Friday, December 22, 2006

Looking at the APA

Post #21: A continuing conversation between Pastor/Author Dave Glesne (Understanding Homosexuality) and Pastor/Author Lars Clausen (Straight Into Gay America)
Dear Dave,

End of the year blessings. I took some days away from the office, including taking our kids downhill skiing for the first time. But I have kept thinking about our conversation. Though I'm no longer in the pulpit, this rules vs. relationship conversation we're having was at the heart of my ministry, and the implications continue to fascinate me.

Pausing to address our comments?
There are so many ways to proceed in our conversation, but with the commenters asking for greater resolution. it seems best for me to put this next post on pause and give opportunity for you to address the comments that are accumulating. I'm reading frustrations that you're brushing off the scientific critiques too quickly and that you're not appreciating the experience of LGBT people.

I want us to have as clear a table as possible when we resume with this conversation about the function of God's law, and where our moral compass comes from. You've raised questions that feel fruiful to me

  • "do we live in a moral universe?"
  • "what is the basis of morality?"
  • "When one person says something is good and another says it is evil, how do you live together in society?"
  • "Have you not in fact put yourself in the place of God and become the moral arbiter of the universe?"
  • "at the end of the road of the subjective, will one encounter fullness of life or a loss of humanness?"
  • How do we interpret Law? - "The Law causes me huge damage and that’s not an insignificant by-product of its work. That is its main purpose and work on me."

Your recommended reading to me: "Psychology Needs Reform."
In your last post, you invited me to read the Presentation by Nicholas Cummings, the past president of the American Psychology Association. http://www.narth.com/docs/cummings.pdf So I did, hoping Cummings article might help me understand more about your position.

Not being an expert on psychology or the APA or its history, I found Cummings article fascinating, including his contention that “psychology seems to have lost touch with the American people.” Cummings paper was presented at the 2006 APA convention as part of a panel, “Psychology Needs Reform…”

Cummings notes a principle established in 1973,

“that when we speak as psychologists we speak from research evidence and clinical experience and expertise. Without that, every psychologist is free to speak their opinion as a citizen through a myriad of advocacy organizations, but when we spoke as psychologists the evidence had to be there. To violate this rule the APA would risk loss of credibility, making it just another ideological voice clamoring to be heard in the sea of opinions.”

Of the list of examples he gives of being out of touch, he notes that the APA’s official endorsement of gay marriage cites “the flimsiest of research evidence.” He also writes,


“the APA has not hesitated to attack therapists practicing reparative therapy…on the other hand, therapy to help patients “come out” is highly encouraged, making sexual preference a one-way street.”*

*Note: Even William Throckmorton (well known in the field of helping individuals try to change their sexual orientation and a past presenter for NARTH) has written a paper explaining the shortcomings of reparative therapy, and its potential detriment to patients. Cummings comment seems to invite further exploration. http://www.drthrockmorton.com/article.asp?id=183

Cummings might be thought to have an ideological agenda, but he has earlier qualified his personal positions.


"I have always been an activist for social justice, including gay marriage, and appointed psychology's first Committee on Ethnic Minority Affairs and the first Task Force on Gay and Lesbian Issues during my APA presidency.

And then he continues with this statement

But I also believe in patient choice of therapeutic goals and respect and treat both my liberal and conservative patients accordingly."*

*Note: I sense a conflict here. Cummings advocates for patient choice in therapeutic goals. He also advocates for "research evidence and clinical experience and expertise. If Reparative Therapy doesn't meet these standards, then perhaps APA member are right in "attacking" it as a therapy type?

In Throckmortons article, he also espouses a belief in patient choice:

"I believe therapy should focus on helping people clarify how they want to live based on a chosen set of values. Often that does involve a reflection on religion, history, upbringing, traumatization, culture, school influences, religious beliefs and the gamut of experiences that may be tied to current attractions to the same sex. My approach is to ask clients to explain the problem as they see it, clarify their objectives and then pursue those objectives by whatever means we agree are consistent with their values."

And yet, Throckmorton does not use the method of Reparative Therapy because he questions, to use Cummings words quoted above, the "research evidence and clinical experience and expertise." Further exploration seems in order.

At dozens of colleges and universities in this country, students can still be dismissed if it is discovered they are gay. As an example, at Jerry Falwell's Liberty University, students who are discovered to be gay have one alternative to dismissal - entering into reparative therapy. While I respect Cummings desire to treat "both (his) liberal and conservative patients accordingly," some conservative centers are providing no choice to students/members/patients. It would seem irresponsible for the APA to ignore these cultural realities. Perhaps APA members are providing a service in both discouraging the use of Reparative Therapy and still respecting patient goals?

Questions from Cummings Presentation:

  1. What data is used by the APA and what data is in question? As you've said, we seek better. As Nadine says in her comment, BAD DATA IS NOT WORTH USING.
  2. What does it mean that Cummings unabashedly describes himself as an activist for social justice, inlcuding gay marriage?

I assume that while Cummings finds the data insufficient for an ironclad statement from the APA, he finds it entirely sufficient for informing his own view and pushing him toward activism. I have to assume the data he does have to work with is consistent with his positions, or he'd take different positions.

I think it's fair to read Cummings paper as a cry for careful official pronouncements, and also as a declaration that for one Nicholas Cummings, for whom objectivity seems so important, the data can be interpreted to give credence for gay rights and gay marriage.

Reading On:
I decided to explore further, including "the gay takeover" theory of how the American Psychological Association was "forced" to remove homosexuality from its list of disorders. This is prominently displayed on the NARTH homepage in an article by Jeffrey Satinover. I found Dr. Jack Drescher's website, a recent candidate for the presidency of the APA and active in LGBT issues in the APA. I emailed him and he wrote me back quickly:

the definitive chronicle of those events (to date) is Ronald Bayer's "Homosexuality and American Psychiatry: The Politics of Diagnosis." The book is still out in paperback (1987, Basic Books) and available on line. Bayer interviewed most everyone involved and it is an even-handed presentation of those events. For the record, APA was not taken over by gay activists. Gay activists disrupted APA meetings which got the attention of the APA, initiating a process within the organization that led to a scientific review of the issues. That process started in 1970 (with protests) and culminated in 1973 (with the removal of the diagnosis) and 1974 (when objection to APA's Board of Trustees removing the diagnosis was defeated in a referendum of APA members who voted to uphold the decision of the Board).

So now I have Ronald Bayer's book to read, too, maybe it will help me understand activism better. I know activists often get a bad rap. But...what changes without activism? Our plates are so full with the status quo that unless someone finds a way to add something to our plates it rarely gets considered. Activism serves this function often in history, including in the formation of our nation, and in the formation of the protestant traditions, rightly called, "The Protestant Reformation." Our guy Luther ended up being one of those activists.

More on the "Gay Takeover."
Gerald Schoenwolf also writes about the "gay takeover." Schoenwolf is the one who wrote that now-infamous paper that was on the NARTH website, the one that was cited as saying African Americans, "in many instances," were better off as slaves than they had been in Africa. "Schoenwolf also likened the Civil Rights Movement to Marxism and wrote:

Civil rights leaders insist there is only one meaning and one way to react. The Marxist view is superimposed on the race issue: Only an absolute and simplistic view of the issue is allowed--one which divides people into good guys and bad guys--either you're with us or you're against us.

Has Schoenwolf ever heard of Martin Luther King Jr? I have never once thought of MLK Jr as absolute or simplistic. Schoenwolfs writes of the "gay takeover of the APA"

Another example of the way the Gay Rights Movement utilized Marxist tactics was how it forced the American Psychiatric Association to normalize homosexuality. Dr. Charles Socarides reports in Homosexuality: A Freedom Too Far (1995) how the Gay Rights Movement, through a series of political maneuvers, intimidated the APA in to taking homosexuality off the DSM category of sexual disorders. Here again were the usual elements of political correctness: The American Psychiatric Association was now the evil oppressor and gays were the innocent victims who needed to take arms against this modern evil and conquer it.

Schoenwolf decries the polarization caused by activists, but I find his own article wearying in its absolutism and simplism. http://www.splcenter.org/images/dynamic/intel/SchoenwolfEssay.pdf.

In your and my tradition, Luther called the Pope the Anti-Christ, also an absolute and simplistic accusation. Activism struggles for voice and probably doesn't always say exactly the right thing at the right time. It's longing is for a place at the table to speak with dignity and respect and value. Over time, this was achieved for LGBT rights within the APA. Here's a list of actions that I found, and which I'm grateful that professionals stood up for and wrote into practice.

The American Psychiatric Association (APA) labeled discrimination in employment based on sexual orientation as irrational in 1988. It opposed exclusion and dismissal from the armed forces on the basis of sexual orientation in 1990. In 1991, the APA added immigration and naturalization decisions to areas in which it opposes discrimination against homosexuals. It supported the right to privacy in adult consensual relations conducted in private, also in 1991. In 1992, the APA encouraged its members to help prevent and respond actively to bias-related incidents related to sexual orientation. An APA position statement in 1998 opposed any psychiatric treatment based on the assumption that homosexuality is a medical disorder or that patients should change their sexual orientation, including "reparative" or "conversion therapies." This was extended in 2000 to a recommendation that ethical practitioners refrain from attempts to change sexual orientation in the absence of research substantiating "reparative" therapies. Also in 2000, the APA approved a position statement supporting the legal recognition of same-sex unions. It endorsed initiative allowing adoption and co-parenting of children by same-sex couples in 2002.

In discovering information about the APA, and NARTH and Schoenwolf's article, I discovered how Dr Warren Throckmorton and others protested Schoenwolf's article. Which led me to Throckmorton's website, www.drthrockmorton.com.

In addition to the already mentioned article, "I Am Not a Reparative Therapist." I also came across an interview Throckmorton did with Dr. Spitzer, the researcher who studied whether there is evidence of any homosexuals changing orientation http://www.drthrockmorton.com/interviewdrspitzer.pdf. I read this article because you quoted Spitzer's work about homosexuals who have experienced a change in orientation. After you wrote, one of our commenters telephoned Spitzer and wrote this comment for all of us.

In Blog #8, Dr Glesne quoted Dr. Robert Spitzer. Spitzer explains that he sought to determine whether people changed their orientation at all, not how often this occurred. "But since it was so difficult to find 200 people who had changed for the study, the likelihood of altering sexual orientation is probably rare, he says. "It's hard to change anything that's basic to a person's personality." He further says, "The Christian right never mentions my conclusion that in the general population, such change is rare, and I find their whole agenda obnoxious. They want to humiliate gays and deprive them of civil rights."

Here’s a direct quote from Dr. Spitzer from a personal telephone conversation I had with him today: November 14, 2006:"It took 2 years to try to find 200 subjects in my study, despite many attempts by Exodus International and NARTH to (find?) them to participate in the study.

This tells me that, although I believe my study shows that change is possible in some, it is almost certainly very rare. Unfortunately, when the Christian Right referred to my study, they never mentioned my noting the likely rarity of change of sexual orientation."

Then I read the article on the NARTH website, titled "Spitzer Study Critiqued In the Journal of Gay and Lesbian Psychotherapy" http://www.narth.com/docs/spitzer4.html. Exactly as Spitzer said, the article made no note of the likely rarity of change. As author A. Dean Byrd wrote in the article:

Spitzer's conclusions are simply this: based on his study, there is evidence to suggest that some gay men and lesbians are not only able to change self-identity, but are able to modify core features of sexual orientation, including fantasies.

Most of the article is used to lambast the gay activists who protested Spitzer's research. But it's no wonder that gay activists are concerned about the misuse of Spitzer's data. In the way that you reported Spitzer's data, and the way Byrd and others have, the data can quickly turn to advocating or pressuring for sexual identity change. Many gay activists can share memories that include endless prayers to not be homosexual, decades of therapy, and electro-shock treatment. Gay activists seem justifiably wary about data being misused and resulting in harm.

When I wrote my concern that your viewpoint causes damage to LGBT people, you wrote back about the Law and how it convicts us all. You also wrote, "There are social dynamics peculiar to LGBT persons in our day, that is true, but when it comes to standing as sinners before the cross we all stand in exactly the same place."

I think my argument has been that we do not all stand in the same place. I believe the work of gay activists like APA former president and gay marriage supporter Nicholas Cummings is the work of leveling the playing field so we can do as you suggest and all stand in exactly the same place.

Thank you for recommending Cummings article for my reading. I hope I have given it a responsible degree of attention. I invite your similar attention to the concerns raised by our blog commenters.

New Year Blessings,

Lars





3 comments:

Lars Clausen said...

Thanks to William Throckmorton for emailing back to my question on how we sort through the various ways of approaching homosexuality. About NARTH, he wrote, “I regard it as an advocacy organization, not a research based group. Very few of their members are licensed professionals or researchers.”

He offered these useful references.

An article Throckmorton wrote to refute a NARTH article claiming that homosexuality is directly linked to disease and lowered life expectancy. http://wthrockmorton.com/2006/12/02/narth-article-asking-why-homosexuality-isnt-a-disorder/
The article to which he refers has been taken off the NARTH website.

Throckmorton’s article is useful in responding to Glesne’s health, addiction, and identity claims made at an earlier point in our dialogue. Glesne wrote -- “Disease-causing behavior, coupled with denial of lethal dangers, provides strong evidence that gay orientation is a compulsive and addictive condition – with practitioners looking for self-justification in a pseudo-identity.”

Throckmorton also responded to an LA Times article written about him. He explored more deeply what can and can’t be said from the data that find higher levels of suicidal feelings than amongst the heterosexual population. He has some interesting analogies in this article.
http://wthrockmorton.com/2006/11/10/mental-health-status-and-homosexuality/#comment-4137

Lars Clausen said...

More reading from Lars

First--apologies--I typed in Warren Throckmorton's name as William. Sorry Dr. Throckmorton!

I just read the "Sexual Identity Therapy Guidelines" proposed by Throckmorton and Yarhouse. You can read them at their blog, http://www.sexualidentity.blogspot.com/.

Here you can also read a brief statement by APA president Gerald Koocher, whose first point is: "The therapist has an obligation to carefully explore how patients arrive at the choices they want to make. Therapists must determine whether patients understand that their motives may arise purely from the social pressures of a homophobic environment. No type or amount of individual therapy will modify societal prejudices."

I'm interested in what people think of these pieces. Please read the full documents if you're going to respond to them. As I already wrote, Throckmorton has written his opposition to the reparative therapy espoused by Exodus, etc, and his convictions about patient autonomy and choice. These guidelines give me more food for thought. Maybe they will for you as well?

Joyce Arnold said...

It's been a long time since I read Allport, and it was good to see the comment added by Joe Norquist. I know this is itself simplistic, but what Allport describes seems to be someone who prefers, for whatever reasons, a "black and white" world, both in terms of view and practice. Give me "the" answers (or a formula by which I can get them), and then I can more easily deal with anything that comes along, no matter how complicated and complex. The different and the other are known "objectively," at least in theory. I'm not sure how anyone can talk about hermeneutics while insisting on an objective perspective, which, if I understand Rev. Glesne is provided by God through revelation. Sort of sounds like you start with faith, but after that step, God provides unambiguous, objective answers for specific "issues," such as homosexuality. Or maybe its an unambiguous method that's provided, by which objective answers are found.


That's how Rev. Glesne comes across to me, and whether or not I'm correct that this is his view, it raises questions. What's the reasoning for this choice? Why this methodology? Another part of the question is why choose sexual orientation as "the" issue, at least in terms of his book? Maybe that's simply because it's what's current. Maybe in part it's because more and more of us "homosexuals" have exited the stifling closets, including a good many who trust God's love for them. For whatever reasons, so many coming from faith groups have made "homosexuals" a favorite black and white "issue." Is there some kind of need for such either / or "problems"?



At least a part of the "why," in general, could include the classic "feel better about myself by identifying someone else as worse than me" kind of thing. Or maybe, it's a way to confirm I've made the right choices? I do think self-perception, self-worth are involved somehow. And I don't mean that I think everyone or even most people who make the kind of arguments Glesne does are denying their own homosexuality -- that is sometimes the case, but I don't think it's as often as some from the LGBTQ communities posit.


Another piece of this might be that we're not only talking about the perspective of any one individual, but we're dealing with a whole "group think" kind of thing. There's certainly a community of like-minded who agree with what Rev. Glesne argues, and that provides something we all need, too -- that community affirmation, belonging, purpose.


Way back when I was doing research for my dissertation one book I found particularly thoughtful was Women's Ways of Knowing. At one point one of the authors wrote about women in the academy "paddling around in the bywaters" rather than the mainstream. The truth is, I like the bywaters. I'm much more at home there. It is messier, of course. Often you're not sure just what direction you're going or where you'll end up. Neat and tidy theories and theologies generally won't help you out very much. But you certainly can learn a lot, though in my experience, it's the kind of learning that results in more questions than answers. You also meet all kinds of interesting people -- for example, this whole blog conversation. I think / believe God is as at home in the bywaters of questions (and answers) as in the mainstream of answers (and questions).



Hmm, that gets me back to the idea of starting with faith but then thinking that the faith relationship with God provides you with an objective and "knowing" perspective for whatever comes along. Subjectivity is left behind. And maybe the necessity of dealing with any real questions or doubts. I still love the "I believe, help my unbelief" response. It certainly fits my life.


Which gets me no further than I was, I suppose. The kind of arguments made by Rev. Glesne and others just strike me as those made by people who only seem comfortable in a familiar, objective "mainstream," one which runs straight and narrow, with well defined banks on either side, and all bywater exits clearly marked as sick and sinful. Certainly Rev. Glesne's kind of judging and diagnosing is kindly done, at least from his perspective; it doesn't feel that way on the receiving end. I believe he genuinely wants to help. Maybe in part because it confirms he's "right"? The "meaning of life" could become all about keeping as near the center of the mainstream as possible -- from where you can pick and choose which messy and dangerous "bywaters" to observe, maybe judge.


Anyone else remember the book (1970's?) "Your God is Too Small"? I doubt there is one of us who hasn't / doesn't sometimes attempt to stuff God into a self-designed box , or maybe self-designed mainstream or bywater. Why do we do that? What's the pay-off?


So much for this round of off the top of my head musing ....