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The ethical and research flaws of "Reparative Therapy"

Wed 31 May 2006 In: Comment View at NDHA

In today's Scoop, Family Life International (a conservative Catholic pressure group) cites the work of the antigay organisation NARTH (National Association for Research and Treatment of Homosexuality) to present long-discredited propaganda about 'changeable' gay sexual orientation. As I noted in a previous article on reparative therapy, the Christian Right emphasises pathological or developmental immaturity arguments against acceptance of same-sex attractions. According to Jack Deutscher's recent research on the origins of 'exgay' psychological theories, one strand can be traced back to Krafft-Elbling, a nineteenth century sexologist, who labelled homosexuality as a 'degenerative disease' on eugenic premises [Psychopathia Sexualis 1886/1965]. By contrast, Sigmund Freud held that homosexuality was a sign of arrested maturity and psychological development, although he cautioned that it was difficult to remove once someone had made that object choice in early infancy. Sandor Rado (1940) argued that heterosexuality was a norm, and that homosexuality and bisexuality should be viewed as dangerous deviance. Irving Beiber and Charles Socarides followed suit, but the fifties and sixties saw evidence-based criticism of the adequacy of pathological and developmental arrest models of homosexuality. In 1973, this culminated in the removal of homosexuality as a 'psychopathology' from the APA's Diagnostic and Statistical Manual III. Meanwhile, Elizabeth Moberly, Joseph Nicolosi and other conservative Christian psychoanalysts sponsored a pathologising and developmental immaturity perspective within their religiously-based 'reparative therapies.' But are these 'conversion therapies' successful? Not according to Irving Beiber (1962) and Charles Socarides (1995), who reported that twenty five to thirty five percent 'conversion rates.' Therefore, this means that two thirds to seventy five per cent of conversion clients don't go straight. Deutscher and other lesbian and gay psychotherapists have discovered disturbing evidence about ethical violations and compromised standards of care in 'exgay' therapeutic circles. Schroeder and Shidlo (2001) mapped one hundred and fifty former clients of conversion therapy and uncovered ample evidence of professional ethical shortcomings amongst proponents of 'exgay' therapy. They found that therapists would often violate the privacy rights and medical confidentiality of clients, often telling schools, fundamentalist 'universities' and parents about client homosexuality. The therapists failed to provide informed consent about mainstream theories of homosexuality as a benign developmental variation, and did not refer ex-clients to mainstream therapists. They engaged in coercive and controlling behaviour toward their clients, pressuring them to remain in therapy, and not providing adequate pre-termination counselling once it became obvious that therapy wouldn't work. These ethical violations cause client trauma in their wake. In 1999/2000, the American Psychological Association and its Commission on Psychotherapy and Psychiatry condemned conversion therapy due to the risks cited above. Deutscher is pessimistic about the above findings. Given that 'exgay' therapy is dominated by poorly trained postgraduate clinicians, religious pastoral 'counsellors' and 'selfhelp' groups, can they ever be expected to develop effective scientific, clinical or ethical criteria? It would seem not. Recommended Reading: 1. LBGT Research About "Reparative Therapy.' Jack Deutscher: "What Needs Changing? Some Questions Posed by Reparative Therapy Practices" New York Psychiatric Society Bulletin 40 (1): 8-10: 1997. Jack Deutscher: "I'm Your Handyman: A History of Reparative Therapies" Journal of Homosexuality: (1998): 36:1: 19-42. Jack Deutscher: "Sexual Conversion/ 'Reparative' Therapies: History and Update" in Billy Jones and Marjorie Hill (ed) Mental Health Issues in Lesbian Gay Bisexual and Transgender Communities: Washington: American Psychiatric Press: 2002: 71-88. David Haldeman: "Therapeutic Antidotes: Helping Gay and Bisexual Men Recover from Conversion Therapies" Journal of Lesbian and Gay Psychotherapy: 5 (3-4): 119-132 (2001). M.Schroeder and A. Shidlo: "Ethical Issues in Sexual Orientation Conversion Therapies: An Empirical Study of Consumers" Journal of Gay and Lesbian Psychotherapy: 5 (3-4): 133-168: (2001). 2: Postscript: More Rebuttals of "Reparative Therapy" After I finished an earlier version of this rebuttal of 'reparative therapy,' a colleague emailed me some more damning indictments of the poor research design of this fringe branch of mental health practice: The ideas that Moberley, Nicolosi and Beiber built upon- absent/distant father, overbearing mother-were Jungian in origin. AlthoughFreud seemed to indicatesuch a theory in his earlier writings, he was less certain of this in later decades, andthey were developed more fully by Jung and his followers. "Krafft-Ebing"- no "l"s (  

Credit: Craig Young

First published: Wednesday, 31st May 2006 - 12:00pm

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