the possibility that certain childhood experiences could influence some people to question sexuality and engage in same-sex behaviors. In addition, some experiences of abuse are associated with risky sexual behavior of all kinds. Therapy, even reparative therapy, might help such people. However, I think these scenarios represent only a portion (probably very small) of the total gay and bisexual population.

Thoughts on NARTH’s statement on sexual orientation change

For the sake of time, I am going to react to parts of NARTH’s new statement on sexual orientation change. First, I want to say a few things about this paragraph:

Finally, it also needs to be observed that reports on the potential for sexual orientation change may be unduly pessimistic based on the confounding factor of type of intervention. Most of the recent research on homosexual sexual orientation change has focused on religiously mediated outcomes which may differ significantly from outcomes derived through professional psychological care. It is not unreasonable to anticipate that the probability of change would be greater with informed psychotherapeutic care, although definitive answers to this question await further research. NARTH remains highly interested in conducting such research, pursuant only to the acquisition of sufficient funding.

I am surprised that NARTH complains about religiously mediated change when they highlight such change on the organization website. In any event, it is good that the writer of this statement acknowledges that religious mediation is different than therapy. Now, if only they would stop offering Jones and Yarhouse as evidence that therapy works.

On the subject of research, I am highly skeptical that NARTH really wants to do the type of study that would really address questions about change related to therapy. I say this because NARTH has been in existence since 1992 and they have had ample opportunities to do research. I believe one study has been funded by NARTH (please correct me if I am wrong NARTH readers).

Regarding funding, I believe the religious conservative world could spare funds for such research if there was a willingness to do it. I recognize NARTH is not a rich organization but there are ways to do research without large sums of money. For instance, Mark Yarhouse has been prolifically doing research on sexual identity and the sexual identity framework without much funding. I have done some research on my own out of my own pocket (although far less than Yarhouse). Surely, some Christian right organizations could go together and get NARTH the funds necessary to really test their claims.

Over the past several years, I have asked various social conservative sources for funding in order to test those who say they have changed in Michael Bailey’s lab at Northwestern. We need somewhere between $60-100K to do it. Bailey has identified profiles of straights, gays and bisexuals. I think we could also identify the spousosexual profile with some creativity but neither one of us has had success in getting funds.

An intellectually more honest position would be to say that NARTH does not know for sure about change since adequately designed research has not been conducted. Until then, NARTH’s leaders who go out to religious right groups saying with confidence that change from gay to straight happens will be violating their own statement.

NARTH issues statement on sexual orientation change

Apparently in response to Alan Chambers’ candor about sexual orientation change, the National Association for the Research and Therapy of Homosexuality issued a clarification of what that organization means by change.

Issued January 27, the statement reads in full:

Current discussions of homosexual sexual orientation change are unavoidably occurring within a sociopolitical climate that makes nonpartisan scientific inquiry of this subject very difficult.  In light of this reality, a few considerations are crucial for accurately understanding the sometimes contradictory opinions regarding the possibility of sexual orientation change.   First and foremost, it is important to recognize that how change is conceptualized has vast implications for our thinking about change.  Some of the more ardent proponents and opponents of homosexual sexual orientation change may view change in strictly categorical terms, where change is an all-or-nothing experience.  Proponents and opponents with this view differ only in the direction of their desired outcome.  Proponents of change understood in categorical terms may view a homosexual sexual orientation as a lifestyle choice that merely needs to be renounced. Opponents who take this viewpoint, on the other hand, may conceive of sexual orientation as essentially hard wired and simply not modifiable.  NARTH does not support either of these perspectives.

NARTH believes that much of the expressed pessimism regarding sexual orientation change is a consequence of individuals intentionally or inadvertently adopting a categorical conceptualization of change. When change is viewed in absolute terms, then any future experience of same-sex attraction (or any other challenge), however fleeting or diminished, is considered a refutation of change. Such assertions likely reflect an underlying categorical view of change, probably grounded in an essentialist view of homosexual sexual orientation that assumes same-sex attractions are the natural and immutable essence of a person.  What needs to be remembered is that the de-legitimizing of change solely on the basis of a categorical view of change is virtually unparalleled for any challenge in the psychiatric literature.  For example, applying a categorical standard for change would mean that any subsequent reappearance of depressive mood following treatment for depression should be viewed as an invalidation of significant and genuine change, no matter how infrequently depressive symptoms reoccur or how diminished in intensity they are if subsequently re-experienced.  Similar arguments could be made for any number of conditions, including grief, alcoholism, or marital distress.  The point is not to equate these conditions with homosexuality, but rather to highlight the inconsistency of applying the categorical standard only to reported changes in unwanted same-sex attractions.

Rather than pigeonholing homosexual sexual orientation change into categorical terms, NARTH believes that it is far more helpful and accurate to conceptualize such change as occurring on a continuum.  This is in fact how sexual orientation is defined in most modern research, starting with the well known Kinsey scales, even as subsequent findings pertinent to change are often described in categorical terms. NARTH affirms that some individuals who seek care for unwanted same-sex attractions do report categorical change of sexual orientation.  Moreover, NARTH acknowledges that others have reported no change. However, the experience of NARTH clinicians suggests that the majority of individuals who report unwanted same-sex attractions and pursue psychological care will be best served by conceptualizing change as occurring on a continuum, with many being able to achieve sustained shifts in the direction and intensity of their sexual attractions, fantasy, and arousal that they consider to be satisfying and meaningful. NARTH believes that a profound disservice is done to those with unwanted same-sex attractions by characterizing such shifts in sexual attractions as a denial of their authentic (and gay) personhood or a change in identity labeling alone.  Attempts to invalidate all reports of such shifts by presuming they are not grounded in actual experience insults the integrity of these individuals and posits wishful thinking on an untenably massive scale.

Finally, it also needs to be observed that reports on the potential for sexual orientation change may be unduly pessimistic based on the confounding factor of type of intervention.  Most of the recent research on homosexual sexual orientation change has focused on religiously mediated outcomes which may differ significantly from outcomes derived through professional psychological care.  It is not unreasonable to anticipate that the probability of change would be greater with informed psychotherapeutic care, although definitive answers to this question await further research.  NARTH remains highly interested in conducting such research, pursuant only to the acquisition of sufficient funding.

To summarize, then, those who are  highly pessimistic regarding change in sexual orientation appear to have assumed a categorical view of change, which is neither in keeping with how sexual orientation has been defined in the literature nor with how change is conceptualized for nearly all other psychological challenges.  NARTH believes that viewing change as occurring on a continuum is a preferable therapeutic approach and more likely to create realistic expectancies among consumers of change-oriented intervention.  With this in mind, NARTH remains committed to protecting the rights of clients with unwanted same-sex attractions to pursue change as well as the rights of clinicians to provide such psychological care.

I hope to post something on this Monday or Tuesday; but for now here is NARTH’s official word on the subject of orientation change. Discuss…

Gingrich says he worries about poor spending money on gambling while supported by gambling magnate

Really?

According to the Miami Herald:

“At the risk of offending some of my friends who’ve been very helpful,” Gingrich said, “I worry about the degree to which the poor are the most likely to spend a large percentage of their income gambling.”

According to the report, Gingrich did not spell out his views on gambling which is a hot topic in Florida now since at least two companies, including Gingrich’s benefactor – Sheldon Adelson – want to put casinos there.
I wish someone in the press covering his campaign would ask him about the two times when Gingrich supported policies favorable to the gambling industry, but did not give Indians a break on policy involving their casinos.

Gingrich says his relationship with Adelson is about Israel and I believe that is partly true. However, Gingrich has conducted at least one fundraiser in one of Adelson’s casinos and supported at least two causes of importance to the gambling industry.

If Gingrich is worried about the poor and the dollars they spend, then why did he show favor to the gambling industry while Speaker of the House? Is this a new worry?

Related:

Former South African President criticizes Uganda’s Anti-Homosexuality Bill

Former South African President Thabo Mbeki criticized MP David Bahati’s Anti-Homosexuality Bill Thursday in Kampala while speaking at an event at Makerere Institute for Social Research.

About the bill’s provisions, Mbeki said:

I mean what would you want? It doesn’t make sense at all. That is what I would say to the MP. What two consenting adults do is really not the matter of law.

Bahati’s responded later to a reporter:

However, Mr Bahati yesterday said the Bill was brought to curb a several issues including inducement, recruitment and funding homosexuality. “His excellency (Mr Mbeki) needs to read the Bill and understand the spirit in which it was brought and the context in which we are talking about,” Mr Bahati said.

Although the Ugandan ambassador to the US recently said the bill was not going to be considered, Bahati seems to believe otherwise.  As far as I can tell, the bill is still “gathering dust” in committee and could still be brought to the floor of Parliament.