(Taken from www.peoplecanchange.org)
Frequently I am asked the
question, "How does reparative therapy work?" Like all forms of
treatment rooted in psychoanalysis, reparative therapy proceeds from the
assumption that some childhood developmental tasks were not completed. It is
understood that when the client was a child, he experienced his parents as
failing to assist him through these developmental phases.
One of the best definitions of
psychotherapy is "the opportunity to give to ourselves what our parents
did not give us." Nevertheless we still need help from others. Reparative
therapy requires the active involvement of male therapists, male friends, and
male psychotherapy group members.
The basic premise of reparative
therapy is that the majority of clients (approximately 90%, in my experience)
suffer from a syndrome of male gender-identity deficit. It is this internal
sense of incompleteness in one's own maleness which is the essential foundation
for homoerotic attraction. The causal rule of reparative therapy is
"Gender identity determines sexual orientation." We eroticize what we
are not identified with. The focus of treatment therefore is the full
development of the client's masculine gender identity.
Reparative therapy works on
issues of both the past and the present. Work on the past involves
understanding early relationships with parents. The client often realizes that
while his mother may have been very loving, she probably failed to accurately
reflect his authentic masculine identity. Mother has often fostered in her son
a false identity, namely that of the "good little boy," with an
unrealistic over-intimacy where mother is confidante, soul-mate, or best
friend. The client may also have had an over-identification with grandmother,
aunts or older sisters.
Although the mother has more
often been over-involved, the father is more often under-involved and
emotionally withholding. He has typically failed to recognize the boy both as
an autonomous individual and a masculine child. He was emotionally unable to
reach out to the son to get the relationship on its proper course. The father
was either unaware of what was happening in the relationship, or incapable of
doing anything to rectify it. He was most likely what I call "the acquiescent
father." Emotional neglect by the father is a particularly painful memory
to be dealt with in treatment.
Other work on the past includes
understanding hurtful childhood relationships with male peers, and often a
hurtful relationship with a domineering older brother. Any early homosexual
experiences with peers or older men need examination and interpretation. It is
not unusual to uncover a history of victimization through sexual molestation in
the client's childhood.
Work on the present includes
understanding how the client has given up his sense of intrinsic power.
Intrinsic power is one's view of self as separate and independent. Failure to
fully claim one's gender identity always results in a loss of intrinsic power.
As one client said:
"As a kid, I didn't go
out and ask for what I wanted...I expected others to know what I wanted, so I
just waited."
"And if you didn't get
it?" I asked.
"I've held secrets all my
life. I kept my power secret."
"What power?"
"My power of getting what
I wanted indirectly...you know, manipulatively."
Central to reparative therapy
is the client's understanding of how his masculine deficit becomes projected
onto idealized males--"The other man has something I lack--therefore I
need to be close to him [sexually]."
Reparative therapy is
initiatory in nature. It requires not just a passive musing over self-insights,
but an active initiation of new behaviors. The client must struggle to break
down old patterns of avoidance and defensive detachment from males in order to
form close, intimate, non-sexual male friendships.
Therapy challenges the client
to master gender-related tasks missed in early boyhood. His developmental path
requires mastering of these tasks during adulthood.
He is called to "catch
up" to what the heterosexual man achieved years before. Thus he may
eventually arrive at a heterosexual place, but from a different direction.
Many early feelings toward the
father and other significant male figures will be transferred onto the male
therapist. Therapy will offer a valuable opportunity to work through these
reactions. Feelings for the male therapist may include anticipation of
rejection and criticism, a tendency toward dependency--including hostile
dependency--and also sexual feelings and anger.
Like all psychotherapies, reparative
therapy creates a meaning transformation. This meaning transformation is the
result of the client's gains in insight. When he comes to see the true needs
that lie behind his unwanted behavior, he gains a new understanding of this
behavior. His unwanted romantic attractions are de-mystified. He begins to
perceive them as expressions of legitimate love needs--attention, affection and
approval from men--which were unmet in childhood. He learns that such needs
indeed can be satisfied, but not erotically.
When this is understood, there
is a meaning transformation--"I do not really want to have sex with a man.
Rather, what I really desire is to heal my masculinity." This healing will
occur when the legitimate love needs of male attention, affection and approval
are satisfied.
Meaning transformation includes
not just intellectual understanding (insight) but also the experience of the
self in the doing of new behaviors.
Embodied experience--that is,
the experience of the body in the world in a new way--transforms personal
identity. Transformation in personal identity occurs through repeatedly feeling
different about oneself in relationship to others. In the case of gender
deficit and homosexuality, increased ownership of one's maleness diminishes
erotic attraction toward other men. The gradual internalization of the sense of
"masculinity as me" distances previously distressing temptations.
Gay Affirmative Therapy vs.
Reparative Therapy
In recent years, Gay
Affirmative Therapy (GAT) has emerged to help homosexuals accept and affirm
their sexual orientations. GAT presumes that dissatisfied homosexuals would be
"satisfied" if they could only be free of the internalized prejudices
of society. GAT sees reparative therapy as playing on a man's self-deception,
guilt and low self-esteem. It makes the arbitrary assumption that "coming
out" is the answer to every homosexual client's problems.
Reparative therapy, on the
other hand, sees homosexuality as a developmental deficit. According to
reparative theory, Gay Affirmative Therapy is expecting the client to identify
with his pathology in the name of health.
William Aaron, in his
biographical book, Straight, says: "To persuade someone that he will make
a workable adjustment to society and himself by lowering his sights and
settling for something that he inwardly despises (homosexuality) is not the
answer."
GAT presumes that homosexuality
is a natural and healthy sexual variation. It then proceeds to attribute every
personal and inter-personal problem of the gay man to social or internalized
homophobia. Its theoretical model frames the life experiences of the client in
the context of victimization, inevitably setting him against conventional
society.
One cannot help but wonder how
GAT would explain the obvious benefits of reparative therapy---increased
self-esteem, with a diminishing of distress, anxiety and depression. Better
relationships with others and freedom from distressing distractions are
typically reported by men in reparative therapy.
Interestingly, GAT and reparative
therapy agree on what the homosexual man needs and desires: To give himself
permission to love other men. But GAT works within the gay ideology of
eroticization of these relationships, while reparative therapy sees sex between
men as sabotaging the mutuality necessary for growth toward maturity.
Reparative therapy frees the homosexual man to love other men--not as sex
partners, but as equals and as brothers.
Group Therapy
Group therapy poses a special
challenge to each man. The group must decide who will speak, for how long,
about what, and for what purpose. Each man must decide for himself how he will
use the group's assistance. Every member is expected to take responsibility for
speaking up and making a place for himself in the flow
of verbal expression.
Group therapy challenges the
men to give up the old habit of passive listening. This is a removed,
self-centered way of hearing that stimulates private associations, rather than
an active response to the speaker's expression. The habit of passive listening--a
consequence of defensive detachment--perpetuates emotional isolationism.
Active listening, in contrast,
means forgetting oneself in order to maintain a felt connection with the
speaker. The active listener feels an internal response to what the other says.
He can then choose to express his response in the form of questions, comments
or advice.
Group therapy offers the men
the opportunity to relate to other males--a lesson never completely learned in
boyhood. As one new client told me, "As a kid, I didn't know how to be a
friend. If I liked a boy, I'd come on too strong, too intense, too possessive.
Today, if I meet a potential friend, I still end up doing the same thing; I
start with the 'Let's go to dinner, let's go to a movie [laughs], what are you
doing for breakfast?"
Most clients have never spoken
openly about their sexuality with other men who share the struggle. This is a
frightening but exciting new adventure. Therefore every client is cautious,
even fearful, at his first group meeting. There is a sense of excitement, and
perhaps even the fantasy of meeting an attractive man with whom he might
develop a particularly close, even sexual relationship.
Although the first group
sessions are characterized by an intense curiosity about one another, there is
also great anxiety about disclosing personal issues. These men are not proud of
their sexual orientation, and there is some sense of shame they must face.
There is the thought, "God forbid I should meet someone I know!" But
eventually, these concerns recede to the background as friendships begin to
form.
Once a part of the group,
however, each man discovers that this is a place to feel accepted and
understood. The group is a place where men share common problems, hard-won
insights, and inspiration.
As one man explained, "For
me, the group has been like putting on a pair of glasses when you're
nearsighted. Before, I could only see vague images and patterns."
Another client said, "I
figured out that I suffered this male deficit before I came here. I came
because I knew I needed help in figuring out what to do about it. The reason I
never made much progress before was that I was working in a vacuum, all alone
and not talking to anybody
The basic model of our weekly
group discussions is divided into three levels of communication:
Level One: "Without"
Level Two: "Within"
Level Three:
"Between"
Level One, "Without"
is typical of the first part of each group session. Both in individual and
group therapy, it serves as safe warm-up talk. Typically, it involves conversation
about what has happened during the week, and is a reporting of external events
with no consideration of interior motivations.
Level 2, "Within",
occurs when two or more people begin to investigate and clarify a member's
motivations behind the events he reports. There is a shared attempt to
understand how he participated in causing the events to happen.
Level 3, "Between,"
is the most therapeutic level. It is the most personally challenging and risky,
but offers the greatest opportunity for building trust. It occurs when at least
two members of the group talk about their relationship with each other, while
it is happening. Timing is central to this third level and members must speak
in the present. When expressing both their positive and negative feelings for
each other at the moment, they describe what they are experiencing.
Considerable time may be
required to break through to Level Three of direct dialogue. Group members may
be easily hurt at this level and there is much approach-avoidance and fault
finding. When a member feels hurt, he often makes veiled references to his
doubts about whether the group is really of benefit to him. He may threaten not
to return the next week.
For all groups, Level Three is the
most rewarding. It affords the opportunity to experience mutuality, with its
balance of challenge ("kick in the pants") and support ("pat on
the back.")
In the first few sessions of a
newly forming group, there is an initial phase of "blemish-finding."
There is resistance to identifying with the group, as complaints fly.
"They're not my type, they're too old," "too young" or
"too promiscuous" or "too inexperienced or "too
religious" or "not religious enough." This blemish-finding is a
symptom of defensive detachment, perpetuating what Brad Sargent
calls "terminal uniqueness"--i.e., the idea that "my specialness makes it impossible for other men to understand
me." This fantasy keeps each man emotionally isolated as he is locked into
the frustrating pattern of creating two kinds of men from all significant male
relationships. He either devaluates, minimizes,
dismisses and delegates other men to an inferior position, or he elevates,
admires and places them on a pedestal.
Placement of other men on this
scale is determined by "type," the symbolic representation of valued
masculine attribute he unconsciously feels he lacks and which the other man
supposedly possesses. These qualities usually have little to do with the
character of the person. Once a realistic familiarity develops, the person
eventually loses his erotic appeal.
In our group process we
frequently return to the distinction made between two kinds of males by our
clients: ordinary and mysterious. Mysterious men are those who possess
enigmatic masculine qualities that both perplex and allure the client. Such men
are overvalued and even idealized, for they are the embodiment of qualities the
client wishes he had attained.
This emotionally crippling
pattern of scaled importance is always reenacted in the group process.
Obsession with "type" is the source of much of the anger and
disappointment in homosexual relationships and accounts for much of the gay
relationship's volatility and instability.
Besides devaluing or
overvaluing other men, there is a third possible mode of response: mutuality.
This is the one toward which we strive. A relationship characterized by
mutuality has the qualities of honesty, disclosure and equality. Even where
there is an imbalance of age, status or life experience, deep sharing with one
another man serves as an equalizer. Mutuality in relationships is the goal of
group psychotherapy, for it is on this level of human interaction that healing
occurs. Mutuality creates the opening through which passes masculine
identification. It is the passage through which each man enters into healing.
One group member said, "If
I came to therapy with the thought that I just had to abstain from sex without
any positive new direction toward intimacy with other men, I don't think I
would be hopeful for real change. Now I have accepted my need for real
intimacy, not the sexual expression of it."
Another group member described
his experience with the words: "My group is the masculine energy I need
every day. It has been a powerful, intense and enriching experience. Our group
has become the father we all need and missed in our early years. There is a
power, a presence among us that keeps us giving, healing, and caring."
All treatment must overcome
some form of resistance against growth. We may say very simply that the
treatment of homosexuality is the undoing of the resistance of defensive
detachment from males. Group therapy is a powerful opportunity to work through
this detachment, which is a refusal to identify with masculinity.
At times it seems as if all our
group members are negatively charged magnets repelling each other. While there
is a sensitivity and genuine concern for each other, there is also a
guardedness and criticalness that can paralyze the entire group process.
Defensive detachment was described
earlier as the blocking process that prevents male bonding and identification.
Originally a protection against childhood hurt from males, in adulthood it is a
barrier to honest intimacy and mutuality with men. The homosexual is torn
between two competing drives: the natural need to satisfy his affectional needs
with men, and his defensive detachment, which perpetuates fear and anger in
male relationships.
Manifestations of defensive
detachment in group appear as hostility, competitiveness, distrust and anxiety
about acceptance. Group members are highly sensitive to issues of betrayal and
deception. We see fearfulness, vulnerability and defensiveness, fragility of
relationships and slow and tentative trust easily shattered by the slightest
misunderstanding.
On the other hand, there is a
resistance to developing friendship with familiar, non-mysterious males--those
who do not possess these qualities. Ordinary men are devalued, sometimes
contemptuously dismissed. One client described his perception of men as
follows: "Unless I was attracted to a particular guy, I perceived men as
these insensitive, Neanderthal types, these monolithic macho things I couldn't
relate to, and had contempt for." As a result of this sort of
misperception, most clients have had few or no male relationships characterized
by mutuality. By placing other men in one of these two categories, a client
justifies his detachment. He either feels too inferior or too superior to
establish the mutuality necessary for friendship.
This resistance to friendships
with non-mysterious males is one reason why, after an initial interest and
excitement about meeting other group members, a client's feelings often turn to
disillusionment. He sees the other members in the group as "just as weak
as I am," and becomes contemptuous of them. He may be particularly
disgusted by the "weaker" group members, those more effeminate, more
emotional, who display personality traits of vulnerability. It is important
this resistance be dealt with in individual therapy.
The essential therapeutic
experience is the demystification of men from sex object to real person (eros to agape). Sorting out his experience of these two
distinct perceptions, one twenty-eight year old client said:
"Immediately after every
homosexual experience, it feels like something is missing. The closeness I
wanted with another man just didn't happen. I'm left with the feeling that sex
is just not what I wanted.
"This is in contrast to my
relationship with my straight friend, Bob. I don't feel the need to be sexual
with him. To be so close to him, getting everything I want from our friendship,
but not even thinking about sex...when I allow myself to really be in those friendships, that's very empowering."
When group members meet
socially, there is always the possibility that they will fall into a sexual
relationship. On rare occasions, there has been such a "fall." Sexual
contact unavoidably damages the friendship and can either destroy it
completely, or furnish the opportunity for further growth through deeper
honesty. The implications of such a fall are great, both for the individuals
involved, and for the group as a whole. Therefore I challenge the men involved
to self-reflect and dialogue.
"After the Fall," the men are asked to speak to each other in response
to the following questions:
1. When did the possibility of
a sexual experience first occur to me?
2. What things did I do to set
you up for the situation?
3. What emotional effect did
this sexual incident have on both of us? Did I violate your personal boundary?
4. Do I feel any anger toward
you?
5. Was
I manipulative? Was I selfish? Did I put my needs before yours?
6. What were the authentic
emotional needs I wanted gratified by you? Comfort,
attention, security, affection, power, sexual release?
7. Did I get what I wanted? If
not, what did I get instead? Did we impede our progress?
8. How has sexual behavior now
changed the quality of our relationship?
Regarding the future:
1. What authentic emotional
needs do I have in relation to you now?
2. What do you want from me
now?
3. How can I facilitate your
development?
4. What lessons about male
friendship do you want to learn from me?
5. What kinds of experiences do
you still need from our friendship?
6. Do I need to ask your
forgiveness?
7. Now, how are we to be for
each other?
If these questions are answered
in painful honesty, then these two men will find new, non-erotic ways of
helping themselves and each other.
The perennial gay fantasy is
that sex is possible within a male friendship. But the group becomes aware of
one inescapable fact--that a sexual encounter between two men permanently
alters the quality of their relationship. Those engaged in a sexual encounter
may deny that anything destructive happened. Or, they may admit that "something"
did happen, but insist that it is of no consequence. Now, we must bring into
focus the fact that sex is never a part of healthy male friendships.
Over the months, the group
addresses many issues. Many of these are related to self-assertion. Often the
men report a tendency to "lose" or compromise themselves for male
approval. There is a sense of victimization, and anger at what they had to do
to gain the other's acceptance. The men see how quickly they can get caught up
in hostile dependencies.
Psychotherapy is a process that
allows us to grow toward wholeness. I tell the group that although supposedly
the subject matter is homosexuality, the underlying process, in fact, is really
the universal one of initiation, growth and change.
The men realize that every one
is challenged to move forward into fullest adulthood, and each
one--heterosexual and homosexual, client and therapist--has his own personal
obstacles to overcome, based on past failures in emotional development. The
distinctly human abilities to self-reflect and choose positive change are true
miracles of human nature.
I am often asked the question, can a homosexual ever "really" become
heterosexual?
Discussing his
own healing, Alan Medinger, a prominent leader
in the ex-gay movement, described the following concern: "Years after I
had left behind virtually all homosexual attractions, and years after a blessed
and pleasurable sexual relationship in my marriage, one factor continued to
disturb me. If an attractive man and an attractive woman enter a room, it is
the man I will look at first."
Indeed, critics of reparative
therapy believe fantasy determines a man's sexual orientation. Yet if a
straight man has a homosexual fantasy, does that make him homosexual? If
someone has a fantasy of stealing something, does that make him a thief?
We might find an answer to this
question of healing in Dr. Salmon Akhtar's book,
Broken Structures, where he describes "The Parable of Two Flower
Vases."
Dr. Akhtar
describes teaching a course on character pathology to a class of clinical
psychology interns. He was asked by one student if a severely disturbed client
could ever be so completely healed by psychotherapy that he would be
indistinguishable from a person who had always been well-adjusted. He replied:
"I paused for a moment and
then prompted by an inner voice spontaneously came up with the following
answer. I said to him, "Well, let us suppose that there are two flower
vases made of fine china. Both are intricately carved and of comparable value,
elegance, and beauty. Then a wind blows and one of them falls from its stand,
is broken into pieces. An expert from a distant land is called. Painstakingly,
step by step, the expert glues the pieces together. Soon the broken vase is
intact again, can hold water without leaking, is
unblemished to all who see it. Yet this vase is now different from the other
one. The lines along which it had been broken, a subtle reminder of yesterday,
shall always remain discernible to an experienced eye. However, it will have a certain wisdom since it knows something that the vase
which has never been broken does not. It knows what it is to break and what it
is to come together."
In my final meeting with the
great researcher Dr. Irving Bieber, a few months
before his death at eighty-two, I asked him, "Did the homosexual clients
you treated, really change internally, or simply gain control of their
behavior?"
Quickly, assuredly, he
answered, "Of course! Many of my patients became completely
heterosexual."
I continued, "But there
often seem to be some remaining homoerotic thoughts and feelings."
With the same instant certainty
he said, "Sure there are. There may always be some," and he shrugged.
Wishing not to argue with an
old sage, I kept quiet but afterward thought, how could Irving Bieber so confidently describe an obvious contradiction?
Akhtar's vases offer an answer: "The broken
vase is intact, can hold water without leaking, is unblemished to all who see
it yet the lines along which it had been broken remain a subtle reminder of
yesterday."
I can but conclude from Akhtar's parable that straight men, vases formed of soft
clay, do not know the trauma of falling from their pedestals nor the wisdom
that comes from knowing what it is to break and what it is to come together.
For many men, reparative
therapy is that way of "coming together."
Book
Excerpt: Healing Homosexuality (1993)
by Joseph Nicolosi,
Ph.D.
(Jason Aronson, Northvale, N.J.,
publisher.
For information, contact the publisher at www.aronson.com.)