“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

by Joseph Nicolosi, Ph.D.

In my search for the particular quality of father-son bonding that is fundamental to the development of the boy’s masculine identity, I have been led to a phenomenon that I call “a shared delight.”

I am convinced that the healthy development of masculine identification depends on this phenomenon. This special emotional exchange should be between the boy and his father, although a father figure or grandfather may serve the purpose where no father is available. It is not a single event or one-time occurrence, but should characterize the relationship.

This particular style of emotional attunement is especially important during the critical developmental gender-identity period.

Homosexual men have great difficulty recalling childhood father-son activities that were fun, exciting and enjoyable and included success and achievement for the client– a shared delight. They typically do not have many positive memories of their fathers coaching them to gain a new skill that involves bodily activity or strength. Indeed, many lament this deprivation.

An example of “a shared delight” is found in writer and social commentator Malcolm Muggeridge’s autobiobiography. Malcolm’s father was his hero; and as a teenager, Malcolm would travel to his father’s office in London. When the young man arrived, he noticed an embodied shift in his father:

“When he saw me, his face always lit up, as it had a way of doing, quite suddenly, thereby completely altering his appearance; transforming him from a rather cavernous, shrunken man into someone boyish and ardent. He would leap agilely off his stool, wave gaily to his colleague… and we would make off together.

“There was always about these excursions an element of being on an illicit spree, which greatly added to their pleasure. They were the most enjoyable episodes in all my childhood.”

As we work with men who experience same-sex attractions, we hear that repeated theme–their inability to recall “a shared delight.”

Physical interaction between father and son appears essential in making the father feel familiar, non-mysterious, and approachable in the boy’s eyes.

So much of what lies behind adult same-sex attraction is that deep, lingering, unsatisfied desire for physical closeness with a man. With internalization of the father’s masculinity, there will be no need to sexualize another man.

by Joseph Nicolosi, Ph.D.

The client who enters Reparative Therapy® is in the midst of a crisis that is disordering his life. Now, his heart and mind have been opened to the need to look within. His intent is to rid himself of a behavioral problem as quickly as possible, but there will be no quick fixes: to re-order the dis-order, he must first descend into the depths of his deeply felt emotions.

Reparative Body Work

During therapy, he will encounter a course of what we call Body Work. It consists of three phases – (1) the defensive; (2) the core-affective encounter, and (3) a final, integrative phase.

Our client begins the session in the defensive phase, not wanting to face and fully feel the conflict in his life. His state of mind is dominated by self-protection as the therapist attempts to move him beyond his anxiety and into the core-affective phase.

Slowly surrendering his defenses, he will enter into and become overwhelmed by his deepest feelings about his personal struggle. This is the essence of Body Work; while maintaining emotional contact with the therapist, he must fully engage (on a body-memory as well as psychic level) his core-affective state, along with the physical tension responses that retain those feelings.

Then begins the cognitive integration phase, where he attempts to understand how his life history has influenced the behavioral decisions that have brought him into therapy. This is the period of Meaning Transformation, which integrates his life crisis into a larger perspective.

Those three phases of the psychological journey may be understood as a microcosmic sequence of the same personal transformation that is represented in the epic themes of both Greek classic and religious literature. Across time and cultures, the three phases convey the same universal truth about human development.

The client believes his problem is one of unwanted attractions; but as he plumbs the depths of the unconscious, he discovers that his problem is really not so much about sexuality, as it is about everything else – particularly, it is a deeper identity problem.

The Universal Transformative Experience

In the epic poems of the Greeks, the transformative experience shows us a three-phase passage: exile, journey, and the return home. Christian literature portrays the three phases as descent, conversion, and ascent. Old Testament biblical stories depict sin, repentance, and grace. In the Book of Exodus, the great transition is the journey from slavery in Egypt to the Promised Land; in psychology, the slavery is emotional repression and the Promised Land is self-autonomy.

This journey always begins with the warrior (or pilgrim) who must radically interrupt his everyday life to be confronted with a test. Our client, confronting his deepest emotions, like the warrior, will encounter frightening forces which are to be wrestled with and tamed.

Returning Home: The Classic Tradition

In Ovid’s Metamorphoses and Virgil’s Aeneid, we have epic tales of descent into the wilderness, and of progress through purification experiences – ending with a final, glorious ascent. Among the Greek mythologies, the allegory of the soul’s progress is found in Homer’s Odyssey. With the warrior Ulysses, we see a man cast on the ocean and tossed about in a small boat that brings home the lesson of his frail human power.

The Christian Tradition

This same quest to go home, to people of faith, is the struggle toward holiness. Within the Christian literary tradition we see the inspiration of the Biblical stories, foremost of which is Christ’s crucifixion and death; his descent into Hell; and his final resurrection. In the Bible, we see the story of the prodigal son who squandered his inheritance, then returned, chastened, and was ultimately redeemed. Greatest among the Old Testament stories is the account of the exodus from Egypt, vividly describing Israel’s escape from slavery, the perilous desert crossing and fording of the Jordan River, and ultimate release into the Promised Land.

In Bunyan’s The Pilgrim’s Progress and St. Bonaventure’s The Journey of the Mind Into God, the wayfarer takes a similar journey. In Dante’s medieval poem, The Divine Comedy, we see the pilgrim traveling into the Inferno, through Purgatory, and then into Paradise. The Divine Comedy portrays the same three phases of interior transformation: descent, conversion, and finally, ascent.

The Journey as Purification

In many of the texts about transformation, the journey is viewed as a process of purification. Successful completion of the process, in Greek mythology, requires the purging of pride (hubris). In religious texts, the pilgrim must purify himself of the Seven Deadly Sins. Within both secular and religious traditions, this purging process is vividly experienced as a sort of “death.”

Reparative Therapy® acknowledges a similar process; we see a death of narcissistic and False-Self defenses with which the client on some level identifies, mistakenly thinking them to represent his True Self. Here, something old (the False Self) must die in order for something new, more beautiful, to be born. Re-birth involves the client’s transformative discovery that life can be lived without those old defenses. When he surrenders the Shame Posture and begins to relate to others through the Assertive Self, he sees his True-Gendered Self slowly emerging.

And always, the journey ends the same way: with a return home to the woman. In all these traditions, it is the feminine who is the giver of life, the mediator of the inner world. Fulfillment of masculine identity – the goal of Reparative Therapy® – now permits the client to receive this once-feared feminine power.

by Joseph Nicolosi, Ph.D.

When the client opens up his emotional life to the therapist, he has engaged in an act of trust which links him to the therapist in an elegant, intimate “dance.” The central healing process of psychotherapy is this experience of attunement.

One very important lesson the client learns in psychotherapy is the vital art of simultaneous feeling-describing. Typically, he has “disowned” aspects of his interior emotional life.Therefore, making that connection between feeling-describing in the presence of another person is almost always distressing to him.

When parents have failed to accurately mirror the small child’s internal experience, and failed to model the lesson that feeling and expressing his feelings is safe, the child will become emotionally disorganized and emotionally isolated. He grows up learning to distrust his own interior perceptions, and becomes prone to shame-infused shutdowns of emotional relations.

The child’s defenses will cause him to shift his attention back and forth from content to feelings, and then back again to content, but avoiding making the link between the two.

At critical moments of strong emotion, I often need to encourage the client, “Try to stay in contact with me and with your feelings at the same time.” Establishing this neural link between thinking and feeling initiates the vital process of unification between left-brain and right brain-hemispheres, between cognitive and affective, between conscious and unconscious, through the medium of human interaction.

Misunderstandings, hurt feelings and hidden resentments are inevitable in the therapeutic relationship. They offer the client an opportunity to learn how to reengage emotionally after a relational breach. Negotiating his way through such an experience shows the client how relationships can survive the critical process of “attunement–misattunement—reattunement” and reveals how relational trust, when lost, can in fact be regained.

Reattunement moments link the client back to the therapist, and also back to himself. Through this process, he gradually increases his capacity to tolerate distress in human relationships. At its best, this emotional reconnection is reminiscent of the earliest, most primal attunement between mother and child.

One never actually “undo” a trauma of the past, of course.Yet a good therapeutic relationship can lay down new, positive neurological pathways on top of the old, traumatic experiences.For too long, these traumas have prevented the person from engaging others through the full sense of personhood that he now longs to claim.

by Joseph Nicolosi, Ph.D.

Over the years, many men have come to my office for help in changing their sexual orientation. Homosexuality doesn’t work in their lives. It just never feels right or true. To these men, it is clear that gay relationships don’t reflect who they are as gendered beings, and that they have been designed–physically and emotionally–for opposite-sex coupling.

But reorientation therapy is a long and difficult process, with no guarantee of success. What if the man doesn’t change? Will he have gained anything of value?

People are often surprised to hear that in Reparative Therapy®, typically there is very little discussion about sex. In fact, it is a mistake for any psychotherapy to focus exclusively on one particular symptom. Clients come in with a difficulty that they want removed from their life–an eating disorder, gambling obsession, or unwanted same-sex attraction– but good therapy addresses the whole person.

I typically tell my clients in the very first session, “Rule Number One is, never accept anything I say unless it resonates as true for you.” The experience of the client, whatever that may be, must always trump any preconceived theory. Reparative theory holds that the origin of SSA is in unmet emotional and identification needs with the same sex, and the client is free to accept or reject that premise. If that doesn’t feel true to him, he will usually decide to leave therapy after one or two sessions.

Through a relationship with an attuned therapist, the client discovers how it feels to emotionally disclose to another man–revealing those long-buried, shame-evoking feelings. He experiences from him a deep acceptance of wherever he is in his life, at that point in time, whether he changes or not. Such an experience is always deeply therapeutic.

Besides an enhanced ability to develop genuine male friendships, the client will discover healthier relationships with females– where he learns to prohibit the boundary violations with women that may have caused him to surrender his separate, masculine selfhood.

But what about the client who fails to change; will he be left in a sort of “intimacy limbo” — not heterosexual, yet unable to be intimate with men? The truth is, our client was never intimate with men. That is why he came to therapy. He also came to us because he believes that true sexual intimacy with a person of the same gender is, in fact, not possible: same-sex eroticism simply fails to match his biological and emotional design, and does not reflect who he is on the deepest level.

Other men enter Reparative Therapy® as gay-identified from the start. With those clients, we agree on a precondition to our working together–that is, we will not address the issue of sexual-identity change, but we will work on all of their other problems in living. And so we work on issues like capacity for intimacy, problems with self-esteem, internalized shame, childhood trauma, and the search for identity.

Some of our clients decide to change course and embrace homosexuality as “who they are.” Others never lose their conviction that they were designed to be heterosexual, and they persist toward that goal. Still others remain ambivalent about change, while going in and out of gay life over a period of months. We accept their choices even if we don’t agree with them, because we accept the person.

by Joseph Nicolosi, Ph.D.

In recent years, I have been gratified to see an increasing number of graduate students interested in working with same-sex attracted (SSA) clients who seek change. Some of these young students struggled with this issue in their own personal lives, and now, they want to take the lessons they learned to help others.

“But is this work worth the price?” they ask.

In reply, I’d like to describe both the positives and the negatives.

The Negatives

People who cannot handle controversy “need not apply.” You’ll quickly learn to refrain from telling the friendly passenger sitting next to you on a plane, what you really do for a living. (You may well discover that this newfound acquaintance is not as open-minded as he seemed at first.) Ditto for cocktail parties. Some people will laud you as a modern-day hero, while others will intolerantly accuse you of intolerance–quite oblivious to that inherent contradiction. Prepare yourself to be misunderstood.

If you use the term “Reparative Therapy®” to describe your approach, know that it’s both a blessing and a curse. Taken literally, it may sound insulting (as in the idea of “repairing” someone, as you would fix a car). Yet that’s not what the term really means. “Reparative” refers to the concept of homosexuality as a reparative drive, which is actually good news to for the client suffering with unwanted SSA. Many men were led to believe that their SSA reveals them to be “weird,” “perverted,” and “degenerate.” But now, through the concept of reparative drive, they realize that their felt needs are a normal and healthy (although developmentally delayed) attempt to gain the gender bonding that they failed to get in childhood. Grasping the reparative-drive concept diminishes the client’s shame and self-loathing, and it also lays out a positive blueprint for change; namely, through the acquisition of nonsexual masculine intimacy. All this requires considerable explanation, but to very many clients, it gradually begins to ring true as the story that explains their lives.

The client quickly discovers that the reparative therapist offers him a more profound acceptance than he has found in the gay community, where the # 1 taboo says, “Never ask why you’re gay.” (See my interview on the NARTH website with former gay activist Michael Glatze.). In contrast, in Reparative Therapy®, the client is encouraged to openly investigate the emotional and bonding deficits of his childhood.

Another disadvantage…you’ll be repeatedly frustrated to see the popular media misrepresent you and quote you out of context. Be prepared to be betrayed by that nice LA Times staff writer who calls your home, gets a half-hour of great quotes, and only uses one sentence–out of context…the very one that mischaracterizes you. Some time later, you may be absolutely convinced by the friendly Washington Post reporter that she, unlike the other reporters, really does want a fair and balanced story, so you bite the bait–believing that fairness will ultimately prevail. But then when the article comes out, you are outraged once again.

Here’s another paradox: Expect that quite a few therapist-colleagues will privately encourage you and reassure you, “You’re doing a great job.” They admire your work and say they are on your side. But, they admit, “I could never say this publicly– it would be too destructive to my career.”

Possibly the most difficult negative is this: Expect to work sincerely with a hurting teenager who’s exploring his sexual-identity options, who sincerely believes that humanity is designed for heterosexuality, and who does very well during the months he’s with you. Then five years later, you find out that he’s been elected president of his college’s Gay and Lesbian Club–and, to your dismay, he now has a video on YouTube that trashes you and your work.

It’s not unusual for young people who are questioning their sexuality to go back-and-forth one or two times before they settle on their sexual identity. The young client with whom you have a close and understanding relationship today, may very well find comfort and support with a newfound group of gay-activist friends, and then decide to publicly reject you and your ideas.

The Positives

If you have not been discouraged by now, read on. The benefits do far outweigh the costs. You have the privilege of investigating and developing a new area of treatment that flies in the face of what the APA–under their current stranglehold of enforced silence about the origins of homosexuality–is trying to accomplish in this area. There’s a counter-cultural satisfaction in achieving success in a field where political correctness reigns. (This satisfaction far outweighs the numbing outrage you feel each time you hear about another episode of the Oprah Winfrey Show.)

But most of all, you have the privilege of working in the most intimate way with idealistic men who are determined not to follow their unwanted feelings, but to fulfill their dream of a traditional marriage and family.

There is great satisfaction is seeing a man come into your consulting room for the first time after having lived a life of private torture; for years, he has struggled against his unwanted SSA, having no clue as to why it torments him so, or what he can do to help himself. As a victim of political correctness in the culture war, he was never offered another perspective about the origins of his SSA. His coming to you is the last step in the road, and in 45 minutes, he “knows that you know,” and he begins to assemble all the little fragments of his life–the hurts, the confusion, the shame, the distractions, the pain, the alienation, the loneliness–and after he presents all these fragments, you, as his therapist, can step into the middle of all of it and help him sort it all out in a way that suddenly makes really profound sense, and has life-transforming effect. For the therapist, this work requires a level of self-giving and exquisite attunement that leaves us exhausted, yet paradoxically exhilarated, at the end of the day.

A powerful fringe benefit, at times when you feel discouraged and begin to believe that the debate will never be won, is receiving a letter in the mail with a picture enclosed of a bride and groom. The note inside says “thank you” from a man you worked with many years ago. Or, when you get a letter from a man who expresses his profound appreciation that you helped him save his decades-long marriage–after another psychologist had told him he was born homosexual and would only find peace if he left his wife and children to begin life anew with another man. In my desk drawer, I keep a collection of such letters and pictures to remind myself what the work is all about.

Indeed, we have the privilege of walking with many such clients to Hell and back.

by Joseph Nicolosi, Ph.D.

It is widely agreed that many factors likely contribute to the formation of male homosexuality. One factor may be the predisposing biological influence of temperament (Byne and Parsons, l993). No scientific evidence, however, shows homosexuality to be directly inherited in the sense that eye color is inherited (Satinover, 1996).

Recent political pressure has resulted in a denial of the importance of the factor most strongly implicated by decades of previous clinical research–developmental factors, particularly the influence of parents. A review of the literature on male homosexuality reveals extensive reference to the prehomosexual boy’s relational problems with both parents (West 1959, Socarides 1978, Evans 1969); among some researchers, the father-son relationship has been particularly implicated (Bieber et al 1962, Moberly 1983).

One psychoanalytic hypothesis for the connection between poor early father-son relationship and homosexuality is that during the critical gender-identity phase of development, the boy perceives the father as rejecting. As a result, he grows up failing to fully identify with his father and the masculinity he represents.

Nonmasculine or feminine behavior in boyhood has been repeatedly shown to be correlated with later homosexuality (Green, l987, Zuger, l988); taken together with related factors–particularly the often-reported alienation from same-sex peers and poor relationship with father–this suggests a failure to fully gender-identify. In its more extreme form, this same syndrome (usually resulting in homosexuality) is diagnosed as Childhood Gender-Identity Deficit (Zucker and Bradley, 1996).

One likely cause for “failure to identify” is a narcissistic injury inflicted by the father onto the son (who is usually temperamentally sensitive) during the preoedipal stage of the boy’s development. This hurt appears to have been inflicted during the critical gender-identity phase when the boy must undertake the task of assuming a masculine identification. The hurt manifests itself as a defensive detachment from masculinity in the self, and in others. As an adult, the homosexual is often characterized by this complex which takes the form of “the hurt little boy” (Nicolosi, 1991).

During the course of my treatment of ego-dystonic male homosexuals, I have sometimes requested that fathers participate in their sons’ treatment. Thus I have been able to familiarize myself with some of the fathers’ most common personality traits. This discussion attempts to identify some clinical features common to those fathers of homosexuals.

For this report, I have focused on sixteen fathers who I consider typical in my practice–twelve fathers of homosexual sons (mid-teens to early 30’s), and four fathers of young, gender-disturbed, evidently prehomosexual boys (4- to 7- year-olds). The vast majority of these fathers appeared to be psychologically normal and, also like most fathers, well-intentioned with regard to their sons; in only one case was the father seriously disturbed, inflicting significant emotional cruelty upon his son.

However as a group, these fathers were characterized by the inability to counter their sons’ defensive detachment from them. They felt helpless to attract the boy into their own masculine sphere.

Clinical Impressions

As a whole, these fathers could be characterized as emotionally avoidant. Exploration of their histories revealed that they had typically had poor relationships with their own fathers. They tended to defer to their wives in emotional matters and appeared particularly dependent on them to be their guides, interpreters and spokespersons.

While these men expressed sincere hope that their sons would transition to heterosexuality, nevertheless they proved incapable of living up to a long-term commitment to help them toward that goal. In his first conjoint session, one father cried openly as his 15-year-old son expressed his deep disappointment with him; yet for months afterward, he would drive his son to his appointment without saying a word to him in the car.

Further, while they often appeared to be gregarious and popular, these fathers tended not to have significant male friendships. The extent to which they lacked the ability for male emotional encounter was too consistent and pronounced to be dismissed as simply “typical of the American male.” Rather, my clinical impression of these fathers as a group was that there existed some significant limitation in their ability to engage emotionally with males.

From their sons’ earliest years, these fathers showed a considerable variation in their ability to recognize and respond to the boys’ emotional withdrawal from them. Some naively reported their perception of having had a “great” relationship with their sons, while their sons themselves described the relationship as having been “terrible.” Approximately half the fathers, however, sadly admitted that the relationship was always poor and, in retrospect, perceived their sons as rejecting them from early childhood. Why their sons rejected them remained for most fathers a mystery, and they could only express a helpless sense of resignation and confusion. When pushed, these men would go further to express hurt and deep sadness. Ironically, these sentiments–helplessness, hurt and confusion–seemed to be mutual; they are the same expressed by my clients in describing their own feelings in the relationship with their fathers.

The trait common to fathers of homosexuals seemed to be an incapacity to summon the ability to correct relational problems with their sons. All the men reported feeling “stuck” and helpless in the face of their sons’ indifference or explicit rejection of them. Rather than actively extending themselves, they seemed characteristically inclined to retreat, avoid and feel hurt. Preoccupied with self-protection and unwilling to risk the vulnerability required to give to their sons, they were unable to close the emotional breach. Some showed narcissistic personality features. Some fathers were severe and capable of harsh criticism; some were brittle and rigid; overall, most were soft, weak and placid, with a characteristic emotional inadequacy. The term that comes to mind is the classic psycholanalytic term “acquiescent” – the acquiescent father.

Homosexuality is almost certainly due to multiple factors and cannot be reduced soley to a faulty father-son relationship. Fathers of homosexual sons are usually also fathers of heterosexual sons–so the personality of the father is clearly not the sole cause of homosexuality. Other factors I have seen in the development of homosexuality include a hostile, feared older brother; a mother who is a very warm and attractive personality and proves more appealing to the boy than an emotionally removed father; a mother who is actively disdainful of masculinity; childhood seduction by another male; peer labelling of the boy due to poor athletic ability or timidity; in recent years, cultural factors encouraging a confused and uncertain youngster into an embracing gay community; and in the boy himself, a particularly sensitive, relatively fragile, often passive disposition.

At the same time, we cannot ignore the striking commonality of these fathers’ personalities.

In two cases, the fathers were very involved and deeply committed to the treatment of their sons, but conceded that they were not emotionally present during their sons’ early years. In both cases it was not personality, but circumstance that caused the fathers’ emotional distance. In one case the father was a surgeon from New Jersey who reported atteding medical school while trying to provide financial support for his young family of three children. The second father, an auto mechanic from Arizona, reported that when he was only 21 years old, he was forced to marry the boy’s mother because she was pregnant. He admitted never loving the boy’s mother, having been physically absent from the home, and essentially having abandoned both mother and boy. Both fathers, now more mature and committed to re-establishing contact with their sons, participated enthusiastically in their therapy. But in both cases, the sons had, by then, become resistant to establishing an emotional connection with their fathers.

Attempt at Therapeutic Dialogue

My overall impression of fathers in conjoint sessions was of a sense of helplessness, discomfort and awkwardness when required to directly interact with their sons.

These men tended not to trust psychological concepts and communication techniques and often seemed confused and easily overwhelmed with the challenge to dialogue in depth. Instructions which I offered during consultation, when followed, were followed literally, mechanically and without spontaneity. A mutual antipathy, a stubborn resistance and a deep grievance on the part of both fathers and sons was clearly observable. At times I felt myself placed in the position of “mother interpreter,” a role encouraged by fathers and at times by sons. As “mother interpreter,” I found myself inferring feeling and intent from the father’s fragmented phrases and conveying that fuller meaning to the son, and vice versa from son to father.

Some fathers expressed concern with “saying the wrong thing,” while others seemed paralyzed by fear. During dialogue, fathers demonstrated great difficulty in getting past their own self-consciousness and their own reactions to what their sons were saying. This limited their empathetic attunement to the therapeutic situation, and to their sons’ position and feelings.

As their sons spoke to them, these fathers seemed blocked and unable to respond. Often they could only respond by saying that they were “too confused,” “too hurt,” or “too frustrated” to dialogue. One father said he was “too angry” to attend the sessions of his teenage son–a message conveyed to me by the mother. At the slightest sign of improvement in the father-son relationship, a few fathers seemed too ready to flee, concluding “Everything is okay – can I go now?”

Treatment Interventions

Before conjoint father-son sessions begin, the client should be helped to gain a clear sense of what he wants from his father. To simply expose the father to a list of complaints is of no value. He should also decide on a clear, constructive way to ask for this. Such preparation shifts the son from a position of helpless complaining, to staying centered on his genuine needs and the effective expression of them.

The Deadly Dilemma

Eventually, within the course of conjoint sessions a particular point will be reached which I call “the deadly dilemma.” This deadlock in dialogue–which seems to duplicate the earliest father-son rupture–occurs in two phases as follows:

Phase 1: With the therapist’s assistance, the son expresses his needs and wants to his father. Hearing his son, the father becomes emotionally affected, so much so that he cannot respond to his son’s disclosure. He is overwhelmed by his own reactions, becoming so “angered,” “hurt,” “upset,” or “confused” that he cannot attend to his son’s needs. Blocked by his own internal reactions, he is unable to give what his son asks of him.

Phase 2: In turn, the son is unable to tolerate his father’s insular emotional reaction in place of the affirmative response he seeks from him. To accept his father’s non-responses, the son feels he must abandon the needs he has expressed. The only recourse for the son is to retreat again to the defensive distancing which is already at the core of the father-son relationship. The son cannot empathize with the father’s non-responsiveness because to do so is painfully reminiscent of childhood patterns that are associated with his own deep hurt and anger: namely the imperative, “My father’s needs must always come before mine.” The son’s hurt and anger is in reaction to what appears to him to be “just more lame excuses” for Dad’s inability to give the attention, affection or approval he has so long desired from him. Indeed, to the son this seems like Dad’s old ploy, with all the associated historical pain.

This deadly dilemma originated, I believe, during the preverbal level of infancy. As one father’s recollections confirmed, “My son would never look at me. I would hold his face with my hands and force him to look at me, but he would always avert his eyes.” Other men have described an “unnatural indifference” to their fathers during their growing-up years.

During the course of therapy with these fathers, I began to see the deep hurt in them–a hurt that came from their sons’ indifference to their attempts (however meager) to improve the relationship.

Reflecting on his now-elderly father, one client sadly recalled:

“I feel sorry for my father. He always had a certain insensitivity, an emotional incompetence. Many of the interactions at home simply went over his head. He was dense, inadequate. I feel a pity for him.”

These fathers appeared unwilling or unable to be open and vulnerable to their sons; unable to reach out, to hear their sons’ pain and anger with respect to them, and unable to respond honestly. Their emotional availability was blocked and they were unable to turn the relational problem around. Rather they remained removed, seemingly dispassionate and helpless.

In conjoint sessions, none of the fathers were capable of taking the lead in dialogue. When dialogue became stagnant, they were unable to initiate communication. I believe the consistent inability of these fathers to get past their own blocks and reach out to their sons played a significant role in these boys’ inability to move forward into full, normal masculine identification and heterosexuality.

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