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Homosexual aversion therapy performed at BYU in the 1970's

Questions

==

• Did the Church ever conduct aversion therapy?
• What was the history of BYU and aversion therapy for treating homosexuality?
• 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?

Detailed Analysis

==

The Church 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 someone at BYU (not everyone at BYU is a Mormon).

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. 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 run on a volunteer basis adhering to the professional standards of the time.

There is no indication that anyone from the church leadership was aware of the experiments. LDS Church leadership does not typically dictate nor oversee the details of scientific research at Brigham Young University.

There are reports that some bishops counseled members with same-sex attraction to undergo aversion therapy. These reports have not been verified, but it would not be uncommon for bishops to counsel members of their congregations who are struggling with problems to seek competent professional help or to undergo therapies recommended by professional medical or psychological societies. Each bishop has significant freedom to recommend what he feels is best for the members of his ward. The church itself has never recommended aversion therapy.

Elder Oaks stated:

"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.

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." ^[1] 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. ^[2]

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. Forms of aversion therapy are still used today by mainstream psychologists to treat a variety of conditions.

We reiterate that the Church does not take a position on any therapy, except for the points mentioned by Elder Oaks above.

History of aversion therapy and homosexuality

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." ^[3] Research was conducted by researchers at many institutions, including prestigious 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. 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. ^[4] Unlike other places, BYU never used aversion therapy to treat ego-syntonic homosexuality, which is where patients are content with their sexual orientation.

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" ^[5] 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.

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). ^[6]

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. 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 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 doing research in this area. McBride's dissertation contains over 17 pages of documentation discussing other studies in which aversion therapy had previously been applied to male homosexuality.

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, as had been done in several other studies at other institutions. 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. 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.

Disclosure. McBride describes the procedures used to ensure full disclosure of what the subjects were to expect. Again, 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. Less frequently, medicines were administered to induce nausea while viewing the male pictures.

Materials. One of the more troubling aspects of the study was the use of erotic pictures in a study performed at BYU, where LDS standards require avoiding pornography. While clearly beyond LDS church standards, the pictures used should not be assumed to be anything like the pornographic material available today. The nude pictures were of the sort available in Playboy and Playgirl and did not imply or display sexual acts. The clothed pictures were of attractive men and women, taken from current fashion magazines. Indeed, the thrust of the study was not to investigate the value of aversion therapy for homosexuality; that had already been established by previous research not done at BYU. Rather, McBride's innovative research was in his investigation of the relative values of clothed versus nude pictures in homosexual aversion therapy.

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.

As far as can be historically ascertained, the McBride study was the only study ever done at BYU in the area of aversion therapy for the treatment of homosexuality. In the APA task force report, BYU's contribution to the field of aversion therapy was not covered, likely because BYU's involvement was too minor to include. Other universities had more participants and conducted their studies later than BYU.

Aversion therapy at other universities

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:

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 orientation. The purpose of the therapy was to relieve that stress. The volunteers for the study wanted help to change their sexual orientation and contemporary medical associations recommended this therapy. This was the basis for the research program undertaken at BYU. If it had been known that aversion therapy could be harmful, it would obviously never have been administered.

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 Same-sex attraction/Suicide.) There is an inherent risk in therapy for mental illnesses. Unfortunately, these risks were not fully understood in the 1970s.

Church's relationship to BYU

Main article: Mormonism and education

Given the negative consequences reported by some as a result of these therapies, we might wonder what the church could have done to stop it. Unfortunately, there was little that could have been done. The church does not make it a practice to direct or oversee scientific research 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. Like other universities, students and professors have significant freedom to pursue their own academic interests.

For example, BYU professor William Bradshaw has given several lectures at BYU on his viewpoint that what he calls "gay tendencies" and the "gay lifestyle" is caused by genetic factors.[7] The church does not have a position on the cause of same-sex attraction, but like the APA believes that sexual behaviors are a choice. Bradshaw is still free to speak on subjects the church does not have a position on and even go against things the church and the APA does have a position on.

In the 1970's, there were a variety of opinions about how to treat mental disorders. Like many other universities, some professors and students were partial to the behaviorist movement to treat mental illnesses, which focuses on physical treatment. Other focused more on cognitive therapy, which focuses on talking with the patient about their problems. 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 would win out.

If a professor or a graduate student favored a behaviorist approach, it was because they favored a behaviorist approach, not because it was mandated by the LDS Church. There were plenty of other professors who favored cognitive approaches, and they were still employed by the same University. Crediting the LDS Church for the behaviorist approach taken by Dr. Thorne and Max McFord makes as much sense as crediting them for the cognitive approach of Dr. Williams, or the genetic theories of Dr. Bradshaw.

Academic freedom at BYU

Main article: Mormonism and education

The fact is that each person has their own theories, and as long as they are inline with standards published by the professional societies, they are free to pursue their line of thinking. 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 would lose accreditation.

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:

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.

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.

Answer

==

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. These experiments were conducted following standards published by professional societies, and were only conducted on adults who gave their permission. Like most experiments at BYU, they were designed and conducted by researchers at the University. 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.

== Notes ==

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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