NARTH at odds with Exodus over reparative therapy

Historically, the National Association for the Research and Therapy (NARTH) has considered Exodus an ally in the social discussion of sexual orientation change efforts. Until recently, Exodus sold reparative therapy books in their bookstore but recently removed them. Also, Alan Chambers recently told an audience at the Gay Christian Network conference that

The majority of people that I have met, and I would say the majority meaning 99.9% of them have not experienced a change in their orientation or have gotten to a place where they could say that they could  never be tempted or are not tempted in some way or experience some level of same-sex attraction.

I asked Alan Chambers about the reason for the removal of the reparative therapy books and he told me that Exodus wants to be clear that Christian discipleship is how they want to be known. He also said that he has respect for reparative therapy observations but added

The reason I removed RT books from Exodus Books is because I don’t agree with using this research as a means to say that “this” is how homosexuality always develops, “this” is the primary means in which to deal with it and this is “the” outcome you can expect.  Too, Exodus, as a whole, is not a scientific or psychological organization…we are a discipleship ministry and that is where I think our strength is and energy should be focused.

Apparently, these developments are troubling to NARTH leaders. One of them, David Pickup, recently penned an article at the Anglican Mainstream in defense of reparative therapy.  He wrote the article in direct response to the comments by Alan Chambers, noted above. Pickup writes:

Authentic Reparative Therapy really works. It works to help men change their sexual orientation, naturally dissipate their homoerotic feelings, and maximize their heterosexual potential.

However, there is evidence from the Exodus ministry that could be signaling an unawareness of this important message. Exodus has indicated a significant change in their views and policies as evidenced by the remarks of Exodus President Alan Chambers at the Gay Christian Network Conference last week. The official commentary on the peter-ould.net website has brought this to our attention. I believe their interpretation of Alan Chamber’s remarks is correct.

Chambers’ remarks essentially indicate that:

1. Exodus will no longer indicate or specifically claim that change from Gay to 100% straight is possible for anyone except for a few rare cases.

2. Exodus has apologized and will continue to do so for making these unrealistic claims, which they now believe have contributed toward misinformation, hurtfulness and homophobia.

3. Exodus will work to achieve a deeper understanding of the truth of homosexuality, which will allow them to minister more effectively and compassionately to those dealing with homosexuality.

Pickup then says something that will leave Exodus and NARTH watchers in disbelief.

In my experience, Exodus has, quite unintentionally for the last 20 years, failed to understand and effectively deal with the actual root causes of homosexuality and what leads to authentic change. I laud their willingness to admit their naiveté’, but I do not see anything so far that indicates they now truly understand the psychological, developmentally-based causes of homosexuality or what produces real change.

According to Pickup, not only is Exodus clueless now, they have been for 20 years. I imagine that will come as a shock to those in Exodus who have been given talks straight out the reparative playbook for all those years.

Pickup then offers his slant on why change in orientation should be recognized even if a same-sex attracted person is still same-sex attracted after they say they have changed.

(Parenthetically, let me state it is important that we recognize that just because a man might feel occasional sexual attractions towards men does NOT mean significant and real change has not occurred. Let’s take other challenges common to many people: depression or anxiety for instance. How many people who have successfully dealt with these issues are 100% changed so that they are not susceptible to later feelings of depression or anxiety? Can a therapist guarantee a client will never have those feelings again? Of course not. The same is true for homosexuality. Real change has occurred; however, no apologies should be made if much successful change has occurred even though homosexual feelings occasionally surface.)

I asked Alan Chambers what he meant by saying “99.9″ don’t change and he said:

I cannot speak for others who say that temptation or attraction don’t equal orientation.  As a layman with regards to that issue, I tend to link them all together and that is where that 99.9%, non-scientifc/anecdotal/experiential statement comes from.

So what does it matter if some same-sex attraction remains? Doesn’t even a little shift deserve the word change attached to it? Alan seems to want to extract himself from this semantic debate by sticking to experience – the vast majority of people he knows retain attractions to the same sex. Pickup wants to explain that away by making sexual attraction analogous to depression or anxiety. Since he sees same-sex attraction as a disorder which stems from childhood wounds, that may work for him, but it won’t work for those who do not see it that way.

One problem here is political. NARTH wants to be able to say SSA people have changed if they experience a reduction in awareness of SSA and perhaps an experience of opposite sex attraction. This is a kind of change and if left in the therapeutic context, I would not quarrel too much with this (except to say that I don’t agree with the kind of techniques often used to push people this way). However, NARTH does not stay in the therapeutic context. They provide support for political groups who want change to mean complete change from gay to straight. Change is such a volatile concept because a modicum of change in the therapeutic setting is then exaggerated in the political and legal settings to argue against same-sex attraction as something intrinsic to the vast majority of people who experience it.

Pickup then lectures Exodus about theology and calls on them to align closer with reparative therapists.

If Chambers and Exodus do want to truly understand the nature of homosexuality, then they should be open to understanding the psychological underpinnings of these issues and start to recommending qualified therapists who are experts at facilitating significant change. If not, then Exodus will fall into deeper controversy than they are in already. They will be reduced to the myopic ministry of simply helping people to deal with their homosexuality through behavioral changes, which, by the way, reflects the American Psychological Association’s belief about Reparative Therapy: that real change is not possible and people may be helped only in the sense of conforming their behavior to reflect their religious beliefs. In short, Exodus will eventually lose even more effectiveness and begin to flounder.

Pickup even claims that reparative therapy is biblical:

Generally, many Exodus members cannot or will not see that Reparative Therapy is reflective of sound biblical principles. They do not understand shame and its role in the etiology of homosexuality. Not knowing this has led to the unintentional shaming of many same-sex attracted individuals for years, and has actually impeded their progress!

So Exodus has been part of the problem all these years?! I have been to several Exodus conferences over the years, and I can say they work hard not to shame people. The only sessions where I heard any shaming take place was in the sessions where reparative therapists told their audiences that the reason they were SSA was because their fathers didn’t love them and their mothers were smother mothers.

After chastising Exodus for shaming people, he engages in the practice by blaming parents and indicting parents and churches for causing the gay.

Many people of faith do not understand the root causes of homosexuality, which are primarily experienced in childhood. If they did understand, they would have to deal with the truth that they may have contributed to the development of their child’s homosexuality by not supplying enough of their emotional and identity formation needs. In general, parents find it very hard to believe how their child’s upbringing could possibly have been so injurious to them since they loved their child so much. However, loving a child and giving the child the love he needs can be two entirely different things. Parents and churches often find this idea to be unbelievable.

All I can say to Pickup’s last sentence there is: if only. If it were true that evangelicals were more skeptical of these ideas, then I believe Exodus would have changed the tune a long time ago. If only evangelicals were more skeptical, we would not be in such a polarized society where Christianity is synonymous with anti-gay.

As if a few anecdotes proves anything, Pickup closes by citing come quotes he says come from satisfied change customers.

“This is really hard work, but when I focus on healing the pain of what I didn’t get from my father or my friends, something in me heals. Then when I get my male needs met, the SSA just goes away by itself.”

“I really feel more attracted to women now. I want to love a woman and have a family.”

“I still have shame issues, and I once in a while feel attracted to a man, but I know how to work on that and feel affirmed by other men now.” I see myself as a man like other men, and the sexual attractions just sort of go away.”

“This affirmation work and the needs I’m getting filled feels a lot better than sex with a guy.”

I have no doubt that healing from real wounds in life can be beneficial emotionally and it can also lead to a better sense of self-control. So when people who are sexually compulsive find some way to understand themselves better, they can resist whatever pressures push them to risky behavior. However, as Alan Chambers recently noted, such benefit infrequently leads to an elimination of same-sex attraction.

Now if four quotes are sufficient for Mr. Pickup, I will end with four statements from my clients about reparative therapy and their experience.

Our therapist told us after taking our money that there was nothing he could do for us because our family didn’t fit the typical family for a homosexual. He even said that our son would grow out of it because we didn’t fit the mold.

I quit going to Journey into Manhood because it just didn’t last. After a weekend, I did lose some of the same-sex attraction but it always came back. I went to a support group, and saw a reparative therapist and it just didn’t change.

When we took our son to the reparative therapist, he told us that same-sex attraction invariably arises due to a broken relationship with me, his father, and a mother who compensates for this. We were devastated; the man said he was describing our family but he was wrong. My son and I have always been close.

You know, I used to want to change my attractions. I felt like a failure when I saw a hot guy. But the last 3 years have been awesome, I don’t have to pretend or anything. I am who I am and that is an SSA man who loves his wife and kids.

I believe it is possible that Pickup’s clients find an adjustment that suits them. However, the mischief starts when reparative therapists generalize those experiences to gay people as a group.

I am sure it obvious that I think Chambers is much more on the right track than Pickup. Although Exodus continues to refer to reparative therapists and there are member ministries that are quite reparative in their approach, I think a move toward ministry and honesty about what people can expect is valuable.

CNN Belief Blog examines congruence paradigm amid Bachmann revelations

On today’s CNN Belief Blog, Dan Gilgoff examines some changes in the evangelical world regarding reparative therapy in light of stories about Bachmann and Associates. Gilgoff contrasts the converstion or change paradigm with what I have called the congruence paradigm.

While many evangelicals once viewed conversion therapy as key way to deal with homosexuality, many of the religious movement’s leaders and organizations have cooled to the practice in recent years, as more science suggests that homosexuality may be innate and as new therapeutic approaches have emerged.

“Evangelicals, in quiet ways, are shifting to this position to where there is just not a lot of support for the change paradigm,” said Warren Throckmorton, an influential voice in the world of Christian counseling, referring to so-called change therapy.

Later in the piece, Exodus’ Alan Chambers weighs in, Al Mohler is referenced as is Marcus Yoars at Charisma and Jonathan Merritt at Christian Science Monitor. I like that the change paradigm is contrasted with the congruence paradigm.

Go give it a read and comment there and here…

Is coming out always best?

I am going to look for this article later today. Looks interesting and potentially relevant to the sexual identity therapy discussions generated by the New York Times Magazine last week.

Released: 6/15/2011 12:25 PM EDT
Embargo expired: 6/20/2011 1:00 AM EDT
Source: University of Rochester

Disclosing Sexual Orientation Makes People Even Happier Than Thought, But Mainly in Supportive Settings

Newswise — Coming out as lesbian, gay, or bisexual increases emotional well-being even more than earlier research has indicated. But the psychological benefits of revealing one’s sexual identity — less anger, less depression, and higher self-esteem – are limited to supportive settings, shows a study published June 20 in Social Psychology and Personality Science.

New York Times on therapy for sexual identity concerns

The New York Times Magazine will have a lengthy print article on sexual identity concerns, especially among evangelical gays this sunday. The well-written article by Mimi Swartz is now up online at this link.

I have been away for several days and won’t be able to comment much under Sunday or Monday, but I think she did a nice job of bringing together several lines of thinking which led to the sexual identity management/therapy approach to handling sexual identity concerns.  Her descriptions of the sexual identity therapy framework start about here and are woven throughout the later part of the article.

The one aspect of the piece I don’t like is the title – Living the Good Lie. We do not encourage this and in fact advocate for acceptance, even if that acceptance is not with approval. More on that when I can reflect a bit more…

Sexual identity: Thoughts on the status of the reorientation wars

(First posted on August 12, 2009)

So now that the dust has started to settle from the APA convention in Toronto, let’s review the status of the Reorientation Wars.

Does therapy change orientation?

In anticipation of the APA’s report, NARTH fired an opening salvo with their paper (What Research Shows…). Perhaps sensing, incorrectly as it turns out, that the APA would advocate a ban on reorientation therapy, NARTH tossed every positive reference to change they could find into the paper. They noted problems in defining sexual orientation but did little to distinguish the various definitions and their meaning in the many studies they cited. They concluded, of course, that therapy can change orientation.

The APA on the other hand, differentiated sexual orientation and sexual orientation identity. Sexual orientation for them is the biological responsiveness to one gender or both. According to their literature review, the evidence that therapy can change orientation is not sufficient to permit therapists to inform clients that therapy can change their orientation. However, sexual orientation identity (i.e., self-labeling) may shift and be responsive to a variety of factors, including religious mediation.

It seems to me that what NARTH is calling sexual orientation includes the APA’s sexual orientation identity. While this statement risks taking us into the “all or nothing” dead end discussion about change, I do not mean that one must change completely for change to be important and psychologically relevant. I suggest instead that what many studies measure is how people see themselves, even if their sexual responsiveness (orientation) has only shifted by a degree (e.g., an average of less than a point on the Kinsey scale in the Jones and Yarhouse study). Jones and Yarhouse suggest as much in their recent paper when they write:

There is also the question of sexual identity change versus sexual orientation change (see Worthington & Reynolds, 2009). Recent theoretical (e.g., Yarhouse, 2001) and empirical (e.g., Beckstead & Morrow, 2004; Yarhouse & Tan, 2004; Yarhouse, Tan & Pawlowski, 2005; Wolkomir, 2006) work on sexual identity among religious sexual minorities suggests that attributions and meaning are critical in the decision to integrate same-sex attractions into a gay identity or the decision to dis-identify with a gay identity and the persons and institutions that support a gay identity. In light of the role of attributions and meaning in sexual identity labeling, is it possible that some of what is reported in this study as change of orientation is more accurately understood as change in sexual identity?

I believe the answer to their question is that it is not only possible but probable that change in sexual identity is what is being reported. The distinction between orientation and identity (or attraction and identity as we often describe it here) is key, in my view, in order for us to understand the experience of those who say they have changed while at the same time experiencing same-sex attraction. I also believe that men and women are different and their change may be different. Women seem to describe less exclusivity than men. Fluidity may be more likely with complete shifts described. I think we need to accommodate atypical experiences such as men and women who completely shift for a time and then shift back. Whatever the pattern, I hope we can agree that sexual attraction patterns may be one thing while meaning making aspects may lead two people with the same attraction pattern to identity in disparate ways.

Is sexual reorientation harmful or beneficial?

NARTH says reorientation might harm some people but that for the most part it is not harmful. The APA says existing studies are not good enough to allow conclusions. Point for the APA here. All we can say is that some people report harm and some people report benefit. The APA notes that the benefits can occur in programs which promote congruence with religious faith. This is clear and the Jones and Yarhouse study demonstrate that health status improves modestly for those who remained in the study. However, I would say we do not yet know much about what the potent or beneficial elements of those programs are. The APA report identified some of those elements.

Homosexuality and pathology

NARTH says homosexuals have more pathology than any other group of similar size. The APA says homosexuality is normal. By this they mean that homosexuality is not a developmental disorder or indicator of a mental disorder. The two recent reports go off in different directions but some observations can be made.

The NARTH report spends lots of time reporting on greater levels of mental health and health problems among homosexuals as compared to heterosexuals. The APA report does not do this. However, I believe the point regarding different levels of symptoms would be stipulated by the APA. However, the APA raises the minority stress model as responsible for many difficulties faced by non-heterosexual people. The NARTH report discounts the role of stigma.

I doubt the APA would dispute the health status data for another reason: greater group pathology does not mean inherent disorder. The APA’s position is not that gays have equal health outcomes but rather that the unequal health outcomes do not imply inherent pathology – that SSA is not inherently the result of pathological development. This is of course in great contrast to the reparative therapists. Joseph Nicolosi says that the only way you get SSA is to traumatize a child.

The reparative impulse to find trauma behind every gay person is misguided I believe, conceptually and for sure empirically. Women have greater levels of mental health problems than men but we would not consider women inherently disordered. NARTH has chosen some good studies to cite in the section of their paper which relates to health status (as well as some really bad and irrelevant ones). However, I don’t think it really gets them where they want to go.

And where do they want to go? This is clear from their press release complaining about the APA task force report. They state:

Further, if some clients are dissatisfied with the therapeutic outcome [of reorientation therapy], as in therapy for other issues, the possibility for dissatisfaction appears to be outweighed by the potential gains. The possibility of dissatisfaction also seems insignificant when compared to the substantial medical, emotional, and physical risks associated with homosexual behavior.

NARTH would suggest that these medical and emotional risks, along with the incongruity of homosexual behavior with the personal and religious values of many people will continue to be the motivation for some individuals to seek assistance for their unwanted homosexual attraction.

According to NARTH, gays ought to seek reorientation therapy because being gay is a risky life, full of health and mental health disadvantages. Their hypothesis is implied but hard to miss: reduce the SSA and reduce the health risks. The assumption appears to be that ex-gays will have better health outcomes than gays. One problem with this line of thinking is that there is no empirical evidence for it and some evidence against it.*

One researcher quoted in the NARTH paper regarding health risks was New Zealand’s David Fergusson. Dr. Fergusson has done significant work in this field. I asked him to look at the section of the NARTH paper in which his work was quoted. Here is a statement he provided about it:

While the NARTH statement provides a comprehensive and accurate analysis of the linkages between sexual orientation and mental health, the paper falls far short of demonstrating that homosexuality should be classified as a psychiatric disorder that may be resolved by appropriate therapy. To demonstrate this thesis requires an in depth understanding of the biological and social pathways that explain the linkages between homosexual orientation and mental health. At present we lack that understanding. Furthermore it is potentially misleading to treat what may be a correlate of mental disorder as though it were a disorder in its own right.

Fergusson also told me that one would need to develop studies to demonstrate that any changes in orientation associate with improvements in health status. The Jones and Yarhouse study provide some very general assessment but many potential confounds are uncontrolled. For instance, it is not possible to say that the modest shifts on the Kinsey scale were responsible for the shifts in health status. These folks were quite religious and religion is associated with enhanced health status. I suspect religious gays have a better health status than non-religious gays, on average. The point is we do not have evidence that sexual orientation status per se is what leads to the differences in health status.

While I am on the subject of health status, I need to mention that there are other factors which NARTH ignored. One, gender non-conformity is strongly correlated with adult homosexuality and is also associated with poorer mental health. Two, homosexuals report higher levels of sexual victimization which is also associated with higher levels of mental health problems. And, three, no one can discount the possibility that biological factors which associate with the development of homosexuality may also influence the development of emotional problems (i.e., in the same way women are more likely to report depression than men).

So where are we? I hope we have a larger middle and smaller numbers of people at the opinion extremes. People on both sides can agree that erotic responsiveness is extremely durable for men and perhaps less so for women, but behavior and self-identity reflection is alterable. People on both sides agree that conclusions about benefit and harm are not possible in any general sense. Also, I hope we can agree that full informed consent should be conducted prior to engaging in counseling. Regarding health status, both sides can agree that homosexuals have higher levels of problems but there is little agreement about what the differences mean.

Those on the far sides of the continuum will continue to argue that change is possible or change is impossible, and/or that reorientation is always harmful or never harmful and/or that health status difference mean something vital or irrelevant about inherent pathology.

The wars will continue but perhaps fewer people will be engaged in them; now is the time rather to reason together.

*Nottebaum, L. J., Schaeffer, K. W., Rood, J., & Leffler, D. (2000). Sexual orientation—A comparison study. Manuscript submitted for publication. (Available from Kim Schaeffer, Department of Psychology, Point Loma Nazarene University, 3900 Lomaland Drive, San Diego, CA 92106) – In this study, the authors found that mental health was better among the gay sample than the Exodus sample.

(Note: Social psychologist David Myers referred to this post in an op-ed on the APA task force printed in the Wall Street Journal.)

Switch to our mobile site