Homosexuality and the Church of Jesus Christ/Aversion therapy performed at BYU


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Homosexual aversion therapy performed at BYU in the 1970's

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Questions

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  • 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?
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Detailed Analysis

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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. 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 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 struggling 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 these or similar problems to undergo standard therapies recommended by professional 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 from Harvard to 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-sytonic homosexuality, which is where the patient is 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. 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. As required by law, 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 even thanks medical professionals at the Salt Lake City Veterans Hospital for their assistance in designing the study and their help with statistical analysis.

The study consisted of 17 male participants, only 14 of which concluded the study. From the McBride dissertation we learn more about the participants:

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.
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.

In the years since the study, some of the study participants have talked publicly about their experiences. Some 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 correctly 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 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. It is likely that this was 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.

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.

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:

Author Year Number Institution Type Publication References and Notes
Fookes

1969

27

?

aversion shock therapy

British Journal of Psychiatry

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

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

McConaghy

1969

40

The University of New South Wales

aversion apomorphine therapy

The British Journal of Psychiatry

Bancroft

1969

16

?

aversive shock therapy

The British Journal of Psychiatry

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.
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.
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

University of Vermont

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

?

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

?

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 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.

Academic freedom at 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.

The Church rarely interferes with what is done at BYU, and there would have been little reason for the Church to stop the experiments, since they were 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 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.

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Answer

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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.

== 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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