Reviews of Dr. Nicolosi’s book, Shame and Attachment Loss

An advocate for gay men and women who are serious about striving to overcome their same-sex orientation and achieving sexual fulfillment heterosexually, Nicolosi–like a voice in the wilderness–audaciously defies conventional psychologists who cling to the belief that changing from homosexuality to heterosexuality is neither possible nor advisable.

Disseminating his point of view is desirable and necessary for society, as well as for gay men and lesbians. Now this is not to definitively assert that for many homosexuals, heterosexuality is preferable to homosexuality; only that this quest should be freely accessible to the homosexual person, if indeed that is his or her wish.

Nicolosi’s treatise on reparative therapy is a groundbreaking and courageous navigation of the tricky shoals, perilous undertows, and precipitous twists and turns required to bypass the psychological community’s declaration that homosexuality is appropriate for all homosexual men and women. Though still controversial, his treatise is punctuated and made more believable through his reliance on the client’s perceptions, feelings, and family dynamics.

In a word, Nicolosi’s thrust in promoting his point-of-view on behalf of this contentious hot-button issue is broad and deep, abstract and experiential, and theoretically and practically depicted.

The policies and resolutions of organizations such as the American Psychological Association and probably the American Psychiatric Association as well, would be better framed and more truthfully based were these organizations cognizant of, and open to, the sentiments promoting reparative therapy.

Nicolosi’s book deserves widespread readership, by friend and foe alike, whether or not, truth to tell, it is still a work in progress; even if in the long run, he is shown to be right, wrong, or somewhere betwixt and between. The paths to ultimate truth can only be forged when consummated fully and unconditionally, and certainly not with impeding and competing ideological polestars misdirecting their voyages…

The author has contributed enormously to the sexual literature by offering his not unreasonable views for consideration by gays and lesbians, by scholars in the field, by the man in the street, and by practicing psychotherapists. His challenging and forceful commentary is must-reading from top to bottom, from stem to stern.

—Robert Perloff Ph.D.
Former President, American Psychological Association
Distinguished Service Professor Emeritus, University of Pittsburgh

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In the current contentious and divisive climate that surrounds the treatment of homosexuality, the well-being of thousands of patients is at stake. Therefore, it is imperative that militant attempts at censorship and ideologies that would limit open inquiry be set aside in the interest of clinical integrity. The right of the patient to choose his or her therapeutic goals is paramount, and attempts to stifle the patient’s freedom-of-choice are not only egregious, but also contrary to the basic commitment of all health care itself. For this reason, even though I disagree with some cause-and-effect relationships proffered in this book, Dr. Nicolosi’s point of view must be part of the equation in an honest, open deliberation until we arrive at ultimate scientific and clinical fact. In my over 60 years of practice as a psychologist I have seen many conditions, both medical and psychological, that were once regarded as incurable to now be readily treatable. In this early stage of the heated debate on the treatment of homosexuality and same-sex-attraction, to prematurely remand all homosexuals to an unchangeable life style would be a disservice to the worst order.

—Nicholas A. Cummings, Ph.D., Sc.D.
Distinguished Professor, University of Nevada, Reno
President, Cummings Foundation for Behavioral Health
Board Chair, The Nicholas & Dorothy Cummings Foundation
Executive Board Chair, CareIntegra
Former President, American Psychological Association as well as Division 12 (Clinical) and Division 29 (Psychotherapy), recipient of psychology’s gold medal for “Lifetime contributions to practice”

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“In this richly detailed book, Dr. Nicolosi shares his experiences of many years working with same-sex attracted men who want to diminish their unwanted attractions and develop their heterosexual potential.

Nicolosi is convinced that the world’s great religious traditions are right: humanity was designed for gender-complementary coupling. The mental-health associations must respect this viewpoint; to do otherwise would be a gross violation of worldview diversity as well as the client’s right to freedom and self-determination.

This new book is a rich source of information– written by an astute clinician whose work with same-sex attracted clients has been groundbreaking, beginning with his 1991 book, Reparative Therapy.

—A Dean Byrd, Ph.D., M.B.A., M.P.H.
Clinical Professor of Psychiatry, University of Utah
President, National Association of Research and Therapy of Homosexuality (NARTH)

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Joseph Nicolosi has written a book that can only be the culmination of decades of clinical observation and scholarly integration of what we know today about the origins and treatment of homosexuality when it is not ego-syntonic. The popular press fosters an idea that the reason for rejecting homosexual impulses must be traditional social disapproval. Objective scientific study says otherwise. Freud noted that all children go through phases of assigning their sexual fantasies alternately to one parent or the other. Most children outgrow this phase and settle on same-sex self identification, with sexual impulses directed toward the opposite sex. Dr. Nicolosi’s work is with the few who do not. The subject fascinates practically everyone, however, because we all have had experience with conflicting attitudes during our formative years. There is not one polemical statement in this treatise.

The theoretical section that begins the discussion is thorough and anyone who follows the literature in the field will enjoy reasoning with Dr. Nicolosi. In Shame and Attachment Loss, Dr. Nicolosi distills the emotional effects of critical family constellations that complicate the sexual development of a child, then adolescent and finally adult. He manages to make a scientific and clinically significant book that any intelligent adult might read with understanding and ease. One help is the excellent organization of the material. Secondly, the book is rich in clinical examples. Even the first part of the book, which provides underlying theory, is saturated with clinical examples that bring theory to life. Close study revealed for Dr. Nicolosi three syndromes which he observed in the groups of men who come for reparative treatment because the continuing early conflicts are inwardly for them so upsetting He discerned when homosexuality is a shame-based behavior, a repetition compulsion to resolve specific disturbing memories, or a reparative drive to make up for angers hidden within the person’s unconscious. The challenge to the therapist is enormous of unraveling the complexities these motivations create for someone.

The treatment section of the book requires therefore 13 chapters to illustrate the various ways in which the men who come to a therapist need to be understood.

What makes this book unique, even beyond the considerable theoretical and clinical contribution I have outlined, is Dr. Nicolosi’s original formulation of the role of grief in these patients. The disruption of attachment that is implied in the book’s title has never been clarified before in psychological literature in efforts to understand homosexual impulses. How shame and the other basic affects interplay in personalty development is vital knowledge for any therapist who wants to work deeply enough with patients to be able to help them at the level of their greatest grief. The clinical examples again show how expectable it is that such work can be freeing to those with the courage to explore sources of pain so long hidden from consciousness. To read Shame and Attachment Loss may seem to some in the psychological field a thing to avoid on grounds of wanting to hold on to prevailing notions about homosexuality. Anyone who does read it will be rewarded with a cogent understanding of personality development and family dynamics and our need to take the psychotherapeutic journey with each individual as a fresh adventure.

—Johanna Tabin, Ph.D.
Member American Psychological Association
Member Division 38 Psychoanalysis
Author, On the Way to Self Ego and Early Oedipal Development

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“For the therapy of unwanted same-sex attraction, very few people have had the depth of experience and wide-ranging success of Joe Nicolosi. A master in the field has here distilled that experience equally for the professional and the interested layperson.

Every genuinely open-minded therapist should be familiar with the important insights that Dr. Nicolosi provides. This book can and should likewise provide the foundation for courses that train interested professionals in the art and science of helping to reverse homosexuality and restore heterosexual desire and functioning to those who seek such changes.”

—Jeffrey Burke Satinover, M.D.
Diplomate, American Board of Psychiatry
Diplomate, American Board of Neurology
Diplomate, C.G. Jung Institute of Zurich, Switzerland
Author, Homosexuality and the Politics of Truth

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“In this groundbreaking book, Nicolosi, a pioneer in the field of reparative therapy, introduces clinicians to the influence of shame and attachment loss within a same-sex drive. By integrating multiple theoretical bases, Nicolosi has developed and effectively presents a fresh and comprehensive framework for understanding and treating male SSA. The techniques and strategies discussed within this cutting-edge work will guide therapists in their work with homosexual strugglers.

This is a must-read and an essential resource for any counselor’s library. It will have a lasting impact on how the scientific and professional mental health communities view and comprehend homosexuality.”

—Janelle Hallman, MA, LPC
Author, The Heart of Female Same-Sex Attraction: A Comprehensive Counseling Resource

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Nicolosi brings extensive professional clinical perspective and deep immersion in the historical literature in this area to his reflections on work with individuals experiencing unwanted SSA. This volume offers fruitful clinical hypotheses for exploration.

The author shows balance in acknowledging possible biological and psychological contributors to causation; in exploring what full informed consent for consultation entails; in respecting appropriate clinical boundaries in professional consultation; and in acknowledging the experiences of those who find such work unproductive, as well as those reporting success.

—Stanton L. Jones, Ph.D.
Provost and Professor of Psychology, Wheaton College (Wheaton, Ill.)
Author, Ex-Gay? A Longitudinal Study of Religiously Mediated Change of Sexual Orientation, and Homosexuality: The Use of Scientific Research in the Church’s Moral Debate

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Dr. Nicolosi’s latest book is, as ever, a continuation of insightful writing based firmly on his experience. Alongside long transcripts covering many facets of his clinical work are numerous superb and highly quotable pinpoint statements from clients, which illuminate many facets of same-sex attraction.

Some of these insights, for example about the sado-masochistic tendencies found among homosexually oriented men, the tendency to flip-flop between extreme views of others [devaluing vs. over-valuing them], and origins of bisexuality, seem underappreciated even in therapist circles, and are relatively new ideas.

Although the book is intended for therapists, there is also much here that deepens understanding for the non-therapist.

Many myths about reparative therapy are refuted by this book. No one taking the trouble to browse it could believe any longer that such therapists are primarily motivated by anti-gay feelings. Considerable care of clients is clear in the transcripts. The approach is refreshingly non-doctrinaire.

Although the basic therapy approach has stood the test of time, it has been refined in the light of experience, and clients who fall in groups demanding different approaches have also been considered, and their needs addressed.

Even critics who abhor this type of therapy might find their opinions modified if they read the book.

—Neil Whitehead, Ph.D.
Author of My Genes Made Me Do It – A Scientific Look at Sexual Orientation and over 120 published scientific papers

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For those who have freely made up their mind to find a different way forward in dealing with the challenges of homosexuality this book is a godsend. Joseph Nicolosi has provided a first rate manual that tackles the issues head on, that works from the best evidence available, and that is rooted in years of therapeutic practice.

We have long needed a book like this: respectful of human choices, realistic in its central claims, clear about its theoretical foundations, aware of relevant objections, and robust in its proposed clinical solutions. Every pastor and therapist, whatever their personal theological or moral commitments, should have this book in their library. They owe this to all those who are reaching for an alternative to the sexual ideologies of our culture; they also owe it to the demands of common honesty and of intellectual virtue.

—William J. Abraham, Ph.D.
Albert Cook Outler Professor of Wesley Studies
Altshuler Distinguished Teaching Professor
Perkins School of Theology, Southern Methodist University

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As an internationally-recognized clinical expert on Reparative Therapy for unwanted homosexual attractions, Dr. Joseph Nicolosi has written a theoretically-sound, clinically insightful, intellectually-brilliant, and highly compassionate practical book that will, no doubt, become a standard professional reference for psychologists, psychiatrists, and other mental health clinicians treating individuals troubled by their homosexual impulses.

Now that scientific studies have established that homosexual orientation can be successfully treated without harmful “side-effects,” mental health professionals are now, more than ever, interested in the theoretical underpinnings of Reparative Therapy and in the specific therapy techniques that produce change. With his decades of clinical experience in successfully treating men with homosexual orientation, enhanced by many hours of systematically analyzing video recordings of actual psychotherapy sessions at his well-known clinic, Dr. Nicolosi presents sound psychodynamic models of the development of homosexual attractions as a basis for his therapeutic techniques. He offers a creative and sound integration of psychological research findings, psychodynamic understanding, recent findings on the neurological structure of the brain, and clinical advances in the art of psychotherapy. What makes this book especially helpful to clinicians are the numerous transcripts of therapy sessions illustrating therapeutic breakthroughs with homosexual clients.

Dr. Nicolosi’s theory and therapeutic method is consistent with my decades of research on childhood gender identity disorders. His book shows how homosexual attractions and enactment functions as a situational reaction to feelings of gender inadequacy and to unmet emotional needs including a developmental lack of male attention, affection and affirmation from father-figures and/or other male mentors. Same-sex attractions function as attempts to “repair” an emotional deficit in a male’s own “perfectly normal and authentic needs for male attention, affection, and approval.

Dr. Nicolosi helps his clients to identify circumstances and emotional states when most tempted to homosexual behavior. He affirms human will, and the reality of the ability to choose to interrupt the sequence of psychological events would otherwise lead to homosexual temptation and to homosexual enactment. This book is not only psychologically sound and theoretically insightful, but it is consistent with the Judeo-Christian theological understanding of the creation of humans as male and female and the normality of close emotional, non-sexual, relationships among men as illustrated by the loving relationship between David and Jonathan. His book clearly illustrates how he assists men with same-sex attractions to adjust to created realities of human personality and relationships, while abandoning a False Self that emerged from a problematic development in early life.

Dr. Nicolosi shows theoretically and therapeutically how strengthening feelings of masculinity diminishes same-sex attraction and how mental health depends on acceptance of psychological realities. He does so with a compassionate understanding of the client’s needs and problems.

—George A. Rekers, Ph.D., Th.D.
Distinguished Professor of Neuropsychiatry and Behavioral Science Emeritus, University of South Carolina School of Medicine
Adjunct Professor of Psychology, Graduate School of Trinity International University, Florida Regional Center

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I would recommend publication of this volume for the following reasons: First, although Reparative Therapy has been maligned by some in Division 12 (Clinical) of the American Psychological Association, it has not been rejected as a therapeutic modality for those seeking to change their sexual orientation– especially Christians.

Second, while there is strong current emphasis on empirically validated treatment modalities, all approaches initially began as theories which were clinically applied long before they were subjected to controlled clinical studies. Reparative therapy as described in Nicolosi’s volume is one such modality. Empirical validation will be the next step in its development, but it should not be discounted for being in this stage of development.

Third, reparative therapy, as detailed by Nicolosi, is not presented as a therapeutic “cure-all,” nor is it presented as a model that explains each and every incidence of homosexuality. Reparative therapy is offered as a hopeful remedy grounded in one environmentally significant determinant – namely, family interaction. It is also offered as an option for religiously motivated persons who seek some alternative to the view that they cannot change.

I would think Intervarsity would be honored to be its publisher.

—H. Newton Malony, Ph.D.
Senior Professor, Graduate School of Psychology, Fuller Theological Seminary, Pasadena CA

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I have just finished reading this book, and . I only wish there had been such research and words of hope earlier in my ministry in counseling homosexuals. Nicolosi’s book offers a refreshing cool cup of reason and hope on one of the most heated topics today. This is a must-read for not only the homosexual who is struggling over his sexuality, but for every parish pastor, counselor and therapist.

As a university professor of graduate studies in family ministry, it will be on my list of required textbooks.

–Roger Sonnenberg, M.Div., M.A. (Pastoral Psychotherapy)
Professor of Graduate Studies in Family Ministry, Concordia University
Author, Human Sexuality: A Christian Perspective

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A legend in the world of gender affirmation, Joe Nicolosi devoted much of his professional career to educating the western world that a change of sexual orientation is possible. Having written three other books on the subject, this latest book, Shame and Attachment Loss: The Practical Work of Reparative Therapy, represents his most recent insights and personal growth in understanding and treating those with unwanted same-sex attractions.

Initially conceptualizing homosexual attraction as a striving “to repair gender deficits,” he now sees it more broadly as a striving “to repair deep self-deficits” and as a “defense against trauma to the core self.” From this profoundly insightful premise, the text principally addresses mental health professionals and faith-based ministry leaders to explain the psychodynamics of homosexuality, its treatment modalities, and the role and resolution of grief in Reparative Therapy.

Not only are brilliant new insights found through out this volume, but it shows how the Judeo-Christian worldview is aligned with practical psychological techniques for healing. I recommend this “must-read” book to anyone who cares to learn about either the causes or treatment of homosexuality. The library of every mental health professional, ministry-leader, and individual concerned about the sexual confusion that runs rampant in today’s world should include this book.

—Arthur Goldberg
Co-Director, JONAH
Author, Light in the Closet: Torah, Homosexuality, and the Power to Change

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As readers have come to expect from Dr. Nicolosi, Shame and Attachment Loss: The Practical Work of Reparative Therapy again is an enormous contribution to making the complexities of homosexuality and its treatment more coherent for parents, therapists, and anyone concerned about cultural issues. Dr Nicolosi continues his pathway of contributing clinically and philosophically in the traditions of a scholar.

—Benjamin Kaufman, M.D.
Clinical Professor of Psychiatry, University of California at Davis
Psychoanalyst

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• Joseph Nicolosi, Linda Ames Nicolosi

• Jan 1, 2003

• Series: Volume 6 – 2003

Nicolosi, Joseph, & Linda Ames Nicolosi A Parent’s Guide to Preventing Homosexuality. Downers Grove, IL: InterVarsity Press. 2002 Paperback, $12.00. 254 pp. ISBN 0-8308-2379-4.

Husband and wife team Joseph and Linda Nicolosi have written a bold, new book that is sure to be of great help to many families. Their work represents an effort of considerable courage as well since they face ostracism from their secular peers for arguing the case of this book as they do. We also owe a debt of thanks to the publisher for putting this helpful material in the hands of the public.

The book’s title is not exactly descriptive of its contents. The book, in actuality, is about how parents can react to a male child or teenager who rejects his own gender and adopts a highly feminized style of activity and interest. To a lesser degree, the book also deals with how parents can and should deal with a female child or teenager who displays intense masculine patterns of interest. In this sense then, the book is about preventing a fuller and more complete expression of homosexuality when the child developmentally reaches adulthood. The book does not concern itself with children and teens who do not display these signs of what the authors term prehomosexuality, gender-conflicted behavior, gender-confused attitudes, or gender-disturbed styles of behavior.

The book is the outcome of years of providing psychotherapy to children, teens, and families who find themselves in the midst of this type of gender confusion. Dr. Nicolosi serves as the President of NARTH (National Association of Research and Therapy of Homosexuality) and has also built a distinguished career of helping active homosexuals who wish to move away from their homosexual lifestyles toward heterosexuality. But that is a topic for another book. Dr. Nicolosi objects to homosexuality, in part, out of his Roman Catholic theological convictions although this book is primarily therapeutic in tone, not theological or biblical.

The main theoretical framework for the Nicolosi team traces its roots to Freudian objections to homosexuality. Neo-Freudians, primarily Elizabeth Moberly, have altered the original psychoanalytical explanation of homosexuality somewhat by focusing on deficits in same-gender parental relationships rather than problems with opposite-gender parental connections. Boys veering toward homosexuality often sustain distant or unconnected relationships with their fathers, and girls often display the opposite pattern. The Nicolosi team refrains from declaring that this developmental pattern is the one, solitary background for all homosexual persons, but they do assert that it is common enough that no one can ignore its relevance. And the beauty of working with children and teens who do come from this type of background is that in most cases the therapist has the option of helping parents change their style of interaction so that the children can benefit from a healthier relationship with their parents and can continue their development toward normal heterosexuality as adults. Reparative Therapy® of adult homosexuals can often only strive for a healing of wounds caused by parental deficits that have long ago slipped into history.

The authors present one case study that is particularly poignant. An adult male homosexual describes his memories of his childhood with the following description:

We had an old farmhouse outside Sioux City, and you opened up this rickety trapdoor and went down these creaky old steps into a dark and damp-smelling basement. My father would escape from the rest of us and spend hours there in his machine shop. But I was forbidden to go there – I might break his tools or get hurt, is what he told me. So I would lie on my belly up above, looking down and watching Dad work. What I’ll never forget is that feeling of mystery about what was going on down below. Eventually my Dad let my two older brothers help him, and they’d be talking and working and laughing. It wasn’t just the mystery of what was being done in the cellar . . . it was the whole mystery of who Dad was, because to this day, I really don’t understand him. If I had to draw just one picture that would represent my entire childhood, it would be of me peering down into the darkness below at my father and my brothers. (p. 102)

For many years research has indicated that “there is a high correlation between gender nonconformity in boyhood and adult homosexuality” (p. 12). The authors concede that biological factors may play a part in the development of homosexuality, but contend that family and environmental influences are far more powerful in determining its ultimate expression. Thus when families notice that a young boy is having difficulty accepting his masculinity or engaging masculine activities and interests, the family can make environmental changes that will in time help the boy more easily accept his gender. Normally these changes consist of focused and loving attention for the boy from his father. The authors are careful not to confuse the encouragement of a “macho” style with what parents need to cultivate in the gender-confused boy. “Of course, the . . .child should not be forced into a predetermined mold that will cause him to deny his fundamental nature – his natural gifts of creativity, sensitivity, kindness, gentleness, sociability, intuitiveness or high intellect” (p. 38). “A gender-nonconforming boy can be sensitive, kind, social, artistic, gentle – and heterosexual. He can be an artist, an actor, a dancer, a cook, a musician – and a heterosexual. . . . No one should try to discourage those abilities and traits” (p. 48).

One very useful feature of the book consists of transcripted interviews Dr. Nicolosi includes as a major portion of the final chapter. He conducted interviews with parents of prehomosexual boys who had been his patients years earlier and asked these parents to reflect on the slow but gradual changes they observed in their sons as the parents made changes to encourage the boy’s acceptance of his masculinity. Included in this section of the book is a rather extended journal written by a mother of a prehomosexual boy that chronicles the slow changes she was able to observe in her son on his way to becoming a much less gender-confused child. For families wondering what to do about a son who displays difficulty accepting his masculinity, this is the book to read. Its practical suggestions for parents will help them deal with an otherwise baffling problem.

James R. Beck, Ph.D.
Professor of Counseling
Denver Seminary

“Nicolosi makes an all important distinction: Being homosexual does not mean being gay…. [The author] is to be congratulated for taking up the gauntlet for a much neglected population–the homosexual male who experiences his sexual orientation as ego dystonic and wants to change.”

–Elaine Siegel, Ph.D.

Offers Hope to Thousands of Men

“In this major and compelling work, Dr. Nicolosi addresses the issue of changing homosexuality with courage and clinical integrity. Refusing to give in to political pressure and attack, he has listened, instead, to his patients–to their developmental dilemmas and to their developmental needs. Basing the treatment plan on this clinical data and on recent advances in understanding gender identity, he offers hope to the thousands of men who do not want to feel coerced by either their own internal conflicts or by outside political pressures to live a life inimical to who they are and to who they want to be.”

–Althea J. Horner, Ph.D.

Speaks to “Non-Gay” Homosexuals with a Tone of Clinical Empathy

“Dissatisfied homosexuals have finally been addressed in a modern work that will satisfy the standards of professionals and laity alike. Direct and comprehensive, [it] speaks to the seldom recognized ‘non-gay homosexuals’ with a tone of clinical empathy that is long overdue.”

–Joe Dallas
President of Exodus International

Reversal to Heterosexuality is Possible

“Dr. Nicolosi has produced a clearly written, scholarly book that covers the developmental, physiological, social-psychological, familial, interpersonal, and gender identity aspects of male homosexuality. Although the influence of mothers in the developmental and adaptive process is given its importance, the more compelling role of an inadequate father-son relationship in a boy’s subsequent homosexuality is again corroborated and becomes a salient theme in reparative therapy. “It has become unpopular to propose that homosexuality is the consequence of a disturbed boyhood and that reversal to heterosexuality through psychotherapy is possible. Influenced only by what the clients were telling him, the author offers a rich harvest of observations that justifies the reparative treatment he describes. “This book is recommended reading, not only for mental health workers, but its easy style makes it attractive for those outside the profession.”

–Irving Bieber, M.D.

The Homosexual Who Wants to Change Can

“This well-written book by a courageous clinician addresses an important societal and clinical issue: How can a homosexual male deal with his orientation without succumbing to the extremes of a gay life style? Nicolosi makes an all important distinction: Being homosexual does not mean being gay. He sees that the usual rite of coming out of the closet can be an enforced trauma, preventing further psychological growth. Instead, Nicolosi sees the quiet spaces of privacy as a growth-producing environment that can foster meaningful insight followed by change and genuine, instead of coerced, decision making. In addition, he stresses the father as an important role model and cites many vignettes in which men have found their full masculine selves during therapy. Nicolosi is to be congratulated for taking up the gauntlet for a much neglected population: The homosexual male who experiences his sexual orientation as ego dystonic and wants to change.”

–Elaine Siegel, Ph.D.

Book Excerpt: Introduction

For many years, I have found myself in the odd position of being a psychologist whose profession says homosexuality is not a problem—yet many homosexual men continue to come to me in conflict.

The fact that so many men continue to feel “dis-eased” by their homosexuality can be explained in one of two ways. Either society and the Judeo-Christian ethic have coerced these individuals into thinking they have a problem; or, the homosexual condition itself is inherently problematic.

In reflecting on the homosexual condition for more than ten years as I have guided many men who are struggling with the problem, I believe some truths have become apparent.

Today, new studies place the homoerotic drive in better perspective by showing us that it originates from the search for health and wholeness. Many homosexuals are attracted to other men and their maleness because they are striving to complete their own gender identification. From this perspective, we now better understand the nature of the homosexual person’s struggle. And with this understanding, we can offer more than tolerance, but–for those who seek it–hope for healing. More than civil rights, we can offer a way toward wholeness.

Empirical research and clinical evidence together will be presented in this book to demonstrate how the homosexual condition is in many cases the result of incomplete gender-identity development. Consequently it is a condition characterized by erotic but frustrating same-sex relationships.

Through my treatment of over l00 men, I have applied clinical observations to the wider body of research, and from these resources I have formulated a psychotherapy. This psychotherapy is not a “cure” in the sense of erasing all homosexual feelings. Nevertheless, it is a valid treatment offering a framework for understanding the homosexual condition and growing in masculine identification.

It should be noted here that “homosexual” is a relative term. Each individual falls somewhere along the heterosexual-homosexual continuum, possibly moving from one direction to the other during different life stages.

Also, the word “homosexual” is used in this book as convenient shorthand to denote “the man with the homosexual problem.” It must always be borne in mind that no man’s personhood can be reduced to a simple sexual identity.

I have chosen the term “reparative therapy” to draw attention to a neglected psychoanalytic perspective of homosexuality which traces its roots to Freud. Due to incomplete development of aspects of his masculine identity, the homosexual seeks to “repair” his deficits through erotic contact with an idealized other. Reparative therapy has recently found support through object relations theory and empirical studies in gender identity.

This book is not for everyone. Some readers will find our theoretical model irrelevant to their personal histories. We do not attempt to propose the reparative model as the sole cause or form of homosexuality. Homosexuality is not a single clinical entity and homosexual behavior results from a variety of motivations. However, the model described here fits the majority of the treatment population I have encountered, and I have no doubt that it is the most common homosexual developmental pattern.

I hope that further understanding of the homosexual condition will lead to a more realistic public attitude, and also to the wiser parenting which would aid in prevention of homosexual development. Most important, I hope to show an option for those who find the gay lifestyle unacceptable–either because of disillusionment in having lived it, or because it is in fundamental violation of their personal identity.

The vast majority of my homosexual clients are men; consequently, the etiology and treatment described in this book will be in regard to the male homosexual. I believe some of the principles stated will apply to women; nevertheless, it will take another writer to refine and apply these ideas to the problem of lesbianism.

Book Excerpt: Chapter One
Non-Gay Homosexuals: Who Are They?

Much has been written in recent years about embracing the gay lifestyle and “coming out of the closet.” “Coming out” is said to mean throwing off the burdens of fearfulness and self-deception to embark on the road to freedom and personal integrity.

Yet there is a certain group of homosexual men who will never seek fulfillment through coming out into a gay identity. These men have chosen to grow in another direction.

The word “homosexual” names an aspect of such a man’s psychological condition. But he is not gay. “Gay” describes a contemporary socio-political identity and lifestyle which such a man will never claim. Therefore, I call him a “non-gay homosexual.”

The non-gay homosexual is a man who experiences a split between his value system and his sexual orientation. He is fundamentally identified with the heterosexual pattern of life. The non-gay homosexual feels his personal progress to be deeply encumbered and by his same-sex attractions. He usually holds conservative values, is identified with a religious tradition, and holds no deep resentments toward Judeo-Christian teachings on homosexuality. In fact he most likely finds them reinforcing and supportive of his struggle.

Before the gay liberation movement, such a man was portrayed in psychiatric literature in a one-dimensional manner from the perspective of his “medical condition.” Now the gay movement has encouraged new research, often conducted by gay researchers, to shed long overdue light on the personal and relational issues of the gay experience.

With the help of these studies, men can now decide whether they want to embrace the gay lifestyle, or to take the road that leads to growth out of homosexuality. It is my hope to help illumine the latter road–the one which leads toward wholeness.

A sixteen-year-old young man came into my office, concerned that he must be homosexual. I told him that if he was, he could choose Gay Affirmative Therapy, or he could seek to grow out of homosexuality. I then proceeded to tell him about the men in therapy with me.

At first he seemed confused and then after some consideration said: “Oh, you mean they’re not yet out of the closet?”

The young man had been confused by the popular rhetoric which assumes that if you are homosexual, then the only honest response is to live out the gay identity. Believing this, he was surprised to hear that there are men who out of the fullness of their identities, choose a different struggle.

Those who seek reparative therapy do not blame social stigma for their unhappiness. Many have looked into the gay lifestyle, have journeyed what became for them a “via negativa” and returned disillusioned by what they saw. Their definition of self is integrally woven into traditional family life. They refuse to relinquish their heterosexual social identity. Rather than wage war against the natural order of society, they instead to take up the sword of an interior struggle.

As one 23-year old client explained:

 

“I’ve had these feelings and these urgings, but the idea of being of gay person is just ridiculous…it’s such a strange lifestyle, on the fringes of society…it’s something I could never be a part of.”

 

Another young man said:

 

“I have never believed I had homosexual tendencies because I was ‘born that way.’ It is quite an insult to my dignity and a gross disservice to my quest for growth to be told that I have no hope for change.”

 

Said another:

 

“To me, embracing a homosexual lifestyle has been like living a lie. I have found it to be a painful, confusing and destructive force in my life. Only since I have started to look at what is behind these homosexual feelings have I really begun to find peace.”

 

I hope to be one voice in support of the non-gay homosexual–to explain in psychodynamic terms who he is, and to gain acknowledgment for his commitment. For non-gay homosexuals are typically seen as an insignificant group of people, and if society does consider them, it is with a certain derision. Their identity is lost between the cracks of popular ideology. The straight world shuns them, and the gay world considers them not their own.

The mental health profession is largely responsible for the neglect of the non-gay homosexual. In its attempt to support the liberation of gays, it has pushed underground another population. By no longer categorizing homosexuality as a problem, it has cast doubt on the validity of this other group’s struggle.

This social neglect is also caused in large part by the non-gay homosexual himself. He is not likely to be found at parades or rallies celebrating his identity. He would rather resolve his conflicts quietly and discreetly. How paradoxically conservative are the men who wage this counter-cultural struggle! Today, even child molesters and prostitutes tell their stories to Oprah or Geraldo.

It is unfortunate that the non-gay must be identified by what he is not. The gay world’s assumption is that what keeps him in the closet is fear or ignorance, and that with enough time and education he too will find liberation. Yet not to be gay is as much a decision and a conscious choice about one’s self-identity as deciding to be gay.

For such a man, “not coming out” can be a dynamic place of growth and self-understanding, a place committed to change. To him, “the closet” is a place of choice, challenge, fellowship, faith, and growth—an interior place which has often opened up into transcendence.

We have recently made great progress in acknowledging the gay man in society. Now, the same understanding must be extended to the non-gay homosexual. He has made a valid philosophical and existential choice. He is not a guilt-ridden, intimidated, fearful person but someone who from the fullness of his own identity, seeks not to embrace–but to transcend–the homosexual predicament.

Book Excerpt:

Reparative Therapy of Male Homosexuality,
by Joseph Nicolosi, Ph.D.

(Publisher: Jason Aronson, Inc., Northvale, New Jersey. 1991. For information, visit the publisher’s website at www.aronson.com)

Repairs Self-Esteem and Relatedness

“This insightful and readable book will help therapists and patients alike. Today, Gay Affirmative Therapy rightly demands respect for patients’ own goals. In that spirit, one must respect some gay men’s unhappiness with their identities and lifestyles. Reparative therapy, as the author says, does not explain all homosexuality, and it is not right for all gay men, but it can allow’ some to claim what they desire. What is repaired is self-esteem and relatedness to others.”

-Arno Karlen, author of Sexuality and Homosexuality

Book Excerpt: Chapter Ten
How Reparative Therapy Works

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.

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 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, nonmysterious 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 nonmysterious 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.)

(InterVarsity Press, 2002, by Joseph Nicolosi and Linda Ames Nicolosi)

“If there’s one thing I’ve learned from being a father,” said Gordon, “it’s that each child is different.” He settled down into the chair in my office with a look of sad resignation.

A successful financial analyst, Gordon was the father of four sons. “When Gloria and I were married, we couldn’t wait to have a family,” he said. “I didn’t have a great relationship with my own dad, so I really wanted to have that closeness.”

The couple had three boys in rapid succession, both of whom now idolized their dad. Then came Jimmy.

Gloria, seated in the easy chair next to her husband, looked at me with sad, worried eyes. “By the time I was pregnant with Jimmy,” she said quietly, “I wanted a girl so badly. Jimmy was to be our last child. When he was born, I was disappointed to tears.”

Perhaps Jimmy and his mother had unconsciously worked together to remedy that disappointment, because at the age of eight, Jimmy was now his mom’s closest friend. A caring and gentle boy who showed a gift for playing the piano, Jimmy was the kind of child who is naturally attuned to what other people are thinking and feeling. By this age, he could read his mother’s moods “like a book,” but had not a single male friend his age. In fact, he was already showing many signs of pre-homosexual behavior. Gloria had recently become concerned about the boy’s increasing social isolation and depression. In contrast, their older boys were happy and well-adjusted.

Jimmy’s gender confusion had first become noticeable years before, when he started putting on his grandmother’s earrings and trying on her makeup. Gloria’s gold and silver hair barrettes had been especially captivating for the little boy, and he soon developed quite an astute sense of what he liked and didn’t like about women’s clothing–all this before he ever started school. He was just four years old at that time.

“I treated Jimmy just like I treated all my other sons,” said Gordon. “And I guess that didn’t work, because he always seemed to take my criticism the wrong way. He’d go off to his room and refuse to speak to me for a couple of days.”

Now, having grown older, Jimmy was presenting many other troublesome signs–an over-active imagination that he used as a substitute for human relationships; immaturity, and contemptuous rejection of his athletic older brothers and the friends they brought home. Gordon recalled that their others ons always had rushed out to meet him when he arrived home from work. But not Jimmy, who had always acted as though his dad was unimportant.

Right now, it was Jimmy’s fantasy world that caused everyone the most concern. He had a “make-believe” life in which he spent hours alone in his room drawing cartoon characters. And Gloria had observed another disturbing pattern–whenever Jimmy became intensely frustrated as a result of a painful event in his life, he immediately retreated into the world of feminine make-believe. When one of his brothers’ friends was visiting the house and had teased or slighted him, he would revert into an exaggerated version of feminine conduct.

Finally, Gloria and Gordon agreed to do something to help their son.

Gordon could see that his son had, for a long time, retreated from him. “When Jimmy was little, I went through a tough time. Our marriage was stretched to the max, and I was having a lot of trouble at work. I guess I just didn’t want to be bothered reaching out to a temperamental little kid who pouted and stomped off to his room whenever I said something he took as criticism.”

The other boys, in contrast, had always been eager to play with their dad and to seek out his attention. “So I just let Jimmy choose not to be with me,” Gordon admitted. “I have to admit, my way of thinking was, ‘Well, if Jimmy doesn’t want to be around me, then that’s his problem.'”

“Our strategy, then,” I explained, “is to do just the opposite of what you’ve been doing. That means, Gordon–you need to actively engage Jimmy. Gloria, you’ll need to learn to back off from him. And the whole family has to keep working together to remind Jimmy that being a boy is a good thing.”

My strategy for him included encouraging Gordon, his Dad, to give him special attention, having him take the boy out with him on errands, and engaging him in contact-type physical play. I try to sensitize fathers to the many daily opportunities, such as going out to gas up the car and allowing the son to hold the gas pump, for example, or stopping to buy an ice cream cone and engaging the boy in a conversation about something that specially interests him. All of these small efforts are part of building the male-male bonding that lay the foundation for a strong father-son relationship.

Sometimes Gordon invited Jimmy to go with him into the back yard to help him work in the garden or start the barbecue. Gordon made it his business to be home when Jimmy had his weekly piano lessons, and to go to all the boy’s recitals. At other times he included the boy in sports outings with his older brothers, hoping to draw Jimmy out from his habit of isolation and his resentment of his brothers.

At first, Jimmy responded with explicit rejection of his father’s invitations. When invited to go along with him to the office, for example, the invitation was turned down in no uncertain terms. But as he developed a more comfortable relationship with his father, Jimmy began to act more like a boy, and at school, he was beginning to find himself teased and scapegoated less often.

With my encouragement, Jimmy’s parents decided to send him to a day camp that encouraged sports participation but that was not competitive, and that had more boys than girls enrolled. Jimmy’s mother Gloria made the special effort of soliciting the help of the camp supervisor, a young college-age man who was willing to give Jimmy the special male attention he needed.

Boys like Jimmy must understand that their parents are supporting, encouraging and uplifting them, not being judgmental and critical.

As a result of his parents’ consistent intervention, there was a gradual diminishment of Jimmy’s gender-inappropriate behavior. This included not only his effeminacy, but his peer isolation, general immaturity, and fear and dislike of more masculine boys.

Later, Gordon told me, “When Jimmy dismisses me and acts like I’m not important, I’ve got to admit it’s kind of a slap at my ego, and I’m tempted to walk away. It’s so much easier just to coast along and accept the status quo. But then I remember that Jimmy’s attitude toward me is a defense. Underneath all that rejection and contempt, he really does want to connect with me. So I put aside my feelings and just keep pursuing him. I dropped the ball with him when Jimmy was younger, but now, I’m not going to let him just turn me away.”

As we’ve seen, boyhood gender confusion is really a retreat from the challenges of masculinity. And many studies indicate that gender confusion is also associated with other problems, which–as in Jimmy’s case–usually includes rejection of his father, social isolationism, and compensation in a fantasy world.

Successful treatment helps the boy find his way in a world which is naturally divided into males and females. With the dedicated help of the two most important adults in his life, his mother and his father, the gender-confused boy can begin to abandon his secret androgynous fantasy and discover the greater satisfaction of joining the gendered world.

As a parent, you’ll need to be sure that your interventions–with or without a therapist–are done gently and affirmatively, but clearly. While discouraging unwanted cross-gender behavior, parents must be sure that the child feels affirmed as a unique individual.

This means your child need not be expected to be a “stylized” boy or girl, with nothing but gender-stereotypical interests. There can be a fair amount of gender role crossover–but at the same time, healthy androgyny must first be built upon a solid foundation of security in one’s original gender.

It is essential that you always respectfully listen to your child. Don’t force him into activities he hates. Don’t make him conform to a role that frightens him. Don’t shame him into covering up effeminate mannerisms. The process of change must proceed gradually, through a series of steps that are always accompanied by encouragement……

Taken from “A Parent’s Guide to Preventing Homosexuality” (c)2002 by Joseph Nicolosi and Linda Ames Nicolosi. Used by permission of InterVarsity Press, P.O. Box 1400, Downers Grove, IL 60515. www.ivpress.com