Sexual identity therapy: A blast from the past

In light of conversations on the Exodus-PFOX thread, I thought it might be good to review a past mainstream media article that brought SIT more into the mainstream conversation.

The LA Times article now titled “Approaching agreement in debate over homosexuality” by Stephanie Simon (now with the Wall Street Journal) was published on June 18, 2007 with the title, “New ground in debate on ‘curing’ gays.”

The article begins with some familiar ground to this blog:

Alan Chambers directs Exodus International, widely described as the nation’s largest ex-gay ministry. But when he addresses the group’s Freedom Conference at Concordia University in Irvine this month, Chambers won’t celebrate successful “ex-gays.”

Truth is, he’s not sure he’s ever met one.

With years of therapy, Chambers says, he has mostly conquered his own attraction to men; he’s a husband and a father, and he identifies as straight. But lately, he’s come to resent the term “ex-gay”: It’s too neat, implying a clean break with the past, when he still struggles at times with homosexual temptation. “By no means would we ever say change can be sudden or complete,” Chambers said.

His personal denunciation of the term “ex-gay” — his organization has yet to follow suit — is just one example of shifting ground in the polarizing debate on homosexuality.

I am not sure if I am correct, but I think Alan later nuanced the remarks about not knowing ex-gays, but I do think he has made efforts including the recent article regarding Bryce Faulkner, to paint an accurate picture of his personal situation.

This article brought to a wide audience conversations that we have been having here for quite awhile — and continue to have. The ex-gay conversation is a recurring one here. Some newer readers may want to review this post (Ex-ex-gay?) and this one ( What does change mean?) and this one (Acceptance and Commitment Therapy).

The LA Times article quoted several people who approved of the framework, including commenter Michael Bussee.

“Something’s happening. And I think it’s very positive,” agreed Michael Bussee, who founded Exodus in 1976, only to fall in love with another man — a fellow ex-gay counselor.

Now a licensed family therapist in Riverside, Bussee regularly speaks out against ex-gay therapies and is scheduled to address the Ex-Gay Survivor’s Conference at UC Irvine at the end of the month.

But Bussee put aside his protest agenda recently to endorse new guidelines to sexual identity therapy, co-written by two professors at conservative Christian colleges.

Other notable folks gave a thumbs-up to the framework as well.

He and other gay activists — along with major mental-health associations — still reject therapy aimed at “liberating” or “curing” gays. But Bussee is willing to acknowledge potential in therapy that does not promise change but instead offers patients help in managing their desires and modifying their behavior to match their religious values — even if that means a life of celibacy.

“It’s about helping clients accept that they have these same-sex attractions and then allowing them the space, free from bias, to choose how they want to act,” said Lee Beckstead, a gay psychologist in Salt Lake City who uses this approach.

The guidelines for this type of therapy — written by Warren Throckmorton of Grove City College and Mark Yarhouse of Regent University — have been endorsed by representatives on both the left and right. The list includes the provost of a conservative evangelical college and the psychiatrist whose gay-rights advocacy in the 1970s got homosexuality removed from the official medical list of mental disorders.

“What appeals to me is that it moves away from the total polarization” common in the field, said Dr. Robert Spitzer, the psychiatrist.

“For many years, mental-health professionals have taken the view that since homosexuality is not a mental disorder, any attempt to change sexual orientation is unwise,” said Spitzer, a Columbia University professor.

Some therapies are widely considered dangerous, and some rely on discredited psychological theories. “But for healthcare professionals to tell someone they don’t have the right to make an effort to bring their actions into harmony with their values is hubris,” Spitzer said.

Just over two years later, we continue to discuss very similar concerns and the tension remains.

Activists on both sides caution that the rapprochement only goes so far.

Critics of Exodus note the group still sponsors speakers who attribute homosexuality to bad parenting and assert that gays and lesbians live short, unhappy lives.

And though Chambers has disavowed the term “ex-gay,” his group’s ads give the distinct impression that it’s possible to leave homosexuality completely behind.

Haven’t we just been discussing this topic?

The article concludes with a reference to the APA Sexual Orientation Task Force.

The American Psychological Assn. set up a task force this spring to revise the group’s policy on sexual orientation therapy. The current policy is a decade old and fairly vague; it states that homosexuality is not a disorder and that therapists can’t make false claims about their treatments.

The new policy, due early next year, must help psychologists uphold two ethical principles as they work with patients unhappy about their sexuality: “Respect for the autonomy and dignity of the patient, and a duty to do no harm,” said Clinton Anderson, the association’s director for lesbian, gay and bisexual concerns. “It’s a balancing act.”

In fact, the Task Force will report soon, in August, sometime during the APA convention. Stay tuned…

Although we will soon migrate the website, more on the SIT Framework is now here.

Bryce Faulkner’s parents say he willingly entered program

Here is a story about a young man who may have entered an ex-gay program. I am not going to comment much at this point as the details are still fuzzy.

One side, a former boyfriend and activist looking to make a name for himself, say the young man was forced into a program. The other side, including the fellow’s parents say he chose to enter.

Eventually, we will find out.

(via Exgaywatch)

Exodus no longer affiliated with PFOX

According to Exodus President, Alan Chambers, you won’t be able to find this reference to PFOX (Parents and Friends of Ex-gays and Gays) on the Exodus website much longer.

PFOX

Within the last couple of weeks, PFOX gave up affiliation with Exodus. While Chambers declined to give reasons for the PFOX move, he indicated that Exodus would not seek any future relationship. He noted that PFOX is a public policy organization and their activities do not fit in with the mission and direction of Exodus. I have asked Regina Griggs, Executive Director at PFOX, for comment and will report the reason for their decision if disclosed.

PFOX seems to be alone among conservative groups in advocating for ex-gays using civil rights language. I recall thinking this was a strange framework for a group that really doesn’t believe homosexual orientation exists. In any event, PFOX and Exodus has not been a good fit on many levels so this separation is a good move.

Reorientation therapies in the UK: Survey results

A new survey from BMC Psychiatry found that 4-17% of therapists surveyed offer some form of therapy designed to reduce homosexual attractions.
From the article in the BBC News:

A significant minority of mental health professionals had agreed to help at least one patient “reduce” their gay or lesbian feelings when asked to do so.
The survey, published in the journal BMC Psychiatry and conducted by London researchers, involved 1,400 therapists.
Many were acting with the “best of intentions”, said the lead author.
Only 4% said they would attempt to change a client’s sexual orientation, but when asked if they would help curb homosexual feelings some 17% – or one in six – said they had done so.
The incidence appeared to be as prevalent in recent years as decades earlier.

Here is the abstract from the journal article:

Background
We know very little about mental health practitioners’ views on treatments to change sexual orientation. Our aim was to survey a representative sample of professional members of the main United Kingdom psychotherapy and psychiatric organisations about their views and practices concerning such treatments.
Methods
We sent postal questions to mental health professionals who were members of British Psychological Society, the British Association for Counselling and Psychotherapy, the United Kingdom Council for Psychotherapy and the Royal College of Psychiatrists. Participants were asked to give their views about treatments to change homosexual desires and describe up to six patients each, whom they have treated in this way.
Results
Of 1848 practitioners contacted, 1406 questionnaires were returned and 1328 could be analysed. Although only 55 (4%) of therapists reported that they would attempt to change a client’s sexual orientation if one consulted asking for such therapy, 222 (17%) reported having assisted at least one client/patient to reduce or change his or her homosexual or lesbian feelings. 413 patients were described by these 222 therapists: 213 (52%) were seen in private practice and 117 (28%) were not followed up beyond the period of treatment. Counselling was the commonest (66%) treatment offered and there was no sign of a decline in treatments in recent years. 159 (72%) of the 222 therapists who had provided such treatment considered that a service should be available for people who want to change their sexual orientation. Client/patient distress and client/patient autonomy were seen as reasons for intervention; therapists paid attention to religious, cultural and moral values causing internal conflict.
Conclusions
A significant minority of mental health professionals are attempting to help lesbian, gay and bisexual clients to become heterosexual. Given lack of evidence for the efficacy of such treatments, this is likely to be unwise or even harmful.

Going a little deeper into the study, it appears that some of the efforts designated as change might not be direct efforts to change after all. Consider some reasons given for what is labeled by the authors as support for change efforts:

“…where someone had a strong faith, then working to help the person accept their feelings but manage them appropriately may be the best approach if (the) person felt they would lose God and therefore their life was not worth living.”
“Some bisexual individuals may wish to choose an orientation that is
comfortable for them and their lifestyle choices for example. This is a
therapeutic issue to explore and support if that is their wish. It is different from behavioural attempts to reshape desire.”
“Yes, possibly those within marriages that wish to continue with that
relationship rather than break up”

Rather, these therapists give what sound like client-centered responses based on the individual circumstances of the clients. I wonder if the authors of this article may have pushed these responses into either change or gay affirming camps without considering a third more neutral position – what Mark Yarhouse and I call sexual identity therapy.
Most of the other comments relied on a belief that therapists should follow the wishes of the client. This seems reasonable if the client is informed that change is infrequent at best and we do not know going in who might shift and by how much. Also, it is necessary to provide prospective clients with accurate information regarding homosexuality without regard to the ideological loyaties of the therapist. Also, it seems clear that non-homosexually identified people experience same-sex attraction. Helping them sort out their particular situation and arrive and a value-congruent position is not the same thing as reparative or reorientation therapy.
The authors paint a picture of 1 in 6 therapists engaging in change therapy and I think that is misleading. The 4% figure seems like the right number of therapists who deliberately promote change among their same-sex attracted clients.

More strict than God

I recall reading an article as an undergraduate regarding legalism. I do not remember the name of the author, nor the title of the article. I do remember a line from the article. The author was noting that many churches have rules for behavior that are not derived from the Bible. The rules seem important to the creator of the rule but should not be imposed on others when such rules make one “more strict than God.”
I thought of that mostly forgotten article when I read a post by Brian Pengelly (“When You’re Told that What God Has Done Is Not Enough”)on Bridging the Gap, the blog of New Directions. In that post, Brian describes a speech to a local youth group where he acknowledges that he is same-sex attracted. Even though Brian has not been in a same-sex relationship since high school, is married with kids (corrected 3/23) and does not advocate same-sex relationships, he was criticized severely by several youth ministers who attended the meeting.
Brian attributed the reaction to a theological difference – one we have discussed here before – and that is the difference between charismatic and non-charismatic Protestant Christianity. Brian’s specific concern relates to “Word of Faith” theology, a view that

…God has promised to heal every area of a believer’s life right now and given them the authority to command that healing into existence.

Remember James Stabile? He was the young man that was supposedly delivered from homosexuality during a Pentecostal street meeting. Problem was, he wasn’t.
Brian elaborates:

Because of this, my testimony was a great threat to them because God had simply not done enough in my life. Despite the fact that I could testify that I had not been in a relationship with another male since high school, despite the fact that I was able to enjoy a happy marriage to a woman, despite the fact that God had clearly been using me in ministry for over a decade….my testimony was not acceptable because God had not completely taken away my attraction to men.

Brian knows the thinking because he used to be a part of the Word of Faith perspective.

The authors assumed that because I was telling my story and had my experiences, I had never confessed my sin or had prayer ministry to cast out the demons in my life that may have entered because of being abused. In fact they were so bold as to write:

“Had at any time in Brian’s life he cried out to God and taken his authority that he has been given as a believer and told his body “IN JESUS NAME I AM NOT GAY AND GOD DID NOT MAKE ME GAY AND I WILL NOT HAVE HOMOSEXUAL TENANDANCIES (sic) ANYMORE”, and then taken his mind captive when ever those thoughts came in, Brian most likely would not struggle with this anymore. Had he at anytime repented of that initial time when he was in the library and he spoke out I am gay, and then asked God to forgive him for all the rest of the times that he has thought thoughts or acted in a homosexual manner, asked God to forgive him for that initial self cursing and THEN had the spirit of sexual perversion cast out of him, Brian most likely would not still struggle with this sin.”

The truth is that I once attended a youth group where they taught such things, and believing that they were true, I did go forward to the altar, confess these very sins, and pray that very prayer meaning it with every cell of my body. I believed that God would heal me…… and then he didn’t. When it didn’t happen I was told it was because I lacked enough faith, or I was doing something wrong. The message I received was that it was my fault. And yet I knew in my heart that I had prayed with all the faith that I had and could do no more. When I said this, I was rejected by that group. I spent years believing that lie, that it was my fault and I just wasn’t good enough to make it all go away. As I grew older and studied the Bible I came to realize that this was a false teaching and turned away from it. But that teaching left me in shame and despair for years of my life.

Then he notes the damage is not reserved for the person who experiences SSA, but for their parents as well.

There has also been a sad legacy within the ex-gay movement of using this kind of teaching to burden parents as being at fault for their children’s sexual orientation. I do not know how many times over the years I heard about generational curses, mixed in with some pop psychology to explain the fact that I was attracted to men. My own story does include significant perceived rejection from my father. But the truth is that causation of sexual orientation is incredibly complex and that there is no good evidence to link it to parental behaviour. In fact, several of my best gay friends had wonderful relationships with their parents. But because of this kind of teaching, I have met with more parents than I can count who blame themselves for their children’s sexual orientation. I have listened to them as they examined every little thing they did or said in their lives wondering where they had spoken curses over their children!

One does not need to go to a Word of Faith church for this guilt, although it apparently helps. A NARTH conference will do. Or a well-meaning but errant Christian radio program.
In traditional Christianity, human nature is not perfectable. Perfect parenting, wonderful therapy or any other reparative concept cannot offset this condition. The causes of sexual orientation, while of scientific interest, should be relatively unimportant in a ministry domain. To require change in the direction of desire as a measure of spirituality seems to me to expect something more strict than God expects.