Shame and Attachment Loss

The Practical Work of Reparative Therapy

Joseph Nicolosi

• Publisher: Liberal Mind Publishers
• Year: 2016
• ISBN:
  9780997637373
• Topic: Medicine
• Subtopic: Sexual Health & Sexuality

Bringing together a Judeo-Christian anthropology with biological and psychodynamic theories of human development and sexuality, psychologist Joseph Nicolosi details the therapeutic techniques of reparative therapy he has developed over the past decades.

Written in three parts, the book first describes the nature of the psychodynamics of same-sex attraction as understood in the reparative therapy approach. The second part describes the various phases of treatment. The final part deals with walking clients through the process of grieving and the healing of their wounding.

Endorsed by numerous notable leaders in psychotherapy, Nicolosi offers practical guidance for counselors and therapists who want to offer reparative therapy to those seeking change.

Revised edition with new chapter on EMDR.

PART ONE

Psychodynamics of Homosexuality

CHAPTER 1

Overview

Advances in Reparative Therapy

Homosexuality may not be a problem for the American
Psychological Association, but it is a problem for me.

– A NINETEEN-YEAR-OLD STUDENT

I hitched my wagon to the wrong star.

– A FIFTY-YEAR-OLD MAN

In recent years, significant advances have been made in our understanding of the etiology and treatment of male same-sex attraction (SSA). This book brings together the new understandings gained since my earlier works, Reparative Therapy of Male Homosexuality; A New Clinical Approach (1991), Healing Homosexuality: Case Stories of Reparative Therapy (1993) and A Parent’s Guide to Preventing Homosexuality (2002).

No Model of Healthy Homosexual Development

At this writing it has been over thirty years since the 1973 American Psychiatric Association depathologized homosexuality. Since that time, no theorist has yet presented a credible model of nontraumatic early development that would result in homosexuality. The best attempt to offer a nonpathological model of homosexual outcome is made by psychologist Daryl Bem (1996).¹ I have critiqued his model elsewhere.

Bem, a psychologist who is himself a gay activist, explains in his “Exotic Becomes Erotic” model that what is exotic – that is, mysterious – to a boy in childhood is what will become erotic to him in adulthood. I agree with that concept; a person eroticizes what he or she does not identify with. Yet remarkably the fact that masculinity should be exotic to a boy is not seen by Bem as problematic. He clearly does not believe, as we do, that normality is that which functions according to its design.

When a man finds masculinity mysterious and exotic, and seeks it outside himself, we believe he is living in a false self, and, as prominent psychiatrist Robert Spitzer recently observed, “something’s not working.”

Social-Parental Factors Remain the Focus

While recognizing the predisposing role of gender-atypical temperament for at least some homosexuals, we continue to focus on the influence of social-environmental factors in the development of SSA. Our emphasis is on the triadic-narcissistic family: the features of narcissism and genderidentity deficit that are associated with SSA, and the etiological role of early parental malattunement. The father’s influence is particularly critical in the case of a boy born with a sensitive temperament.²

In terms of our treatment principles, we continue to emphasize the powerful healing experience of the relationship with an accurately attuned, same-sex therapist and the ongoing (indeed, lifelong) necessity of close male friendships.

The essential principle of reparative therapy remains the same – simply stated by one client as “When a real man sees me as a real man, then I become a real man.”

Recognizing Gender Deficits and Self-Deficits

Recently, reparative theory has expanded to conceptualize homosexual attraction as more than a striving to repair gender deficits. We now see it more broadly, as a striving to repair deep self-deficits.

My longtime clinical observation suggests one repeated trend in early childhood: specifically, an accumulation of early, core emotional hurts that have led to an attachment injury. I believe that homosexuality is not only a defense against gender inferiority but a defense against a trauma to the core self.

Beyond the previously recognized needs of same-sex identification and affirmation, we now better understand the condition as an attempt to heal an abandonment-annihilation trauma. We see homosexuality as typically an attempt to “repair” a shame-afflicted longing for gender-based individuation. As such, homosexuality can be seen as a pathologic form of grieving. Adopting concepts from bereavement and grief literature, we thus turn new attention to the contributions of attachment theory and the role of shame.

An Interactional Model

Within our etiological parameters there are many plausible combinations of causes for homosexuality. For each person these factors come together in a unique way. Our model focuses on biological influences (a sensitive temperament), but more importantly on the parents’ failure to support the boy’s emerging identity. Negative childhood same-sex peer experiences play a role as well.

All of those factors lead to the sense of estrangement from males that gay-activist psychologist Bem has also identified – where the boy with SSA considers other males to be mysterious, different from him, in a word, exotic.

Over the years in working with thousands of men struggling with unwanted SSA, I have repeatedly heard the same childhood themes of painful relational deception, betrayal and, ultimately, inconsolable disappointment. Clients repeatedly complain of feeling weak, inadequate and out of control, and demonstrate a guarded stance toward life and relationships.³ It is in addressing those profound hurts that therapist and client encounter one another on the deepest level. At this level of human encounter, the healing begins.

The Big Picture

Thank you, homosexuality! Through the misery you’ve caused me, you forced me to look at myself – face all those things that I’ve pushed under, avoided. I’m more alive because I faced my homosexuality.

A major step forward in therapy occurs when the client’s focus of concern shifts from his perceived original problem at the start of treatment, namely, his unwanted SSA, to the deeper and more consequential issues that prompt his susceptibility to homosexual enactment. Understanding this distinction, one client explained what so many others have also told me: “My problem is this low-grade emptiness in my life that sets me up for male attractions.”

Another client, grasping the larger context of his homosexual problem, announced after six months of therapy, “The good news is that my problem is not my homosexuality. The bad news is that it’s about everything else!” By “everything else” this man meant his compromised style of engaging others – his pervasive difficulty relating in mutuality with other men, and his need to present a false self to the world.

Another man described the same conviction that he was facing a much more fundamental problem than unwanted homosexuality: “It’s like what my singing teacher used to say to me: ‘The problem with your singing is in the way you breathe.’”

This idea that emotional inauthenticity is what leads a man into homosexual enactment is most clearly evidenced in an analysis of what we call “The Scenario Preceding Homosexual Enactment.” This is our model of ordinary day-to-day events that tells us when the client is most likely to be tempted into unwanted sexual activity. Closely following the details of our clients’ lives and their shifting self-states, we see that it is the assertion-versus-shame conflict that most consistently propels the man into the depressive state that we call the “gray zone.” And it is from within the gray zone that homosexual desire is most compelling.

This understanding that homosexuality is a symptom of a larger issue of self-identity is supported by the almost universal complaint of clients that they feel “insecure,” “inadequate,” “a little boy in an adult world,” “out of control” and lacking relational authority. For years I have heard clients express this interpersonal powerlessness: “She upsets me, they annoy me, he doesn’t take me seriously.”

Shame as Integral to SSA

The struggle with shame is reported by almost all therapists in describing the SSA men they work with. In fact, virtually all gay-affirmative therapists – those who actively encourage clients to embrace a gay identity – identify shame as a primary therapeutic issue. However, they see this shame as “internalized homophobia” – a socially induced conflict that is said to prevent the man from accepting his normal and healthy homoeroticism. While it is apparent that society’s reaction to the homosexual condition produces shame, I believe the origins of the homosexual condition began with shame – specifically, in the person’s unsuccessful struggle for secure attachment and masculine identity.

Based on this premise the therapeutic approach we take at our clinic draws the client’s attention beyond his presenting complaint to address the larger question of the role or “stance” he assumes in his relational world. We have come to believe that a felt compromise of personal integrity prompts shame, which in turn prompts the need for self-esteem regulation (reparation), which in its turn, motivates the man to seek a same-sex erotic attachment. Thus a particular focus of reparative therapy is on helping the client reject shame to live life in the assertive stance.

Unlike gay-affirmative therapists, who see shame as a consequence of socially disapproved homosexuality (homophobia), we see homosexuality as a narcissistic solution to a shame problem. Referring to his day-to-day struggle with homosexuality – which he calls “It” – one man composed the diary entry below:

The False Comfort of “It”

It is my shame

That gives “It” power over me.

“It” always goes back to my shame.

There are moments when the It is not there,

Not present in my life, and I think,

“Wow this is beautiful, peaceful.” But then my shame

Comes – and with that, once again, the It.

When shame takes over my life, then It looks like

THE BIG PROMISE OF COMFORT!

My challenge is to live my life without shame.

Then I won’t need the false comfort of It.

Therapeutic Body Work

In a new approach to reparative treatment, we have adopted a set of interventions from the therapeutic school known as Affect-Focused Therapy (AFT). The most influential writers within this movement are Davanloo (1980); Neborsky (2004); Alpert (2001); Coughlin Della Selva (1996) and Fosha (2000).

AFT’s intensive technique centers around reducing core intrapsychic conflicts and trauma. Particular core conflicts occur with almost predictable regularity in the life of the SSA man, for which the principles and techniques of AFT are especially useful.

We call our own model of AFT “body work.” (No touching is ever involved.) We have modified this treatment approach, which in other applications can be very confrontational, into a “kinder, gentler” version for our men. Our client population has a history of feeling victimized by manipulation and control; therefore our modality emphasizes not so much confrontation but a collaborative and supportive working alliance.

Body work necessitates the client’s responding with his authentic feelings in the present, rather than reacting to present situations as if they were events in the past. It focuses on the expression and resolution of emotional conflict, and is reminiscent of Fritz Perls’s Gestalt Therapy. By addressing the client’s defensive structure of affect inhibition, while using an “overdrive” or accelerated method, body work offers quick access to effective emotional breakthrough and consequent self-insight. These techniques work well to unblock defenses and gain immediate access to feelings. They are especially applicable to the SSA client, whose presenting symptomatology is very often a consequence of affect inhibition – the consequence of traumatic shame.

The goal for the client in reparative therapy is to no longer act out his past hurts in the present but to experience those authentic feelings about his past while in the presence of the therapist. When the therapist supports and encourages the client to open up, the cli...