Sexual Identity Therapy is Not Reparative Therapy

I have had to make this case several times over the years but the defensive posture of reparative therapists of late makes it necessary to do it again. As more people are coming against reparative drive theory, reparative therapists are softening and in some cases altering their rhetoric regarding what they believe and what they do. Note my posts here and here.

In a NBC News article last Wednesday, NARTH’s Executive Secretary David Pruden defends reparative therapy with a line of reasoning that doesn’t sound half bad.  He says

“Once people felt less shamed – and I think that’s really positive – there was less a feeling that they couldn’t talk about it,” Pruden said. But those who do want to minimize those feelings, Pruden said, “deserve to have their needs met as well.”

“To say to them, we’re not willing to walk alongside you in your journey feels to me as cruel as the other extremes we used to be at, when people were hurt for saying, ‘I’m gay, and I’m OK with that,’” Pruden said. “In a sense it’s a pro-choice movement – people should have the right to deal with this.”

Walking along side someone in a journey and acknowledging a client’s right to deal with conflict surrounding sexuality seems reasonable and fair.  However, that stance is not what is under attack in legislatures and court rooms around the country. If all reparative therapists did was support clients in exploration of their beliefs and values about their sexual orientation, then they would not be experiencing the scrutiny they are now.

What Pruden describes in this brief interview (and to be fair, he may have said more about change therapy that the reporter did not include) is similar to what Mark Yarhouse and I promote in the sexual identity therapy framework. We walk along side people who are struggling with conflicts involving their sexuality and moral beliefs. We do not offer change interventions and in fact stress that we do not see orientation change as the aim of the SITF.  I indicate to clients that the evidence does not support efforts to change orientation. I respect the rights of people to make behavioral choices in line with what they believe to be right and work with people to move in a moral direction they believe in. However, reparative therapists do so much more than that.

Check out what Joseph Nicolosi believes about homosexuality as stated in the NBC article. He gives the usual reparative narrative about weak fathers and overbearing mothers being the culprit and then to those who don’t want to take his therapy he says:

“We say, fine, you want to be gay, but are you curious in understanding why you’re gay?” Nicolosi said.

Reparative therapists think they know why people are gay and their interventions of building masculinity with journeys into manhood, complete with holding therapy, sports training, etc., are what attracts the ire of opponents. The reparative therapists have a hammer and to them every gay person is a nail. The reparative therapists on the Dr. Oz show last week seemed oblivious to the message being delivered by the reparative drive theory. Reparative therapy begins with the assumption that gays are disordered and in need of some kind of treatment to cure the underlying psychological damage which may (they don’t all promise that the proper therapy leads to complete change) then lead to a lessening of attraction to the same sex.  They compare being homosexual to being an addict, depressed or some other malady.

Walking along side someone does not require what reparative therapists do. Working with someone to work out an adjustment involving religious morality and sexual behavior does not require a belief that same-sex attraction is a disorder or the result of deficient families.

Let’s keep things straight, reparative therapy is one thing and sexual identity therapy is another.

 

 

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  • ken

    “Let’s keep things straight”

    Well that certainly sounds like NARTH’s motto :)

    “reparative therapy is one thing and sexual identity therapy is another.”

    yes, but given the recent scrutiny reparative (and other SOCE) therapy has been getting (through the NJ lawsuit and the CA ban), I’m not surprised reparative therapists are looking to shift what they claim they do (and have been doing).

  • Teresa

    ken says:

    “Let’s keep things straight”

    Well that certainly sounds like NARTH’s motto :)

    LOL! thanks ken … I needed a good laugh this morning.

    @Warren,

    Thanks for the Post; and, especially this part:

    Walking along side someone does not require what reparative therapists do. Working with someone to work out an adjustment involving religious morality and sexual behavior does not require a belief that same-sex attraction is a disorder or the result of deficient families.

    I bolded the part that struck me as key to much that is going on. I think this is the heart of the great goings-on with same sex attractions … the guts of it all. NARTH, Restored Hope (?) Robert Gagnon, Andrew Comiskey, the Catholic Church with their emphasis on same sex attractions themselves being ‘disordered’ … so many want to emphasize the ‘disorder’, implying that we as persons are disordered (although they’ll always try to deny that) … so, these peoples, groups, perhaps meaning well, want to cure the ‘disorder’ …

    They see persons with same sex attractions as diseased, and their job is to cure the disease.

    And, quite frankly, I did not understand that SITF stood outside this ‘disorder’ model. I understood that SITF did not latch onto the deficient family model.

    So, Warren, as a Christian, conservative Christian at that … how did you and Mark step away from the ‘disorder’ model?

  • inca nitta

    Warren, I have read your links to SITF and I’ve read NARTH’s website. My personal conclusion is that you guys have a lot in common, with a few minor disagreements, but to me, it seems totally fine. Many scientists disagree with each on different topics, all the time. It’s just because I find that you have more in common than you don’t, I don’t understand why is it difficult for you to work together?

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

      inca nitta: If you don’t see it after reading here and there, I don’t think I can help you much. We have very little in common.

  • Ford

    Dr. Throckmorton,

    You have been very clear about how your approach differs from reparative therapy. And I have to say, as a Christian who is gay, I completely appreciate the not-so-nuanced difference in approaches. I have to wonder, though, does the conservative sexual ethic underpinning both approaches cause the need for any type of therapy in the first place?

    As someone who has studied and prayed about the sinfulness of homosexuality for years, I have come to believe that monogamous, romantic same-sex relationships are not proscribed in scripture; in fact, I believe they are a beautiful, natural expression of our God-given sexuality. I understand you disagree with my theology; I just want to make sure my cards are on the table.

    From my perspective, presenting a “celibate only” message to a gay kid presents him with a terrible (and false) ultimatum. Live a life devoid of the prospect of romantic love, or displease God. It is a traumatizing message: you are deeply flawed; you are not created worthy of giving or receiving romantic love. Anecdotally, I think this message encourages a quick retreat to a deep closet with the attendant depression, detachment and self loathing. How many Christians who are gay have I talked to who have been desperate to be straight even to the point of suicide?

    Would you ever counsel someone that it is OK to be gay and not celibate? My understanding is that you wouldn’t. If I’m wrong, then my apologies.

    But if I am correct…With all due respect (and MUCH is due), I understand why you are constantly having to differentiate your work from that of NARTH (et al.). The conservative sexual ethic as it relates to gay people is damaging (perhaps even abusive); both sexual identity and reparative therapy seem intended to help gay people cope with the damage caused by the doctrine. In my understanding of scripture, the damage is unnecessary in the first place.

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

      Ford – In my role as a therapist, it is not up to me to tell my clients what the Bible teaches. They need to determine that for themselves so that their paths are authentically chosen without coercion from me. While I hold to the more traditional position, I know there are ambiguous passages and meanings in the Scripture. My approach is to follow the lead of the client when it comes to this doctrine.

  • Richard Willmer

    I would tend to agree that there is no clear ‘proscribing’ of loving same-sex sexual relations in the Bible. When ‘homosexuality’ is (apparently) mentioned, it is usually in a rather specific context (if one looks at the main apparent reference in the NT – that in Romans 1 – the point being by made the writer is that certain beliefs, attitudes and behaviours lead to “envy, murder, strife, deceit and malice” [v. 29], and one must surely ask the question “if a certain course of action does NOT lead to these things, is it still wrong according to that portion of scripture?”).

  • Richard Willmer

    @ Warren

    I personally wouldn’t describe Romans (often cited as the ‘killer passage’ on ‘homosexuality’ in the NT) as ‘ambiguous’: to me it is very clear that it is beliefs, attitudes and behaviours that lead to “envy, murder, strife, deceit and malice” that are being presented as a threat to a person’s soul, and not ‘same-sex relations’ per se. But that’s my interpretation, of course … and I’m not infallible!

  • Ford

    Dr. Throckmorton.

    I’m trying to understand the sexual identity therapy process. I thought that the concept was that a gay person with unwanted SSA does not need to try to become straight, but neither does he need to identify as gay. So the narrow third choice is some form of asexuality (i.e., not defined by sexuality). Would you encourage a client to explore all theologies? Does embracing the possibility of a committed relationship move one into the gay-identity zone? If so, as a sexual identity therapist, would you continue to work with a client who comes to believe that gay relationships can be godly? Would you help a client who came to a belief contrary to your own work through the the practical implications of that belief?

    I’m not trying to agitate (I know my questions could be viewed as confrontational). I’m sincerely trying to understand sexual identity therapy perspectives and practices.

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

    Ford – Yes, some clients decide that their religious views incorporate gay identification and others do not. It isn’t up to the therapist. Some therapists might need to refer at some point if the dissonance becomes too great but there is nothing in SIT that requires a referral.

    For more, see the SITF website – http://www.sitframework.com.

  • Christopher Doyle

    Warren,

    What is your client load? Who are your clients (meaning, what issues do they primarily come to you with)? Are you currently practicing psychotherapy? It seems you talk a lot about the research, but not a lot about your clinical experience.

    Sincerely,

    Christopher

  • Ford

    Dr. Throckmorton.

    Thanks. I have reread the link you provided. From what I gather there and from your comments, you deal with a clients who have unwanted SSA – unwanted because of their religious convictions. Unlike reparative therapists, you do not engage in efforts to change sexual orientation (which can be dangerous and is based on dubious research). Neither do you encourage people to change the “unwanted” part of the equation. Through psycotherapy, you try to reduce the distress through some form of repression of sexuality. If I have any of the broad strokes wrong, please correct me.

    You say that you help people who end up embracing rather than repressing their sexuality. But that belies the whole raison d’être of the model. From what I gather, sexual identity therapy deals only with the consequence of beliefs and does nothing to help a client explore the reasons why they believe as they do. This is hardly an unbiased approach. It automatically affirms the source of the distress.

    I’m someone who has lived through the process of reconciling my conservative faith and my sexuality. Just as it is (nearly) impossible to change one’s sexual orientation, so too is it impossible divorce sexuality from the other essential attributes of one’s person. I’m unconvinced that sexual repression is a harm-free alternative to SOCE.

    To me, you are like a medical doctor who agrees to amputate a patient’s left hand because they don’t want to be left handed. Of course you advise them that there are high functioning left handed people and that no one knows what causes left handedness. Still, they insist and you oblige. In the final analysis, is that really any better than reparative therapy?

    In the bigger picture, sexual identity and reparative therapies have a strong commonality. Neither deal with the underlying cause of distress (the clients belief system) which means that both perpetuate it.

    Because of this commonality, I believe you will continue to be lumped in with SOCE. In the larger context, the two approaches are a distinction without a difference.

    Sincere thanks for engaging in the conversation. It has been helpful to get to understand your position more fully.

  • ken

    Ford says:

    December 12, 2012 at 5:00 am

    “In the bigger picture, sexual identity and reparative therapies have a strong commonality. Neither deal with the underlying cause of distress (the clients belief system) which means that both perpetuate it. ”

    The mistake you are making in this analysis is you are assuming the clients would be better off by accepting their orientation and rejecting their religious beliefs, but that is you imposing your own biases. For some your assumption may be correct, for others it is not. And that is the big difference between SITF and reparative therapy. SITF works with the clients to determine which case is best for the individual client, and helps the clients achieve their goal. NARTH’s approach is the same (but in the opposite direction) as yours. NARTH’s approach is to assume the clients are better off accepting their beliefs and rejecting their orientation.

  • inca nitta

    Wow, Ford!

    I’m so impressed with your interpretation of SITF and SOCE/NARTH, and the fact that it comes from a person who believes that same-sex relationships are okay, I”m that apparently I’m not the only one who thinks that these therapies have things in common.

  • Ford

    Ken –

    “The mistake you are making in this analysis is you are assuming the clients would be better off by accepting their orientation and rejecting their religious beliefs, but that is you imposing your own biases.”

    That was not what I intended to communicate. After rereading my comments I understand why you would have that impression. So please let me clarify:

    If a client intentionally decides that they would like to pursue a life of chaste singleness, then I think it is 100% appropriate and helpful for a a therapist to help them devise strategies for dealing with the emotional and practical realities that flow from that decision.

    However, I believe that the therapist should facilitate the intentional decision making process by creating the space for a client to explore and challenge the beliefs that are causing distress. To make an intentional decision, the client must understand why they believe as they do. Is this decision a deeply held religious conviction resulting from a personal faith exploration? Is this decision an attempt to appease and be accepted by family and community? Is this decision a form of blind obedience to faith-based traditions or other people’s interpretation of scripture?

    It is not enough to say (as Dr. Throckmorten did) that there is no coercion by the therapist; after all, someone else in the client’s life may have already done the coercing. There has to be some process to ensure that the client does the WORK to make an intentional decision about how to deal with their sexuality. I see no such process in Dr. Throckmorton’s framework document.

    A therapist who “follows the lead” of the client without making sure the client has sufficiently explored their own beliefs is not serving the client – they are serving their own bias. That approach is at least as suspect as the SOCE approach.

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

    Ford wrote:

    I believe that the therapist should facilitate the intentional decision making process by creating the space for a client to explore and challenge the beliefs that are causing distress. To make an intentional decision, the client must understand why they believe as they do. Is this decision a deeply held religious conviction resulting from a personal faith exploration? Is this decision an attempt to appease and be accepted by family and community? Is this decision a form of blind obedience to faith-based traditions or other people’s interpretation of scripture?

    This sounds like just the kinds of discussions that take place within SIT sessions. Re-read pages 12-14 in the framework. The language there is not dramatic but the exploration we describe is in practice what you are referring to. We are very aware of differences between intrinsic and extrinsic religion. We believe clients can organize their lives how they want to but we foster value/belief clarification as an aspect of therapy.

  • Ford

    Dr. Throckmorton – I’m still not seeing the value/belief clarification part in your framework document, but I will certainly take you at your word. Thank you for the clarification. That piece was completely missing for me, and it changes my impressions of SIT (for the better).

    Sincere thanks again for engaging in the conversation.

  • Ann

    Ford,

    I think one of the most substantial differences between SITF and the 200 or so reparative therapists, is that SITF does not tell their clients they can change orientation. This, in itself, opens a whole new world for a client in so many ways as they reason through how they want to live their life according to what they value and believe.

  • Ann

    so too is it impossible divorce sexuality from the other essential attributes of one’s person.

    Ford,

    What other essential attributes are you referring to and how does one’s sexuality affect them?

  • Jeremy

    I don’t see how this is any different than gay-affirmative therapy – except for the patronizing pat on the head. Homosexuality is a disease that destroys people’s lives and yet this “therapy” simply encourages that false identity – while claiming to support an individual’s right to still hold on to their religious views.

    Homosexuality is like Cancer.

    Reparative Therapy is like Chemotherapy (helpful, but imperfect).

    “Sexual Identity Therapy” is like hospice care run by Dr. Kevorkian.

  • Dave

    Well Jeremy I see you have decided to be a troll. I will not be responding to your posts any longer. For someone who has allegedly spent a year here you show no respect for anyone .. even those who agree with a conservative position .. of which there are many here .. both gay and straight.

    Dave


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