The Bieber study: A review revisited

A reader sent along a link to a review of the psychoanalytic study of homosexuality headed by Irving Bieber and reported in 1962. Titled Homosexuality: A Psychoanalytical Study of Male Homosexuals, the nine-year study of 106 gay men summarized the reports of psychoanalysts about their patients but did not interview the patients directly.
The pdf of the the review by George Carter, MD is here. Since it is brief, I am going to post it and then comment.

Homosexuality—A Psychoanalytic Study of Male Homosexuals
Irving Bieber et al.
New York, Basic Books, Inc., 1962,358 pp.
A statistical comparison from questionnaires submitted not to their patients, but to a group of
psychoanalytic psychotherapists, gives much interesting information about 106 overtly homosexual male patients, as compared with 100 not overtly homosexual male patients (controls). Most of the study patients were seen once (13%), twice (50%), or three times (31%) a week for periods varying from months to years. The group included patients with character disorders, neurotics, and schizophrenics The questionnaires intensively covered wide areas of development and functioning including relationships between parents,. patient and mother, patient and father, patient and siblings; sexual development and current, functioning; choice of homosexual partner; relation to women; latent homosexuality, etc. The emphasis is on conscious present and past attitudes, experiences, and behavior of the subjects, and does not explore the therapist’s dynamic understanding of the material. It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?” It is also difficult to evaluate the statistics at times. For example, the authors base some of their theoretical conclusions on the fact that they find ‘latent homosexuality” less frequently (in their controls) than is ordinarily reported in psychoanalytic literature. But the data collection method may not be psychoanalytic, since it is not clear that the reporting analysts asked their patients to free-associate! It is difficult to evaluate the results.
Nonetheless, the study does point up some interesting issues. It suggests most strongly that overt homosexuality is especially apt to occur among those exposed to certain constellations of early family relationships, including what the authors call a close-binding, intimate mother and a distant or detached father. There are many other interesting inferences, especially about prognosis and treatment. However, the authors’ stated basic theoretical conclusion that homosexuality is the result of hidden, but incapacitating fears of the opposite sex seems over-simplified and over-determined, since they started with this as a working assumption, but found direct evidence for it, as I understand it, in only about 70% of the studied group and in at least one-third of the nonhomosexual controls.
GEORGE H. CARTER, M.D.

One observation I had not noticed before relates to the evaluation of the survey by the analysts involved:

It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?”

If most participants in the study did not believe the instrument captured the essence of the patient how can any conclusions be drawn from the results? There are numerous problems with this research as a study of causation, but this is another serious blow to the validity of the approach Bieber used.
The Bieber study is often cited as a foundation for reparative drive theory. Bieber, like modern day reparative therapists, believed that a “constructive, supportive, warmly related father precludes the possibility of a homosexual son; he acts as a neutralizing, protective agent should the mother make seductive or close-binding attempts.” As the reviewer above pointed out, Bieber went into the study believing that a fear of women as a reaction to a too close mother, was at the root of male homosexuality. He believed that the father could bring the boy out of this problematic attachment, if he was “warmly related.”
The reviewer hints at but does not elaborate on the confirmation bias at work here. Bieber believed homosexuality was the result of a certain set of family forces and found what he expected to find. As Carter points out, the patterns were not universal and existed in the heterosexual controls as well.
However, despite the problems with validity, no follow up, no direct questioning of patients, etc., Bieber made a conclusion which continues to have influence in the modern ex-gay movement. The concept of the father’s intervening role with the overinvolved mother can be seen in the masculinity enhancement approach to reparative therapy. If you make a man more trusting of men (as dad should have done), then you give a man the courage to distance himself from mother (women). Once distant from mother (women) and in the world of the father (men), he loses his fear of being engulfed by mother (women) and finds them appealing. I think the appeal of the New Warriors Training Adventure comes from this view of masculinity. The Mankind Project view is that women have prevented men from being initiated into manhood. Only a man can initiate a man. So since by (reparative) definition, SSA men are fearful of mother (women), the need is to initiate them in the world of men (father) by other men (pretend fathers). What I have never heard addressed by reparative advocates is why these family constellations mark both same-sex and opposite-sex attracted men. If this set of factors was determinative in some general way for all same-sex attracted men, then why do we see SSA men who do not have these backgrounds and OSA men with them?

Reports of adverse reactions to abortion: How should mental health professional groups respond?

In addition to my work in sexual identity issues, I am quite interested in policy relating to the psychological reactions of women who have had abortions.
I have observed over the past several years that women who associate their abortion with mental health distress have approached the American Psychological Association with their concerns and stories. I blogged about an effort like this in 2007. Briefly, the letter sent by advocacy group, Silent No More, offered to put APA researchers in touch with women who had adverse reactions and asked for a meeting with the APA to discuss means of helping women with post-abortion problems. Georgette informed me that 600 women signed the letter. However, Georgette’s group received no response from the APA.
Another group, Lumina: Hope and Healing After Abortion, led by Theresa Bonopartis, sent a letter to each member of the Mental Health and Abortion Task Force requesting the opportunity to provide information about post-abortion reactions. She also received no response.
Contrast the reaction of the APA to women who believe abortion has triggered harm with the APA reaction to clients who report harm as a result of participation in reparative therapy and/or ex-gay ministries. The APAs (both the psychiatric and psychological groups) have been quite responsive to them, crafting advisories and almost banning reparative therapy in advance of publications systematically demonstrating harm. The major study of adverse reactions by Ariel Shidlo and Michael Shroeder took 5 years to solicit nearly 200 reports of various types of harm. In addition to this study, groups representing glbt people have met with and requested assistance from the APA to oppose reparative therapies.
Before I go on, I need to say that I am in favor of the APA taking seriously client concerns regarding reparative therapy and ex-gay ministries. I have been a persistent critic of reparative approaches as a general response to same-sex attraction. Further, I have consistently acknowledged that harm has been done by various methods to attempt sexual reorientation. The APA should vigorously pursue concerns about client welfare which are presented by clients and their advocates. Due respect should be shown to those who seek such services and ministries, but nonetheless, reports of adverse reactions should be addressed and investigated.
Having noted the appropriateness of the professional groups to attend to reports of adverse psychological reactions, I ask why the APA has not responded to the reports of adverse psychological reactions to abortion? These reports are common and compelling. Many more studies have found adverse reactions associated with abortion than have found such negative reactions to reparative therapy. I recognize that abortion is a much more common procedure than is reparative therapy but this fact should prompt an energetic response. In this context and speaking about APA conclusions about abortion and adverse reactions, I want to quote again a provocative question (see letter #2) from Bill Samuel, President of Consistent Life to APA president Alan Kazdin:

Is there any other phenomenon where the conclusion is based on those who do not have problems rather than on the therapeutic needs of those who do?

I might be misinformed, and in fact have an email in to the APA to check this, but I can find no indication that the APA has met with or responded directly to groups representing women who experienced adverse psychological reactions they attribute to abortion.
Now for some discussion. Am I missing something here? Is there something so different about these adverse reactions that could explain the differential response? At this point, I am thinking out loud…

Homosexuality 101 has some space

My Space, that is. Dr. Julie Harren, NARTH president-elect has launched a MySpace page extolling her Homosexuality 101 video. The description reads:

Committed to educating the church and the world on the origins of homosexuality, we believe that freedom is possible! Although the two largest schools of thought on the issue today are that individuals are either (1)born gay or (2)choose to be so, we advocate that both views are incorrect. Based on scientific and psychological research along with hundreds of testimonies from ex-gays and supporting therapists, we support a developmental origin. Please see below for further information, including a video presentation on our perspective and other available research and resources from the following sites:

NARTH, her Homosexuality 101 site and Exodus are then listed. I take issue with the assertion that “the two largest schools of thought on the issue today are that individuals are either (1)born gay or (2)choose to be so…” There are many researchers who believe prenatal forces are at work to a greater or lesser degree in sexual orientation, but I cannot think of one researcher of any stripe who believes people choose to be same-sex attracted.  Instead, Harren offers reparative drive theory as a developmental alternative; one which is based “on scientific and psychological research.”

Regular readers will not be surprised to read that I do not think research provides basis for confidence in any theory as settled truth about the causes of same-sex attraction. Simply asserting that the theory makes sense to some is not new and, by itself, might not prompt a post. What is troubling to me about this site is the use of John 8:32 (“Then you will know the truth and the truth will set you free…”) underneath the video clip of Dr. Harren’s Homosexuality 101. Using (misusing) this Scripture sets just the kind of tone I believe continues to be a problem in the Evangelical world regarding homosexuality – unsupported theory set forth as fact.  The presentation of the video and the Scripture, not so subtly, suggest that since the teacher is Christian, then the teaching about homosexuality on this video is “truth” which will, when heard or believed, set one free. I am persuaded via my conversations with ex-gays and ex-ex-gays that the promise of freedom from homosexual attraction figures prominently in the frustration many same-sex attracted Christians experience in current sexual identity ministry.

UPDATE: A reader alerted me that Dr. Harren has removed the reference to John 8:32 as a caption to her video on the MySpace page.

Disputed Mutability on Love Won Out

Dismuted Mutability is a blogger and a blog that I like to read. She provides insight into someone who has grappled with sexual identity issues in a refreshing and honest manner. Her last couple of posts are descriptions of her recent visit to Love Won Out in Indianapolis. Regarding her first post (general impressions), I cannot comment much. I did not attend that one and I am told there have been many changes in LWO since I attended in St Louis in February of 2006.

On change that has been made is that Joe Dallas is conducting the session “The Condition of Male Homosexuality” in place of Joe Nicolosi. I am posting here the link to DM’s review of Joe D’s talk. From DM’s review, the content has also changed, and in my view, for the better.

She begins with the good news:

IF you HAD to have a talk putting forward the standard developmental/reparative theory of male homosexuality, I don’t think you could get a much better talk than the one Dallas gave.

The rest of the post is well worth the read. I think she is very likely correct when she says:

I don’t think it’s a stretch to suggest that those who spend any time in exgay ministry or counseling are more likely to feel (or at least hope!) that developmental theories fit them.  After all, those who don’t feel they fit are likely to consider those approaches and the ministries that offer them a waste of time. For another thing, I would suggest that exgay ministries/counseling have a tendency to encourage a certain perception of one’s childhood experiences and parental relationships. Speaking personally, I know that I was coached to look at myself, my childhood, and my parents in a certain way by the exgay movement. Now, they might just be helping us to see what’s really there. Or they could be leading us to make a big deal out of all the ordinary imperfections of children and parents, and in some cases perhaps even something more unhelpful than that.  Anyway, my point is that there are excellent reasons for being skeptical of drawing conclusions about gays in general from observations of those who seek out and attend exgay ministries/counseling.  I think that being fully honest would require bringing this out clearly.

Mankind Project position statements on therapy

In response to my request, Mankind Project Executive Director, Carl Griesser yesterday emailed the MKP’s position statement on reparative therapy. He also confirmed the accuracy of a position paper I found online which addresses the question of whether New Warriors is therapy. You can read each statement by clicking the links below.

Reparative therapy and MKP

New Warriors and therapy

Clearly, the Mankind Project does not want to give any impression that what they do in the NWTA is therapy. This is understandable since staff would need to demonstrate training and credentials to conduct group therapy. The NWTA claims to address fears and wounds from the past and help a person become a better person. I recognize that therapy is hard to define but resolving unwanted states and trauma is generally considered an aspect of treatment. Here is a statement from the Mankind Project’s website regarding what the NWTA aims to accomplish:

The New Warrior Training Adventure is an invitation to step forward and look in the mirror. What do you see? Are you the leader that you are looking for? Are you living on the edge of your life? What stands between you and taking action in your world? What is the risk for you to take full responsibility for your life, for living it from the inside out? Do you have the courage to face your own fears and insecurities and discover the tremendous power and beauty that lies within you? Are you willing to step into the fullness of who you really are? Are you willing to discover the real joy and terror of being a man? If so, this training may be for you.

We do not recommend this training for every man. To participate in this training, you must be highly committed to your life, and ready to take a hard look at yourself, your deepest fears, your wounds from the past, and the specific ways your life is not working for you. We choose to work only with men who are ready and willing to do this initiatory work with us.

Facing “insecurities,” “your deepest fears,” “your wounds from the past,” and “the specific ways your life is not working for you” sounds like an active attempt to address dysfunction and trauma. However, I remain open to dialogue on this point and intend to speak further with MKP, perhaps yet today.