Tag: Dean Byrd

Spontaneous change compared to therapeutically mediated change

Something has been bothering me, running around in my head since I did the brief series of posts on Dean Byrd’s review of LDS book, In Quiet Desperation (here, here and here).

In their review of Ty Mansfield’s book, Byrd et al make this statement:

The book inadvertently limits the power of the Atonement in the lives of people who struggle with homosexual attraction. As professionals with many combined years of practice in treating those with unwanted homosexual attraction, we have witnessed changes in the lives of many of these individuals, and the epiphanies have been many.

Like all emotional challenges, the outcome data has ranges of success. What is clear is that when the same standard applied to treatment outcomes of similarly situated difficulties is applied to the treatment outcomes of those with unwanted homosexuality, the results are remarkably similar. There is much in the professional treatment protocols that are compatible with the restored gospel. Appropriate professional help along with the healing powers of the gospel have repeatedly convinced us that there is no struggle for which the Atonement is not sufficient.

There are several things that bother me about these two paragraphs, but for now I want to focus on this sentence:

What is clear is that when the same standard applied to treatment outcomes of similarly situated difficulties is applied to the treatment outcomes of those with unwanted homosexuality, the results are remarkably similar.

Despite a claim of clarity, nothing is particularly clear to me about treatment outcomes for “unwanted homosexuality.” It is not clear to me what other conditions are “similarly situated” in comparison to same-sex attraction. This was not explained.

However, my thoughts about outcomes ran to the studies reported in the NARTH literature review of sexual reorientation, the Jones and Yarhouse study and the usual reparative therapy contention that change results were along a continuum – one-third dramatically changed, one-third somewhat changed and one-third not changed. However, whatever numbers one likes, one cannot put it in context without a control or comparison situation. Another term for this in this context is spontaneous remission. Don’t some people change in various ways for reasons unrelated to therapy?

Certainly that is the case for other situations which are the proper focus of therapy. Note this abstract for a study of improvement rated by patients at a community mental health center in Utah.

It was hypothesized that outpatient psychotherapy in a mental health center would result in an improvement rate of 65% or more, a spontaneous remission rate of 36% or less, and a difference of at least 29% from gain in improvement due to therapy. The analysis of 201 follow-up questionnaires supported all three hypothesis. A five-year follow-up questionnaire provided evidence for external validity in the form of a correlation between original improvement rate and subsequent need for outpatient treatment and inpatient treatment. The results were interpreted as being significant evidence for the efficacy of psychotherapy and for the validity of self-report method of measuring improvement and spontaneous remission.

Note that the rate of improvement was significantly higher than expected based on a spontaneous improvement rate of 36% or less. The authors had reasons to predict this rate and took it into account when assessing the meaning of a 65% improvement rate overall. 

My point is not to compare sexual reorientation to mental health improvement near Salt Lake City, Utah. However, I want to raise the issue that considering spontaneous improvement is important when one is communicating the meaning of changes reported without a control group. There are a couple of studies which have looked at spontaneous change, although none would be directly comparable to any current studies of sexual reorientation. Diamond found spontaneous change in her study of 100 women. In 2005, Kinnish, Strassburg and Turner reported varying levels of sexual orientation flexibility in the Archives of Sexual Behavior. Their report found that 19% of men and 17% of women in their sample moved in a heterosexual direction (from gay to bisexual,  or bisexual to straight — none went from exclusively gay to exclusively straight). In 2003, Dickson, Paul and Herbison reported spontaneous change in a New Zealand cohort. The chart of movement can be viewed here. Note that 5 of 15 went from some same-sex attraction to only heterosexual attraction and none from “major attraction to the same sex” to straight.  

While these studies are suggestive, they cannot be directly compared to existing studies of sexual reorientation.  However, the fact that some men with some same-sex attraction and many women might shift spontaneously should be taken into account when thinking about the role of therapy in mediating sexual orientation change.

The Dickson study is intriguing in that the results can be interpreted as supporting the existence of different types of homosexual orientation. About their results, the authors note in the abstract:

These findings show that much same-sex attraction is not exclusive and is unstable in early adulthood, especially among women. The proportion of women reporting some same-sex attraction in New Zealand is high compared both to men, and to women in the UK and US. These observations, along with the variation with education, are consistent with a large role for the social environment in the acknowledgement of same-sex attraction. The smaller group with major same-sex attraction, which changed less over time, and did not differ by education, is consistent with a basic biological dimension to sexual attraction. Overall these findings argue against any single explanation for homosexual attraction.

To me, this is a reasonable hypothesis. I believe there are multiple pathways to adult sexual orientation and for some, apparently the social context means more than for others. Also, for some the trait may continue to shift around through life with changing circumstances, yet for others, not at all.

UPDATE: In an odd attack piece, the gay website Queerty reads this post (actually the Crosswalk version) as a kind of strange defense of change therapies or change of orientation in general.  A commenter named Timothy (is it our Timothy?) gets the point, but whoever writes for them and the commenters thus far over there are clueless.

LDS scholars critique Byrd, Cox & Robinson review

Monday, I posted a statement from J. Michael Bailey, prolific sexual orientation researcher at Northwestern University, regarding what he called a “blatant misquotation” and misrepresentation of his views by Dean Byrd, Shirley Cox and Jeffrey Robinson in a 2005 book review of In Quiet Desperation. Yesterday, I posted a link to the rebuttal by In Quiet Desperation co-author, Ty Mansfield.

Today, I am posting another rebuttal to the review from Byrd et al, this time from four LDS scholars who write on gay issues – William Bradshaw, Robert A. Rees, Ron Schow, and Marybeth Raynes. You can read the review and the authors’ bios on an LDS website featuring resources for same-sex attracted people.

As with the Mansfield, I want to include excerpts and make a comment at the end.

Bradshaw et al make religious critiques of Byrd et al and then note what appears to be confirmation bias emerging in the review.

It is disturbing that Byrd, Cox and Robinson, all of whom have had extensive experience in counseling, would make judgments about both Stewart Matis and Ty Mansfield that they are in no position to make. Without knowing anything about the personality or therapeutic history of either man and based only on what evidence they find in the Matis-Mansfield narratives, they draw therapeutic conclusions, characterizing Stuart Matis as having “temperamental sensitivity,” “an obsessive preoccupation with being different,” and “perfectionism.” They assert, again without having counseled with him, that Stuart’s “story may have had a much different outcome had Stuart found. . . needed help”; they challenge the Matises’ interpretation of “their son’s attraction for other boys (‘crushes’) as somehow related to his homosexual attractions,” by stating declaratively, “They are not”; they state, “What Stuart failed to secure was competent, professional help, the kind of help that could assist him deal [sic] with very chronic, very difficult challenges.”

They conduct the same kind of arm-chair psychological analysis of Ty Mansfield: “Though Mansfield notes that his homosexual feelings have remained unchanged, this is impossible”! As they do with Stuart Matis, Byrd, Cox and Robinson, pigeonhole Mansfield as suffering from “temperamental sensitivity, obsessive introspection and perfectionism.” They seem to know Mansfield’s therapeutic experience: “Rather than seeking help, however, Mansfield seems stuck in his gender confusion”; “Mansfield has simply conceded victory to his homosexuality.” Such conclusions are as irresponsible as the medical analysis of Senator Bill Frist upon viewing videotape of the comatose Terry Shiavo. If these authors are familiar with what are surely the confidential medical and psychotherapeutic records of Matis and Mansfield, they should say so; otherwise, their analysis is not only inappropriate, it is professionally irresponsible.

A common theme among reparative influenced therapists is to see nails since the tool they have is a hammer. If you think homosexuality is caused by weak fathers, temperamental sensitivity, and/or perfectionism, then that is what you see in those who are same-sex attracted. Even if you only have a bits of information about a person, it is enough because you can always fill in the blanks.

Here the authors note the lack of documentation or data for the claims of reorientation.

Without providing adequate scholarly documentation, Byrd, Cox and Robinson refer to the success of reparative therapy (although they don’t label it as such). They contend that “many men (and women),” “many individuals,” “many people,” and “many men and women” “make successful transitions out of homosexuality.” In a review critical of others’ use of scientific evidence, one would expect some reference to a scholarly study that details exactly how many “many” is. Given the fact that Byrd was the lead person directing therapy for same sex attraction at Church Social Services during a period when many hundreds of Latter-day Saints were undergoing reparative or change therapy, one would think he would cite the findings of such therapy. It is in fact scandalous that such studies either were not undertaken or have been suppressed since the findings would help enlighten our present discussion of this subject. We are acquainted with one therapist at Church Social Services during Byrd’s tenure who did a large portion of this work in that he counseled with nearly a thousand homosexuals and whose experience contradicts the point of view taken in this review.2

The footnote #2 reads:

Our informant has told us that in over a 30 year career at LDS Family Services he worked with about 400 single men, 200 of whom left therapy after 1-2 sessions. Of the remaining 200, only 20 (10%) were able to marry. Furthermore, 19 of the 20 who married identified themselves as bisexual when they entered therapy. The quality of these marriages is unknown. Another Latter-day Saint therapist with whom we are familiar reports that of the hundreds of clients with sexual identity issues she has seen only those clearly identified as bisexual are given any chance of making successful marriages.

This seems reasonable but it is unfortunate that the mystery therapist did not step forward with some verification.

It seems clear that there are some divisions within LDS circles which are similar to what occurs in the evangelical world.

In Quiet Desperation: Rebuttal to Byrd, Cox & Robinson

I posted yesterday that Dean Byrd, Shirley Cox, and Jeffrey Robinson misrepresented the views of Northwestern University researcher Michael Bailey. The misrepresentation happened in a review of the book, In Quiet Desperation. The book was written by Fred and Marilyn Matis and Ty Mansfield and in the first part explores the suicide of Stuart Matis from his parents’ perspective and in the second part, Ty Mansfield explains his views of homosexuality from the vantage point of an observant Latter Day Saint.

Beyond the problem with how Byrd et al handled research in their review, Ty Mansfield claims the trio of NARTH members mishandled his book. I have not read the book so this post simply reports an excerpt from his rebuttal and an observation. I invite readers to read the book and this exchange and decide for yourself.

Now, in response to Byrd, Cox, and Robinson, a reader’s response to a book can have as much or more to do with the reader’s own preoccupations and paradigms as it does with the actual content of the book. And where an author is silent—as I tried to be regarding clinical themes—individuals will fill in the empty space with their own biases. People can stubbornly remain stuck with a given point of view and only see evidence that confirms that view, and any contradictory evidence is ignored. This phenomenon is so common that psychologists have even given it a name: confirmation bias. In Quiet Desperation has been subject to that distortion from two sides. Those who believe that homosexual relationships should be accepted by the Church have co-opted the book for their own purposes. And these reviewers have done the same, but in an opposite direction.

So there will be no further confusion, let me set the record straight. First, I do not believe in a biologically determined cause of homosexuality, and our book does not once make that claim. Second, I wholeheartedly support the Church’s teaching on the family, heterosexual monogamy, and the sanctity of the eternal union of man and woman as the only means of attaining the highest degree of the Celestial Kingdom, and that this ideal is one that everyone should hope and strive for, no matter what their temporal challenges might be. My beliefs, I feel, are in complete harmony with what the Lord’s Prophets and Apostles teach. In addition to supporting the Church’s teachings, most of the reviewers’ scientific assertions about homosexuality I have no quarrel with. Further, I respect the dedication and hard work of these individuals and so many others in assisting those who have sought them out for treatment for their unwanted homosexual feelings. They have brought great encouragement and tireless energy to helping their many patients.

Despite the authors’ affirmation of LDS teaching, Byrd et al criticize the In Quiet Desperation authors with being too pro-gay. Clearly, Mansfield rejects that accusation.

As I read the rebuttal, it occurred to me that this debate was the LDS parallel to the differences between the change and congruence paradigms we discuss here. In fact, Mansfield links to and quotes a Christianity Today article from an anonymous writer which laments both the evangelical focus on change of orientation and those who believe living a gay life is the only alternative for same-sex attracted people.

This author sounds very much like the person I wrote about in the essay, A Valued Life. It seems as though Mansfield is describing a realistic approach to same-sex attraction within the framework of adherence to LDS theology. However, that is not good enough for Byrd, Cox, and Robinson. They write:

However, with appropriate help, many individuals who struggle with same-sex attraction are able to diminish or eliminate that attraction and make substantial changes in their lives. Those who read In Quiet Desperation, therefore, should do so with the knowledge that the Stuart Matis story may have had a much different outcome had Stuart found the needed help.

Similarly, Ty Mansfield and the reader should understand there is much hope and substantial evidence that those who want to overcome same-sex attraction can make changes and achieve happiness and peace in their lives. Therefore, this review is written to contradict for Ty, and the many others who continue to struggle with same-sex attraction, the vision of hopelessness perpetrated through In Quiet Desperation.

I have heard the same criticism. To some, realism and an honest appraisal of the evidence is somehow hope squelching. If the study of Jones and Yarhouse is to be believed, more people in Exodus are living within the congruence model than have reported change. Given the modest change, it seems that what is happening via Exodus mediation is congruence for the lion’s share of the 53% who reported a positive response.

However, for Byrd et al, within their understanding of LDS theology, Mansfield’s approach is “A Slippery Slope that Limits the Atonement” as they title their review. They write:

The book inadvertently limits the power of the Atonement in the lives of people who struggle with homosexual attraction. As professionals with many combined years of practice in treating those with unwanted homosexual attraction, we have witnessed changes in the lives of many of these individuals, and the epiphanies have been many.

Like all emotional challenges, the outcome data has ranges of success. What is clear is that when the same standard applied to treatment outcomes of similarly situated difficulties is applied to the treatment outcomes of those with unwanted homosexuality, the results are remarkably similar. There is much in the professional treatment protocols that are compatible with the restored gospel. Appropriate professional help along with the healing powers of the gospel have repeatedly convinced us that there is no struggle for which the Atonement is not sufficient.

I know very little about the LDS doctrine of the Atonement, but if Mansfield limits it, I would argue that they also limit it in a different manner, given their reliance on “professional help.” It seems to me that what they are saying is that counseling plus the gospel is needed. Well, actually, that is what they say when they write: “Appropriate professional help along with the healing powers of the gospel have repeatedly convinced us that there is no struggle for which the Atonement is not sufficient.” So a little reparative therapy is needed to make the Atonement sufficient.

In any case, the authors offer no “outcome data,” or no research to support their claims of epiphanies. As we discuss within the evangelical context, this debate seems to be in part theological for some involved, rather than based in science. For Byrd et al, it appears their need for the change paradigm is based, at least in part, on their belief that their religious beliefs require that paradigm. Somehow, living in accord with LDS beliefs is insufficient, one must change one’s attractions to demonstrate progression in the faith. In general, I think psychologists have trouble seeing the role of their worldview loyalties in how they interpret data. Too often, loyalty to one’s worldview can lead to confirmation bias when approaching science, picking the studies that seem to fit and ignoring or failing to consider adequately those which do not.

APA brochure kerfuffle

The Southern Voice has an article regarding the recent breathless, echo-chamber enhanced series of articles from some conservative blogs and news services about changes in the American Psychological Association statement regarding sexual orientation.

As I noted here awhile back, the recent flurry was not new news. My first blog about it was when NARTH’s Dean Byrd produced an article for the NARTH website.

In the Sovo article, the APA’s Clinton Anderson seems bemused by the far right response to something they did over a year ago.

Clinton Anderson, director of the APA’s lesbian, gay, bisexual and transgender concerns office, said the change was so subtle that “from our perspective, there really hasn’t been any change.”

But some conservative groups have hailed the wording change as apparent affirmation that sexual orientation is not genetically defined.

Peter LaBarbera, president of Americans for Truth about Homosexuality, said the reason “so many people in the pro-family movement are delighted by this is that it seems to confirm our doubts that there’s a gay gene, that homosexuality is inborn.”

“A lot of gay activists have used the idea of genetic homosexuality as a convenient argument to further their case,” he said. “This makes it harder for them to do that, because they can chastise the religious right, but it’s harder for them to chastise the APA.”

I still wait for NARTH to issue a similar position statement regarding the nature of homosexuality – multiple factors, multiple pathways, we don’t know how any of this works very well, etc.

Instead NARTH trumpets a paper saying that research leads to a conclusion that homosexuality is not innate – despite the absence of any evidence to support the “conclusion” in the paper.