Author: Warren Throckmorton

Sexual identity therapy: What it is and what it isn’t

There is lots of discussion occuring on various blogs/media sources about the sexual identity therapy framework. I want to link to a couple and comment.

Two threads at ExGayWatch involve the framework. One is an open forum triggered by my appearance on CNN with Dr. Benjamin McCommon and the other references Peterson Toscano’s statements about what change is and isn’t. It appears that many observers want to link the framework with reparative therapy which is a clear misunderstanding. I invite you to go on over and read the comments there. However, I will say here that if therapists tell clients why they have same-sex attraction as a precursor to therapy or engages in confirmatory questioning (e.g., “many men who are attracted to the same sex say they were distant from their fathers, what was your relationship with your father like?”), then they are not operating consistently with the framework. Furthermore, we do not focus on change of orientation, but rather living a valued and congruent life. Success is not measured by moment by moment assessments of attractions but rather by satisfaction with the help received. People may indeed change if there are clear links from past experience to present unwanted behavior (ask Joe Kort about this) but that is not initial focus of the framework.

Speaking of Joe Kort, he had a go at the framework as well. Beginning on a positive track, the train derailed quickly when he said:

The problem is that when you read on both Throckmorton and Yarhouse talk about homosexuality as being able to be changed. Like reparative therapy they promise to make straight soldiers out of homosexual men.

and then near the end of the post:

I do wish Throckmorton and Yarhouse would stop promising to change peoples sexual and romantic orientation.

Puzzled, I am. In fact, here is what we say in the framework:

Prior to outlining the recommendations, let us define what they are not. They are not sexual reorientation therapy protocols in disguise. Although some investigators (e.g., Spitzer, 2003) have attempted to examine sexual orientation change, numerous criticisms have been leveled at client self-report as a means of assessing such change. Currently, no other means of sexual orientation assessment has found wide acceptance. A consensus about accurate assessment and measurement of sexual orientation would be required in order to empirically test therapies purporting to produce sexual orientation change. At present, such consensus does not exist (Kinnish, Strassberg & Turner, 2005).

Current assessment methods do allow us to ask clients about their perceptions of sexual identity during psychotherapy. Furthermore, we have tools that assess overall client well-being, mental health and satisfaction with how therapy is conducted. To varying degrees, some clients may come to believe change has occurred in their sexuality while some will believe little or no change has occurred. These perceived changes can be examined but we do not view such change as a determinant for the success or failure of sexual identity therapy. Instead, client satisfaction and overall mental health improvement are more efficiently assessed. In any case, we believe guidelines are needed for therapy with clients who experience sexual identity conflict no matter what their beliefs are about sexual orientation and whether it can be altered.

Joe, you had your wish before you made it.

The Edge continues “My ex-gay life” series: Dissecting reparative therapy

The Edge’s David Foucher continues his series regarding all things ex-gay with an article today regarding reparative therapy. There are extensive and interesting quotes from Joseph Nicolosi, Clinton Anderson, Jack Drescher, Robert Jay-Green, yours truly and others.

There are a number of quotes that caught my eye. This one from Robert Jay-Green left me scratching my head:

“All these theories are all promulgated by the ex-gay people,” he points out. “They have this theory that distant fathers and overly-close mothers cause homosexuality. Well, that’s been disproved. The research shows that there is no similarities in the pattern of family development in kids who grow up to be lesbian or gay versus kids who grow up to be straight.”

I don’t think that is want he wanted to say. I think he meant no differences.

In fact, there are some differences but they are only of modest effect statistically speaking. In fact, as we have noted here, gay psychotherapist, Joe Kort thinks there are some family dynamics that can lead to homosexual behavior. He believes this homosexual behavior for these actually and essentially straight people can be changed when they get appropriate psychotherapy.

Dr. Nicolosi lays out the core of reparative therapy. As he describes, it is not compatible with the sexual identity therapy framework:

“[Success] occurs by their understanding the causes of their same-sex attraction,” Nicolosi explains. “We call it the three A’s: attention, affection, approval. These are underlying emotional needs that were not fulfilled by their same-sex parent – the father for the male homosexual and the mother for the lesbian.

“There are two jobs [for the patient],” he continues. “The first task is about the past, and the other is about the present. The past aspect is facing the reality that they did not get this love, making it very clear and conscious, and then going through a grief process. They have to grieve that their father never did and never will love them the way they need to be loved – to the extent they need it. And what that does is free them up from the illusion that they are going to get it somehow either by that father or by somebody else of the same sex.”

According to Nicolosi, the next challenge is to replace that need with an emotional connection in their present.

“[They need to] get those needs met thought a relationship with other men,” he says. “The focus is not on not having gay sex… it’s putting the emphasis on making deep emotional attachments. And we have seen that when these men make deep emotional attachments to other men, their sexual interest diminishes.”

While for people who did have problems with parents, there can be some value in acceptance and grieving. However, presenting this scenario to clients as a general explanation for all attractions to the same sex is not consistent with the sexual identity therapy framework. As I noted in this Edge article, I do not believe the research support is there. Thus, we cannot tell clients we know something we don’t know, but rather theorize.

I will be on the Michelangelo Signorile show today

Tune in Tuesday, July 24, at 4:30pm eastern time on Sirius Radio for this live interview. I suspect we will discuss many topics but focus on the sexual identity therapy framework and the work of the APA.

UPDATE – Well, hope springs eternal. I thought we might get some kind of real dialogue about the merits of sexual identity therapy as opposed to reparative therapy. However, this did not happen. He chose to focus on making me defend a client’s right to maintain a religious persuasion that Signorile obviously dislikes. It seems clear to me that he sees evangelicalism as inherently bigoted so there is no place for such beliefs in his view. So the choir was preached to but still remains ignorant of honest attempts to grapple with real human conflicts.

New York Magazine on married men who stray with men

The New York Magazine has a lengthy examination of a married man who seeks liaisons with men. The article by David Amsden provides an inside look at a man who remains anonymous but opens up a bit about his double life and is relevant to our recent discussions. Thanks to reader NickC for making me aware of the article.

Seems to me multiple “explanations” could be advanced for this situation. I found myself wondering what I might do with this man had he come in for counseling. His values were/are not religious but he seems as if he is intent on maintaining the duplicity. What are his values then? His marriage, his child, his social standing? I have worked with such folks; those who intently value their marriage look for a counselor who will assist them to remain married, even for reasons that are not religiously motivated. I am curious what readers think of counseling that collaborates with such men to maintain a marriage if that is indeed what they value most.