Citation: Mark A. Yarhouse (2019). Templeton Press.
There is much to commend in Yarhouse’s book on therapy with clients experiencing sexual and religious identity conflict. While not totally compatible with the views of LGBTQ+ Affirmative Therapy, we appreciate his fostering this important conversation. Perhaps the author’s greatest accomplishment is simply his courage to take on such a sensitive topic, trying to navigate between two strongly held values systems and trying to find common ground where possible. Further, we applaud his focus on the need for therapists to understand and honor the importance that religion has for many clients and to recognize that this intersectionality has sadly been overlook by some in the Affirmative Therapy community, although this assertion must be assumed to be anecdotal given the lack of research citations to justify it. Finally, he rightly points out the distress caused when religious ideology conflicts with one’s sexual attractions and the need for treatment strategies that provide help and not harm.
Mark Yarhouse has been a leader in encouraging dialogue between proponents of Affirmative Therapy approaches and therapists whose practice is informed by their conservative religious ideologies. His professional accomplishments include participation in the development of the APA’s position paper entitled, “Appropriate Therapeutic Response to Sexual Orientation.” Evidence of his clinical expertise is seen throughout the book, as well as his knowledge related to LGBTQ+ psychology. He speaks to the topic at hand with authority.
According to the author, this book has two goals: presenting a description and justification for Sexual Identity Therapy (SIT) and providing a toolkit for conducting it. In this review, we will focus on the first goal, since the second is predicated on the first. Grounded in the view that same sex attractions are not pathological per se, he encourages therapists not to set a predetermined “fixed outcome” regarding their clients’ final resolution of their sexual and religious identity conflict. To his credit, he counsels clinicians on the dangers of bias and the need for careful self-evaluation of one’s values and how they may interfere with the clients’ reaching their therapeutic goals. He also provides helpful clinical tips for conducting SIT.
Yarhouse speaks most eloquently when describing the dilemma of clients from conservative religious backgrounds who experience persistent non-heterosexual attractions. He describes this as identity incongruence. These clients typically would not seek help from clinicians that identify with the LGBTQ+ community or advertise as LGBTQ+ Affirmative. Where can these clients go for help with these conflicts? By providing an approach that does not stigmatize their attractions, they are hopefully opened to options beyond conversion therapy. While honoring their religious beliefs, clients are helped to explore their attractions and to find ways to reconcile them.
On a less favorable note, this book tries to accomplish too much. A book providing the foundations of SIT would have been enough. That aside, the book also suffers from some unexamined bias directed to what he calls “Gay Affirmative Therapy.” He identifies two life scripts that need to be examined and perhaps reconsidered: The Shame Script and the Gay Script. This distinction felt to our team members to be a false equivalency in order to make the case for a third way. While the discussion does point out the destructiveness of shame, it falls short of challenging homophobic churches to change their ideologies. Further, to accuse Affirmative Therapists of applying a “Gay Script” seemed reductionistic and without cited evidence.
Particularly disturbing was a passage where he quotes Doug Haldeman’s 2002 article stating that [adult] clients have the right of self-determination, “including the choice for entering conversion therapy” (p.186). Since we have learned a great deal about the potential risks of conversion therapy since then, does Yarhouse mean recommending that clients participate in treatment methods that have been demonstrated to be harmful, such as aggressive support for internalized homophobia? The team’s concern was that simply choosing to ignore its impact would not alleviate the pernicious effect of self-directed hatred, conscious or unconscious. In any case, we feel that assisting clients to understand the potential harm of conversion therapy is a necessary aspect of any informed consent.
Even with the book’s weaknesses, we felt that having an opportunity to engage with it provided our group an excellent opportunity to clarify our own beliefs and values. While we aren’t prepared to recommend this book as a manual for therapy, our group felt using the book as a stimulus for dialogue between conservative and affirmative clergy and therapists provides an excellent opportunity to learn about each other and how to work together. Moreover, we support the continued development of therapeutic approaches that specifically help clients find congruence between their religious and sexual identities. We would like to see these approaches take a more collaborative stance, including clergy and spiritual counseling and providing clients with an opportunity to explore a range of therapeutic and community options for growth. These efforts should help clients explore the diversity within communities and take into consideration multicultural intersections. Clients should be encouraged to experiment with identities and behavior and try them on for size, realizing that resolutions may not last forever and may require fine-tuning over the course of one’s lifetime.
Reviewers
Peter Goldblum, PhD, MPH, is professor emeritus and founding director of the Sexual and Gender Identities Clinic at Palo Alto University (PAU). Brandon Hoeflein, MS, recently completed his dissertation at PAU on Sexual Minority Suicide, Minority Stress and Religious/Spiritual Processes. Michael J. Adee, PhD, is director of the Global Faith and Justice Project, Graduate School of Theology, University of Redlands. Rev. Floyd Thompkins is former director of the Center for Innovation in Ministry at San Francisco Theological Seminary and currently CEO of the Justice and Peace Foundation, Palo Alto, Calif.
opens in new window