Category: sexual identity

Sexual identity therapy and neutrality, Part one

Continuing the discussion about sexual identity therapy, I want to contrast our framework with both gay affirming and reparative therapies on the dimension of value neutrality in two posts. As a springboard for my thoughts, I want to quote from an article by Joseph Nicolosi on the NARTH website called, “Why I Am Not A Neutral Therapist.” He led with this explanation:

A Christian psychologist contacted me to discuss reorientation therapy for SSA men. Hoping to find a politically “safe” compromise with the APA, he was anxious to avoid value judgments and remain noncommittal about homosexuality. The solution, he thought, would be a simple behavior modification program. Speaking from my 25 years of experience in this field, I told him I found his approach naïve and ultimately unworkable.

Then he adds:

“Furthermore, why should I refuse to discuss philosophical issues with clients,” I told him, “when gay-affirmative therapists are working very hard as boosters of their philosophy? They tell clients that same-sex feelings are ‘sacred.’ They push them to revolutionize society’s and the church’s attitudes. Any client’s conviction that heterosexuality is the norm will be redefined by the therapist as a ‘psychological illness — homophobia.'”

“The fact is, neutrality fails for clinicians on both sides of this issue,” I told the psychologist. “Clinicians like you and me, who believe that humanity was designed for heterosexuality, must speak up about our philosophy. These men with unwanted SSA want boosters, allies, advocates, as they claim their masculine identity — someone who believes in them and stands strongly at their side.”

Dr. Nicolosi parallels his disclosure of reparative drive theory as an ideology to what he believes gay affirming therapists do with clients but from an opposing perspective. After all, if it is ethical for gay affirming therapists to promote homosexuality as a moral good, then why shouldn’t reparative therapists promote heterosexuality as God’s design?

Before I discuss this further, one might question whether gay affirming therapists or therapists in general really have a worldview on the matter. I cannot go into this exhaustively but a statement from the APA’s Clinton Anderson from a recent AP article by David Crary suggests there are favored and disfavored religious views on matters gay. Speaking about religious views which are at odds with homosexual behavior, Dr. Anderson said:

“We cannot take into account what are fundamentally negative religious perceptions of homosexuality — they don’t fit into our worldview,” Anderson said.

So can therapists be neutral?

In my view, not all therapists can practice in a neutral manner. In our sexual identity therapy framework, we have clear guidance which allows for referrals when value conflicts impair what therapy has to offer a client. In other situations, the role of the therapist is to assist clients clarify their own perspectives and work toward congruence. For clients who do not know what they believe, it can be very valuable for the therapist to refrain from imposing a religious worldview or stigmatizing conservative religious views.

Some people want a non-neutral therapist on either side of the worldview spectrum. Perhaps they would not be happy with sexual identity therapy. My investigations into this arena suggest that retrospective assessments of therapist helpfulness are associated with therapists not attempting to impose a contrary value position on to the client. And so, I continue to believe that SIT occupies a niche that offers something not available in ideologically-driven approaches. For those who are still figuring things out or have not felt successful with other approaches, our framework could provide something different.

Part two will explore where the sexual identity therapist isn’t neutral.

Bishop Gene Robinson discusses change therapy

Ex Gay Watch posted a link to an interview with Episcopal Bishop Gene Robinson that covered many topics but included several of recent interest to readers here. He specifically says that he had twice weekly reorientation therapy in his younger years.

He says it worked but didn’t work at the same time.

Q. Did you feel it (the therapy) had worked, or did it just put you in denial?

‘It didn’t work, and it almost never works for people who attempt it. I guess I did think it had worked. I suspect it didn’t make the same sex feelings go away, but it certain worked in that I felt ready emotionally and spiritually and physically for a relationship with a woman, so it certainly made that part of myself possible. And so when I entered into a relationship with the woman who became my wife, it was full of integrity – I wasn’t pretending to be something that I was not. And yet within a month of meeting her, I shared that all of my primary relationships had been with men, that I had been in therapy to make a heterosexual relationship possible, and that I felt I was in a good place to do that.’

Speaking descriptively here not prescriptively, many people in the ex-gay movement might characterize their results very similarly (same-sex attractions remain but opposite-sex attractions develop), but would consider this outcome a success. An unasked question in the interview was what changed in his thinking, beliefs, or values that led to the mutual decision to end the marriage.

Read the whole article; in my opinion, it is a candid and fascinating interview.

APA symposium to examine sexual identity therapy

Next week (August 17) I will participate in a symposium on sexual identity conflicts at the American Psychological Association annual conference in San Francisco, CA.

Here is the brief description from the association website (scroll down to Division 36):

Div. 36 (Psychology of Religion)

Friday, 2-2:50 p.m.• Symposium: “Sexual Identity Therapy to Address Religious and Spiritual Conflicts.” Co-chairs: Mark A. Yarhouse, PsyD, and A. Lee Beckstead, PhD.Participants: Warren Throckmorton, PhD, Mark A. Yarhouse, PsyD, and Erica S.N. Tan, PsyD.

Click the links above to read the abstracts of the sessions.

This search page supports a search of sexual identity to find further description of the symposium (or just click the link).

Session Title: Sexual Identity Therapy to Address Religious and Spiritual Conflicts

Session Type: Symposium

Division(s): 36

Building–Room: Moscone Center–Room 2016

Location: Second Floor-West Building

Day/Time: Fri/2:00PM – 2:50PM

Event Type: Division Event

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.