Clients' perceptions of how reorientation therapy and self-help can promote changes in sexual orientation

Presented is a summary of 882 homosexual people's responses to 5 open-ended questions about sexual reorientation therapy. Of the 882 participants, 726 reported that they had received reorientation therapy from a professional therapist or a pastoral counselor. As a group, 779 (89.7%) of the participants viewed themselves as "more homosexual than heterosexual," "almost exclusively homosexual," or "exclusively homosexual" in their orientation before receiving reorientation therapy or making self-help efforts to change. The majority reported they believed sexual reorientation therapy and various forms of self-help were helpful to them, psychologically, spiritually, and sexually.     

Beliefs and practices of therapists who practice sexual reorientation psychotherapy

There is currently controversy regarding whether sexual reorientation or conversion therapies are ethical and effective forms of treatment for dissatisfied homosexually oriented people. We present the results of a survey of 206 psychotherapists who practice sexual conversion therapy. 187 therapists said they believed homosexuality is a developmental disorder and that the 1973 decision by the American Psychiatric Association to "depathologize" homosexuality was politically motivated and unscientific. The therapists believe that the majority of dissatisfied homosexually oriented clients who seek conversion therapy benefit from it, experiencing both changes in their sexual orientation and improved psychological functioning. We conclude that therapists who persist in providing reorientation therapy do so because they believe it is an effective and ethical treatment option for their clients.     

Narrative Sexual Identity Therapy

Sexual identity therapy is an alternative to the two polarized positions of sexual reorientation therapy and gay-integrative therapy for clients who present with sexual identity concerns. This alternative model focuses on sexual identity—the private and public acts of identifying and communicating one's sexual preferences—and how the decision to do so is informed by dominant stories about what sexual attractions mean to a client. As one expression of sexual identity therapy, this paper presents narrative sexual identity therapy, an approach that utilizes a narrative therapeutic approach and techniques to facilitate exploration of dominant narratives and counter-narratives that speak to sexual identity with the goal of achieving a synthesis that reflects felt congruence of clients' beliefs/values and behavior/identity.     

Sexual reorientation therapy: an orthodox perspective.

This article evaluates the phenomenon of sexual reorientation therapy from the standpoint of Orthodox Christian theology. It is argued that homosexual desire is the product of the fall of mankind and cannot be considered "normal." At the same time, however, reorientation therapies, whether secular or Christian, are inherently reductionistic and fail to address the underlying spiritual pathologies involved in homosexual desire (or any other deep-seated passion). The purpose of therapeia in the Orthodox Church is the psycho-somatic transfiguration of the whole person into the image of Christ, not merely the cessation of homosexual activity or the "reidentification" of one's "lifestyle."     

Homosexuality, ethics and identity synthesis.

Implicit metaphysical assumptions concerning the nature of sexual orientation are reflected in the language used to frame ethical debates concerning "reorientation" therapies. An alternative metaphysical construal is presented concerning sexual orientation and sexual identity development and synthesis. This alternative construal allows for humility concerning what we know and do not know about sexual orientation, underscores the client's self-determination and autonomy, and demonstrates regard for personal and religious valuative frameworks. Rather than focusing on therapies aimed specifically at sexual reorientation, clinicians would do well to provide clients with informed consent and to facilitate identity development and synthesis in keeping with their clients' requests for professional services.     

Is continence enough?

The ideal of virtue demands not only right choice and right behavior but also right desire in the emotions. Homosexual desire, then, even if it does not result in overt homosexual behavior, is contrary to virtue, and the completion of virtue demands right desire. If a homosexual has no plan to marry, then right desire implies only the removal of homosexual desire and not the revival of heterosexual desire at which reorientation therapy aims. On the other hands, if a homosexual is married or plans to marry, then right desire includes heterosexual desire for one's spouse. If homosexual desire is viewed as an emotional disorder, and not merely as a moral defect, then it may require reorientation therapy to bring about heterosexual desire. The pursuit of virtue, then, may recommend reorientation therapy, but even this recommendation is fairly limited, since reorientation therapy may be burdensome and may not be that effective. In conclusion, married homosexuals or homosexuals planning to marry may have a limited moral obligation to pursue reorientation therapy.     

Are we ready for sexual reorientation therapy in the U.S. military? A response to David W. Lutz.

In his paper "The Catholic Church, the American Military, and Homosexual Reorientation Therapy," David W. Lutz ultimately concludes that it is "appropriate, and highly ethical" for the American military to offer reorientation therapy to help homosexuals overcome "the vice of sodomy." The major thrust of his paper, however, is to call for abandonment of the "Don't Ask/Don't Tell" policy currently in place in the military. Lutz's paper covers much ground, and this review begins by examining whether such a wide view is necessary for the ultimate conclusions. It goes on to ask whether Lutz has omitted to mention important considerations bearing on this issue, and whether Lutz's call for the introduction of reorientation therapy is a serious call or a symbolic response to homosexual activities. Lutz fails to address essential issues such as the actual experiences of other nations having homosexuals in the military, and issues regarding what constitutes "reorientation therapy," the latter leading to questions about how such a therapy would actually be implemented.     

Conflict Between Religious Commitment and Same-Sex Attraction: Possibilities for a Virtuous Response

This article addresses the treatment of individuals who experience conflict between their religious convictions and their same-sex attraction. Recently, attention has been drawn to the ethical issues involved in the practice of sexual reorientation therapy (SRT) with such conflicted individuals. This article reviews the ethical arguments for and against SRT through the lens of the general ethical principles of the American Psychological Association's (2002) ethics code. Practitioners are then challenged to think about how they might respond virtuously (Meara, Schmidt, & Day, 1996) when presented with such a client. Thought questions are presented to assist therapists to develop in virtue while working with religious clients who are conflicted about same-sex desire.     

Subjectivity and sexual difference: New figures of the feminine in Irigaray and Cavarero

This paper argues that the metaphors of breath and voice as employed in the recent works of Luce Irigaray and Adriana Cavarero yield a reconceptualization of subjectivity as unique, embodied and relational. When interpreted in light of Cavarero's reorientation of the question of subjectivity from a what to a who, this newly configured notion of subjectivity can serve as the basis for a non-essentialist politics of sexual difference.     

A psychophysiological therapy for dental fear

A partly automated method for treating dental fear and avoidance is outlined. The method combines a desensitization procedure with EMG biofeedback and cognitive reattribution. After therapy, 21 out of 24 patients suffering from severe dental fear were able to complete dental rehabilitation. The therapy process is discussed in terms of reconditioning, cognitive reorientation and coping training.     

Attachment Change in Emotionally Focused Couple Therapy and Sexual Satisfaction Outcomes in a Two-year Follow-up Study

Emotionally focused couple therapy (EFT) is an empirically validated attachment based approach to couple therapy. From an EFT perspective, sexual functioning is viewed within the context of an attachment bond, but sexual satisfaction in EFT has not been empirically tested. We examined self-reported sexual satisfaction across 24?months in a sample of 32 couples who received an average of 21 EFT sessions. We found that sexual satisfaction increased across six time points from pre to post therapy and across follow-up (6, 12, 18, and 24?months), and that decreases in attachment avoidance from pre to post therapy predicted increases in sexual satisfaction across time. These findings provide evidence that EFT may help couples improve their sexual satisfaction by reducing attachment avoidance in therapy.     

Relationship factors in the treatment of sexual dysfunction

The role of marital harmony in the development, assessment and treatment of sexual dysfunction is addressed in the present study. Twelve couples with mixed sexual dysfunctions received both sex therapy and marital therapy in a balanced cross-over design. The major variables investigated were therapy outcome on measures of sexual satisfaction and marital adjustment as a function of treatment modality (sexual or marital) and relationship functioning. Findings showed significant differences in outcome between treatment approaches with a strong mediating effect of relationship factors. Limited interpersonal understanding and inaccurate perceptual agreement in relationship functioning characterized those couples who failed to exhibit a differential response to treatment in favour of sex therapy over marriage therapy. Implications of these findings for the assessment and treatment of sexual dysfunction are discussed.     

The Catholic Church, the American military, and homosexual reorientation therapy.

Homosexual activist groups have targeted the Catholic Church and the American military as institutions especially in need of transformation. Associations of healthcare professionals are also under assault from homosexual activists. It is, nevertheless, appropriate for the Church and the military to defend themselves against this assault, to affirm that homosexuality is incompatible with Christian ethics and military service, and to help homosexuals free themselves from the vice of homosexuality. Arguments that homosexual reorientation therapy is unethical are unsound. Such therapy is consistent with the Christian virtue of charity.     

Exploitation in therapy and counselling: a breach of professional standards

Exploitation in therapy and counselling may occur in only a minority of cases, but when it does, its effects are potentially damaging to both the client and the profession. Exploitation in therapy may take the form of psychological, covert and overt abuse. The most reported form of abuse of the therapeutic relationship is of a sexual nature. However, psychological abuse usually forms the backdrop to sexual exploitation, preceding and perpetuating the sexual involvement. Sexual exploitation in therapy is an abuse of the power imbued in the therapist by nature of his professional role. It allows the therapist a sexual gratification which he would not have been likely to achieve outside the therapeutic relationship. The prevention of sexual exploitation in therapy is an issue of concern to training, employing and professional organisations who seek to maintain high standards of counselling delivery. Determining the variables which may contribute to exploitation is fundamental to avoiding its incidence. This paper discusses the factors underlying the use of therapy and counselling as a medium for therapist abuse. It examines (i) the prevailing conditions for abuse to occur, (ii) how the therapist overcomes client resistance, and (iii) the implications for the maintenance of professional standards.     

The Satir Model with Female Adult Survivors of Childhood Sexual Abuse

Child sexual abuse is a recognized problem in the United States and Canada. There are several approaches to therapy with adult survivors of childhood sexual abuse. This article discusses Virginia Satir's model of therapy as it applies to sexual abuse. The emphasis of the Satir model is on transforming the impact of the abuse, no matter how the client chooses to process her relationship with the abuse, and is illustrated through a case study.     

Recovery from sexual assault: an innovative two-stage group therapy model

This article describes an innovative two-stage model of sexual assault therapy groups for women in a university setting. This model is recommended for use in various settings and includes a supportive therapy group and two specialized therapy groups, one for childhood sexual abuse survivors and the other for sexual assault (acquaintance rape and stranger rape) survivors. Theoretical underpinnings of the model are discussed in addition to practical aspects of group development such as elements of an effective group, screening of potential members, and marketing and recruitment techniques.     

Five reasons to doubt the existence of a geometric module

It is frequently claimed that the human mind is organized in a modular fashion, a hypothesis linked historically, though not inevitably, to the claim that many aspects of the human mind are innately specified. A specific instance of this line of thought is the proposal of an innately specified geometric module for human reorientation. From a massive modularity position, the reorientation module would be one of a large number that organized the mind. From the core knowledge position, the reorientation module is one of five innate and encapsulated modules that can later be supplemented by use of human language. In this paper, we marshall five lines of evidence that cast doubt on the geometric module hypothesis, unfolded in a series of reasons: (1) Language does not play a necessary role in the integration of feature and geometric cues, although it can be helpful. (2) A model of reorientation requires flexibility to explain variable phenomena. (3) Experience matters over short and long periods. (4) Features are used for true reorientation. (5) The nature of geometric information is not as yet clearly specified. In the final section, we review recent theoretical approaches to the known reorientation phenomena.     

Barriers to Intimate Sexuality: Concerns and Meaning-Based Therapy Approaches

Despite the voracious need for intimate connection, Western society does not promote intimacy, particularly with regard to partner sexuality. Obstacles to sexual intimacy that are discussed include: Media portrayals of sexual and gender role stereotypes, performance-oriented sexual standards, the invisibility of the elderly as sexual beings, and the glamorization of nonrelational sexuality and clandestine affairs. Unfortunately, the sex therapy literature, too, tends to focus on depersonalized and goal-oriented models of sexuality. Paradigms which can overcome barriers and promote intimate sexual connections are required. This article calls for humanistically based changes, in the media and in sex therapy, to satisfy the need for sexual intimacy.     

Structural couple therapy in the treatment of inhibited sexual drive

Abstract

This paper presents a study of a structural couple therapy approach to the treatment of inhibited sexual desire (ISD). ISD is first conceptualized as a relational phenomenon that may be most effectively treated in a couple context. Structural couple therapy is advanced and applied to the treatment of a clinical sample of couples presenting with ISD. Results of the study suggest that a structural couple therapy approach to ISD is effective in reducing symptoms of the sexual disorder and in increasing couple satisfaction.     

Woman to Woman Sexual Violence

This article addresses woman to woman sexual violence, a topic that is seldom addressed in the therapy literature. A brief history of research and theory on sexual violence is presented followed by two case studies. Treatment issues are discussed and challenging questions are raised in an attempt to increase counselors' awareness of the issue of sexual violence between women with the goal of providing more comprehensive treatment to survivors of woman to woman sexual violence.