Reparative therapy and confirmation bias: An illustration

One of the biggest problems I have with reparative therapy is the self-fulfilling nature of the approach. Reparative therapists assume that the existence of same-sex attraction means a person has suffered gender based trauma during a specific period of childhood.

Reparative therapist David Pickup has commented on another post that straight men may have wounds but, from his point of view, they are not as deep as those which haunt gay men. In other words, if a straight man says he was traumatized in the same way, the reparative therapist’s answer is that the trauma wasn’t deep enough to trigger the reparative drive leading to same-sex attraction. If the gay man says he does not recall any such trauma, then the reparative drive theory posits that the gay man has repressed it and needs to uncover it. It seems to me the powerful effects of confirmation bias are at work.

The assumptions necessary to work as a reparative therapist remind me of the assumptions often associated with the repressed memory movement. Especially during the decade of the 1990s, many therapists assumed that negative moods such as depression or relational problems were due to childhood abuse of some kind that had been forgotten via the defense mechanism of repression. Some therapists harbored a belief that clients who could not remember trauma from the past were in a state of denial. This belief  led some therapists to repeatedly ask about recollections of trauma and hold out the possibility to their clients that they were simply unable to remember.

By questioning the mechanism of repression, I am not questioning the reality of gender based trauma. I am not questioning that some gay people had very impoverished childhoods. Of course that is true. But so did many straight people. In his recent comment, Mr. Pickup proposed that gay people have experienced deeper trauma than straight people experienced. This seems circular to me. How can you tell which experiences are worse? As far as I can tell, the way reparative therapists answer this question iss by knowing the sexual orientation of the client. Straight people have deep wounds; gay people, by definition according to the reparative approach, have deeper wounds.

As an illustration of how clients can adapt themselves to the theories of their therapists, I offer the experience of Carol Diament. Ms. Diament initially thought she would not need to detach from her family, as the other clients at Genesis Associates did. However, after awhile, “memories of abuse came up” and she detached from her parents (over three years), husband and even small children (at least 8 months and maybe longer).

Eventually Carol got away from Genesis, sought another therapist and came to realize that her memories were reconstructed with the help of her therapists at Genesis. By then, the damage was done. She had lost years of her life and had even lost her immediate family.

The clip is just over nine minutes long, but I hope you will watch it all the way through. Then, I hope you will discuss this and let me know what you think. Am I seeing a parallel with reparative theory that is valid or not?

Over the years, I have worked with many clients, gay and straight, who have experience significant trauma with parents. However, I have not been able to differentiate them based on the severity of their experiences. Furthermore, I know and have worked with many gay men and women who recall no deep trauma relating to their parents or peers. I also know gay men who experienced trauma after they came out to their parents because of the tension surrounding homosexuality. However, prior to the disclosure, the relationship was on par with any comparable straight person’s home life.

I also want to be clear that I am not closed to the possibility that certain childhood experiences could influence some people to question sexuality and engage in same-sex behaviors. In addition, some experiences of abuse are associated with risky sexual behavior of all kinds. Therapy, even reparative therapy, might help such people. However, I think these scenarios represent only a portion (probably very small) of the total gay and bisexual population.

Print Friendly

  • Michael Bussee

    I often find myself wondering if the folks at NARTH took any required courses on research design and methodology. In our classes we were warned:

    (1) Not to assume that what our clients presented in therapy was true of the larger population.

    (2) Not to confuse correlation with causality — the “post hoc, ergo propter hoc” fallacy.

    (3) Not to start with a conclusion and then look for data to support our assumptions and prejudices.

  • http://beyondexgay.com Dr. Jallen Rix

    I, too, see similarities between these two “modalities.” As an ex-gay survivor and a sexologist, I would go as far as to say that the similarities border on the cultic. I can speak first hand of the cultic aspects I have experienced in more of the overtly religious ex-gay “ministries” – us vs. them mentality, detaching (and blaming) parents, digging for repressed memories, leaders unwilling to be questioned, and many more features… What deeply concerns me is that just about every reparative therapist I am aware of has a core belief that God has mandated that homosexuality does not have a place in society. If you look diligently, you can see this religious bias in their unwillingness to incorporate all of the psychological/sexological research available, but you wouldn’t know it from the “therapist’s” psychological demeanor. Indeed, they often present themselves as “leaders” in their field of speciality.

  • StraightGrandmother

    I almost wrote this exact same thought on the last article and instead opted to ask questions instead.

    Warren =

    The assumptions necessary to work as a reparative therapist remind me of the assumptions often associated with the repressed memory movement.

  • StraightGrandmother

    The video was spooky. It was really chilling to hear the woman in a very flat voice say how much better she is now, that before she was just very “flat.” Since Nicolsi says that they constantly have to bring their clients back to how they were in their childhood, when they were ashamed isn’t that more or less the same thing as Genesis, especially for people who had good parents and no shame moments to go back to?

  • Teresa

    This is NARTH to a ‘t’. They get what they look for. I can imagine every single homosexual seeking out therapy at NARTH, without opening their mouths, is already classified as mentally ill; and, NARTH knows these mentally ill clients have deep, deep, dark wounds … really, really deep wounds.

    If any NARTH associated therapist, who uses RT, is reading any of this thread; please enlighten us to your approach. Have you already concluded that when someone like me walks into your office, that I’m mentally ill, with trauma to my little psyche that only you can ‘discover’.

    Wow, this can be really scary stuff. I had no idea how some therapists can really wreck lives.

    Thank you, Warren, for being who you are; and, using SIT as your therapeutic approach.

  • StraightGrandmother

    Warren, what has happened to Mr. Pickups comments? I don’t see them any more.

    + 2 of my comments no longer appear. I had a comment on the last article that asked 10 questions for Mr. Pickup, it is no longer posted and it was there at one time.

    In this article I had a comment saying how Nicolosi’s therapy was similar to Genesis as both require the client to go back and remember childhood memories. If the person did not have childhood trama then they have to make some up. That comment isn’t here in this article.

    If you removed Mr. Pickup’s comments for a reason, I think it would be courteous to let us know that you have deleted comments (at the users request or some such thing) . Or is this a software glitch, it is very confusing to your readers. Or maybe did an article disappear? There remain 3 articles on NARTH and none of them (on my computer) have Mr. Pickup’s comments. I can’t figure it out.

    thx

  • Michael Bussee

    I remember well the pain of clients who were told by “repressed memory” “therapists” that their depression or anxiety was due to trauma which they could not remember.

    This was especially true of “therapists” who insisted that every depressed woman must have been molested by someone in her family — and who then benevolently assisted her in dredging up these false memories. I saw patients (and their familes) utterly destroyed by such nonsense.

    I have also encountered “reparative therapists” who have done great harm by insisting that every lesbian is a molest victim (whether she recalls it or not) and who have harmed gay men and their families by “helping” them to see how their parents were “inadequate”.

    My own mother bought into this, reading the “reparative therapy” books and then blaming herself and my Dad that I was gay. She couldn’t eat for days, felt “sick in her soul” and said whe wanted to drive her car off a cliff. It took me years to help her see that I was OK as I was and that she could not take the blame (or the credit) for me being gay.

    What kind of “therapist” does such a thing? Where’s the science to support this malarkey?

  • StraightGrandmother

    Michael =

    My own mother bought into this, reading the “reparative therapy” books and then blaming herself and my Dad that I was gay. She couldn’t eat for days, felt “sick in her soul” and said whe wanted to drive her car off a cliff. It took me years to help her see that I was OK as I was and that she could not take the blame (or the credit) for me being gay.

    What kind of “therapist” does such a thing? Where’s the science to support this malarkey?

    StraightGrandmother = This makes me sick to my stomach just reading about it. Your poor mother and father, my oh my.

  • Teresa

    Another thought: the absolute necessity for longitudinal studies. What Carol thought during therapy, and sometime after, was radically different than the person she became sometime later.

    I am going to be very, very suspect of any studies that only use subjects during therapy or anything within a year after.

  • http://www.patheos.com/blogs/warrenthrockmorton Warren

    No, I did not remove anything. Mr. Pickup’s comments are on the the thread about Exodus and NARTH.

  • http://www.patheos.com/blogs/warrenthrockmorton Warren
  • ken

    I’d like to see some reparative therapists willing to participate in an updated version of Evelyn Hooker’s old study (although, I doubt any ever would). Basically, you take 30 straight men (randomly selected) and 30 gay men (not randomly selected). Have them respond to a battery of questions about their childhoods (the rep. therapists can devise the questionaire), then give the answers to the reparative therapists and see if they can sort the straight men from the gay men.

    I doubt they could and I’m pretty sure they know they couldn’t, which is while they would rationalize away why they wouldn’t participate in such a study.

  • StraightGrandmother

    Oh thanks Warren, I must be getting old. I could not find that article anywhere. I guess I need a nap.

  • StraightGrandmother

    Teresa =

    Another thought: the absolute necessity for longitudinal studies. What Carol thought during therapy, and sometime after, was radically different than the person she became sometime later.

    I am going to be very, very suspect of any studies that only use subjects during therapy or anything within a year after.

    StraightGrandmother = I don’t even think it has to be that complicated. I would be satisfied with a study that

    -Open File Cabinet, pull out files of every patientwho last saw the doctor in the years 1997 (15 years ago), 2002 (10 years ago), 2007 (5 years ago)

    -Call them up and ask them how they are doing.

    Your report would be-

    “Saw the doctor 30 times over 2 years and now reports being homosexual.”

    Just do that for all the patients who last saw the doctor in those 3 specified years.

    I would be happy with this kind of report. It doesn’t have to be that elaborate. I don’t even need to know what they did in the ensuing years, tried religious based efforts, saw other therapists etc. If you surveyed EVERY patient in those 3 specified years there would be enough data that the statistics would jump out at you I bet.

    Instead of making an elaborate study that never gets done, how but a nice short one that does get done. At least we would learn something.

  • Jim Guinnessey

    Why waste time bringing up silly NARTH? Why waste time on reparative therapy?

    There are lots of gay men and women today and yesterday who for whatever motive have married and raised children not because of shame or fear of being dicovered but because of the nature of their jobs or pressures from society to keep their lives private. In Europe and Latin America many gay men will marry, have children and have sexual relationships with men on the side. True, family pressures often oblige a gay man or woman to marry because of parental demands for grandchildren and heirs to family estates or fortunes in some societies. Homosexuality has been with us since the cave days and will always be with us. NARTH is just another delusional entity.

  • Patrocles

    Dr.Throckmorton’s critique and his comparison with the “repressed memory movement” is basically right. On the other hand, that’s a problem of most kinds of depth psychology, including psychoanalysis etc..

    Therapy isn’t the same as research, a therapist often (ore mostly) works from theories he doesn’t test within his therapy. Theories in depth psychology are difficult to test, notwithstanding it’s not impossible to design kinds of tests, and NARTH has to do that.

    As a parent I would never exclude that I have had a bad influence on my children. That’s life.

  • ken

    Jim Guinnessey# ~ Feb 1, 2012 at 9:53 am

    “Why waste time bringing up silly NARTH?”

    Because NARTH spreads misinformation about sexual orientation that harms sexual minorities. And if no one challenges that mis-information, the harm continues.

    Do you think that if Michael, Warren, et. al. hadn’t spent years challenging Exodus, that Alan Chambers would have made the statements he did about actual change in orientation?

  • Michael Bussee

    Patrocles said: “Therapy isn’t the same as research, a therapist often (ore mostly) works from theories he doesn’t test within his therapy.”

    No, therapy and research are not the same — but good “therapy” is based on sound scientific research. This is true of medicine and psychotherapy.

    If a therapist is providing a service to a patient, the patient should have the confidence that the provider has a solid footing in scientifc research to support the methods and theories he is using.

  • Michael Bussee

    Patrocles: Are you familiar with the “reification fallacy”? From my Psych 101 notes: “It occurs when a word or concept takes on a life of its own, in people’s heads. The construct becomes treated as something concrete and independently existing, even though there is no independent verification of its existence. This may unduly limit the thought processes of researchers (and therapists).”

    I think this is the problem when therapists deeply believe something that has not been verified by research or cannot be verified in that way. For example, the belief that homosexuality is caused by “deep wounding” or “inadequate parenting”. Where is the solid, scientific research to support this theory?

    It seems that doesn’t matter much to folks at NARTH. They believe it and that makes it so. And I don’t think it’s far-fetched to suggest that their clients pick up on that belief and repeat back what the therapist already believes and want to hear.

    Is it possible that bad parenting causes homosexuality? Perhaps. Perhaps not. Believing it doesn’t make it so. I agree with Warren: “Reparative therapists assume that the existence of same-sex attraction means a person has suffered gender based trauma during a specific period of childhood.”

    And that “assumption” takes on a life of its own. It also leads therapists to make the “post hoc, ergo propter hoc” mistake — confusing correlation with causality. They “know” what “causes” it — and then find “evidence” to support that assumption — even “helping” the patient to “remember” it.

    Or as Warren put it: “If the gay man says he does not recall any such trauma, then the reparative drive theory posits that the gay man has repressed it and needs to uncover it. It seems to me the powerful effects of confirmation bias are at work.”

  • Teresa

    Michael Bussee wrote:

    but good “therapy” is based on sound scientific research. This is true of medicine and psychotherapy.

    I don’t agree with this, Michael; mainly, because psychotherapy is a ‘soft science’ with very limited population base. According to Dr. Stanton L. Jones latest essay found here:

    Sexual Orientation and Reason: On the Implications of False Beliefs about Homosexuality

    the gay/lesbian population percentages are very low, extremely lower than what anyone is thinking here. Women with same-gender attraction are only .6% of the population. If this is true, we’re statistically insignificant (meaning women). Gay men fare a bit better with 1.2% of the population.

    How can samples, not contaminated by researcher bias or participant bias, ever be achieved. Population size is an important piece of research; especially for ‘soft sciences’. Frankly, I coming to believe that when it comes to sexual orientation, research studies are next to impossible to achieve, let alone put in faith in them.

  • Michael Bussee

    I stand by my statement. Good therapies (for example, Cognitive-behavioral therapy with depressed patients) have solid research to support their efficacy.

    The fact that sexual orientation is more complex and more difficult to study is no reason to abandon good science and substitute deeply held prejudices instead.

  • Teresa

    I agree with your comment above, Michael. However, I’m still not convinced that sexual orientation can be addressed properly in scientific studies. Frankly, I don’t think either the right or the left can look at this issue with “eyes wide open”.

    How about all of us in the ‘silent middle’ on this issue. Those of us, and I suspect we’re the greater number, don’t ever get addressed in studies. We’re not out to change the existing social fabric. We don’t make waves pretty much anywhere. We’re, often, single … or, married and managing … We’re not advocating or marching. We’re not joining religious ‘you can change’ groups, of whatever stripe. And, many of us, don’t have the money for therapy; or, simply don’t see the need to ‘open that can of worms’. And, we’re certainly not about to answer an ‘ad’ for a research project.

    Yeah, you’ll say “we’re in the closet”; and, I’d say that’s pretty much true, to some extent. But, hasn’t that been the case throughout the centuries?

    Who’s gonna do a study about us? Who’s even going to find us?

    Studies, like the Jones and Yarhouse Study, with 98 Exodus participants is hardly a representative sample, is it? Lisa Diamond’s Study is hardly a representative sample for women, is it?

    And, as an aside, quite frankly, both the Right and the Left on this issue have made our lives more uncomfortable than they already may be … and, no sample from either group is representative of ‘US’ … period.

  • Ann

    Who’s gonna do a study about us? Who’s even going to find us?

    Teresa,

    I have been saying this for years – no one is listening.

  • ken

    Teresa# ~ Feb 1, 2012 at 1:27 pm

    The fact that gays represent a low percentage of the population does not mean we cannot study sexual orientation. The percentage of albinos in the US (or world) is incredibly small, does that mean we can’t study or learn anything about albinism?

    As with ANY study involving people, evidence it built from various independent studies using various samples. With regards to research, the “population size” that matters most is the sample size. And even if only 1% of the US population is openly gay, that represents a pool of over 3 MILLION to draw from.

  • Michael Bussee

    Teresa — As I said, it’s difficult. But I still think it can be approached with more of a sense of honest scientific inquiry — instead of making up a story about what “causes” something — and then (low and behold) finding patients in therapy who will agree with you. That’s confirmation bias.

    “Confirmation bias (also called confirmatory bias, myside bias or verification bias) is a tendency of people to favor information that confirms their beliefs or hypotheses. People display this bias when they gather or remember information selectively, or when they interpret it in a biased way. The effect is stronger for emotionally charged issues and for deeply entrenched beliefs.” ~ Wikipedia

    Personally, I don’t think we will ever discover what “causes” sexual orientation — gay, straight or in between. It’s much too complex an issue. But we can get closer to the truth by at least trying to be scientific about it. For anyone to assert that they “know” is just plain arrogant or foolish. NARTH believes their story as though it were fact. It’s not surprising that they find folks to reinforce it.

  • Carol A Ranney

    http://www.wheaton.edu/CACE/Hot-Topics Jumping around through various links I found this article by Stanton L. Jones of Wheaton College, titled “Sexual Orientation and Reason.” One of the best articles I’ve read from a Christian viewpoint that throws no stones, jumps to no illigical conclusions, and leaves everyone with dignity intact and many questions clarified, if not answered. The faith-based community needs more of this!

  • Michael Bussee

    Wow, it’s a lengthy article. I will have to set aside some time to read and really digest it. But I like this, so far:

    “How can we ever make assertions about homosexuals in general until we are assured that we have a representative sample of these persons? Samples that are not intentionally structured to be representative can fall prey to what is called “volunteer bias,” the problem of samples misrepresenting the broader community by the subjective responses of subjects to their perceptions of the themes and focus of the research.”

    That makes a lot of sense.

  • ken

    Carol A Ranney# ~ Feb 1, 2012 at 8:36 pm

    While pointing out that science has been mis-represented by people on both sides of the debate, I find some of his claims to be a bit misleading. For example from the link you cited:

    “Same-sex sexual attractions, behavior, and orientations per se are normal and positive variants of human sexuality.”[13] It is less clear that this assertion is false than it is obscure how such a statement can be “scientific fact” in the first place … But how this assertion of value could be established as a matter of “scientific fact” is truly mystifying.

    However if you actually go to the APA cite referenced , you will see the APA did explain its reasoning:

    Same-sex sexual attractions, behavior, and orientations per se are normal and positive variants of human sexuality—in other words, they do not indicate either mental or developmental disorders.

    Now, if Jones wants to argue that simply because it is not a disorder that isn’t sufficient to make it a “normal variant” that’s up to him, but to leave out the explanation by the APA and then declare their decision “mystifying” is misleading.

    Another example:

    He (LeVay) frequently frames the argument as if the only two etiological theories are total biological causation or total environmental causation. At no point does he engage a true interactionist hypothesis where experiential variables (familial, peer, cultural) or human agency can interact with biological influences.

    .

    I’ve spoken with LeVay personally, and while it would be fair to say he puts more weight on the biological components than psychological ones, I believe the above quote is a mischaracterizes his views.

  • Jayhuck

    Carol A –

    From the article to which you posted a link:

    Only in the last several decades have the first studies begun to emerge from study populations large enough to generate samples that might be representative of GLB persons. This delay, in turn, is first a function of the surprisingly low prevalence of homosexuality; surprising, that is, in light of the bloated but widely shared belief that “10% or more” of the population is homosexual. A recent research synthesis by Gary Gates[8] of the Williams Institute, a think tank at UCLA Law School “dedicated to advancing critical thought in the field of sexual orientation law and public policy,” provides an excellent analysis of the best research on prevalence in the Western world. Gates concludes that “An estimated 3.5% of adults in the United States identify as lesbian, gay, or bisexual…. Among adults who identify as LGB, bisexuals comprise a slight majority (1.8% compared to 1.7% who identify as lesbian or gay).” With remarkable consistency, across multiple high quality studies, male homosexuality tends to be twice as prevalent as female homosexuality. Thus, simplistically, the 3.5% of adults in the United States, Canada and Europe that identify as GLB should be broken down roughly as 1.8% bisexual men and women, 1.1% gay men, and 0.6% lesbians.

    This is only one small example of why, as nice as this article tries to be, it is still largely slanted towards Evangelical and conservative audiences. The number of gay people, at least in this country, is still very undetermined. Although it is likely the population of gay people is not at the 10 % mark, there have been studies showing that the number of gay people range from anywhere between 3% and 7%, and of course you have to factor in the possibility that not all gay people and/or couples are willing to acknowledge their existence, even today, as such.

    I read the beginning of this article and was filled with so much hope until I hit this paragraph. I should have known it was coming. Its unfortunate it had to be there at all

  • Jayhuck

    Carol –

    Similar claims are made even more explicitly in other places. The website[10] of the American Psychological Association, for instance, even today declares, after decades of research to the contrary, that “being gay is just as healthy as being straight.” This is, sadly, not what the research shows.

    And after all your supportive praises I had to hit this! What a sad and erroneous paragraph. Sigh

  • Jayhuck

    Carol A –

    There is sufficient evidence, however, to know that sexual orientation is quite dis-analogous to race.

    I realize that you did not write the article, but really? This statement is laughable? Does this statement attempt to suggest that there is no overlap between race and sexual orientation or that there are no similarities shared between the fight for civil rights for African Americans and those for Gay Americans? If this is what it attempts to do, and it offers no further explanation that this is not what it is trying to do – it is wrong and misleading. Forshame

  • Jayhuck

    Carol A –

    Perhaps most importantly, we failed and continue to fail to engage individuals who embrace homosexual identity with compassion, understanding, and love, and to seek to defend them against unjust discrimination and violence.

    The best, and only truly supportable thing to come out of that article to which you linked (outside of the info on Evelyn Hooker) is this paragraph. It makes me wonder what the author would say about the unjust treatment that so many gay families receive because the parents cannot marry. It would be interesting to know

  • David M.

    @Carol A Ranney

    Stanton Jones is more rational than some proponents of ex-gay ministries. But it seems to me that much of what he has written, including the article you link, begs the question of what constitutes significant change in orientation. In the past at least, he has generally accepted the measures of change used by ex-gay ministries, namely, the capacity either to refrain from gay sex or the capacity to maintain a heterosexual relationship for some given period of time.

    By either of those definitions, I was straight as can be until I was in my late 40s. The truth was, though, that my attractions were almost exclusively toward men, and my attempts to live as a straight man were causing me a great deal of anxiety and depression, and bringing me to the edge of attempted suicide many times. If that’s what it means to be a success, I prefer to be a failure, thank you very much.

    Most of us, including Alan Chambers, understand that the ability to maintain a heterosexual relationship does not mean that one’s felt orientation has changed. I realize that sexuality is complex, and behavior is one way to measure an aspect of orientation. But the way one experiences one’s sexuality is, usually I think, not primarily behavioral.

  • Jayhuck

    Stuff like this from Stanton Jones is in no way a small contributor to the rise of Atheism in this country and around the world :)

  • StraightGrandmother

    I hope Warren puts up a topic on this so that we can discuss it in it’s proper context.

    I am to page 17 and Jones really starts to go off the rails here. Again we are comparing Sexual Minorities who are NOT legally Married to legally Married Heterosexuals. We are equating Sexual Minorities in civil unions or committed partnerships to MARRIED heterosexuals. The Noway study AGAIN! (Grrr) In Norway and Sweden the Sexual Minorities were NOT MARRIED.

    Starting along about page 16 he is really “reaching” to make his point.

    How many times do I have to read, “The Sexual Minorities gave biased answers because they wanted the study to show them favorably but in OUR study of people who perceived that they moved a little bit in their sexual orientation “Oh NO ,OUR GUYS were telling the truth, but the gays they were all lying when they answered.”

  • StraightGrandmother

    Page 18, “My informal synthesis would be that gay parenting is associated with an approximate tri- pling or quadrupling of the rate of same-sex attraction in these children. How can attention be drawn away from this important statistic showing a probabilistic trend?”

    StraightGrandmother = Well where is the footnote for that? Footnote, reference anybody? Do we all just meekly agree that Stanton Jone’s “gut feeling” is right?

    Where is the Patterson Study? Anybody? Anybody see the Patterson Study??? The study that had a good sample size and compared couples who were heterosexual, lesbian, and yes gay fathers. Whoops I guess he can simply say, “My bad” that should cover it right?

  • Pingback: Reparative therapy and confirmation bias: Langer & Abelson’s 1974 study of clinical bias — Warren Throckmorton

  • Michael Bussee

    So who’s in denial? The patient who says he had good parents or the “therapist” who refuses to believe him?


CLOSE | X

HIDE | X