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| + | #REDIRECT[[Homosexuality and the Church of Jesus Christ#Did the Church of Jesus Christ of Latter-day Saints (Mormons) ever conduct aversion therapy?]] |
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| − | =={{Question label}}==
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| − | * What was the history of BYU and aversion therapy for treating homosexuality?
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| − | * How did that relate to medical and psychological science as understood at that time?
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| − | * What was the role of the Church in BYU's treatments?
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| − | =={{Response label}}==
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| − | In the mid-1970s, a graduate student at Brigham Young University conducted a clinical study in the use of aversion therapy to treat ego-dystonic homosexuality. (More details of this study are provided, below.) At the time, homosexuality was considered a mental illness and aversion therapy was a standard practice for cure. Experiments were run on a volunteer basis adhering to the professional standards of the time. Even so, there is no indication that anyone from the church leadership was aware of the experiments. Church leadership is typically not involved in minute details of the daily activities of BYU such as approving standard procedures being run by graduate students.
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| − | There are reports of bishops counseling people to undergo aversion therapy. These reports have not been verified, but it would not be uncommon for bishops to counsel people to go to standard therapies recommended by professional societies. Each bishop has significant freedom to recommend what they feel is best for the people in their congregation. The church itself has never recommended aversion therapy.
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| − | President Kimball did quote from several reputable medical sources about how the practice of homosexuality could be abandoned through treatments, but he did not specify what treatments those were. The important thing for President Kimball and for the church is that sexual actions could be controlled. This is the same stance the Church has today, and is fully supported by modern medical associations.
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| − | Elder Oaks stated:
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| − | :"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."
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| − | === Aversion therapy is a standard technique ===
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| − | 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."[http://www.psychologytoday.com/blog/the-human-beast/201002/smoking-most-effective-quitting-technique-little-known] The Encyclopedia of Mental Disorders has this entry for aversion therapy:
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| − | :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. [http://www.minddisorders.com/A-Br/Aversion-therapy.html]
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| − | Over the years, the methods have been refined and approved. Today, we have decades of research that were not available in the 1970s. It was not known 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. For whatever reason, aversion therapy is still a therapy used by mainstream psychologists.
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| − | We do NOT take a position on any therapy, except for the cases mentioned by Elder Oaks above. We only talk about the state of the art therapy so we have a better frame of reference when discussing aversion therapy.
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| − | === History of aversion therapy and homosexuality ===
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| − | 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 lead to "a great burst of enthusiasm about changing homosexuality [that] swept over the therapeutic community." (p. 156, 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) Research was conducted by researchers from Harvard to King's College in London.
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| − | Historically, there were two types of homosexuality that were treated, ego-dystonic homosexuality and ego-syntonic homosexuality. The therapy administered at BYU was used to treat ego-dystonic homosexuality. This is when a patient experiences distress over their sexual orientation, and the goal of the therapy is to reduce that stress. Ego-dystonic homosexuality was considered a mental illness by the American Psychological Association until 1987, and is still considered a mental illness by the World Health Organization. [http://apps.who.int/classifications/apps/icd/icd10online/?gf60.htm+f661] Unlike other places, BYU never used aversion therapy to treat ego-sytonic homosexuality, which is where the patient is content with their sexual orientation.
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| − | Even after the declassification, aversion therapy could still be used to treat distress over sexual orientation, which is still classified as a sexual disorder in the DSM-IV. 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" (Health Care Needs of Gay Men and Lesbians in the U.S. American Medical Association Report, 1994) and not until 2006 that using aversion therapy to treat homosexuality has been in violation of the codes of conduct and professional guidelines of the American Psychological Association and American Psychiatric Association.
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| − | In 2009, a task force was commissioned by the American Psychological Association to investigate therapies used to treat homosexuality, including aversion therapy. They reported:
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| − | :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...
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| − | :We conclude that there is a dearth of scientifically sound research on the safety of SOCE. 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).[http://www.apa.org/pi/lgbt/resources/therapeutic-response.pdf]
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| − | ==== Aversion therapy at BYU ====
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| − | In the mid-1970s a graduate student, Max McBride, conducted a study entitled ''Effect of Visual Stimuli in Electric Aversion Therapy''. From the reports of some participants, 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 his PhD dissertation in the BYU Department of Psychology. As required by law, the study was conducted under the auspices of Dr. D. Eugene Thorne, who also served as McBride's PhD committee chairman. All study procedures followed common medical practice; McBride even thanks medical professionals at the Salt Lake City Veterans Hospital for their assistance in designing the study and help with statistical analysis.
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| − | The study consisted of male 17 participants, only 14 of which concluded the study. From the McBride dissertation we learn more about the participants:
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| − | :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. The nature and extent of homosexual activity ranged from frequent sexual activity with multi-partner involvement to covert activity. Covert activity was restricted to deviant ruminations without significant involvement. Subjects were comparable as to level of formal education and age. All subjects were attending college as undergraduate or graduate students; their ages ranged from 18 to 31 years, with a mean of 23.6 years. All subjects who participated were active or semi-active members of the Church of Jesus Christ of Latter-day Saints. They were either self-referrals or referrals from various local agencies to Dr. D. Eugene Thorne of the Psychology Department at Brigham Young University. Each prospective subject was offered free treatment if he would participate fully in our research program.
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| − | :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.
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| − | In the years since the study, some (but not all) of the study participants have talked publicly about their experiences. Some of these reports can be quite painful to read, as can similar reports from participants in studies at other universities and facilities of the time. While there is no doubt that the McBride study was traumatic to some of the individuals involved, it must be remembered that the study was not far-reaching, it was done according to common medical practice, all participants were volunteers, each participant had explained to them beforehand what the study would entail, and any participant could leave the study at any time they wanted. These caveats are not mentioned to minimize the statements of these participants in any manner; they are only made so that proper context for the study can be maintained in the face of agonizing reports.
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| − | As far as can be historically ascertained, the McBride study was the only study ever done at BYU in the area of aversion therapy and the treatment of homosexuality. It is interesting to note that BYU's contribution to the field of aversion therapy was not covered by the APA task force report. This was probably because they considered BYU's involvement to be too minor to include. Other universities had more participants and conducted their studies later than BYU. The role of BYU in aversion therapy research was very minimal, and was limited to treating ego-dystonic homosexuality.
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| − | Contrary to the assumptions of some, BYU did not pioneer the use of aversion therapy for this type of treatment and it stopped use of the therapy decades before the APA stopped recommending the practice. The university was simply one of many places that did research in the area when little was known about it. In fact, McBride's dissertation there are over 17 pages of documentation discussing other studies in which aversion therapy was applied to male homosexuality.
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| − | ==== Aversion therapy at other universities ====
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| − | 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 and development of using aversion therapy to treat homosexuality:
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| − | * The University of New South Wales [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5W-45XTVVT-89&_user=10&_coverDate=12%2F31%2F1981&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1681661053&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a942e6089eba7694d0116091f6f51b38&searchtype=a]
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| − | * Joint project from Harvard and University of Chicago [http://archpsyc.ama-assn.org/cgi/content/abstract/25/4/314]
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| − | * The Royal College of Psychiatrists [http://bjp.rcpsych.org/cgi/content/abstract/115/529/1417] [http://bjp.rcpsych.org/cgi/content/citation/115/520/339]
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| − | * University of Vermont [http://www.ncbi.nlm.nih.gov/pubmed/4690218] [http://psycnet.apa.org/journals/abn/81/1/60/]
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| − | * University of Glasglow [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1812608/?page=1]
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| − | * Illinois State University [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5V-46JGXS6-4&_user=10&_coverDate=09%2F30%2F1972&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1681836896&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=99693da1b0a79bafb66badcd1de34ba6&searchtype=a]
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| − | * University of Louisville [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMW-4K664R0-8&_user=10&_coverDate=03%2F31%2F1975&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1683127764&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=f2a618b828f15769fd42d213612da034&searchtype=a]
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| − | * Glenside Hospital [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1957923/pdf/brmedj02859-0056.pdf]
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| − | * University of Toronto [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMW-4K605GH-9&_user=10&_coverDate=04%2F30%2F1971&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1683142140&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=9ea2a557c8b953234e666f603596e72a&searchtype=a] [http://www.mhamic.org/sources/freund.htm]
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| − | * King's College, London [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5W-4VT1WJ3-C&_user=10&_coverDate=12%2F31%2F1972&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1683171148&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=1dbf2c8194438bf0daa9dc176d847b3f&searchtype=a]
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| − | * University of Wisconsin-Milwaukee [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5V-46KC6WM-1D&_user=10&_coverDate=12%2F31%2F1972&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=32d542dfb72d160bd92504744f3ef810&searchtype=a]
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| − | * Crumpsall Hospital [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1842087/?page=1]
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| − | * Allan Memorial Institute [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMW-4K605KB-4&_user=10&_coverDate=01%2F31%2F1972&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1683181121&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=384b29ea4d021e09974f7f263e31ee6a&searchtype=a]
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| − | * Northeast Guidance Center [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7XMW-4K664PP-7&_user=10&_coverDate=10%2F31%2F1975&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1681671317&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=93ae98d985c42fe37a42148137749fbf&searchtype=a#fn1]
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| − | * Center for Behavior Change [http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6V5W-4VS5RSF-8&_user=10&_coverDate=05%2F31%2F1973&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_searchStrId=1681676165&_rerunOrigin=google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=8e09375e2e0e0fd272dc6c3994853f79&searchtype=a]
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| − | * University of Pennsylvania
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| − | === Purpose of psychological therapy ===
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| − | The goal of therapy is to help the patient reach their desired end. One of the fundamentals is patient self-determination. The therapist does not set the goals, but the patient. Aversion therapy is not administered to smokers as a way to torture them, but to help them achieve their goal of being smoke-free.
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| − | The therapy at BYU was administered towards people who felt distress about their sexual orientation. Distress is not a good thing. The purpose of therapy was to relieve stress. If it was known that aversion therapy would be harmful, then they probably wouldn't have administered it. People were asking for help to change their sexual orientation, major medical associations said aversion therapy would help them, so why not try to help them with the best medical knowledge available at the time?
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| − | It is unfortunate that these methods that were meant to help may have caused or exacerbated distress and poor mental health, especially depression and suicidal thoughts. (For more information on suicides, see [[Mormonism and gender issues/Same-sex attraction/Suicide|Same-sex attraction/Suicide]].) There is an inherent risk in therapy for mental illnesses. Unfortunately, these risks were not fully understood in the 1970s.
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| − | === Academic freedom at BYU ===
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| − | {{Main|Mormonism and education}}
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| − | When we hear of negative consequences from these therapies, some people wonder what the church could have done to stop it. Unfortunately, there was little that the church could have done. The church did not endorse BYU's experiments. They don't typically endorse any experiments at BYU. Some people have the wrong impression that the church mandates what experiments are done, and which are not. This is not true. Even at BYU, people have a variety of opinions and approaches for doing things.
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| − | The Church rarely interferes with what is done at BYU, and there would have been little reason for the Church to stop the experiments as it was conducted according to then-standard practices. Graduate students at BYU have significant freedom to pursue whatever academic interests they want. Especially in areas such as psychological research and therapy, BYU relies heavily on standards set forth by professional associations. This is partially needed so the school can be accredited. If the school starts imposing their own standards, rather than those used by professional associations, it could loose accreditation.
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| − | Besides the problem of making up their own standards, it is contrary to Mormonism to command in all things. Mormons are encouraged to think for themselves, and find their own answers to questions. Doctrine and Covenants 58:26 reads:
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| − | :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.
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| − | Encouraging academic freedom and individual agency unfortunately means that sometimes people will make mistakes. Sometimes they will run experiments and not have them turn out the way they want to. However, the answer is not to do away with academic freedom.
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| − | =={{Conclusion label}}==
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| − | Like many other places in the western world, aversion therapy was conducted by a graduate student at BYU in the 1970s. These experiments were conducted following standards published by professional societies, and was only conducted on adults who gave their permission. Like most experiments at BYU, they were designed and conducted by researchers at the University. For better or for worse, the Church typically does not interfere with standard experiments run by graduate students. Given the knowledge available at the time, the church had little reason to interfere with these experiments.
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