Reparative Therapy of Male Homosexuals: A New Clinical Approach by Joseph Nicolosi (Jason Aronson, 1991, 355 pp.)
by Dr. Ralph Blair
If this book were titled Non-reparative Therapy of Male Homosexuality: An Old Clinical Approach nobody seeking to rid self or others of homosexual feeling would buy it. The book has a market because its title seems to promise a new clinical approach to therapy that fixes damaged sexuality, changing it from homosexual to heterosexual. But at the end of his Introduction, Nicolosi, a Christian psychotherapist, admits: “Reparative therapy is not a ‘cure’ in the sense of erasing all homosexual feelings”. Nothing in his 355 pages gives a believable basis for hope that reparative therapy erases any homosexual feelings. Indeed, according to Nicolosi: “In reparative therapy the client … commits himself to treatment with the belief that ‘irrespective of how I feel, I am a latent heterosexual’.”
What is new in Nicolosi’s book is his spin on older and discredited psychoanalytic speculation about failed relations with fathers and alleged arrested gender identity that clinical and social psychological research finds is not, as such, associated with homosexual orientation. Nicolosi cites statements of even his own experts only very selectively, failing to acknowledge their later and fuller opinions at variance with his own. For example, he fails to say that one of his experts concluded that “an overt homosexual way of life can play a constructive … role in the personality”. He cites a psychoanalyst’s 1956 paper but not his 1965 paper that concludes: “It is unrealistic to try to eradicate the homosexual’s desires for members of his own sex”. He appeals to another’s “success in treatment” without citing this man’s saying that “even after [a client] has gained and sustained control over his homosexuality, relapses can evoke … a period of protracted homosexual practice”. Nicolosi does note “the failure by the profession to find a successful cure” or even “to devise a reasonably successful treatment”. But he does not note the failure of the religious “ex-gay” efforts he recommends, nor does he note the fact that the “research” he cites in support of these has been discredited (e.g., that of the Pattisons). He does admit that even his therapy cannot “cure” homosexuality but can “improve a man’s way of relating to other men and … strengthen masculine identification” – whatever that means, however unrelated to homosexuality it is, and no matter how far short it falls from readers’ expectation of real “repair”. Nonetheless, he decorates the title page of Part III, “Psychotherapy”, with two quotes promising heterosexuality. One is from a psychoanalyst who eventually concluded: “The therapeutic experience is not …calculated to convert homosexuals into heterosexuals” and the other is from a leader in the religious “ex-gay” movement who was discovered to have been having sex with many of his male clients. Nowhere in the book does Nicolosi mention either of these facts.
He admits that his therapy is not useful to homosexuals who are satisfied with homosexuality. He admits that there are even homosexuals who are dissatisfied with homosexuality who “are inappropriate for reparative therapy because they show no signs of gender identity deficit and do not match our developmental model”. He claims that his own clients “choose a different struggle … an interior struggle” instead of what he says is the struggle to live “the gay life-style” – whatever that is. He admits that “the treatment of homosexuality [is] a lifetime process”. But he tends to slip into contrary and misleading phrasing such as “reparative therapy” and “outgrowing homoerotic thoughts, feelings, and behaviors”. For Nicolosi, treatment goals can be either “heterosexual marriage” or “a commitment to celibacy”. But how is either of these anything but attempted accommodation and maladjustment within continuing homosexual orientation? How is this “reparative”?
Nicolosi’s representations are frequently so biased as to leave readers misinformed. Two instances: He claims that Freud viewed homosexuality as “pathological” but does not balance that with Freud’s saying that it “cannot be classified as an illness”, that it is found in “normal … unimpaired” people and is merely “a variation of the sexual function”. Nicolosi repeats the Right-wing propaganda that the American Psychiatric Association’s removal of homosexuality from its Diagnostic and Statistical Manual was due to intimidating political pressure even though it actually was based on a two-fold scientific standard consistently applied to the entire DSM. If homosexuality had not been dropped it would have been the only mental disorder in the revised DSM that did not meet the established scientific qualifications of a mental disorder.
Among Nicolosi’s errors is his foundational rationale. He says he offers help to homosexuals who “experience conflict between their values and their sexual orientation”. However, by his own definitions, the conflict is not between their values and their sexual orientation but between their values and the values of some other homosexuals in what they and Nicolosi too broadly call the gay lifestyle. But there are as many “gay lifestyles” as there are individual homosexuals living out their own values. Moreover, the conflict is between a person’s sexual orientation and introjected and imposed values and ignorance of a homophobic ecclesiastical establishment.
“Reparative” in this book really doesn’t mean “to fix” but, rather, “to go back”, repairing again and again to homosexual feelings, homophobia and lifelong “reparative” therapy. Antigay crusades by backers of this book bring another meaning to mind: reparation. But the crusaders are giving no mind to reparation. Reparation is making amends for mistreatment of “the least of these” who never asked to be homosexual and who cannot change to heterosexual and who have sexual intimacy needs as strong as heterosexuals do. In the words of Georgia Harkness, in this her centennial year: “… but other hearts in other lands are beating with hopes and dreams as true and high as mine.”