Multiple pathways to sexual orientation, Part 2

I have referred to this story several times. Seems like a fitting parable for our discussion.

The Blind Men and the Elephant
John Godfrey Saxe
It was six men of Hindustan
To learning much inclined,
Who went to see the Elephant
(Though all of them were blind)
That each by observation
Might satisfy the mind.
The first approached the Elephant
And happening to fall
Against his broad and sturdy side
At once began to bawl:
“Bless me, it seems the Elephant
Is very like a wall”.
The second, feeling of his tusk,
Cried, “Ho! What have we here
So very round and smooth and sharp?
To me ’tis mighty clear
This wonder of an Elephant
Is very like a spear”.
The third approached the animal,
And happening to take
The squirming trunk within his hands,
Then boldly up and spake:
“I see,” quoth he, “the Elephant
Is very like a snake.”
The Fourth reached out an eager hand,
And felt about the knee.
“What most this wondrous beast is like
Is mighty plain,” quoth he;
“‘Tis clear enough the Elephant
Is very like a tree!”
The Fifth, who chanced to touch the ear,
Said: “E’en the blindest man
Can tell what this resembles most;
Deny the fact who can,
This marvel of an Elephant
Is very like a fan!”
The Sixth no sooner had begun
About the beast to grope,
Than, seizing on the swinging tail
That fell within his scope,
“I see,” quoth he, “the Elephant
Is very like a rope!”
And so these men of Hindustan
Disputed loud and long,
Each in his own opinion
Exceeding stiff and strong,
Though each was partly in the right
And all were in the wrong.
So oft in theologic wars,
The disputants, I ween,
Rail on in utter ignorance
Of what each other mean,
And prate about an Elephant
Not one of them has seen!

NARTH not petitioning APAs

During his visit to London, Joseph Nicolosi touted the research supporting reparative therapy. He also said on at least one occasion that NARTH was petitioning the American Psychological Association with studies which verify the approach.
From Virtueonline:

Nicolosi said his organization – the National Association of Research and Therapy of Homosexuality (NARTH) is petitioning the American Psychiatric Association to look at the scientific data.

The BBC News quoted Nicolosi as saying:

“We have a great deal of evidence showing that these individuals are not harmed and that the therapy does work.
“We are petitioning the American Psychiatric Association to look at the scientific data.”

In this BBC News radio interview at about 2:08, Nicolosi says,

We have a great deal of evidence showing that these individuals are not harmed and that the therapy does work…We are petitioning the American Psychological association to look at the data.

It seems clear to me that the APA at issue is the psychological group and not the psychiatric assocition. I asked David Pruden, NARTH Executive Director about the specifics of this petition to the APA. He referred the question to Dean Byrd, past-president of NARTH. Dr. Byrd replied:

NARTH has no plans to petition APA on behalf of reparative therapy (or any other therapy for that matter). Dr. Nicolosi, of course, is free to do whatever he likes.
The Scientific Advisory Committee of NARTH has been working on a number of projects aimed at preserving the rights of individuals to seek psychological care for unwanted homosexual attractions as well as protecting the rights of licensed professionals to provide ethical, effective care for this client population. When these projects are completed and ready for distribution, announcements will be made via press releases on the NARTH website and through other venues.

I am not sure what form a petition would take but it would be important news if some formal research report was available which purported to support reparative therapy (in the sense Nicolosi was using in the term in London – his brand of change therapy). There are various peer-reviewed professional journal articles around which review the available research (I have done two of them) on a host of approaches to behavior and attraction change. In my opinion, those reviews do not present evidence favoring the developmentally based, reparative drive theory and therapy.

Multiple pathways to sexual orientation, Part 1

On other threads, we have discussed why reparative therapy vignettes and ex-gay testimonies are so often alike. I have suggested that there are different causal pathways which lead to different sexual orientation outcomes. Also, therapists like Joe Nicolosi and Richard Cohen have strong public positions which promote a particular causal narrative. Clients who may have histories in line with those narratives seek counseling from those therapists. The same dynamic likely occurs in Exodus ministries where unhappy people seek help based on reading or hearing public testimonies.
People seeking help for unhappiness might be more likely to have life circumstances which they view as causal. Therapists looking for such causes ask questions which validate the hunches. It seems easy enough to imagine how therapists and clients can arrive at a common narrative without even trying to do so.
Same-sex attracted people who have not been traumatized in some way often react with puzzlement and frustration when, like palm readers, therapists go through a litany of questions about non-existent past trauma, seeking some confirmation of the predicted narrative. Eventually small, forgotten hurts and deprivations are identified as evidence for the expected patterns.
While I believe this occurs often, I have no idea how often. I also am pretty sure that the histories of some people are relevant to their sexual attractions. The research on the variability of pathways to sexual orientation is sparse but there is some and it demonstrates that on average same-sex attracted people who seek help of some kind (therapy or Exodus) recall more troubling relationships with parents than same-sex attracted people who have not sought therapy or ministry help.
The primary reference in this regard is Bell, Weinberg & Hammersmith (1981) Sexual preference: Its development in men and women. Bloomington: Indiana University Press. An important section on the differences between clinical and nonclinical groups is reprinted here from pages 202-203.

Homosexuals in Therapy
More than half of the WHMs [white homosexual males] (58%) said that at one time or another they had sought help for a personal or emotional problem from a professional counselor such as a psychiatrist or a psychologist. Most previous studies of the development of male homosexuality have been based on the reports of homosexuals “in treatment,” and many scholars have tried to generalize their findings to other homosexuals as well. When our own findings failed to support so many widely held clinical views, we were curious to see whether the reports of respondents who had been in therapy would differ from those made by respondents who had never sought professional counseling or therapy.
What we found was that those respondents “ever in treatment” did indeed have the kinds of paternal variables in their model that were consistent with what clinicians have always thought to be typical of homosexual males. The path model of those “never in treatment,” on the other hand, either did not contain such variables or showed their influence to be weaker. For example, as the literature suggests, the “therapy” group tended to have Detached-Hostile Father (t.e.= .29), a variable that is tied to the son’s gender nonconformity and early homosexual experiences. This variable does not even appear in the model for the men who have never been in therapy, however. Moreover, although the “nontherapy” group had more Negative Relationships with their Fathers, this variable (t.e.= .11) did not influence their gender nonconformity at all. In addition, two other variables that were important for the therapy group — Cold father and Negative Image of Father — do not appear at all for the nontherapy males. Although the rest of the path model is much the same for both groups, clearly the model for the therapy group corresponds much more closely to the way fathers have been considered in theories about the etiology of male homosexuality.
How might this discrepancy be explained? On the one hand, it could be supposed that cold, detached fathers make for troubled sons who are likely to seek psychological treatment at some point in their lives. Likewise, it could be argued that “therapy” often involves an “education” of client by the therapist in which the client comes to believe what the therapist supposes must be true of the client’s parents. Alternatively, it could also be argued that fathers tend to withdraw (become detached) from psychologically troubled sons, who are later to seek psychological counseling.
Whatever the case may be, at least on the basis of what our respondents could remember about their parents, Cold or Detached-Hostile Fathers cannot be regarded as important in the development of male homosexuality in general, since their alleged influence does not even appear among those who neve sought therapy or counseling. Finally, it should be noted that the differences between the therapy and non-therapy groups do not stem from differences between these two groups in terms of effeminacy or bisexuality. We found no significant correlations between being exclusively homosexual and having been in therapy, the more effeminate WHMs were only somewhat more likely than the non-effeminate WHMs ever to have been in therapy (64% versus 54%).

Bell et al, also compared WHMs and WHTMs (white, heterosexual males) who had and had not been in therapy. The findings regarding these comparisons are not drawn out in the same manner as above. However, there is a footnote on page 202 briefly describing the analysis.

The path analysis on which these findings were based included all the white heterosexual males, whether or not they had been “in treatment.” Separate analyses, one comparing only those WHMs and WHTMs “ever in treatment” and and one comparing those WHMs and WHTMs “never in treatment” replicated the results reported above.

For women, the picture was somewhat different. The authors noted that 2/3rds of the WHW had been in therapy and then on page 209, they wrote:

We do find some differences between the path model for the women who had been in therapy and those who had not. Notably, Childhood Gender Nonconformity appears to have been a more important factor for the respondents who had been in therapy or counseling (t.e.= .71 versus .52 for the women who had never been in therapy or counseling.)
In addition, the path model for the homosexual women who had in therapy or counseling includes two variables pertaining to a sense of estrangement or unhappiness while they were growing up: Unhappiness in Adolescence (B=.14) and Felt Different from Other Girls in High School (B=.11). The path model for the nontherapy group contains no comparable measures.
Finally the path model for the women who had been in therapy or counseling includes two variables pertaining to an unhappy recollection of the mothers: Negative Relationship with Mothers (t.e. = .24) and Unpleasant Mother (t.e. = .22). The nontherapy group on the other hand, appear to have been slightly more influenced by their fathers. Their path shows significant — but weak — paths from Weak Father (t.e. = .20), Aloof Father (t.e. = .14), Controlling Father (t.e. = -.10), and Mother Dominated Father (t.e. = .14). Otherwise, the differences between the women in therapy or counseling and those with no such experience show little pattern.

In the path analysis procedure used in Bell et al’s research, the “t.e.” you see repeated throughout this passage refers to the “total effect” of one variable on another, in this case sexual preference. Think of it as a measure of the strength of effect of each variable mentioned and sexual orientation, with the larger numbers representing a larger effect. While there are many points we could discuss here, the primary reason for this series is to examine the possibility that multiple paths exist which yield the direction of sexual attractions. A practical implication is that therapists who frequently counsel those who are seeking help probably get a skewed picture of same-sex attracted people in general. Another implication is the effects noted by the reparative drive theorists are not huge and must rely on other pre- and post-natal factors. Also, those who take a solely biological perspective should expand the complexity of their model to consider that the sexual behavior of some people are influenced by certain environment experiences.
The next posts in this series will include additional research as well as more results from Bell et al. Some research does find differences between gay and straight groups on developmental recollections. What do these differences mean? Stay tuned…

Nicolosi claims 75% cured

SEE UPDATES BELOW…
Last week I blogged about a homosexuality conference in London hosted by the conservative Anglican Mainstream, and featuring Joseph Nicolosi, Jeff Satinover and Arthur Goldberg. One attendee was David Virtue who runs Virtueonline.com. His website is popular among conservative Anglicans. Virtue had much to say about the conference but one quote stood out. The quotes within this segment of Virtue’s article come from Nicolosi.

Nicolosi said he has been helping people to “increase their heterosexual potential” for 25 years, and puts his success rate among men at about two out of three. “75% of our clients are completely cured, the 25% who are not usually have other factors that are not brought into the counseling situation.”
“It is not the absent father, but the non-responsiveness of the father. It is when the father shuts downs and rejects the boy’s masculine striving and he shames the boy in his strivings to become a man. That boy will find some male to connect with. It is the negative experience of the father that destroys him and pushes him towards men who offer him homosexual sex as a way out.”

Something happened on the way from 2/3 to 75%. In either case, this is an astounding claim and represents an inflation from previous statements. In a NARTH conference report, Nicolosi is reported to have proposed that the change rate was 1/3.

Joseph Nicolosi gave the following counsel in closing the meeting: we should study the literature, obtain good training, get to know the arguments (from both sides), and be aware that research indicates about one-third of those who persevere in therapy for unwanted homosexual attractions are successful in making a significant change in behavior and identity and developing heterosexual responsiveness. Even if the change may not be complete, there is substantial improvement along with greater life satisfaction, better self-esteem and improved relationships with others.

UPDATE: Linda Nicolosi emailed this evening to say the 75% figure was a misquote. She said, “Joe has never made such a claim.” Earlier today, I checked the number with David Virtue who was in attendance and who interviewed Nicolosi here. Mr. Virtue confirmed that Nicolosi gave the 75% figure during his remarks in London. So at this time (late Monday night) there is some dispute about what is being claimed.
UPDATE (4/28/09) – David Virtue changed his article regarding the the claims of cure without notice. The current version is here. The paragraph in question has been changed to read:

Nicolosi said he has been helping people to “increase their heterosexual potential” for 25 years, and puts his success rate among men at about two out of three.

A .pdf of the original is here and a screen capture of the relevant section is here.

Anglican group hosts reparative therapy conference in London

Beginning today, the Anglican Mainstream is hosting a conference called Sex in the City in London. The speakers are Joseph Nicolosi, Jeff Satinover and Arthur Goldberg. A Christian Today article provides a description of the speakers about the content.

The Sex and the City Conference, hosted by Care and Anglican Mainstream, aims to help clergy, rabbis and psychologists among others to address issues like therapeutic approaches to same-sex attractions, mentoring the sexually broken, the sexualisation of culture, and sex and the Bible.
“We want to convey the message that change is possible,” said Joseph Nicolosi, founder of the US-based therapeutic organisation NARTH, ahead of the conference.
“Many people who have same-sex attractions are told you can’t change, it’s biologically predetermined, it’s genetically based, and that’s not true.
“After 30 or 40 years of trying to find the gay gene it has not been discovered and many people, especially young people, are being told that they don’t have a choice and that’s really tragic.
“Basically they are resigning themselves to a gay lifestyle not knowing that there are options for them.”
Nicolosi said young people were at risk of developing “self-defeating, self-destructive, maladaptive behaviours” because they were not being told of the emotional dangers of entering into homosexual relationships. He said research, including studies from within the gay community, had found that people in homosexual relationships suffer more from depression, anxiety and failed relationships than people in heterosexual relationships.

While virtually all others who write and work in the field of sexual orientation recognize that sexual orientation involves a variable mix of biological, contextual, cultural, and psychological factors, Dr. Nicolosi, Satinover and Goldberg want the world to know that there is no gay gene. Later this year, we will get more specifics about the genetics when Alan Sanders reports on his work. However, the best twin studies we have indicate around 35% heritability. Much is related to individual differences beginning in the womb. The research we have does not support the developmental scheme offered by the reparative therapists as being generally true or most or all gays. See the Reparative Therapy Information Page for more on this point.
Once formed, sexual attractions appear to be quite durable for most people. Recent research has found that brain differences between gays and straights associate with reported sexual orientation. These differences are quite large and make it clear that once formed, sexual attractions become automated. Some people spontaneously change and some seem to alter sexual responses with effort, although there is no reliable evidence that identifies the potent factors even for those changers. In any case, even if we knew the causes, we do not know that such knowledge could lead to consistent change.
Given that this conference is being sponsored by a Christian group, a related question I have is: Why is the basic message ‘change is possible?’ It seems to me that the basic message for a non-affirming group should be ‘a faithful Christian life is possible.’ Later, in the Christian Today article, Nicolosi says,

“The Christian view is to overcome your sin and if a believer believes that his homosexuality is a sin to overcome we are providing the ways with which he can overcome it.”

Surely he means behavior choice and not internal desire. Even Nicolosi acknowledges that most of his successful clients are still same-sex attracted. However, many people will read these promises and think they will hear about a way that the same-sex desires will be eliminated (overcome). This kind of confused presentation is what is so potentially damaging about these conferences and the ‘change is possible’ mantra. Many same-sex attracted people keep looking for the magic path to freedom from their desires. They drop lots of cash and time and untold emotional resources into approaches which may or may not have other benefits but which do not lead to elimination of their same-sex attractions. Many in frustration decide their religious tradition was wrong all along and leave the faith – any faith. Others keep searching and think they need to get “healed” before they can really enter life and pursue their life’s goals. In fact, what is possible is a recognition of what can and can’t be changed (or at least what is or is not within my power to change) and then pursuing a life that is congruent with one’s beliefs and values, bumps and all.