Category: Professional issues

Sexual Identity Therapy Framework to Be Reviewed

I posted this to the SIT Blog and I hope other bloggers post this on their blogs.  

News Release 

Sexual Identity Therapy Framework to Be Reviewed

The Sexual Identity Therapy Framework, authored by Warren Throckmorton and Mark Yarhouse, will be reviewed in 2008 for possible revision. Proposed as a means to help counselors work with clients who experience value conflict surrounding homosexual attractions, the Framework is endorsed by Nicholas Cummings, the father of managed behavioral healthcare and Robert Spitzer, the architect of modern psychiatric diagnosis. The framework respects diversity of sexual orientation and religious practice and anticipates a planned review of sexual orientation counseling which will be reported by the American Psychological Association in 2008.

“We believe this area of counseling practice is changing rapidly and we want to be sensitive to how therapists and consumers of sexual identity therapy feel the framework helps or hinder excellent outcomes. We want to hear from professionals and consumers alike,” said Dr. Throckmorton.

The authors are asking for public and professional comment on the Framework though the end of February, 2008.

Interested persons can download and review the Framework at http://www.sexualidentity.blogspot.com. One may leave comment there or send extended comments to Warren Throckmorton at [email protected] and/or Mark Yarhouse at [email protected]. Therapists interested in a registry of therapists who adhere to the Framework should visit, http://www.sexualidentityinstitute.org.

Selected endorsements:

I have reviewed the sexual identity framework written by Warren Throckmorton and Mark Yarhouse. This framework provides a very necessary outline to help therapists address the important concerns of clients who are in conflict over their homosexual attractions. The work of Drs. Throckmorton and Yarhouse transcend polarized debates about whether gays can change their sexual orientation. Rather, this framework helps therapists work with clients to craft solutions tailored to their individual situations and personal beliefs and values. I support this framework and hope it is widely implemented.

Robert L. Spitzer, M.D., is Professor of Psychiatry, Columbia University, New York State Psychiatric Institute, New York City, NY. Dr. Spitzer was Chairman of the committee that developed the Diagnostic and Statistical Manual of Mental and Emotional Disorders, 3rd Edition and 3rd Edition (Revised).

Drs. Throckmorton and Yarhouse have brilliantly resolved contention in psychotherapy by providing the field with unbiased guidelines that are responsive to scientific evidence, are sensitive to professional practice, and which restore patient determination in choosing his/her goals in psychotherapy.

Dr. Nicholas Cummings, PhD, ScD is Distinguished Chair in Psychology, University of Nevada, Reno. Dr. Cummings is the President of the Foundation for Behavioral Health and Chairman of the Nicholas & Dorothy Cummings Foundation, Inc. He was the founding CEO of American Biodyne (now Magellan Behavioral Care). He is also the former President of the American Psychological Association. Dr. Cummings was the founder of the four campuses of the California School of Professional Psychology, the National Academies of Practice, and the American Managed Behavioral Healthcare Association. He was the former Executive Director of the Mental Research Institute. Dr. Cummings is the co-editor with Rogers Wright of Destructive Trends in Mental Health.

One point I am considering is to discourage referral to NWTA and I-groups as a means of changing orientation. While no outcome studies have been done on this point, it seems clear that such referrals do nothing on average to change orientation. We welcome feedback and suggestions.

Mind Games: The gap between therapists and researchers

Researching rebirthing in the context of the Mankind Project, I ran into an article by social psychologist, Carol Tavris titled, Mind Games: Psychological warfare betwen therapists and scientists. Tavris mentions rebirthing as a process for which there is no evidence, but her reasoning could be applied to other approaches as well (e.g., holding therapy, bioenergetics, etc.).

Here a couple of excerpts:

Our society runs on the advice of mental-health professionals, who are often called upon in legal settings to determine whether a child has been molested, a prisoner up for parole is still dangerous, a defendant is lying or insane, a mother is fit to have custody of her children, and on and on. Yet while the public assumes, vaguely, that therapists must be “scientists” of some sort, many of the widely accepted claims promulgated by therapists are based on subjective clinical opinions and have been resoundingly disproved by empirical research conducted by psychological scientists. Here are a few examples that have been shown to be false:

• Low self-esteem causes aggressiveness, drug use, prejudice, and low achievement.

• Abused children almost inevitably become abusive parents, causing a “cycle of abuse.”

• Therapy is beneficial for most survivors of disasters, especially if intervention is rapid.

• Memory works like a tape recorder, clicking on at the moment of birth; memories can be accurately retrieved through hypnosis, dream analysis, or other therapeutic methods.

• Traumatic experiences, particularly of a sexual nature, are typically “repressed” from memory, or split off from consciousness through “dissociation.”

• The way that parents treat a child in the first five years (three years) (one year) (five minutes) of life is crucial to the child’s later intellectual and emotional success.

Indeed, the split between the research and practice wings of psychology has grown so wide that many psychologists now speak glumly of the “scientist-practitioner gap,” although that is like saying there is an “Arab-Israeli gap” in the Middle East. It is a war, involving deeply held beliefs, political passions, views of human nature and the nature of knowledge, and — as all wars ultimately do — money and livelihoods. The war spilled out of academic labs and therapists’ offices and into the public arena in the 1980s and ’90s, when three epidemics of hysteria caught fire across the country: the rise of claims of “repressed memories” of childhood sexual abuse; the growing number of cases of “multiple-personality disorder” (MPD), from a handful before 1980 to tens of thousands by 1995; and the proliferation of day-care sex-abuse scandals, which put hundreds of nursery-school teachers in prison on the “testimony” of 3 and 4-year-old children.

She continues…

But psychotherapeutic nonsense is a Hydra: Slay one set of mistaken ideas, and others take their place. Recovered-memory therapy may be on the wane, but “rebirthing” techniques and forms of “restraint therapy” — physically abusive practices that supposedly help adopted or troubled children form attachments to their parents — are on the rise. In Colorado, 10-year-old Candace Newmaker was smothered to death during rebirthing, a procedure in which she was expected to fight her way through a “birth canal” of suffocating blankets and pillows. The two therapists convicted in Candace’s death are now serving time in prison, but efforts in Colorado to prohibit all forms of “restraint therapy” were defeated by protests from “attachment therapists” in the state and throughout the country. After Candace’s death, one member of the Colorado Mental Health Grievance Board noted with dismay that her hairdresser’s training took 1,500 hours, whereas anyone could take a two-week course and become “certified” in rebirthing. Yet the basic premise — that children can recover from trauma, insecure attachment, or other psychological problems by “reliving” their births or being subjected to punitive and coercive restraints — has no scientific validity whatsoever. 

In the rest of the article, Tavris calls practitioners to base our interventions on research and to take a skeptical stance toward our work in order to avoid confirmation bias. 

Mankind Project and Recovered Memories

I recently came across this account of how methods used in the Mankind Project activities (New Warriors Training Adventure and Integration Groups) might stimulate participants to reconstruct memories of abuse. It is long so I am going to post a link to the document with excerpts here. I have permission from the author who wishes to remain anonymous at this time.

The personal account begins:

It started at my NWTA at the carpet work. MKP leaders had me “kill” my father in a process to deal with physical abuse I got as a child. At the end of this process, a MKP leader said to me, “…and you were sexually abused too!” I immediately said to myself, “I was never sexually abused. What is this guy talking about?”

Just a few months later I believed that not only was I sexually abused, but that I was sexually abused by 3 different males, at different periods of time, for multiple instances throughout my entire childhood. All of this while having NO memory of sexual abuse before joining MKP!

The rest of the article describes the “bucketing process” which I described earlier via a citation from a MKP manual. According to this individual, the process of “memory” recovery is aided by the emotive techniques and suggestions from the leaders. There are some statements in this article that I cannot verify as yet (e.g., one of the founders is a gestalt therapist, the APA has all but banned “rebirthing”) but I post this because the experiences described here sound very much like what are described in the NWTA manuals and accounts from other witnesses with whom I have spoken. I know I have posted this before, but this You Tube clip of Rage Therapy seems quite relevant to this man’s account.

Year in review: Top Ten Stories from 2007

Since it was so much fun last year, I decided to compile a top ten list of stories of the year on the blog. Since I am the only voter, the list is subjective and regular readers might arrange them differently or think I should have included another story over one of these. The stories are arranged in the order of the interest they seemed to create here on the blog and elsewhere.

1. APA Task Force on sexual orientation – I first reported here that the APA had convened a task force to review APA policy regarding therapeutic responses to sexual orientation. Initial information released from the APA noted that gay advocacy groups sought assistance from the APA in order to negatively evaluate efforts to change sexual orientation. The charge also involves therapeutic responses to individuals who wish to alter behavioral expression of their sexuality. The issue was the subject of a CNN segment involving yours truly, an Associated Press article and was the subject of several posts on the blog. A large coalition of religious groups and interested individuals wrote the APA regarding the religious aspects of the committee’s charge. Efforts to further regulate orientation change efforts spilled over to other professions, notably, the American Academy of Physician Assistants. The APA Task Force will likely be featured as a top story again since the report is expected to be released sometime in 2008.

2. The sexual identity therapy framework – The SIT framework was the subject of national news stories and identified by Stephanie Simon of the LA Times as an important component of changes in therapy for those in conflict over sexual identity. I did numerous posts on the framework in an attempt to distinguish it from other approaches. Mark Yarhouse and I presented aspects of the framework at the American Psychological Association convention, the American Association of Christian Counselors World Conference and other local conferences. A revision of the framework and several high level presentations are slated for 2008.

3. The release of the Exodus outcomes study by Stanton Jones and Mark Yarhouse – After months of speculation, Stanton Jones and Mark Yarhouse released the results of their longitudinal study of Exodus International participants at the AACC conference in September.  Although the study garnered little national media attention, many blogs, (including this one), and the gay and religiously based news services thoroughly covered the study. With additional data to be collected and reported, this story will most likely reappear in 2008.

4. Donnie Davies – For a short time in January and February, blogosphere was captivated by the “Rev. Davies” and the “The Bible Says” music video. In a kind of “Where’s Waldo” cyber hunt, numerous bloggers were eager to crack the case and learn find out who Donnie Davies was, where was he hiding, and to learn if his act for real. I did 11 posts on the subject and became acquainted via email with Joey Oglesby, the actor behind the spoof. We even wondered if Mr. Oglesby and Rev. Davies were twins separated at birth because of their uncanny resemblance. Will Donnie do an anniversary reunion tour in January? Stay tuned.

5. The Cameron Eastern Psychological Association presentation – In March, Paul and Kirk Cameron released a series of news spots claiming that data from Canada, Norway and Denmark supported their contention that gays die between 20-30 younger than straights. In reviewing their study, first presented as a poster session at the Eastern Psychological Association annual meeting, I disputed key assumptions underlying their claims. In addition, Danish epidemiologist, Morten Frisch reviewed the study here on the blog finding it inadequate. Paul and Kirk Cameron provided rebuttals to criticisms and a nine-part series resulted.

6. New Warriors Training Adventure and the Mankind Project – A post regarding the suicide of Michael Scinto in an October issue of the Houston Press led to a series of posts about the Mankind Project and New Warriors Training Adventure. I received numerous emails from men who attest to benefit and those who believe NWTA was harmful and coercive. One irony about NWTA is that public proponents of reparative therapy and gay affirmative therapy both recommend NWTA to clients to enhance masculinity. Reparative therapists believe NWTA may lead to reduced same-sex attraction and gay therapists believe NWTA can enhance security in a gay identity. I remain curious about the mechanisms inherent in NWTA and other such programs to effect either benefit or harm. With the Scinto trial schedule for later in 2008, this story will remain of interest through the next year.

7. Montel Williams show on reparative therapy – The Montel Williams show purporting to examine reparative therapy was a lightning rod for controversy. On the show, psychiatrist Alicia Salzar falsely claimed that science has shown that 96% of people attempting to change orientation cannot do so and experience harm. Her claim was based on a study, the authors of which acknowledged cannot be used to make such a claim. The unwillingness of the show to retract the statement led to a ethics complaint against Dr. Salzar, filed by Exodus International.

8. Pro-life/abortion related stories – The most viewed post on the blog consisted of an interview with Grove City College colleague and historian Paul Kengor regarding the religious beliefs of Hillary Clinton.  Other such interviews have been immensely popular with readers as well. Another APA task force, this one on abortion and mental health issues, stimulated grassroots activism, reported here in November.

9. Emergence of the ex-ex-gay movement – At this year’s Exodus conference, a group of people once involved in ex-gay efforts had a parallel conference to discuss their efforts to recover from their experiences. Perhaps, the newest ex-ex-gay, James Stabile is a 19 year old young man from Dallas who encountered evangelists from the Heartland World Ministry Church in early September. Recorded on film and broadcast on the Christian Broadcasting Network, it appeared that Mr. Stabile was dramatically converted and even reported change in homosexuality. Later it was learned that Mr. Stabile had not changed and was back home with his parents after a stay at ex-gay residential program, Pure Life Ministry.

10. Richard Cohen – An early 2007 debacle on John Stewart’s Daily Show led Mr. Cohen to pledge on my blog that he would do no additional media appearances. He ended his email with a fundraising appeal. In response to this appearance, Exodus issued a statement distancing the organization from Cohen’s work, and NARTH and PFOX quietly removed references to Mr. Cohen from their websites. Cohen made something of a comeback however, with You Tube videos including his family, and a new edition of one of his books with Evangelical publisher, Intervarsity Press. Then, later, I looked into the Unification Church connections of Mr. Cohen’s assistant director and former board member, Hilde Wiemann. Both Cohen and Wiemann initially denied these connections but they were clear enough that cult expert, Steve Hassan, briefly placed the International Healing Foundation back on his list of Unification Church connected groups. Eventually, Mrs. Wiemann acknowledged, in contrast to the initial claims, that she had been involved in the church and had only recently left it. After her repudiation of Moon, Mr. Hassan then again removed the IHF from his list of Unification connected groups.

Well, that was quite a year. I suppose one could make a case for other stories, e.g., the Omaha websites advocating violence, the quick emergence and then retreat of Michael Glatze as an ex-gay spokesman, Ted Haggard’s three week therapy, the wide stance of Larry Craig, the Surgeon General nominee James Holsinger, Stephen Bennett’s public division with Exodus, Al Mohler’s comments on biology and homosexuality, the retirement of I Do Exist, and my musical comeback and resultant #1 Internet hit.

Now cast your opinion – What would your top ten list for this blog look like for 2007?

Godspeed to all and a Happy New Year!

An antiboy antibody? Problems for the “maternal immune hypothesis”

In June 2006, Anthony Bogaert released a study in the Proceedings of the National Academy of Science which created a world wide buzz about a possible biological basis for the same-sex attraction of some men.

A recent Journal of Biosocial Science article by Neil Whitehead takes on this hypothesis and finds several problems. I don’t have time for a detailed analysis at this time (I am behind on as it is on these – notably on the Witelson brain study), but I do want to get this on the radar. Here is his concluding section:

An antiboy antibody? Unlikely. Gooren (2006), in his review on psychosexual development, bluntly concludes ‘The biological basis advanced for the fraternal birth order hypothesis lacks any experimental support’. The present paper argues further that there is a significant weight of evidence against the MIH, whatever the explanation of the FBO [fraternal birth order] effect may be. The MIH was an intellectually clean and satisfying explanation for the FBO effect, and its original authors are to be commended. However, present evidence is for alloimmune reactions being probably too rare to account for the SSA prevalence observed, no support for macrostructural-level attack, unlikely attack on brain if not on testes, no MIH-related lower birth weight, healthier late-birth-order males. At the least, any modification of the MIH would demand serious consideration of the apparent disproportionate deaths of female fetuses during immune attack. One might sincerely hope that any revised theory will be simpler than the present one – which in any case attempts to account for only 17% of SSA.

The very division of SSA into FBO origin and other more major origins seems to raise difficulties. Twin study conclusions are challenging because they simultaneously dispose of most biological and social reasons for SSA; erratic and individualistic causes should predominate.

Because of the erratic nature of SSA in later-birth-order boys, even an acceptance of the MIH would seem to demand an acceptance of a principle that something akin to chance predominates.

This is close to my current view of orientation development on the whole – not terribly satisfying, but an honest appraisal of the research as it is. Note this is an assessment of the development of SSA and says nothing about how changeable it might be. Nothing here relates to women either. As an aside, I have been reading some research which suggests that the erotic orientation of men becomes more channelized than for women; meaning that in brain scans, for instance, men show very specific reactions to their preferred object of sexual attraction, whereas, women more frequently demonstrate sexual arousal to images of both gender.