Reparative therapy information
I have done several articles and numerous posts on reparative drive theory and related issues. This page serves to bring those together in one place. The format for now will provide the link and a brief explanation of the post or article.
I Am Not a Reparative Therapist – This article was controversial at the time and is a good starting point to understand some of my concerns about reparative drive theory and related therapy.
Sometimes I am referred to as a reparative therapist which is inaccurate. I recently made that even clearer with this article published on Crosswalk.com and elsewhere which questions the theory’s helpfulness in counseling and ministry.
Research and reparative drive theory
Within the psychoanalytic tradition, several views of homosexual etiology have been proposed. As noted here, Freud believed homosexuality was a developmental arrest. However, he did not think change was likely nor psychologically necessary. If a boy did not identify with father as a resolution to the Oedipal drama, he would likely identify with mother thus preferring males as sexual objects. Some later psychoanalytic writers have looked to the mother-son relationship as crucial (would the son develop an engulfment phobia surrounding women because of mom), whereas others, such as the reparative drive theorists have put the focus on father (if the father and son do not bond well, then the boy will seek to reconnect with masculinity via homosexual attraction/behavior). Joseph Nicolosi tells fathers, “If you don’t hug your son, some other man will.”
A focus on the mother and the father is common in reparative drive theory and is referred to as the “classic triadic model.” This means that reparative therapist believe the family structure which is common to homosexual males is a too-close, smother-mother and a distant or hostile father who ridicules, diminishes or ignores the son’s developing masculinity.
Direct tests of the reparative drive theory
I have privately and publicly asked proponents of reparative drive theory for the three best studies which support the theory. The most frequent response I have gotten is the Bieber et al (1963) study and to review the book by Fisher and Greenberg (1996).
In this 2007 post (Psychoanalytic theory and the etiology of homosexuality: What does research say?), I review what Fisher and Greenberg found in their examination of research on cause. About the research they said:
The post-1977 material we have reviewed concerning male homosexuality has narrowed the apparent support for Freud’s formulation in this area. Previously, we regarded the empirical data to be congruent with with Freud’s theory that male homosexuality derives from too much closeness to mother and a distant negative relationship with father. As noted, the increased pool of data available reinforces the concept of the negative father but fails to support the idea of the overly close, seductive mother…So we are left with only one of the major elements in Freud’s original formula concerning the parental vectors that are involved in moving a male child toward homosexuality. This reduction in confirmed points on the graph makes it all too easy to conjure up alternative theories of homosexuality that could incorporate the “negative father” data…There would be no need to appeal to the Oedipal image of a son competing with his father for mother’s love.
Note that Greenberg and Fisher dismiss one corner of the classic triadic model. To these authors, who originally believed the research supported the model, the body of research between 1977-1995 did not support the classic model. Even though some studies (not all) found more negativity between fathers and homosexual sons that heterosexual sons, the explanation for this is not of necessity causal. In other words, the father-son relationship problems could have derived from the fact that the son disclosed homosexuality. Also, possible is the fact that the father perceived some difference in the son (related to developing homosexuality) which led to a rocky relationship.
I address Bieber et al briefly in the I Am Not a Reparative Therapist paper. I am working on a post which more directly critiques the study. There are many flaws in Bieber, namely, the sample of homosexuals were all clinical patients with personality disorders, schizophrenia, etc. Any attributions about homosexuality and their parenting would have to be confounded by the fact that home life of these people may have been troubling and contribute to the multiple problems that brought them to therapy. There are reasons from later research to believe that the group of people who seek therapy related to homosexuality is likely to have more troubling parent-child relationships than those who do not seek therapy.
Although Bieber believed he had proven the classic triad, 76 of Bieber’s 106 homosexual subjects did not fit the triadic pattern. A majority of men had some disturbance in the home but the typical pattern was not so typical.
Nottebaum et al. (2000) asked gay and participants in Exodus International ex-gay ministries if they had good relationships with their mothers and fathers while growing up. Generally, Exodus ministries promote the view that homosexuality is the result of the classic family triad. The gay male/lesbian participants described a significantly better relationship with parents than did the Exodus group. The Exodus males, more so than the females, said their parental relationships were poor.
Seutter and Rovers surveyed 130 heterosexual and 24 homosexual seminarians to examine differences in perceptions of parents. There were no difference between groups on maternal relationships and sense of being intimidated by their fathers. There was a moderate difference between groups on a dimension they called intimacy with father, with homosexually attracted participants feeling less intimate. Again, as in past studies, there was considerable overlap between gay and straight groups, with some gay seminarians feeling very close to their fathers and some straight men describing a lack of intimacy. Also, there was no check on which came first making it impossible to specify direction of causation.
Andrew Francis released a study in 2008 which demonstrated very little effect of parenting and family dynamics on sexual attraction or behavior. Reparative drive theory predicts that disrupted parenting and family should lead to more homosexuality. This study did not find that, rather:
Francis also examined family structure and found more trivial associations. For instance, he found a 3.8% increase in the likelihood of ever having a same-sex sexual partner among those who did not live with either parent. In contrast to reparative theory expectations, he reported that identifying as less than 100% heterosexual for males was associated with living with only dad. No romantic attraction or same-sex behavior was reported for males living with only mother.
There were other factors which Francis reported but the real take home point from this study is how little any of these variables predict sexual orientation. This study undermines reparative drive theory due to the unremarkable performance of the parental variables to predict orientation. One would expect to find great differences between male heterosexual participants and same-sex attracted participants if fathering/mothering were crucial to male sexual orientation as Joe Nicolosi teaches. In fact in this YouTube video, Nicolosi says that the main factor in the development of male homosexuality is a distant or hostile father.
The Francis article finds very little predictive power in family dynamics of any kind. There is no predictive power at all for those whose parents are separated. Living with dad should insulate against a homosexual outcome and living with mom alone should enhance the likelihood of same-sex attraction and/or behavior. In this sample, it does not.
Ivanka Savic introduced a series of studies which compromise the reparative drive notions. The first series demonstrating that brain responses to putative pheromones predict sexual orientation in men, and (somewhat less so) in women.
Sexual abuse and sexual orientation: A prospective study – Reparative therapy predicts that attachment disruptions set up a situation where the person seeks to repair the detachment from the same-sex gender parent with defensive longing. From this foundation, one would expect that abused and/or neglected children would be more likely to demonstrate homosexuality in some form. However, in this 2009 report by Widom and Wilson, this result did not show up. The authors knew the abuse and neglect histories of their participants and interviewed them about sexual behavior. They did find an association between male sexual abuse and later homosexual behavior, but it was not huge. They did not find a significant relationship between neglect and homosexuality. The authors noted:
These results were consistent for men and women and support the conclusions of Bell et al (1981) that early parenting experiences, positive or negative, play little direct role in the development of sexual orientation. Among women, we also found no associations between childhood sexual abuse and same-sex relationships.
Multiple factors involved in sexual orientation: New study – The authors of this study (Niklas Långström, Qazi Rahman, Eva Carlström & Paul Lichtenstein) provided this summary of results:
“The results show, that familial and public attitudes might be less important for our sexual behaviour than previously suggested”, says Associate Professor Niklas Långström, one of the involved researchers. “Instead, genetic factors and the individual’s unique biological and social environments play the biggest role. Studies like this are needed to improve our basic understanding of sexuality and to inform the public debate.”
Overall, the environment shared by twins (including familial and societal attitudes) explained 0-17% of the choice of sexual partner, genetic factors 18-39% and the unique environment 61-66%. The individual’s unique environment includes, for example, circumstances during pregnancy and childbirth, physical and psychological trauma (e.g., accidents, violence, and disease), peer groups, and sexual experiences.
This at first may sound promising for reparative theory advocates. However, while for some people unfavorable attachments could be relevant, the study indicated that there was no one set of environmental experiences which associated with homosexuality, as predicted by reparative theory. In fact, common family experiences of twins did not show up at all for men and only slightly for women.
Posts on the theory
Reparative therapy for females – Discounts Janelle Hallman’s thesis that lesbians do not have “selves.”
Father – Son estrangement – This brief post quotes research on father-son relationships in general and how that relates to the thesis that male homosexuals have poor relationships with their fathers. Straights have such poor relationships too.
Many people want to know why they experience same-sex attraction. Reparative drive theory provides a narrative but it may not be correct. In Why Do I Have These Feelings? I examine how this pressure for a narrative may be misleading.
Masculinity and reparative therapy
Mankind Project clarifies stance on reparative therapy – Reparative therapists often refer clients to activities and groups which promise to enhance masculinity as a means of reducing same-sex attractions. Macho Man group Mankind Project clarifies that the New Warriors Training Adventure is not a form of reparative therapy.
Sexual identity Therapy and Reparative Therapy
As I wrote here, sexual identity therapy and reparative therapy as described by Dr. Nicolosi are not compatible. Reparative therapy begins with the idea that homosexuality always derives from deficient childhood experiences and tells clients this theory. If the client does not buy it at first, the client eventually changes his mind or leaves therapy. In sexual identity therapy, clients are not given a narrative or a prescription and are provided with the totality of evidence regarding causation and change.
In Sexual identity therapy: Is neutrality a bad thing? I take up the approach of reparative therapists to impose a narrative about childhood experiences and present adjustment on clients.
Use of research
Confirmation bias is an issue for all who work in theoretical matters. Humans seek information which confirms previously held ideas and ignore or forget data which do not confirm our views. I have several posts where I have pointed this out with specific studies and topics.
In 2008, NARTH released a “fact sheet” regarding female homosexuality. I critiqued this paper in two parts. Part one was a general review of the paper and the misleading aspects of it. Part two, specifically examined claims regarding sexual abuse and female homosexuality.
Regarding the efficacy of reparative therapy, this post about NARTH’s use of Shidlo and Schroeder’s study of harm stands out. Facilitated by Neil Whitehead’s reanalyis of Shidlo and Schroeder’s work which did not reach statistical significance, reparative therapist and NARTH president, Julie Hamilton suggests that reparative therapy reduces suicidality. One may believe that but the Shidlo and Schroeder cannot be used to make that claim.
Lisa Diamond is well-respected research from the University of Utah who researches the sexuality of women, especially sexual fluidity. Her work is sometimes cited by NARTH as evidence for change. However, she believes they mislead people in the way they use it as I noted in a November, 2008 post.