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Jul
19

Either/Or Thinking: Therapeutic? Ethical?

Warren Throckmorton commented on-air at CNN Tuesday:

The congruence for some clients will be with their sexuality. The congruence for others will be with their religious beliefs.

Clearly, some people feel that the most core aspect of them is their sexuality.

Others, on the other hand, believe that their religious values and religious beliefs are most core, and they would rather explore congruence of their behavior with those beliefs and values.

Dr. Throckmorton has my respect for being a thoughtful, available presence at his blog. He has earned Michael Bussee’s endorsement of the sexual identity framework.

In that context, I won’t/can’t lash out in activist mode about the ache I felt when I heard him say those words. And yet, the ache remains.

One of the thinnest stereotypes of lesbian, gay, bisexual, transgender, and other queer-identified folks is that we have made a choice favoring our sexuality at the expense of our faith. With words similar to Dr. Throckmorton’s, we are cast as prioritizing sexuality above all else, choosing selfishness over selflessness, cheap grace over personal sacrifice.

I’m not surprised to hear the stereotype offered as fact by folks who have not known lgbtq people of faith personally. Those who haven’t heard our stories, or only know of folks who left their faith communities after being given ex-gay ultimatums — be ex-gay or go away — may not have experience which contradicts the stereotypes. They haven’t stood side by side with friends whose coming-out journeys were more spiritual than sexual. They haven’t known parents whose adult kids’ coming-out brought them into their own spiritual journeys, hand-in-hand with friends, pastors, and spiritual mentors.

Dr. Throckmorton, though, speaking as a therapist who seeks to guide other therapists, has no lack of experience with lgbtq people. He has written about faith-based support for lgbtq people; he interacts with gay people of faith regularly.

I followed a self-directed ex-gay path of sorts for many years. I didn’t believe that God called all lesbians and gays to deny their orientation or live celibately. But I believed (and intensely hoped) that God had made me at least nominally bisexual and intended me to be married without acknowledging my attractions to guys.

Starting my coming-out journey meant connecting with God in a more intensive way than I had previously. I embarked on that journey with the counsel of a 15-year friend who was also an Episcopal priest. I received guidance from the rector at St. Andrew’s Episcopal Church in Des Moines (who is now a bishop) and was welcomed and integrated fully in the community there. My mother also reached out to our family priest in Minnesota for information and support.

There were so many questions for me to ask, and some answers which surprised me, along that path. The pastoral and spiritual advice I heard wasn’t about either/or choices. I heard voices of empathy, compassion, and encouragement. The counsel I received avoided pat answers and encouraged me to be fully engaged in my spiritual journey. I met other lgbtq folks in the church. I also met people in the church who were living with same-sex attractions either celibately or monogamously in heterosexual marriage.

I don’t hold myself out there as a notable because of my spiritual journey… my story is simply characteristic of so many other stories in which faith has been integral to, not excized during, the coming-out journey.

But, where is Dr. Throckmorton’s awareness of or compassion toward this facet of living with same-sex attractions? I ache to think of tender, vulnerable folks hearing him reinforce their worst fears equating being gay with amputating faith.

Religious beliefs are certainly relevant to therapeutic work with queer and ex-gay people of whatever flavor. For guidance on how faith and psychotherapy can coexist, we can look to the American Association of Pastoral Counselors (AAPC), which promotes itself as “Professionally Integrating Psychotherapy and Spirituality.”

One of the AAPC’s mission statements is to:

Promote pastoral counseling and care practices that are ethically sound, clinically competent, theologically grounded and sensitive to multiple faith and spiritual practices.

Their Code of Ethics includes:

We show sensitive regard for the moral, social, and religious standards of clients and communities. We avoid imposing our beliefs on others, although we may express them when appropriate in the pastoral counseling process.

To be clear, I don’t expect that Dr. Throckmorton is a member of the AAPC or has made a commitment to its code of ethics.

Members of the AAPC model something important, though: How religious leaders can ethically offer spiritual guidance hand-in-hand with psychotherapy. The organization is open only to ministers (defined as people “who [have] been authorized by a religious endorsing body through ordination, consecration or equivalent means [...] to exercise specific religious leadership”). So, unlike Dr. Throckmorton, AAPC members are explicitly committed to specific theologically-based messages. And yet, ethical practices require them not to impose their beliefs on others.

Dr. Throckmorton mentions that his work has been published by the Christian Association for Psychological Studies (CAPS), a group whose ethics code requires respect for client autonomy, but doesn’t appear to call for respect toward divergent beliefs. He is cited as the past president of the American Mental Health Counselors Association and current chair of its Ethics Committee. The Code of Ethics there includes:

Preamble

Mental health counselors believe in the dignity and worth of the individual. They are committed to increasing knowledge of human behavior and understanding of themselves and others. [...]

Principle 13: Public Statements

[...] All public statements, announcements of services, and promotional activities should serve the purpose of providing sufficient information to aid the consumer public in making informed judgements and choices on matters that concern it. [...]

I don’t get it. A sexuality counseling expert who also wears the hat of an ethics committee chair appears to be violating his own organization’s code by promoting misleading stereotypes.

In 1993 and 1994 my then-wife and I hired a Christian therapist to do relationship counseling. One of the core issues for us was that my wife and I were coming from distinctly different theological perspectives on same-sex attractions. It was understood by all of us that the therapist’s personal beliefs were not aligned with mine. When discussing her services before hiring her, the therapist indicated that she was equipped and committed to working with us from a foundation of mutual respect, especially regarding divergent religious beliefs.

The work we were doing was taxing and complex. It required much from the therapist.

The couples therapy broke down after nearly a dozen sessions, though, when the therapist discovered that she had misspoken at the time we hired her: Contrary to her best intentions and hopes, she was not equipped to work with us from the foundation of mutual respect for divergent beliefs.

I received indications that appropriate steps were taken by the therapist’s employer in the form of additional training, mentoring, and supervision after her work for us ended. I appreciated her optimism and hope that her skills would bear fruit; I know she intended no harm.

But the harm we experienced was devastating. Instead of helping us at a tenuous and difficult point in the marriage, this therapy contributed to its fracture. I don’t know what the specific outcome would have been with a competent, ethical therapist. I can’t help but wonder how the ugly, adversarial relationship which emerged after that work ended might have been different, though.

The lesson I take from this experience is simply that these codes of ethics matter. When they are not in place, backed by professional commitment and competence, real harm can result.

And, to be complete, I can’t find any reference by Dr. Throckmorton that he is a licensed, practicing mental health professional. A license verification search on his last name at the Pennsylvania Department of State Bureau of Professional and Occupational Affairs doesn’t turn up anyone holding a Psychologist’s license. It looks like this information from the Pennsylvania Counseling Association is relevant:

Counselors who practice in the community, with clients of any age, must be licensed through the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors in order to call themselves “Licensed Professional Counselors (LPC).” Information about this process can be found in Chapter 49 of the Pennsylvania Code found on the Board’s website. There is no license or certification required for counselors who practice exclusively in colleges or universities (unless requested/required by a particular employer); however, many counselors practicing in these settings do choose to become LPCs.

It strikes me as odd that a person presenting himself as an expert to the national media appears to have no license to practice as a mental health professional.

Maybe Dr. Throckmorton can clarify, though:

  • What ethical code(s) of conduct does he seek to, or is he required to, comply with?
  • After considering his statements on CNN, would he like to issue a retraction or correction?
  • Is licensure not relevant or necessary to his academic work, to creating the sexual identity therapy framework, or to membership and leadership in the AMHCA?

4 comments

  1. Warren Throckmorton says:

    Steve: You have misread me. First, your questions. I follow the AMHCA code; I helped revise it several years ago. I also follow the sexual identity therapy framework I wrote along with Mark Yarhouse which actually is pretty similar to the AAPC code you referenced above. Go check it out.

    I am licensed in Ohio as an professional clinical counselor. It is currently inactive since I don’t live there. I helped write the PA counseling law and have applied for LPC here. My file was lost by the board recently and I am recreating the paper work. It is lengthy. It is true in PA that the law is a title law, meaning that you can practice without a license if you do not use the title LPC. In my consultation practice, I do not use this title.

    Regarding the CNN statements, I was not referring to all possible resolutions of conflict. I am very aware that one may maintain religious commitment and be gay. This is completely envisioned by the sexual identity therapy framework. Please do read it, I think it will address your concerns.

    What I said on CNN is absolutely true for many people in my experience and actually was stated in so many words by Dr. McCommon preceding me. However, it was not complete and in that context (brief interview answering a direct question from an interviewer), I do not understand why you would expect it to be.

    You wrote:

    One of the thinnest stereotypes of lesbian, gay, bisexual, transgender, and other queer-identified folks is that we have made a choice favoring our sexuality at the expense of our faith. With words similar to Dr. Throckmorton’s, we are cast as prioritizing sexuality above all else, choosing selfishness over selflessness, cheap grace over personal sacrifice.

    I did not say you chose selfishness over selflessness, nor did I judge any choice made by a person regarding their sexual identity distress. If given more time and a different question/context, I would have been able to describe the person who integrates sexuality and faith in a way that incorporates both as primary aspects of identity.

    I am really sorry you felt offended by the segment but if you will examine my work, I hope you come to a different conclusion than you have written here.

  2. Bose says:

    Thanks for your prompt response, Warren.

    My experience includes being told the things I mentioned — that I favored my sexuality at the expense of my faith, that I chose selfishness over selflessness, and cheap grace over personal sacrifice — and thus I did not attribute those words to you. What I did was point out the synergy between those words and your words.

    My partner Dale received similar messages along with ultimatums from well-meaning people of faith that he needed to either be ex-gay or abandon his music ministry. When they wanted to offer him hope, his despair increased instead.

    I can accept that you were speaking to your personal experience. CNN’s invitation to you wasn’t driven by their sense that you have intriguing anecdotal observations to offer, though, right? You were there to speak as a national expert in your field. That role, particularly in the context of your ethical commitments, carries a responsibility to emphasize evidence over anecdotes.

    I encourage you to think about cultural and political context, Warren. Politically- and religiously-motivated leaders routinely reinforce stereotypes that gays and gay-affirming folks are not just faithless, we are enemies of traditional faith.

    So, my perception of the CNN segment is that an expert’s podium was used to reinforce a hurtful stereotype, though perhaps unintentionally. When I re-read the words I’m referring to, they remain clear and unqualified to me: Some people choose allegiance to their sexuality, the rest to their faith.

    If that perception is contrary to your intent, or you don’t want it to stand unaltered and unqualified as part of your professional legacy, the option is yours to clarify as much at your site.

    To be clear, I didn’t say was offended; I noted that I felt an ache.

    And, if I understand your apology, you’re sorry about my feelings, not about the message offered on air?

  3. Warren Throckmorton says:

    Actually Steve, it was Dr. McCommon who said first people align themselves with their sexual orientation — which to me could imply (it is a stretch but I am trying to understand how you are hearing all of this) that something (religion?) gave way to congruence with sexuality. I said it can occur either way for those in conflict. The word was congruence (not allegiance) and it was used first by Dr. McCommon.

  4. Bose says:

    Hey Warren… again, thanks for being so responsive…
    Pardon my redundancy, but here are the words I heard and responded to:

    The congruence for some clients will be with their sexuality. The congruence for others will be with their religious beliefs.
    Clearly, some people feel that the most core aspect of them is their sexuality.
    Others, on the other hand, believe that their religious values and religious beliefs are most core, and they would rather explore congruence of their behavior with those beliefs and values.

    And, my question to you as a mental health professional boils down to, “Do these words accurately characterize your expertise?” If so, no further comment is necessary. If not, I look forward to seeing a more substantive response in a public venue.
    I am motivated by my experience as a 14-year-old. It was 1973, and I had the luxury of conviction that the recurring flutter in my tummy about my tall buddy Brian was was a silly anomaly. I have no clue what it’s like to be a 14-year-old gay kid in today’s world, not insulated from awareness of the culture wars. With all of the adversarial messages available today, what would a 14-y/o take from your words?
    And, I am motivated by my experience as a 40-something survivor of my beloved’s suicide almost 7 years ago. I have repeatedly wished that I could simply leave that experience behind. It’s a messy one — it defies my preference for speaking only to my direct personal observations and experiences because Dale entrusted me with his life before he found himself compelled to end it.
    As much as I resist using the word hate, I hate the impact that losing Dale has had on me. And yet, I believe it is important for me to fully own my experience of loving and losing him. He didn’t survive his 46th year, and yet he entrusted me with so much of himself. He died without leaving an iron-clad manifesto behind for me to follow, and at the same time he died believing… oh geez, I’m at a loss to reconcile the hope I saw in him with the reality of his struggle with depression and coming-out issues.
    Warren, I’m trying to picture a living, breathing person who finds him or herself in some shadow of or parallel to Dale’s experience 6 months before he died. Beloved by many, yet struggling.
    If that person hears your words, without having a deeper relationship with you, just hearing the message that a faith-affirming expert has said that non-straight sexuality and faith are mutually exclusive, are you OK with that? Or, if that person does a Google search on your name, do you want them to find an unequivocal statement directly from you at your site that you regret the impression created by your CNN appearance?
    Or, do you want that person to find something more couched, less definitive?
    I know it’s politically incorrect, but I am firmly, rationally, intellectually convinced that the things I said and did prior to Dale’s suicide may have contributed to the outcome, and that different words and choices on my part might have changed the outcome.
    So, that speaks to my core issues. I’m feeling exposed, and OK with making myself vulnerable, yet needing to close now.
    Hoping you are well…

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