Tag: reparative therapy

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 prove 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. (He didn’t grow out of it)

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 honesty about what people can expect is valuable.

New study: Lesbian parents not associated with homosexual behavior in sons

In one of the better studies of the effects of lesbians as parents of sons and daughters, researchers reported that 17-year old boys raised by lesbians were no more likely to be gay than those raised in straight homes. Gartrell, Bos and Goldberg found that 5.6% of boys raised in lesbian households reported sex with other boys whereas 6.6% of boys from a representative national survey reported ever engaging in sex with other boys. The difference was not large enough to be considered a statistically significant finding.

Reparative theorists claim that boys who are raised without a strong, salient father often become homosexual. In this study, the boys of lesbian parents had not been raised with any father figure and yet they were no more likely to report a gay identification than boys surveyed in a national sample with predominantly straight parents. If the absence of strong male role model generates same-sex attraction, the effect should show up in this sample.

I need to add that the group of lesbian parents represent a convenience sample and may not be representative of all lesbian parenting. Even so, the fact that boys raised in these homes displayed no behavioral indication of the effect predicted by reparative therapists is worth noting.

I assume these researchers will continue to follow these families and the results may shift more in line with reparative expectations. However, at present, this study is a challenge to the classic reparative theory.

Gartell, N. K., Bos, H. M. W., & Goldberg, N. G. (2011). Adolescents of the U.S. national longitudinal lesbian family study: Sexual orientation, sexual behavior, and sexual risk exposure. Archives of Sexual Behavior, 40, 1199-1209.

For more on this study, see this post. I should also make clear that this post is not intended to be a comprehensive review of this study. I am here highlighting one aspect of it. There are many findings of interest, including the results with girls which indicates  that girls are more likely to engage in same-sex sexual behavior.

NARTH Founder Retracts Claim of Sexual Reorientation via Lexapro

While examining NARTH’s 2009 review of past studies on homosexuality  (Journal of Human Sexuality, Vol.1 – click the link for the entire issue), I ran across this citation:

Nicolosi (in press) found that while conducting reparative therapy, a 50-year-old male client reported a sudden and dramatic freedom from unwanted homosexual thoughts, feelings, and behaviors after taking Lexapro. The client reported that he continued to be free of these unwanted symptoms more than 18 months after starting the anti-depressant medicine.

To better examine these claims, I asked one of the authors of the NARTH paper, James Phelan, for access to the source. Thanks to Dr. Phelan for supplying the paper for review.

The paper by Joseph Nicolosi was apparently submitted for publication in 2009 to a journal but there is no record of it being published anywhere. As noted, it describes the case of a 50 year old man who was diagnosed by Nicolosi with ego-dystonic homosexuality. The patient was seen for 142 sessions over “about eight years” with no progress. During therapy, the patient described “generalized hopelessness and helplessness, along with a pervasive sense of inadequacy…” He also described himself as “a non-entity.”

After the lengthy unsuccessful treatment for unwanted same-sex attraction and depression, the patient began taking “a 5 ml dosage of Lexapro,” a selective serotonin reuptake inhibitor. According to Nicolosi, the patient had “an almost immediate decrease in his sense of worthlessness and inadequacy, followed soon after the elimination of his homosexuality.”

The paper describes the situation:

After awhile, the patient stopped taking the drug because he was feeling so much better. However, this brief drug holiday did not work out well.

However, there is more to the story.

I wrote to Dr. Nicolosi and asked permission to post the entire paper. He wrote back quickly to clarify that the claim made in the NARTH paper is not longer valid. Nicolosi explained,

I can say that two years later now, that the use of Lexapro has not fulfilled its promise. We no longer see the use of Lexapro as a positive addition to Reparative Therapy.

So another one of the papers referred to in NARTH’s landscape review can be set aside as evidence for sexual reorientation.

Even in Nicolosi’s paper, there was evidence that the medication effect was an anomaly. Nicolosi wrote:

However, these cases were not mentioned in the NARTH review. Instead of noting that the case reported was only one success out of four tries, the authors only noted the one case which appeared to be a success at the time. Now, according to Dr. Nicolosi, Lexapro has not lived up to that claim.

This report can be added to others where significant questions have been raised  (e.g., the Bieber study, the Kaye study, the work of Masters and Johnson, the Pattison and Pattison research).

What if NARTH was a scientific organization?

Yesterday, I pointed out that most members of the National Association for the Research and Therapy of Homosexuality (NARTH) are not mental health professionals or scientists. Even though the name of the organization promotes research and therapy, three-fourths of the members are not trained or credentialed to do either activity.
Despite the constituency of the group, NARTH is promoted by religiously conservative groups as a scientific organization. One example of this is an appearance in July of this year by NARTH President Julie Hamilton on Washington Watch Weekly, a radio program of the Family Research Council. FRC has taken a lot of heat, from me included, about the information they disseminate about sexual orientation. Some of that criticism should also be directed at the sources of their misinformation. As this interview illustrates, one such source is NARTH.
Tony Perkins sets up the interview by referring to the then current controversy over Marcus Bachmann’s counseling clinic and the allegations that he provides reparative therapy. Then he gets to the interview:

There’s a bigger agenda here. They [gay advocates] want to discredit anything that has to do with Christianity. But there’s something even more troubling here. And what they are doing is that they are trying to discredit a type of therapy that’s based on scientific research and that’s why I’ve invited my next guest to join me. Dr. Julie Hamilton is the President of the National Association for the Research and Therapy of Homosexuality, or NARTH. NARTH is a professional scientific organization that offers hope to those who struggle with unwanted same-sex attraction. They’re not a Christian organization per se, they are focused on the science to help people who want to escape the lifestyle of homosexuality. Dr. Hamilton is also featured by the FRC’s new documentary, The Problem with Same-Sex Marriage and you can find out more about that at FRCRadio.org.

After the introduction, he gets to the bottom line:

Perkins: It’s no surprise to us that faith based counseling is under attack but what does the scientific research say about sexual orientation and an individual’s ability to change it?
Hamilton: The research is clear that people are not simply born gay and that people can change in the area of their sexual orientation.

After some conversation about client self-determination, the interview returns to what research says about change therapy.

Perkins: Now in the wake of this attack on Congresswoman Bachmann and her husband Marcus, we see a number of quote-unquote experts, counselors parade out on cable networks, and I’ve not seen, it’s certainly not a debate, it’s one-sided and they’ve all said, ‘well, all of this type of counseling, the reparative therapy, the idea that people can come out of the lifestyle, that’s been disproven, it’s been rejected and that is harmful and should not be allowed.’
Hamilton: Ok, that’s simply not true. What’s missing from the discussion is what research really reveals. Recently, NARTH releases a landscape survey and an analysis of 125 years of data. So basically we looked back 125 years of case studies, reports and research studies looking to answer the question, is change possible? And what we found is that over the last 125 years, change of sexual orientation has been documented in the scientific literature. And so we know looking at that that for years it has been clear, and even in the recent studies it has been very clear, that people can and do change in the area of behavior as well as attraction. So, and the other thing that we looked at in our landscape review was whether or not change attempts were harmful. And we found very clearly that there is no established report of harm to individuals that therapy tends to be more helpful to people and that it is not a harmful thing. There’s no, and even the American Psychological Association did admit in a report in 2009 that there is not enough evidence to claim that it’s harmful.

There is a lot wrong with Hamilton’s defense of change therapy. First, she glosses over the fact that even the most charitable reading of studies of orientation change find that most participants aren’t successful. Second, she cites the NARTH review which dismisses the flaws in the studies conducted over those 125 years of research. In the NARTH review, George Rekers is cited and we now know the rest of the story about his failed research on gender variance and his own personal issues. The work of William Masters and Virginia Johnson is cited despite the fact that none of Masters’ co-workers have come forward to say they ever saw any of the conversion therapy clients claimed by Masters. Even Masters’ wife and co-author, Virginia Johnson had questions about the existence of the conversion cases.
Some therapists who produced case studies of cure simply made up the cases (e.g., Cornelia Wilbur in collaboration with journalist Flora Schreiber). Many of those old studies were aversive therapy studies where electric shock was used to provide pain in association with same-sex attraction. While some people reported changes, there is very little follow up to find out if they remained changed or simply adapted to the shocks. These methods were discontinued for ethical reasons. NARTH continues to tout studies of approaches no one uses now to bolster their claims. I could go on, but I’ll stop after I note that Hamilton did not mention the studies that find minimal or no change, like the Edification study where the same-sex attracted member of mixed orientation marriages reported no change in attraction on average.
What if NARTH’s representatives disclosed the problems with the research in their public statements? What if they were candid and reported that some of the old studies are flawed to the degree that they cannot be used? What if these representatives disclosed that many of those who report change continue to be attracted to the same sex? Or also mentioned that some studies find no change? What if the differences in results for men and women were disclosed? Or the existence of bisexuality was included in the discussion of what the reported changes mean? What if they reported data from studies discrediting reparative therapy?
Can you imagine a 125-year landscape review of autism or childhood schizophrenia produced in the manner NARTH touts its survey? NARTH reps would be on the radio bringing back cold, distant refrigerator mothers as the cause.
It is possible that groups like the Parents Action League, ACPEDS, and Defend the Family International (Scott Lively) could find some other way to promote their views, but if NARTH was a scientific organization it wouldn’t be NARTH.

Do broken parental attachments cause homosexuality? An interview with Diana Fosha

Earlier this week, NPR produced a report briefly telling the stories of Rich Wyler and Peterson Toscano. Wyler is the co-founder of People Can Change and Journey into Manhood, both of which seek change of sexual orientation via a variety of highly provocative techniques. Toscano sought change for 17 years and then accepted that he was not changing despite a variety of methods.
In that report, Wyler and Toscano both referred to the belief that attachment disruptions with the same-sex parent contribute to homosexual attractions (Toscano now believes the theory to be completely false). Regular readers of this blog know some about the source of those ideas.
One of the more recent theorists and therapists who traffics in the reparative therapy is Joseph Nicolosi, co-founder of the National Association for the Research and Therapy of Homosexuality.
Nicolosi often refers to mainstream theorists and therapists in his talks about reparative therapy. Specifically, of late, he asserts that he has incorporated the research and insights of therapists who focus on assisting clients with disruptions in important attachments. This is not unexpected given that reparative drive theory proposes that attachment disruptions help create homosexual strivings. One such therapist referred to often in Nicolosi’s recent book, Shame and Attachment Loss: The practical work of reparative therapy, is Diana Fosha. Fosha is an accomplished psychotherapist who is widely credited as a leader in experiential therapy. She is author of the book The Transforming Power of Affect and Director of the Accelerated Experiential-Dynamic Psychotherapy Institute.
Nicolosi describes Fosha’s work with the label, Affect-Focused Therapy. In fact, if you search for Affect-Focused Therapy and Diana Fosha in Google, Nicolosi’s references to her are the first few hits. Generally, Nicolosi credits Fosha and other like-minded therapists for making reparative therapy more effective.
Over the years, I have appreciated the contributions of attachment theorists to various approaches to therapy and so Nicolosi’s reference to Fosha made me curious. I decided to contact her to find out her views on the idea that attachment disruptions play a part in orienting sexual attractions toward the same or opposite sex. I also asked her if there was new research in her area of practice that might shed light on the prospects for sexual orientation change. Here is what she had to say.
Throckmorton: Dr. Fosha, are you aware of any evidence that past attachment problems with same-sex parents can lead to homosexual attraction?
FOSHA: No. If you really think of it, half of people who have attachment problems have attachment problems with the same-sex parent. There are no studies that I am aware of that in any way link attachment problems of any kind with gender identity, sexual identity and issues of attraction. None. Attachment problems predict interpersonal problems and affect regulation patterns, and are a risk factor for compromised resilience in the face of trauma across all sexual orientations
Throckmorton: Do you know of any evidence that affect focused therapy (AFT) can change gays to straight or in some way alter a person’s sexual orientation?
FOSHA: None
Throckmorton: So then, you know of no evidence that sexual orientation can be changed from gay to straight by addressing and ameliorating attachment issues with parents or others?
FOSHA: No, none. When attachment disruptions are addressed successfully, people are generally happier and may develop stronger adult relationships, greater resilience and greater well-being, but their essential sexual orientation stays the same, whether they are straight or gay.
Throckmorton: Do you or your organization offer any trainings or educational experiences using AFT to achieve sexual reorientation?
FOSHA: No.
Throckmorton: Do you or your organization have any position on using AFT to try to achieve sexual reorientation? Are you neutral about it; favor it or oppose it?
FOSHA: I have not read Nicolosi’s work, so I would not presume to be definitive, but based on what I know from the popular media about such methods (whether this applies to his or not, I do not know) leads me to strongly oppose such efforts– and view them as misguided at best, and dangerous at worst.
While Dr. Fosha is candidly unaware of the specifics of reparative therapy, it is informative that she does not see any relationship between attachment problems and sexual orientation. If such problems were frequently associated with sexual orientation changes, I would think she would see evidence of a relationship in her work. Her experience mirrors my own – attachment problems are so pervasive among same, other and both-sex attracted people that one cannot point to these disruptions as the general driving factor behind sexual orientation.