Tag: Joseph Nicolosi

NARTH Founder Retracts Claim of Sexual Reorientation via Lexapro

While examining NARTH’s 2009 review of past studies on homosexuality  (Journal of Human Sexuality, Vol.1 – click the link for the entire issue), I ran across this citation:

Nicolosi (in press) found that while conducting reparative therapy, a 50-year-old male client reported a sudden and dramatic freedom from unwanted homosexual thoughts, feelings, and behaviors after taking Lexapro. The client reported that he continued to be free of these unwanted symptoms more than 18 months after starting the anti-depressant medicine.

To better examine these claims, I asked one of the authors of the NARTH paper, James Phelan, for access to the source. Thanks to Dr. Phelan for supplying the paper for review.

The paper by Joseph Nicolosi was apparently submitted for publication in 2009 to a journal but there is no record of it being published anywhere. As noted, it describes the case of a 50 year old man who was diagnosed by Nicolosi with ego-dystonic homosexuality. The patient was seen for 142 sessions over “about eight years” with no progress. During therapy, the patient described “generalized hopelessness and helplessness, along with a pervasive sense of inadequacy…” He also described himself as “a non-entity.”

After the lengthy unsuccessful treatment for unwanted same-sex attraction and depression, the patient began taking “a 5 ml dosage of Lexapro,” a selective serotonin reuptake inhibitor. According to Nicolosi, the patient had “an almost immediate decrease in his sense of worthlessness and inadequacy, followed soon after the elimination of his homosexuality.”

The paper describes the situation:

After awhile, the patient stopped taking the drug because he was feeling so much better. However, this brief drug holiday did not work out well.

However, there is more to the story.

I wrote to Dr. Nicolosi and asked permission to post the entire paper. He wrote back quickly to clarify that the claim made in the NARTH paper is not longer valid. Nicolosi explained,

I can say that two years later now, that the use of Lexapro has not fulfilled its promise. We no longer see the use of Lexapro as a positive addition to Reparative Therapy.

So another one of the papers referred to in NARTH’s landscape review can be set aside as evidence for sexual reorientation.

Even in Nicolosi’s paper, there was evidence that the medication effect was an anomaly. Nicolosi wrote:

However, these cases were not mentioned in the NARTH review. Instead of noting that the case reported was only one success out of four tries, the authors only noted the one case which appeared to be a success at the time. Now, according to Dr. Nicolosi, Lexapro has not lived up to that claim.

This report can be added to others where significant questions have been raised  (e.g., the Bieber study, the Kaye study, the work of Masters and Johnson, the Pattison and Pattison research).

Do broken parental attachments cause homosexuality? An interview with Diana Fosha

Earlier this week, NPR produced a report briefly telling the stories of Rich Wyler and Peterson Toscano. Wyler is the co-founder of People Can Change and Journey into Manhood, both of which seek change of sexual orientation via a variety of highly provocative techniques. Toscano sought change for 17 years and then accepted that he was not changing despite a variety of methods.
In that report, Wyler and Toscano both referred to the belief that attachment disruptions with the same-sex parent contribute to homosexual attractions (Toscano now believes the theory to be completely false). Regular readers of this blog know some about the source of those ideas.
One of the more recent theorists and therapists who traffics in the reparative therapy is Joseph Nicolosi, co-founder of the National Association for the Research and Therapy of Homosexuality.
Nicolosi often refers to mainstream theorists and therapists in his talks about reparative therapy. Specifically, of late, he asserts that he has incorporated the research and insights of therapists who focus on assisting clients with disruptions in important attachments. This is not unexpected given that reparative drive theory proposes that attachment disruptions help create homosexual strivings. One such therapist referred to often in Nicolosi’s recent book, Shame and Attachment Loss: The practical work of reparative therapy, is Diana Fosha. Fosha is an accomplished psychotherapist who is widely credited as a leader in experiential therapy. She is author of the book The Transforming Power of Affect and Director of the Accelerated Experiential-Dynamic Psychotherapy Institute.
Nicolosi describes Fosha’s work with the label, Affect-Focused Therapy. In fact, if you search for Affect-Focused Therapy and Diana Fosha in Google, Nicolosi’s references to her are the first few hits. Generally, Nicolosi credits Fosha and other like-minded therapists for making reparative therapy more effective.
Over the years, I have appreciated the contributions of attachment theorists to various approaches to therapy and so Nicolosi’s reference to Fosha made me curious. I decided to contact her to find out her views on the idea that attachment disruptions play a part in orienting sexual attractions toward the same or opposite sex. I also asked her if there was new research in her area of practice that might shed light on the prospects for sexual orientation change. Here is what she had to say.
Throckmorton: Dr. Fosha, are you aware of any evidence that past attachment problems with same-sex parents can lead to homosexual attraction?
FOSHA: No. If you really think of it, half of people who have attachment problems have attachment problems with the same-sex parent. There are no studies that I am aware of that in any way link attachment problems of any kind with gender identity, sexual identity and issues of attraction. None. Attachment problems predict interpersonal problems and affect regulation patterns, and are a risk factor for compromised resilience in the face of trauma across all sexual orientations
Throckmorton: Do you know of any evidence that affect focused therapy (AFT) can change gays to straight or in some way alter a person’s sexual orientation?
FOSHA: None
Throckmorton: So then, you know of no evidence that sexual orientation can be changed from gay to straight by addressing and ameliorating attachment issues with parents or others?
FOSHA: No, none. When attachment disruptions are addressed successfully, people are generally happier and may develop stronger adult relationships, greater resilience and greater well-being, but their essential sexual orientation stays the same, whether they are straight or gay.
Throckmorton: Do you or your organization offer any trainings or educational experiences using AFT to achieve sexual reorientation?
FOSHA: No.
Throckmorton: Do you or your organization have any position on using AFT to try to achieve sexual reorientation? Are you neutral about it; favor it or oppose it?
FOSHA: I have not read Nicolosi’s work, so I would not presume to be definitive, but based on what I know from the popular media about such methods (whether this applies to his or not, I do not know) leads me to strongly oppose such efforts– and view them as misguided at best, and dangerous at worst.
While Dr. Fosha is candidly unaware of the specifics of reparative therapy, it is informative that she does not see any relationship between attachment problems and sexual orientation. If such problems were frequently associated with sexual orientation changes, I would think she would see evidence of a relationship in her work. Her experience mirrors my own – attachment problems are so pervasive among same, other and both-sex attracted people that one cannot point to these disruptions as the general driving factor behind sexual orientation.

Roots of reparative therapy – Sandor Rado and the reparative adjustment

This week I am surveying some roots of reparative drive theory – the view that homosexuality is a reparative, but pathological, response to a broken attachment with one’s same-sex parent. For reparative therapists, same-sex attraction is an attempt to gain connection to the appropriate sense of gender lost or defended against due to poor attachment with the same sex parent.
While Freud had several things to say about homosexuality, he often wrote about sexual departure from heterosexuality in terms of failure during the Oedipal phase of psychosexual development. In the case of homosexuality, a young boy might come to identify with mother due to unwillingness or inability to give up the mother’s love. He may identify with her to the degree that he wishes to possess what she possesses, a man. There is more to Freud’s views on this but my point here is not to offer a comprehensive account. I want to move to those who revised his views of sexuality, today in particular, Sandor Rado.
In objecting to Freud’s views of bisexuality, Rado introduced the concept of non-heterosexual behavior as a “reparative adjustment.” In a 1940 paper, Rado wrote:

The basic problem, to state it briefly, is to determine the factors that cause the individual to apply aberrant forms of stimulation to his standard genital equipment. Following up this line of inquiry, we find that the chief causal factor is the affect of anxiety, which inhibits standard stimulation and compels the “ego action system in the individual” to bring forth an altered scheme of stimulation as a “reparative adjustment” (12, IJ).
Both the inhibitory and thereparative processes begin far back in early childhood, leading up to the picture which we encounter in the adult. The reparative adjustment may allow the individual several alternatives of morbid stimulation, or may take the form of a rigid and inexorable pattern on which he depends for gratification. This approach, of which we can give here only the barest suggestion, has in practice unfolded a wealth of clinical details leading to a theory that is free of inconsistency and that serves as a reliable guide to treatment. (p. 466)

In this paper, Rado does not drawn out what kind of reparation takes place in various forms of non-heterosexual behavior. He does conclude that whatever they are, they start in childhood and they in some way increase anxiety which requires a reparative adjustment. Anxiety is the culprit that make gays. Nicolosi has his “Grey Zone” which sounds like Rado’s anxiety. And as we all know, straights are relaxed and anxiety free.
On the other hand, Rado does not completely discount “constitutional factors,” which apparently open the door for biological influence. In fact, Rado seems more open minded to these factors than his heirs at NARTH.

It also demands a change in outlook toward the underlying problem of constitution. If we assume, as we must, that constitutional factors may have an influence on morbid sex developments, we are now justified in considering this influence to be of two kinds: one preparing the ground for the inhibitory action of anxiety, the other modulating the course of the reparative adjustment. In considering the factors so involved we must not overlook the possibility of general, i.e., non-sexual factors, as well as innate defects of the sexual action system of as yet unknown character. It is well to recall, lest we underestimate this eventuality, that we are still in the dark even as regards the physiological mechanism of such an elementary phenomenon as sexual attraction. Still another possibility is of course the presence of elements of the action system of the opposite sex such as reflexes, or rather chains of reflexes, susceptible to resuscitation by hormones or other agents. However, not until somatic research has disclosed such elements shall we be able to determine by psychological methods their role in shaping morbid sex behavior. (p. 467)

Rado here shows much more respect for biological influences than demonstrated by today’s reparative therapists. Rado assumes (without empirical evidence) a reparative mechanism but to his credit, he recognizes that biological factors would have to mediate the response. In other words, homosexuality, even for Rado, is more complex than a set of family dynamics or a specific kind of attachment break. If environmental factors have any relevance, they would surely be mediated by nature.
Rado also noted that at the time almost nothing was known about brain and sexual attraction. He seemed open to being corrected in his thinking based on what he called somatic research. He also called upon psychoanalysts to give deference to researchers in discovering and elucidating the biological elements of sexuality.
We do know much more about sexuality and have brain studies which demonstrate significant differences associated with sexual orientation. In my view, NARTH supporters only incorporate one aspect of Rado’s suggestions.

Roots of reparative therapy – Philip Wylie and megaloid momworship

For WWII and post war mom blamers such as Edward Strecker and Philip Wylie, moms were not just responsible for individual immaturity in their sons, they were, by extension, the ruination of democracy. Strecker (who referred to this book by Wylie in his book) made that case very directly in his book, Their Mothers’ Sons, which I reviewed briefly Monday and Tuesday.
In his book, Generation of Vipers, Philip Wylie aims his rhetorical gun at just about everyone; mother blaming was not his sole purpose. However, to best understand why mother blaming could take root so deeply in American culture, one needs to review Wylie’s chapter in Generation of Vipers, titled “Common Women.” I will give a few portions here.

Wylie apparently thought Freud cogent on matters of mother blame, writing:

Freud has made a fierce and wondrous catalogue of examples of mother-love-in-action which traces its origin to an incestuous perversion of a normal instinct. That description is, of course, sound. Unfortunately, Americans, who are the most prissy people on earth, have been unable to benefit from Freud’s wisdom because they can prove that they do not, by and large, sleep with their mothers. That is their interpretation of Freud. Moreover, no matter how many times they repeat the Scriptures, they cannot get the true sense of the passage about lusting in one’s heart–especially when they are mothers thinking about their sons, or vice versa. (p. 185)

Wylie thinks mothers and sons are just sickening, creepy close. Americans however, are behaviorally oriented, he says. Since American men are not actually sleeping with their mothers, they can excuse their stifling emotional closeness. Wylie says instead that it is the thought that counts — men are too concerned about their moms, to the point of worship. He continues:

Meanwhile, Megaloid momworship has got completely out of hand. Our land, subjectively mapped, would have more silver cords and apron strings crisscrossing it than railroads and telephone wires. Mom is everywhere and everything and damned near everybody, and from her depends all the rest of the U. S.  Disguised as good old mom, dear old mom, sweet old mom, your loving mom, and so on, she is the bride at every funeral and the corpse at every wedding. Men live for her and die for her, dote upon her and whisper her name as they pass away, and I believe she has now achieved, in the hierarchy of miscellaneous articles, a spot next to the Bible and the Flag, being reckoned part of both in a way. She may therefore soon be granted by the House of Representatives the especial supreme and extraordinary right of sitting on top of both when she chooses, which, God knows, she does. At any rate, if no such bill is under consideration, the presentation of one would cause little debate among the solons. These sages take cracks at their native land and makes jokes about Holy Writ, but nobody among them–no great man or brave–from the first day of the first congressional meeting to the present ever stood in our halls of state and pronounced the one indubitably most-needed American verity: “Gentlemen, mom is a jerk.”

Mom is something new in the world of men. Hitherto, mom has been so busy raising a large family, keeping house, doing the chores, and fabricating everything in every home except the floor and the walls that she was rarely a problem to her family or to her equally busy friends, and never one to herself. Usually, until very recently, mom folded up and died of hard work somewhere in the middle of her life. Old ladies were scarce and those who managed to get old did so by making remarkable inner adjustments and by virtue of a fabulous horniness of body, so that they lent to old age not only dignity but metal. (pp. 185-186)

According to Wylie, moms stifle men and reduce them to compliant boys.

Mom had already shaken him out of that notion of being a surveyor in the Andes which had bloomed in him when he was nine years old, so there was nothing left to do, anyway, but to take a stockroom job in the hairpin factory and try to work up to the vice-presidency. Thus the women of America raped the men, not sexually, unfortunately, but morally, since neuters come hard by morals. I pass over the obvious reference to the deadliness of the female of the species, excepting only to note that perhaps, having a creative physical part in the universe, she falls more easily than man into the contraposite role of spiritual saboteur. (pp. 187-188)

Much of the chapter is a full on attack on what Wylie perceives to be the ways of mom, comparing her at various times to Hitler and Satan, with most societal evils laid to rest at her door. Along the way, Wylie returns to the greatest achievement of mom, emasculating sons.

“Her boy,” having been “protected” by her love, and carefully, even shudderingly, shielded from his logical development through his barbaric period, or childhood (so that he has either to become a barbarian as a man or else to spend most of his energy denying the barbarism that howls in his brain – an autonomous remnant of the youth he was forbidden), is cushioned against any major step in his progress toward maturity. Mom steals from the generation of women behind her (which she has, as a still further defense, also sterilized of integrity and courage) that part of her boy’s personality which should have become the love of a female contemporary. Mom transmutes it into sentimentality for herself. (pp. 195-196)

Wylie goes on to develop the concept of mom as barrier to manhood (I imagine Wylie is god at the Mankind Project). The close-binding-intimate (CBI mother) mom of Irving Bieber, direct influence on Nicolosi and NARTH is a psychiatric incarnation of Wylie’s momistic mom. As an aside, Bieber was described in saintly tones during my brief sojourn in the NARTH wilderness with presentation after presentation blaming smother mothers and inept, cranky dads for the “condition” of homosexuality. Wylie, predating Bieber, ridicules men but blames moms for his plight.

The mealy look of men today is the result of momism and so the pinched and baffled fury in the eyes of womankind…we will first have to make the conquest of momism, which grew up from male default. (p. 197, 203)

In reparative drive theory for male homosexuality, the relationship with the father becomes more of a focus. Cultural and early psychiatric opinion focused on mom the usurper, but reparative therapy extends the fault lines to include the weak or aggressive but surely distant father who allows mom to conquer the triad of mother-son-father, with the son becoming the defensively detached pre-homosexual. The Strecker-Wylie-Nicolosi fix is simple and if you don’t understand why or how it works, trust them, they know.