Marketing the Bieber Study: Cornelia Wilbur’s Other Scandal

Monday, I wrote about a new book by Debbie Nathan which examines the famous multiple personality case of Sybil, a young woman who claimed 16 personalities. For her book Nathan reviewed the notes of Flora Rheta Schreiber, the journalist who collaborated with Sybil’s psychiatrist Cornelia Wilbur in order to turn the case of Shirley Ardell Mason (Sybil’s real name) into a media sensation. Nathan’s findings debunk the claims of Wilbur and expose the distortions and fabrications which led to the famous case. In looking into Sybil’s history, Nathan also takes a long look at psychoanalyst Wilbur. It turns out that multiple personality was not the only controversial diagnosis Wilbur treated.

While Wilbur was discovering Sybil’s personalities, she also collaborated with Irving Bieber on his study of male homosexuality. Wilbur was one of nine co-authors of Homosexuality: A Psychoanalytic Study, published in 1962. Wilbur also had the distinction of being involved as co-author of the other study of homosexuality conducted by the Society of Medical Psychoanalysts published in the 1960s. Wilbur worked with psychoanalyst Harvey Kaye on a team to research female homosexuality, at the time reporting that half of subjects changed orientation.

With the publication of Sybil by author Flora Schreiber, Wilbur became famous. However, the book about Wilbur’s patient Shirley Mason was not the first collaboration between Wilbur and Schreiber. According to Sybil Exposed, Wilbur and Schreiber met when Wilbur was pitching the findings of the 1962 Bieber study. According to Nathan, Wilbur claimed that the Bieber study reported the causes of male homosexuality and boasted of the 27% cure rate as the result of work with analysts like Wilbur.

Schreiber, a free lance writer, was interested in the research and pitched the idea of a story on the subject to several magazines. Cosmopolitan accepted the pitch and assigned her to write a story about a mother with a gay son “eager to help him go straight.” Schreiber then asked Wilbur for a case which could be turned into an article.

According to Nathan, Wilbur turned over information about Case 129 from the Bieber study. You can read about this case on pages 54-58 of Bieber’s 1962 book (click the links to read it – A, B, C). The case is important for two reasons. One, Schreiber did not like it because the main character was an adult and she was assigned to write about a mother and teen son. Two, according Nathan’s research, the case may have been a thinly veiled reference to Wilbur’s work with actor Roddy McDowall.

After summarizing Case 129 from Bieber’s book, Nathan connects the dots,

The public knew that Roddy McDowall’s father had worked on ships. They knew his mother had pushed him into voice lessons and Hollywood, and that he’d later moved to New York and found success in show business. What McDowall never talked about openly was that he was gay and that after arriving in New York he’d begun an affair with the charismatic, bisexual actor Montgomery Clift, who was eight years his senior and a raging alcoholic. When Clift called off the affair, McDowall tried to kill himself. These facts did not become widely known until after McDowall died in 1998.

Indeed, McDowall’s homosexuality was considered an open secret and one Clift biographer, Patricia Boswell, said that McDowall was suicidal after a breakup with Clift.

However, since Schreiber needed a teen-aged homosexual, the case, no matter how interesting, had to be altered. So, according to her own notes, Schreiber changed the subject of case 129 into an adolescent, Don, who tearfully confessed his homosexuality to his mother, Eve, in a fit of desperation. In the first draft of the article, according to Nathan, Schreiber used many of the details from Wilbur’s case 129 except for the age of the young man.  The adolescent boy attended psychoanalysis with Wilbur, who explained the causes of homosexuality right from the Bieber study. Unfortunately for Schreiber, this clinical tale did not suit the Cosmo editor who insisted on changes just before going to press. Nathan writes:

One afternoon just before press time, Flora was summoned to Cosmopolitan’s offices on Fifty-seventh Street. When she got there she was informed that her piece was not acceptable. Eve, the homosexual boy’s mother, was overly intelligent, and her son, Don, seemed too sophisticated. The editors and printers ordered Flora to do an immediate rewrite. She sat down and worked as fast as she could.

The result was an article which was published in January, 1963 under the title, “I Was Raising a Homosexual Child” (click the link to read it on Google books). In this fabrication, Don’s homosexuality was revealed to his parents by means of a phone call from police. Don had been arrested for cuddling with another man in Central Park. However, Schreiber maintained the same causal narrative about smother-mothers and distant fathers advanced by the Bieber book. In the story, the fictional Don saw Dr. Wilbur for psychoanalysis and eventually decided that he didn’t really like guys after all. The Cosmo piece reads like a promotional piece for Bieber and Wilbur’s book, which is apparently what Wilbur hoped for. According to a letter from Wilbur, referred to by Nathan, Wilbur said Schreiber “had gotten things right” in the Cosmo article. Wilbur then thought of Schreiber when it came time to pitch the book about her multiple personality patient, Shirley.

(Note that the article says the names have been changed, implying that the case was real.)

There are many other shocking details about Wilbur’s work with Sybil detailed in the book. For instance, Wilbur supplied Shirley/Sybil with money and hired her for a variety of projects. One of the projects was typing up the manuscript for Bieber’s book on the study of male homosexuality. Although not mentioned in her book, Nathan told me in an interview that Shirley/Sybil was hired to type the book manuscript and even submitted an idea for the cover art.

So before Wilbur pitched the case of Sybil to Flora Schreiber, there was the pitch to Schreiber about the Bieber study. As it turns out, Sybil was a fictional tale only loosely tied to Shirley Mason. However, Don, the allegedly “cured” homosexual, was a complete fabrication.

The Bieber study is at the heart of the reparative narrative about the cause of homosexuality. Many articles on The National Association for the Research and Treatment of Homosexuality website refer to Bieber’s findings as authoritative. Most observers outside of NARTH dismiss the study as hopelessly subjective and flawed. However, for those inclined to give it weight, the study rises and falls on the credibility of the reports from the psychoanalysts who contributed cases since the patients were never surveyed. With the publication of Sybil Exposed, it is now reasonable to call into question the credibility of those reports.
“Sybil Exposed: The Extraordinary Story Behind the Famous Multiple Personality Case,” by Debbie Nathan, is published by the Free Press and went on sale this week.

Additional note: After Wilbur died, Richard Kluft edited a book on multiple personality disorder and included a tribute to Cornelia Wilbur. Wilbur’s work with Sybil and other patients changed the way dissociative states were treated. An interview with Wilbur is included in the opening pages of the book. Here she notes the connection of the Cosmo article on Don, the fictional cured homosexual, and her decision to use Schreiber to write Sybil.

Note Wilbur says that Schreiber got everything right.

 

Bieber Study Co-Author, Cornelia Wilbur, Accused of Fabricating Case of Sybil

Sunday, Salon briefly reviewed a book by Debbie Nathan which claims to debunk the case of Sybil. Sybil, actually a young Minnesota girl named Shirley Mason, was one of the first cases of multiple personality disorder to catch the public attention. The book about the case sold 6 million copies and inspired a movie starring Sally Field.
The Salon article by Laura Miller gives enough detail to hook my inner skeptic. According to Nathan, most of the details reported in the book were fabricated, based on grueling sessions where Shirley/Sybil was under the influence of Sodium Pentothal, administered by her psychoanalyst, Cornelia Wilbur. At one point, Shirley Mason wrote Wilbur confessing that the information about lost time, and other personalities was made up to keep her therapist’s attention. Miller writes:

Nevertheless, Mason did at one point attempt to jump off Wilbur’s train, writing her doctor a long letter confessing that all the multiple-personality stuff — the lost time, the named “alters” and the grotesque tortures supposedly inflicted on Mason as a child by her supposedly psychotic mother — had all been made up. Wilbur briskly dismissed this as a “major defensive maneuver” designed to derail the “hard work” of therapy lying ahead. The pitiably vulnerable Mason soon caved.

The Salon article and the book it features would be interesting enough for a post. However, it gets more interesting. While she was involved in the invention of multiple personalities, Cornelia Wilbur was a member of the Society of Medical Psychoanalysts, along with Irving Bieber. In fact, she was a co-author of the famous “Bieber study” from which current reparative therapists derive much of their claims about the causes of male homosexuality. The Bieber authors surveyed psychoanalysts about their patients (presumably Wilbur was one of the participants as well) and reported their results in the 1962 book Homosexuality: A Psychoanalytic Study.
The Bieber study has been widely criticized, and for good reason.  First, the homosexual participants were psychoanalytic patients in analysis with doctors who already believed that homosexuality was a pathological condition. Also, the patients themselves were never interviewed. Rather, the authors surveyed the analysts to assess the histories and attitudes of their patients. The analysts had already formed the opinion that homosexuality was shaped in childhood and that is exactly what they reported as results.
So it is intriguing to read about Cornelia Wilbur’s conduct in relationship to her most celebrated case. Is it possible that her biases about homosexuality operated first in the Bieber study? While one cannot say based on the case of Sybil, I think is natural to question her part in the Bieber study as a result. This seems especially true given how open the Bieber methodology was to confirmation bias.
The Bieber study is central to reparative therapy. Whenever I have asked reparative therapists for the three best studies which they believe support reparative therapy, they always mention Bieber.
A number of studies mentioned over the years as supports for sexual reorientation change efforts have later come into disrepute. Rekers work with Kyle Murphy, and the Masters and Johnson studies are just two other prominent investigations which later have been questioned.
Additional information: The New York Time Magazine has a lengthy piece on Wilbur and the Sybil case here. This article makes it clear that the sessions with Mason took place while Wilbur was involved with the Bieber study.

NARTH Touts Jones and Yarhouse Study

I was wondering when NARTH would weigh in on the Journal of Sex and Marital Therapy publication of the Jones and Yarhouse study. Dated October, 2011, the title of the post — Change in Sexual Orientation is Possible — immediately spins the study. Here is what the press release about the Jones and Yarhouse study says:

WHEATON, Ill., Sept. 27, 2011 /Standard Newswire/ — Many professional voices proclaim that it is impossible to change homosexual orientation, and that the attempt to change is commonly and inherently harmful. Psychologists Stanton L. Jones (Wheaton College, IL) and Mark A. Yarhouse (Regent University) have just published in the respected, peer-reviewed Journal of Sex and Marital Therapy the final results of their longitudinal study of individuals seeking sexual orientation change through involvement in a variety of Christian ministries affiliated with Exodus International. The results show change to be possible for some, and the attempt not harmful on average. These results stand in tension with the supposed professional consensus; more information is available at www.exgaystudy.org.
In prior studies, in the words of the American Psychological Association, “treatment outcome is not followed and reported over time as would be the standard to test the validity of any mental health intervention.” This study assessed evolving sexual attractions and psychological distress levels of 98 individuals seeking sexual orientation change beginning early in the change process, and then followed them with five additional assessments over a total span of 6 to 7 years. The researchers used standardized, respected measures of sexual orientation and of emotional distress to test the study’s hypotheses.
Of the original 98 subjects, 61 were successfully categorized for general outcome at the last assessment. 53% were categorized as successful outcomes; specifically, 23% reported success in the form of successful “conversion” to heterosexual orientation and functioning, while an additional 30% reported stable behavioral chastity with substantive dis-identification with homosexual orientation. At the 6 year mark, 20% reported fully embracing gay identity. Modest but statistically significant changes were reported on average for decreases in homosexual orientation. The measure of psychological distress did not, on average, reflect increases in psychological distress associated with the attempt to change.
These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some. The results do not prove that no one is harmed by the attempt to change, but rather that the attempt does not appear to be harmful on average or inherently harmful. The authors urge caution in projecting success rates from these findings, as they are likely overly optimistic estimates of anticipated success. Further, it was clear that “conversion” to heterosexual adaptation was a complex phenomenon.
Jones and Yarhouse argue that implications of their findings include respect for the integrity and autonomy of persons seeking to change unwanted sexual attractions for moral, religious, or other reasons, just as we respect those who for similar reasons desire to affirm and embrace their sexual orientation. Full information should be offered to consumers about the options and their potential risks. The results also suggest that it would be premature for professional mental health organizations to invalidate efforts to change sexual orientation and unwanted same-sex erotic attractions.

Some might argue that the press release is not appropriately clear because it speaks of change of orientation in the same release as it says this:

These results do not prove that categorical change in sexual orientation is possible for everyone or anyone, but rather that meaningful shifts along a continuum that constitute real changes appear possible for some.

Most of the reviews of this study have missed this statement. Categorical change — moving from a homosexual orientation to a heterosexual one — is not what has been reported by the Jones and Yarhouse. Clearly some people reported changes which allowed them to make an attribution change to themselves – they feel more straight and so they identify with the label. However, the absolute shifts on average were modest, leading to the assessment from Jones and Yarhouse that “meaningful shifts along a continuum that constitute real changes appear possible for some.”
The NARTH article does not link to the press release and does not mention the assessment that the study does not prove categorical change to be possible for anyone. The review is not as skewed as some I have seen, but it does shade the picture.
I have a more focused post about the study planned, but for now, let me add that the concept of bisexuality is not satisfactorily addressed by the study or by reviewers. Bisexuals I have spoken to describe their lives as a series of shifts. For whatever reason, the direction of their attractions shifts with time and/or with relationships. From their point of view, they are not changing orientation when they fall in love with an opposite sex person after a period of same-sex relationships. Instead, they are flexing along a continuum, all of which is understood to be within their essential orientation.
The other group of people which I worked with are the mixed orientation couples. Some of them believe they have become straight because they have fallen in love with an opposite sex spouse. However, these folks do not plan this, nor does it appear to be subject to manipulation or ministry.
Another issue not addressed well by the study or the reviewers is the difference between men and women. Women are probably more likely to report big changes than men. However, Jones and Yarhouse have mixed groups. Separating men and women in the analyses would clarify the possibility that women change more than men.
In all, I am disappointed that the study has re-ignited the “change is possible” political machine. There is fluidity for some people in their sexual attractions, however this says very little about the experience of people who don’t experience that fluidity. Change of orientation for a small group of people is one hypothesis. However, there are other explanations. I think explanations incorporating the reality of bisexuality, cross orientation relationships, and male-female differences are also plausible. In fact, I think they are more plausible.
As an aside, the NARTH review ends with the obligatory slap at the APAs:

Unfortunately, however, the major mental-health associations appear to be moving further away from a purely scientific approach and toward one apparently directed by activists, whereby the purpose of their science does not seem to be understanding those who report change, but rather debunking, dismissing, and ignoring them.

All I can say is: takes one to know one.
NARTH does the same thing they accuse “major mental-health associations” of doing, just on the other side of the ideological perspective. The purpose of NARTH’s “science” seems to be to debunk, dismiss and ignore those who report no change. Regarding activism, NARTH is featuring anti-gay activist Michael Brown in a plenary session at this year’s conference. Brown has no scientific credentials but will be there as an activist, decrying the “homosexual agenda.”
Even more ominous is the presence of Sharon Slater at this year’s conference. Slater runs Family Watch International, a group who lobbies foreign governments at the UN and internationally to maintain laws criminalizing homosexuality. Slater uses NARTH materials in her work. Slater has no scientific credentials, she is there as an activist. I have asked NARTH but gotten no answer as to what scientific benefit Brown and Slater bring to the NARTH audience.
NARTH’s approach may not be “directed by activists.” Perhaps, it is more of a partnership.

Michael Brown: Here is a taste of next month's NARTH conference

The National Association for the Research and Therapy of Homosexuality claims to be a scientific organization. However, a review of their website finds lots of anti-gay advocacy. In the past, when I bring this up with NARTH supporters, what I have been told is that they do it because the APA does it.
While I don’t deny that the mental health groups lean left and this bias comes out at their conferences at times, I wonder why NARTH makes any pretense of being distinct from the APA when they feature non-scientists in prominent speaking spots. Cases in point: this year’s conference features advocate of keeping homosexual criminal Sharon Slater who will speak in an applied workshop (I wonder what application NARTH wants participants to take from Slater’s workshop?). In addition, minister Michael Brown will speak in a plenary meeting to all participants. Brown has a book out called A Queer Thing Happened to America. It is not a science book.
You can hear a little of what he might have to say next month here, courtesy of Right Wing Watch.

Really?
There will always be extremes in any social group who want to say, ‘off with their heads’ to people not in the club. We got our reconstructionists and dominionists and the gays may have them some gay dominionists somewhere. I don’t really think I should be judged by the reconstructionists. Should we judge all gay folk by Brown’s gay dominionists (if they exist)?

NARTH Report: Suicide attempts increase during sexual orientation change therapy

Writing in the second edition of NARTH’s (National Association for the Research and Therapy of Homosexuality) Journal of Human Sexuality, Neil Whitehead proposed a reanalysis (NARTH summary here) of a paper by Ariel Shidlo and Michael Shroeder on potentially harmful outcomes of sexual orientation change efforts. NARTH’s headline describing the paper is

Sexual Orientation Change Efforts Do Not Lead to Increased Suicide Attempts.

Contrast NARTH’s headline with the title of my post. After examining  Whitehead’s  article, I submit that his analysis supports my title as much or more than it does NARTH’s claim.
 Shidlo and Shroeder wrote the following about suicide attempts in their 2002 report:
 

In examining the data, we distinguished between participants who had a history of being suicidal before conversion therapy and those who did not. Twenty-five participants had a history of suicide attempts before conversion therapy, 23 during conversion therapy, and 11 after conversion therapy. We took the subgroup of participants who reported suicide attempts and looked at suicide attempts pre-intervention, during intervention, and post-intervention to see if there was any suggestive pattern. We found that 11 participants had reported suicide attempts since the end of conversion interventions. Of these, only 3 had attempted prior to conversion therapy. Of the 11 participants, 3 had attempted during conversion therapy.

In his NARTH paper, Whitehead makes a series of assumptions about the participants in the Shidlo and Schroeder study. I think these are questionable assumptions but for sake of discussion, I will play along. First, he assumes that these suicide attempts occur over a span of 25 years (13 years pre-therapy, two years in therapy and then 10 years post-therapy). He then assumes that the attempts occurred at a constant rate over that span to calculate an expected number of suicide before, during and after therapy. Whitehead then compares his expected attempts with the actual number of attempts as reported by Shidlo and Schroeder. Whitehead summarized his findings as follows:

(a) Comparing pre-therapy, therapy, and post-therapy groups, there is overall no significant increase in suicides per unit time.
(b) There is a very clear increase in attempts during therapy.
(c) There is a trend to fewer attempts after therapy.

Using his assumptions, Whitehead wrote:

Suicide attempts reported before therapy were 25, and those reported during and after therapy combined numbered 34. The expected numbers allowing for the time periods and normalized to the above total are 30.55 and 28.44. The expectation on which this is calculated is that therapy has no effect, either positive or negative.

In this analysis, no difference shows up in suicides related to therapy when suicide attempts before therapy are compared with the time period during and after therapy. However, Whitehead does not stop there. About suicide attempts during therapy, he wrote:

For attempts before and during therapy, the observed results are 25 and 23, and the calculated expected normalized figures are 42.18 and 5.82. These are very different from the observed, and the chi-square test produces a result of p < 0.001. They are not the same, and therapy has therefore been associated with a several-fold increase in attempts.

In other words, there is a very large increase in suicide attempts during therapy. The title of my post is accurate. According to this NARTH report, sexual orientation change “therapy has therefore been associated with a several-fold increase in attempts.”
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