Mormonism and gender issues/Same-sex attraction/Aversion therapy performed at BYU

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    Homosexual aversion therapy performed at BYU in the 1970's

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QUESTIONS


  • Did the Church ever conduct aversion therapy?
  • What was the history of BYU and aversion therapy for treating homosexuality?
  • Did BYU ever use vomitting as part of therapy?
  • Did BYU ever force students to undergo therapy?
  • How did that relate to medical and psychological science as understood at that time?
  • What was the role of the Church in BYU's treatments?

CONCLUSION


The Church never conducted aversion therapies of any sort. They never recommended it, and they never mandated it.

Like many other places in the western world, aversion therapy was conducted at BYU in the 1970s. At this time, aversion therapy was applied to a number of behaviors. At BYU the therapy was conducted following standards published by professional societies and unlike other places, it was only conducted on adults who gave their permission. The Church does not oversee research at BYU.

DETAILED QUESTIONS AND ANSWERS

Aversion therapy at BYU

In the mid-1970s a graduate student, Max McBride, conducted a study entitled Effect of Visual Stimuli in Electric Aversion Therapy. It appears that the study was conducted during 1974 and 1975 with the average length of treatment during the study being three months. The results of this study were published in August 1976 as McBride's PhD dissertation in the BYU Department of Psychology. McBride's research has recently been sensationalized and several incorrect claims have been made about his study. The following facts need to be kept in mind as the study is evaluated.

Basis for the study. BYU did not pioneer the use of aversion therapy as a treatment for homosexuality and it ceased use of the therapy decades before the APA stopped recommending the practice. BYU was one of many places where research in this area was done. McBride's dissertation contains over 17 pages of documentation discussing other studies from across the discipline in which aversion therapy had previously been applied to male homosexuality. In fact, the purpose of the McBride's study was not to determine the effectiveness of aversion therapy in treating homosexuality. That question was generally accepted, at the time, to have been satisfactorily answered in the positive as a result of previous studies at other institutions.
Supervision. The study was conducted under the supervision of Dr. D. Eugene Thorne, who also served as McBride's PhD committee chairman. All study procedures followed common medical practice. McBride acknowledges the assistance of medical professionals at the Salt Lake City Veterans Hospital in designing the study and completing the statistical analysis.
Population. The study was limited to ego-dystonic homosexuality and did not involve any treatment of ego-syntonic homosexuality. The volunteers for McBride's study were all men whose same-sex attraction was contrary to their desires and who wanted to change their sexual orientation.
Subjects. McBride discusses the subjects chosen in the following excerpt from his dissertation:
Seventeen male subjects were used in the study, 14 completed treatment. Selection was on the basis of clinical evidence of homosexuality; absence of psychosis (no prior history); desire for treatment; no history of epilepsy, alcoholism or drug addiction.
Disclosure. McBride describes the procedures used to ensure full disclosure of what the subjects were to expect. We quote from his dissertation:
It was mandatory that all subjects chosen to participate sign and have witnessed a prepared statement explaining (a) the experimental nature of the treatment procedure, (b) the use of aversive electric shock, (c) the showing of 35 mm slides that might be construed by subject as possibly offensive, and (d) that Brigham Young University was not in any direct way endorsing the procedures used. This was to insure that all subjects were in full agreement and understanding as to what the treatment procedure would involve, provide and demand from them.
Nature of the study. The techniques used by McBride followed the standard aversion therapy procedures of the time. The volunteers were subjected to electric shocks applied to their upper arms while being shown both clothed and nude pictures of men. They were able to choose to end the shocks by switching to nude and clothed pictures of women.
Materials. The materials used in the study consisted of nude pictures of men and women and pictures of clothed men and women taken from current fashion magazines. None of the pictures displayed or even implied sexual acts. In fact, the thing being investigated in McBride’s study was not the effectiveness of aversion therapy, but the relative value of clothed versus nude pictures in this type of therapeutic procedure.

In the years since the study, some of the study participants have talked publicly about their experiences. Many of these reports are troubling to read, as are similar reports from participants in studies at other universities and facilities of the time. While it seems likely that the McBride study was traumatic to some of the individuals involved, it must be remembered that participation in the study was voluntary, each participant had a clear explanation beforehand what the study would entail, and participants could leave the study at any time they wanted. Indeed, three of the seventeen participants in the study did not remain to its completion. These points are not mentioned to minimize the experiences of these participants in any manner; they are only made so that the professional and ethical context of the study can be properly evaluated.

It is also important to note that aversion therapy as a treatment for homosexuality was not a major element of BYU research. In the APA task force report, BYU's contribution to the field of aversion therapy was not covered. This is probably because BYU's involvement was too minor to include. Other universities had more participants and many conducted their studies later than BYU.

Vomiting was not used

McBride's thesis thoroughly describes the methods used to induce aversion. He did not use vomiting. This fact is verified in the interview with Dr. Thorne, available as the FAIR podcast referenced above, as well as by a specific statement to this effect from BYU:

The BYU Counseling Center never practiced therapy that would involve chemical or induced vomiting.[1]

Most of the accusations of using induced vomiting come from: 1) a person who admits that he never underwent therapy and 2) from the "documentary" 8: The Mormon Proposition (which contains several false accusations as detailed here). These two accounts are not consistent with each other. In short, there is no reliable documentation of the use of induced vomiting at BYU.

Participation was voluntary

Aversion therapy was completely voluntary at BYU. Participants could enter and leave as they wish. In an interview with FAIR, Dr. Thorne explained that the voluntary nature was essential to get scientific results. He said any type of pressure for the participants to give certain answers would jade the results of the study. For this reason, they would not have accepted referrals from the Honor Code office even if they had been given. There was also a strict separation between what they did and what the honor code office knew about so as to remove any possibility of "pretending" to have certain results to please the honor code office. As reported in the thesis, participants could drop out at any time for whatever reason, as evidenced by the fact that some did.

Did the Church perform aversion therapy?

The Church has never conducted aversion therapy. It doesn't conduct psychological therapy of any type. The LDS Church is a church, not a medical institution. People who happen to be LDS or go to BYU do a great variety of things. The Church does not take responsibility for everything done by a Mormon or for everything done by someone at BYU (not everyone at BYU is a Mormon).

In this particular case, a graduate student and his faculty mentor at Brigham Young University conducted a clinical study in the use of aversion therapy to treat ego-dystonic homosexuality. Ego-dystonic homosexuality is a condition where an individual's same-sex attraction is in conflict with his idealized self-image, creating anxiety and a desire to change. At the time, the American Psychiatric Society considered ego-dystonic homosexuality to be a mental illness, and aversion therapy was one of the standard treatments. Experiments were only run on those who had expressed a desire for the therapy, and all of the subjects indicated they had improved as a result of the therapy. The experiments adhered to the professional standards of the time. As stated in the paper that reported the results of this research, the research was never endorsed by BYU.

LDS Church leadership does not dictate nor oversee the details of scientific research at Brigham Young University. Like many universities, there are many different research projects going on with many different views on many different subjects. The Church is not responsible for every view held by one of its researchers. The church itself has never recommended aversion therapy.

The church has posted on its website an interview with the following quote:

"The Church rarely takes a position on which treatment techniques are appropriate for medical doctors or for psychiatrists or psychologists and so on. The second point is that there are abusive practices that have been used in connection with various mental attitudes or feelings. Over-medication in respect to depression is an example that comes to mind. The aversive therapies that have been used in connection with same-sex attraction have contained some serious abuses that have been recognized over time within the professions. While we have no position about what the medical doctors do (except in very, very rare cases — abortion would be such an example), we are conscious that there are abuses and we don’t accept responsibility for those abuses. Even though they are addressed at helping people we would like to see helped, we can’t endorse every kind of technique that’s been used."

President Kimball once cited reputable medical sources indicating that the practice of homosexuality could be abandoned through treatments, but he did not specify any treatments by name. The point President Kimball wanted to make, and that the church still makes, is that sexual actions can and must be controlled.

Church's relationship to BYU

The church does not direct or oversee scientific research at BYU and does not mandate what experiments are to be done or not to be done. At BYU, as at other universities, students and professors have a variety of opinions and approaches and have significant freedom to pursue their own academic interests.

As an example, retired BYU professor William Bradshaw has presented biological evidence supporting his view that homosexuality is not an acquired tendency and lifestyle.[2] Bradshaw is free to share this view at BYU even though the church does not have a particular position on the causes of same-sex attraction and certainly believes that the lifestyles we follow represent a choice.

In the 1970's, there were a variety of opinions about how to treat mental disorders. Some professors and students were partial to the behaviorist movement to treat mental illnesses while others focused on verbal therapy. Today, the APA recommends cognitive therapies to help people who feel distress about their sexual orientation, but, in the 1970s, it was unclear which approach was best. If a professor or a graduate student favored one approach over another, it was because they favored that approach, not because it was mandated by the LDS Church.

Academic freedom at BYU

The fact is that every member of the BYU community is free to espouse his or her own theories. As long as they remain in line with standards published by the professional societies and with the school’s academic freedom policy, all are free to pursue their own line of thinking. Actually, this situation is one of the requirements for university accreditation, and BYU is an accredited university.

It should also be remembered that, contrary to the popular caricature of the church, Latter-Day Saints are encouraged to think for themselves and find their own answers to questions, without coercion from church leadership. Doctrine and Covenants 58:26 reads:

For behold, it is not meet that I should command in all things; for he that is compelled in all things, the same is a slothful and not a wise servant; wherefore he receiveth no reward.

And it was Joseph Smith himself who famously said:

I want the liberty of thinking and believing as I please. It feels so good not to be trammeled. [History of the Church 5:340]

Aversion therapy

Aversion therapy is a standard technique

Aversion therapy is still used today for a variety of treatments, such as gambling, smoking, alcoholism, and violence. A 2010 article in Psychology Today states "To date, aversion therapy using shock and nausea is the only technique of quitting [smoking] that offers decent gambling odds." [3] The Encyclopedia of Mental Disorders has this entry for aversion therapy:

A patient who consults a behavior therapist for aversion therapy can expect a fairly standard set of procedures. The therapist begins by assessing the problem, most likely measuring its frequency, severity, and the environment in which the undesirable behavior occurs. Although the therapeutic relationship is not the focus of treatment for the behavior therapist, therapists in this tradition believe that good rapport will facilitate a successful outcome. A positive relationship is also necessary to establish the patient's confidence in the rationale for exposing him or her to an uncomfortable stimulus. The therapist will design a treatment protocol and explain it to the patient. The most important choice the therapist makes is the type of aversive stimulus to employ. Depending upon the behavior to be changed, the preferred aversive stimulus is often electric stimulation delivered to the forearm or leg. [4]

Over the years, the methods have been refined and approved. Today, we have decades of research that were not available in the 1970s, giving us a better understanding of where aversion therapy would be effective and where it would not be effective. The methods of the 1970s may seem crude compared to today's standards, but today's standards will probably seem crude in another 40 years. Forms of aversion therapy are still used today by mainstream psychologists to treat a variety of conditions.

History of therapy and homosexuality

Homosexuality was once illegal in many countries, and those convicted were forced into various therapies against their wills.[5]

In 1966, Martin E.P. Seligman conducted a study at the University of Pennsylvania which showed positive results in applying aversion therapy to help people stop engaging in homosexual behavior. According to Seligman, this led to "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community." [6] Research was conducted by researchers at many institutions, including universities like Harvard and King's College in London.

Historically, there were two types of homosexuality that were treated, ego-dystonic homosexuality and ego-syntonic homosexuality. Ego-dystonic homosexuality is a condition where an individual's same-sex attraction is in conflict with his idealized self-image, creating anxiety and a desire to change. Ego-syntonic homosexuality describes a situation where the subject is content with his or her sexual orientation. Ego-dystonic homosexuality was considered a mental illness by the American Psychological Association (APA) until 1987, and an ego-dystonic sexual orientation is still considered a mental illness by the World Health Organization (F66.1). [7]

Even after the APA declassified ego-dystonic homosexuality as mental illness, aversion therapy could still be used to treat distress over sexual orientation, though not the sexual orientation itself. Persistent and marked distress about sexual orientation is still classified as a sexual disorder in the DSM-IV under Sexual Disorder Not Otherwise Specified (302.9). It was not until 1994, that the American Medical Association issued a report that stated "aversion therapy is no longer recommended for gay men and lesbians" [8] and it was not until 2006 that using aversion therapy to treat homosexuality became a violation of the codes of conduct and professional guidelines of the American Psychological Association and American Psychiatric Association.

In 2009, a task force was commissioned by the American Psychological Association to investigate therapies used to treat homosexuality, including aversion therapy. They reported:

Early research on efforts to change sexual orientation focused heavily on interventions that include aversion techniques. Many of these studies did not set out to investigate harm. Nonetheless, these studies provide some suggestion that harm can occur from aversive efforts to change sexual orientation...
We conclude that there is a dearth of scientifically sound research on the safety of SOCE [sexual orientation change efforts]. Early and recent research studies provide no clear indication of the prevalence of harmful outcomes among people who have undergone efforts to change their sexual orientation or the frequency of occurrence of harm because no study to date of adequate scientific rigor has been explicitly designed to do so. Thus, we cannot conclude how likely it is that harm will occur from SOCE. However, studies from both periods indicate that attempts to change sexual orientation may cause or exacerbate distress and poor mental health in some individuals, including depression and suicidal thoughts. The lack of rigorous research on the safety of SOCE represents a serious concern, as do studies that report perceptions of harm (cf. Lilienfeld, 2007). [9]

Ego-syntonic homosexuality was not addressed in the BYU studies, though it was a subject of research performed at other institutions. Furthermore, BYU only treated adults. Other institutions, such as UCLA, treated children as young as 6.[10]

Aversion therapy at other institutions

A significant number of hospitals and universities historically offered aversion therapy as a way to treat homosexuality. It would be impossible to list all of them, but here are a few of the major places where people were involved in research using aversion therapy to treat homosexuality:

Author Year Number Institution Type Publication References and Notes
Max

1935

?

New York University

Aversion therapy

Psychological bulletin

  • Max, Louis William. "Breaking Up a Homosexual Fixation by the Conditioned Reaction Technique: A Case Study," Psychological Bulletin (Washington, D.C.), Vol. 32 (1935): p. 734·
Freund

1960

67

University of Toronto

Aversion apomorphine therapy

Adult sexual interest in children

  • Kurt Freund, "Assessment of pedophilia," in Cook, M. & Howells, K. (eds.), Adult sexual interest in children, London: Academic Press, 1981, pp. 139-179.
James

1962

1

Glenside Hospital (Bristol, U.K.)

Aversion apomorphine therapy

British Medical Journal

Miller

1963

4

Howard University

Hypnotic-Aversion

Journal of the National Medical Association

Thorpe, Schmidt, Brown, Castell

1964

-

Banstead Hospital

Imaginary aversive therapy

Behavior Research Therapy

Golda, Neufelda

1964

39

Guy's Hospital

Imaginary aversive therapy

Behavior Research Therapy

McGuire, Vallance

1965

39

Southern General Hospital

Aversive shock therapy

British Medical Journal

MacCulloch, Pinschof & Feldman

1965

4

Crumpsall Hospital, Manchester, UK

Anticipatory avoidance with aversion shock therapy

Behavior Research and Therapy

  • MacCulloch, M. J., Feldman, M. P. and Pinschof, J. M., “The application of anticipatory avoidance learning to the treatment of homosexuality—III : The sexual orientation method,"] Behaviour Research and Therapy Volume 4, Issue 4, November 1966, Pages 289-299
Solyom & Miller

1965

6

Allan Memorial Institute

Aversion shock therapy

Behavior Research and Therapy

  • Solyom, L., & Miller, S. (1965) A differential conditioning procedure as the initial phase of the behavior therapy of homosexuality. Behavior Research and Therapy, 3, 147-160.
MacCulloch & Feldman

1967

43

Crumpsall Hospital (Manchester, U.K.)

Anticipatory avoidance with aversion shock therapy

British Medical Journal

Bancroft & Marks

1968

-

Institute of Psychiatry and Maudsley Hospital

Electric aversion therapy

Proceedings of the Royal Society of Medicine

Fookes

1969

27

?

aversion shock therapy

British Journal of Psychiatry

Bancroft

1969

16

?

aversive shock therapy

The British Journal of Psychiatry

McConaghy

1969

40

The University of New South Wales

aversion apomorphine therapy

The British Journal of Psychiatry

Barlow

1973

-

The University of Mississippi

Variety

Behavior Therapy

Birk, Huddleston, Miller, & Cohler

1971

18

Joint project from Harvard and University of Chicago

Aversive shock therapy vs. associative conditioning

Archives of General Psychiatry

  • Lee Birk, MD; William Huddleston, JD; Elizabeth Miller; Bertram Cohler, PhD, "Avoidance Conditioning for Homosexuality," Archives of General Psychiatry. 1971;25(4):314-323. This study, published in 1971, involved eight treated subjects and eight placebo subjects. A follow-up study was conducted two years after the original treatment. The study was published in the Archives of General Psychiatry.
Feldman, MacCulloch, & Orford

1971

63

Crumpsall Hospital

Aversive therapy

-

  • Feldman, M. P., MacCulloch, M. J., & Orford, J. E (1971) Conclusions and speculations. In M. P. Feldman & M. J. MacCulloch, Homosexual behaviour: Therapy and assessment (pp. 156-188), New York: Pergamon Press.
Colson

1972

1

Illinois State University

Olfactory aversion therapy

Journal of Behavior Therapy and Experimental Psychiatry

  • Charles E. Colson, "Olfactory aversion therapy for homosexual behavior," Journal of Behavior Therapy and Experimental Psychiatry Volume 3, Issue 3, September 1972, Pages 185-187. Concluded that olfactory aversion therapy provides many advantages over more traditional forms.
Segal & Sims

1972

1

Murray State University

Covert Sensitization

Journal of Consulting and Clinical Psychology

Hallam & Rachman

1972

7

King's College, London

aversion shock therapy

Behaviour Research and Therapy

Hanson & Adesso

1972

1

University of Wisconsin-Milwaukee

Desensitization and aversive counter-conditioning

Journal of Behavior Therapy and Experimental Psychiatry

  • Richard W. Hanson, and Vincent J. Adesso, "A multiple behavioral approach to male homosexual behavior: A case study", Journal of Behavior Therapy and Experimental Psychiatry Volume 3, Issue 4, December 1972, Pages 323-325. This study took place in 1972, involved a single male subject, and included a follow-up six months from the original treatment. The study was published in the Journal of Behavior Therapy and Experimental Psychiatry.
McConaghy, Proctor, & Barr

1972

40

Prince Henry Hospital (Sydney, Australia)

Apomorphine aversion conditioning

Archives of Sexual Behavior

Callahan & Leitenberg

1973

23

Carmarillo State Hosp., California

aversion shock therapy

The Journal of Abnormal Psychology

McConaghy & Barr

1973

46

University of New South Wales, Institute of Psychiatry of New South Wales

Classical conditioning, avoidance conditioning

The British Journal of Psychiatry

Tanner

1974

16

Center for Behavior Change

aversion shock therapy

Journal of Behavior Therapy and Experimental Psychiatry

McConaghy

1975

31

University of New South Wales

Aversion shock therapy

Behaviour Research and Therapy

  • N. McConaghy, "Aversive and positive conditioning treatments of homosexuality", Behaviour Research and Therapy Volume 13, Issue 4, October 1975, pages 309-319 This study used both aversive conditioning against homosexuality and also positive conditioning toward heterosexuality. It concluded that the positive conditioning was ineffective.
Tanner

1975

16

Northeast Guidance Center

Aversion shock therapy

Behavior Therapy

Freeman & Meyer

1975

9

University of Louisville

Aversion shock therapy

Behavior Therapy

McConaghy

1976

157

University of New South Wales

Aversion apomorphine therapy

The British Journal of Psychiatry

James

1978

40

Hollymoor Hospital, England

Anticipatory avoidance, desensitization, hypnosis, anticipatory avoidance

Behavior Therapy

McConaghy, Armstrong, & Blaszczynski

1981

20

University of New South Wales

Aversive therapy

Behavior Research and Therapy

Purpose of psychological therapy

The purpose of therapy is to help patients towards their desired goals. One of the fundamentals in the field is patient self-determination. It is the patient who sets the goals, not the therapist. Aversion therapy, which is still administered today to help smokers, is not administered as a way to torture the subjects for smoking, but to help them achieve their goal of being smoke-free. Similarly, the therapy at BYU was administered to people who felt distress about their sexual lives. The purpose of the therapy was to relieve that stress. The volunteers for the study sought help to change their homosexuality and medical associations of that time recommended this therapy as just one among several.

An analysis of similar aversion therapy studies indicate that they may have caused or exacerbated distress and poor mental health, especially depression and suicidal thoughts. (For more information on suicides, see Same-sex attraction/Suicide.) Whether or not these effects were experienced by the participants at the studies run at BYU could not be determined. There is an inherent risk in therapy for mental illnesses. As with many experiments, the risks were not fully understood at the time they were being run.

Endnotes

  1. [note] Nigel Barber, Ph.D., "Smoking: Most effective quitting technique little known," February 17, 2010
  2. [note]  "Aversion Therapy," Encyclopedia of Mental Disorders
  3. [note]  Seligman, Martin E.P., What You Can Change and What You Can't: The Complete Guide to Self Improvement Knopf, 1993; ISBN 0-679-41024-4, p. 156
  4. [note] "Mental and behavioural disorders," International Statistical Classification of Diseases and Related Health Problems, 10th Revision Version for 2007
  5. [note]  "Health Care Needs of Gay Men and Lesbians in the U.S.," American Medical Association Report, 1994
  6. [note] "APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation." (2009). Report of the Task Force on Appropriate Therapeutic Responses to Sexual Orientation. Washington, DC: American Psychological Association.


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