Category: APA

APA Apologizes for Role in Racism and Eugenics

Although long overdue, the American Psychological Association on October 29 issued an apology to people of color and indigenous people for the role of psychologists, including many leaders of APA, in promoting racism and eugenics thoughout the formative years of the profession. Accompanying the apology is a remarkable historical timeline of events documenting the role of psychologists in promoting white supremacy, racism, and eugenics. Finally, the APA also passed a resolution which calls on psychologists to work toward ending racism.

For the first time, I have been teaching a course in the history of psychology this semester and have covered some of this ground. Especially in considering the role of G. Stanley Hall, Lewis Terman, Paul Popenoe, Robert Yerkes, Henry Goddard and others, one must confront that at least one purpose for which these men did their work was to promote “race betterment” via eugenics policies.

This is the dark side of the history of psychology and we cannot avoid it. I am pleased to see these documents and statements from the current APA leaders. Perhaps, one of the most important immediate benefits will be to confront the same attitudes which seem increasingly common today.

So Who Could Be Against This?

When the statement was released, The Bell Curve author Charles Murray had this response.

You may remember Murray’s policy recommendations from The Bell Curve relating to government assistance to poor people:

“The technically precise description of America’s fertility policy is that it subsidizes births among poor women, who are also disproportionately at the low end of the intelligence distribution. We urge generally that these policies, represented by the extensive network of cash and services for low-income women who have babies, be ended.”

Murray’s advice is a barely sanitized version of a eugenicist’s dream. For instance, Charles Goethe, founder of the California Eugenics Society wrote this letter to the editor in the Sacramento Courier Journal in 1953.

This same Goethe visited German in 1934 and then wrote fellow Human Betterment Foundation member E.S. Gosney:

You will be interested to know that your work has played a powerful part in shaping the opinions of the group of intellectuals who are behind Hitler in this epoch-making program. Everywhere I sensed that their opinions have been tremendously stimulated by American thought and particularly by the work of the Human Betterment Foundation. I want you, my dear friend, to carry this thought with you for the rest of your life, that you have really jolted into action a great government of 60 million people.”

This was published in the organization’s newsletter and thus available to psychologist Lewis Terman and marriage counselor Paul Popenoe who were members of the Human Betterment Foundation.

The APA steps forward with regret that psychology in the form of scientific racism and intelligence testing was used to promote sterilization, discrimination and racism, and some people today still object. I say it is about time and their reasonable service.

Nick Cummings USA Today Article on Reorientation Therapy

A couple of readers asked me to comment on Nick Cummings USA Today column on reorientation therapy. With some caution, I think it would be good to do so.
First I want to say that I have always liked and admired Nick. His work in managed behavioral health care was pioneering. In the 1980s, Nick promoted the idea that excellent clinical services could save businesses a lot of money and actually expand access to therapy. He was correct and helped create modern managed behavioral healthcare, which is essentially the dominant system today. In addition to the new business strategies that Nick’s company (American Biodyne) innovated, Nick was/is a gifted clinician and trainer. I learned a lot from Nick about therapy as a Biodyne clinician in the mid-1980s. I will always be grateful for his influence on me at that time.
Nick is an admirable gentleman in many ways. He seems to be indestructible and maintains an ambitious and rigorous schedule into his older age. He also reads and studies Greek (another area of common interest) and has developed a cooperative program with China that is helping to shape their behavioral health system.
Having declared a sincere admiration for Nick, I have to add that we disagree about his recent push to defend reorientation therapy as a modality. Nick is an endorser of the Sexual Identity Therapy Framework and I have heard him promote the ideals we support.  Thus, I know that any person who sought change therapy from him would not get the usual reparative therapy explanations for homosexuality, nor would religion be used as a coercive tool. In other words, I don’t believe Nick wishes to defend any and all approaches to change therapy; I think he wishes to defend the right of clients to arrange their lives and seek help to do it. However, it is dismaying that his defense comes in the context of  the JONAH’s court case. Much of what is done in the name of reorientation cannot be defended.
One area Nick and I disagree about is how much to emphasize the role and importance of bisexuality. Nick once told me that clients who had no prior heterosexual experience were not successful in changing orientation and so over time, the Kaiser-Permanente therapists discouraged orientation change for those clients. To me, this suggests that many of those “changed” clients were bisexuals who found ways to live with or minimize their same-sex attractions. Furthermore, to my knowledge, no one was discussing “spousosexuals” from 1959-1979. Some men and women are generally attracted to the same sex but spontaneously fall in love with one person of the opposite sex. Some of those successes could easily have been people who had the potential for that kind of fluidity. Another problem with relying on Nick’s data is that follow up was lacking for many of the clients. Nick is aware that some of his clients remained changed, but he does not have systematic data on the population.
If all reorientation therapists were like Nick, I doubt we would have the conflict and polarization we have seen over the past decade or so. I also doubt there is anybody currently vocally defending reorientation who practices as Nick did. Current reorientation therapists blame parenting and masculinity deficits for same-sex attraction, some of them put people through emotionally taxing and empirically questionable human potential exercises, still others attempt to coerce people with religion. My impression is that Nick and his crew did none of that. Certainly, in all of my dealings with American Biodyne, no one ever suggested any of that. The emphasis was always on helping the client find strategies to enhance mental health and live in accord with their aspirations.
Nick’s closing paragraph makes me think that he believes that there are some, perhaps many, therapists who work empirically and ethically with “fully informed persons.” This is where we disagree. The way reorientation is practiced as I have seen it and heard it described at various conferences and by various therapists in my travels during the last decade or so gives me no confidence that he is right this time.
Given those concerns, I continue to support the APA’s distinction between sexual orientation and sexual orientation identity; the former being durable once established and the latter being more subject to modification. I am skeptical there are many current reorientation therapists fully inform their clients about that distinction.

American Psychiatric Association’s DSM 5 draft is now available for review

The draft of the APA Diagnostic and Statistical Manual, 5th edition is now available for review and comment.  

A Message from the DSM-5 Task Force Chairs

Dear Reader,

Welcome to the DSM-5 Development Web site.  This site provides information culminated from over 10 years of revision activities, made possible thanks to the generous dedication of more than 600 global experts in the field of mental health. 

The DSM-5 Task Force and Work Group members are working to develop criteria for diagnoses that not only reflect new advances in the science and conceptualization of mental disorders, but also reflect the needs of our patients. We encourage you to delve into the wealth of information contained within this site to become familiar with some of the advancements in scientific and clinical knowledge that will assist in making diagnoses more accurate, valid, and clinically useful.  We also hope that this knowledge will pave the way for further research in these important areas. 

Your input, whether you are a clinician, a researcher, an administrator, or a person/family member affected by a mental disorder, is important to us.  We thank you for taking part in this historic process and look forward to receiving your feedback. 

David J. Kupfer, M.D., DSM-5 Task Force Chair

Darrel A. Regier, M.D., M.P.H., DSM-5 Task Force Vice-Chair

Sure to be controversial, the Task Force will accept comments until April 20. I will accept comments starting now and never ending…

APA Monitor on the APA sexual orientation and therapy report

The current American Psychological Association Monitor briefly reports on the August report from the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Not much new here for regular readers of the blog. The big news in my view was the treatment of religion which did not get as much coverage as the discouragement of change therapies.

The article ends with quotes from NARTH’s Julie Hamilton and me.

Warren Throckmorton, PhD, an associate professor of psychology and fellow at the Center for Vision and Values at Grove City College in Grove City, Pa., described the task force’s work as a “well-done effort.”  

“I felt the treatment of religion was very respectful, and in doing so, it created space for clients of conservative religious faith to explore the reality of their sexual orientation, while maintaining their faith commitments,” said Throckmorton, who researches sexual orientation and homosexuality and writes about such issues from a Christian perspective.

Julie Harren Hamilton, PhD, president of the National Association for Research and Therapy of Homosexuality (NARTH), said she appreciated what she described as the task force’s recognition that clients have a right to self-determination, and its respect for religious diversity. But she disagreed with the task force’s main conclusions, and charged that the task force was composed only of members opposed to sexual orientation change efforts. 

“We believe that if the task force had been more neutral in their approach, they could have arrived at only one conclusion, that homosexuality is not invariably fixed in all people, that some people can and do change,” she said.

 Some people may change something but there is little evidence which would allow more than guesses about what the potent elements in any such change might be. The NARTH review found that all kinds of approaches reported some degree of change. Can they all be right? In such a situation, a more plausible guess might be that there was some common element of the clients and/or the therapy that could be involved. And as Jones and Yarhouse suggested in the discussion section of their APA report, perhaps sexual identity is a better concept to consider when discussing categorical change. If someone shifts a Kinsey point or two, one might feel satisfied with this and justified in considering themselves to have changed.

As I have noted, the distance between opposing views may be narrowing significantly.

The APA report and the sexual identity therapy framework

The recent American Psychological Association task force report on sexual orientation and psychotherapy included several positive references to the SITF. I have archived those on the SITF website and am providing two here with brief commentary.

The abstract of the sexual identity therapy framework (SITF) says

Sexual identity conflicts are among the most difficult faced by individuals in our society and raise important clinical, ethical and conceptual problems for mental health professionals. We present a framework and recommendations for practice with clients who experience these conflicts and desire therapeutic support for resolution. These recommendations provide conceptual and empirical support for clinical interventions leading to sexual identity outcomes that respect client personal values, religious beliefs and sexual attractions. Four stages of sexual identity therapy are presented incorporating assessment, advanced informed consent, psychotherapy and sexual identity synthesis. The guidelines presented support the resolution of identity conflicts in ways that preserve client autonomy and professional commitments to diversity.

 

I think the APA report and the SITF are compatible in many important ways.  They both recognize the difference between attractions, behavior and identity. They both recognize that informed consent is critical and that client may seek congruence with other aspects of personality, other than sexual desire, a distinction made in this segment from page 18 of the APA report: Continue reading “The APA report and the sexual identity therapy framework”