from What do clinical studies say?
Dr. A. Dean Byrd Reviews Dissertation on
Factors In Re-orientation Success
March 13, 2006 - In a doctoral dissertation directed by Dr. Jay C. Wade, Department of Psychology, Fordham University, New York, Elan Y. Karten investigates the psychological and religious characteristics of dissatisfied same-sex attracted men who seek sexual re-orientation interventions.
As a logical follow-up to Spitzer's landmark study, the Karten research was specifically designed to investigate the following: the respondent's relationship to his father; type of sexual self-identity; quality of psychological relatedness to other men; and which form of religious values demonstrated the strongest relationship to change. Karten defined "success" in this study as "an increase in heterosexual functioning, a decrease in homosexual functioning, improved psychological well-being, and a greater heterosexual identity."
Among Karten's most robust findings: treatment success is best predicted by a reduction in conflict regarding the expression of non-sexual affection toward other men.
This finding has important theoretical and clinical implications. Perhaps for some boys, early childhood development of strong, non-sexual relationships with other males will prevent the development of homosexuality. Such a theory finds support in the psychodynamic literature, as well as the more recent "Exotic Becomes Erotic" (EBE) theory of Daryl Bem. In addition, Karten's finding strongly suggests that development of healthy, non-sexual relationships with men is an important part of the treatment process. His finding also provides supportive evidence for the effectiveness of men's groups that foster healthy, non-sexual male relationships.
Karten also found significant differences in the perceived effectiveness of traditional psychotherapy, religious interventions, alternative approaches, and self-education. Interestingly, traditional psychotherapy was rated as the least helpful intervention in this category. Religious interventions, alternative approaches and self-education were deemed important. The psychological variables examined in the study such as high lack of psychological relatedness to other men, reduction of conflict associated with restrictive affectionate behavior between men, heterosexual identity, high intrinsic religiosity, and absent/weak bonding with father as a group predicted treatment success. Men who became more comfortable in expressing their thoughts and feelings to other men and those who became comfortable with non-sexualized touch demonstrated a significant advantage in treatment.
Contrary to expectations, Karten's findings indicate that the more one identified as heterosexual, the less change there was in the individual's sexual feelings and behavior toward both women and men. Logically, Karten concluded that the more an individual self-identifies as heterosexual, "the less likely the individual would even seek change in his orientation to be more heterosexual."
Of particular interest was the finding that problematic masculinity may be more amenable to sexual reorientation interventions than an absent/weak paternal bond. This finding suggests that homosexual attractions may be more related to gender (a sense of maleness or masculinity) than to sexuality itself. Also, it may suggest that treatment aimed at strengthening gender identity may be more efficacious than focusing on strengthening parental bonds.
Thus Karten's study, along with others, adds to the body of clinical and research data that conclude that homosexuality is more fluid than fixed. Indeed, the quality of such research, mentored by seasoned professionals, provides scientific evidence to refute the repeated claims of The American Psychological Association (APA) that there is "no published scientific evidence supporting the efficacy of reparative therapy as a treatment to change one's sexual orientation." The Spitzer study provided clear evidence to the contrary. And now, the Karten study expands on the Spitzer study by identifying factors that are associated with treatment success.
With such data providing support for the efficacy of reparative therapy with some individuals, the question of the ethics of APA discouraging such therapy now becomes center stage. No longer can the opponents of reparative therapy state there is no scientific evidence of its effectiveness. More importantly, as reparative therapy is studied, perhaps it is time for APA to insist on data to support the efficacy of other therapies, including gay affirmative therapy.
The ethical route demands the following: clients should be informed of the possibility that they may be disappointed if therapy (for any reason) does not succeed, so they can make a rational decision whether or not enter therapy. Offering such a choice should be fundamental to any therapeutic endeavor, and is central to client autonomy and client self-determination. In fact, it is clearly unethical for any professional, informed by the literature and guided by evidence-based interventions, to deny the choice of therapy to those who are unhappy with their same-sex attractions and seek therapy to diminish those attractions.
Though such research into sexual reorientation may be viewed as politically incorrect, no longer can it be ignored. Sociopolitical concerns must not interfere with the scientist's freedom to research any reasonable hypothesis, or to explore the efficacy of any reasonable treatment.
Elan Karten, supported by his mentors at Fordham University, has made a major contribution to the scientific literature. He has departed from the academy which has so often capitulated to political correctness, and has agreed with Dr. Robert Spitzer who noted that "science progresses by asking interesting questions, not by avoiding questions whose answers might not be helpful in achieving a political agenda." Perhaps other universities will follow Fordham's lead.