Holding therapy and the Sexual Identity Therapy Framework

In light of the Exodus statement regarding the techniques displayed by Richard Cohen in the media, I thought it good to point out that the sexual identity therapy framework specifically identifies “holding therapy” as being inappropriate. From the framework:

Therapists should maintain professional boundaries in the therapeutic relationship. Therapists should follow ethical guidelines of their profession in conducting sexual identity therapy. Some approaches to sexual reorientation may blend appropriate therapeutic boundaries and are discouraged (e.g., Cohen, 2000). For instance, therapists should not engage in dual relationships with clients or provide physical touch or nurturance to clients. Therapists may supervise or oversee the client’s involvement in physical contact with others of the client’s choosing (friend, family member) during sessions only if the client has given consent. Clients should not be expected to become physically close to other clients in a group therapy situation. Therapists should not refer clients to retreats, support groups or interventions requiring boundary violations as a condition of participation.

Clearly, at times, family sessions involve hugging and the like, but the therapist should not participate. Especially troubling is the paternalism of this arrangement. Clients seeing the therapist as a parent figure should worked through, not encouraged. While we do not specifically discourage emotive techniques (beating pillows and screaming), we might consider whether we should add something to this effect – if for no other reason, to manage liability risk exposure. I have mentioned Genesis & Associates before as a negative example of how good intentions can go very wrong. Indeed, people who feel positive about an alternative technique at the time can later feel quite damaged by it. Specifically, a former Genesis & Associates client reported to CBS News in 2004 that she was damaged by therapists she formerly lauded on the 1995 documentary Divided Memories. In that CBS News report, the techniques were described that led to Ms. Diament’s dissatisfaction with her Genesis experience:

Carol says Mansmann prescribed two controversial treatments. One was “rage therapy” which included beating pillows while screaming. The other, “detachment therapy.” Mansmann urged Carol to move out of her home, away from her family. (italics mine)

To be fair, I suspect the detachment caused as much or more harm than the rage therapy. However, the rage therapy set up her willingness to believe that she was mistreated as a child and then to detach from her family. In hindsight, the “therapy” led to harmful results she was not able to anticipate.

In our guidelines, we do discourage therapists who have apriori determined the “root reasons” for same-sex attraction. Such emotive techniques as a given cannot be consistent with our guidelines since they are predicated on the notion that all same-sex attraction is a response to historical trauma or relational wounding.

UPDATE: 4/4/07 – I received an email from Richard Cohen this evening taking exception to my characterization of his work. Here is the email, which I indicated that I would include here to allow him to describe his work.

Dear Warren,

If you’re going to reference my work, here is the correct statement and my position:

Holding is not done by the therapist or by ministry leaders. It is to be done by OSA (Opposite-Sex Attracted) mentors, ideally the individual’s parent.

For clarification, this is stated clearly in Coming Out Straight on page 203, and in Chapters Ten and Twelve. I highly suggest you read the book and those chapters to better understand this issue.

Richard

Richard Cohen, M.A.

Director

International Healing Foundation

I recall asking Richard in an email about two weeks before his CNN appearance if he held his clients and he said he did not. Then he shows up on CNN holding one of his clients. Where was the mentor? Past clients have said he does indeed hold them so I think it is up in the air. I am also referring in this post to the whole approach which is promise change based on a faulty view of homosexuality in general. It is not hard to see how boundaries bent can become boundaries broken.