Shame and Attachment Loss: The Practical Work of Reparative Therapy

by Joseph Nicolosi

Bringing together a Judeo-Christian anthropology with biological and psychodynamic theories of human development and sexuality, psychologist Joseph Nicolosi details the therapeutic techniques of reparative therapy he has developed over the past twenty years. Written in three parts, the book first describes the nature of the psychodynamics of same-sex attraction as understood in the reparative therapy approach. The second part describes the various phases of treatment. The final part deals with walking clients through the process of grieving and the healing of their wounding. Endorsed by numerous notable leaders in psychotherapy, Nicolosi offers practical guidance for counselors and therapists who want to offer reparative therapy to those seeking change.

Genres: Psychology

474 pages, Paperback

First published May 1, 2009

About the author

Joseph Nicolosi is an American clinical psychologist, founder and director of the Thomas Aquinas Psychological Clinic in Encino, California, and a founder and former president of the National Association for Research and Therapy of Homosexuality.

Reviews

[Julio Genao · Rating 1 out of 5]

...oh, it's you.



i thought we spoke about this.



go on, now. git. don't make me fetch the hose.



because next time i won't be so nice.

[Heather K (dentist in my spare time)]

Anyone else tempted to send some male strippers to the poor souls who've 5-starred this book? You know they need it.

[Karlyflower *The Vampire Ninja, Luminescent Monster & Wendigo Nerd Goddess of Canada (according to The Hulk)* · Rating 1 out of 5]

The sheer arrogance ignorance it takes to believe that YOU have a right to dictate how another should or should not lead their life is unfathomable to me.



I cannot believe that in TWO THOUSAND AND SIXTEEN this bullshit still exists.

Homosexual, bisexual, pansexual, transgender, intersex, cisgender, heterosexual....... who the fuck cares?! Love IS Love; there is no right way to love!

To all of my fellow human beings walking around living their lives with love in their hearts, I adore all you diverse lovely beings.

[Jyanx]

[Jo ★The Book Sloth★]

For all of you "psychologists" out there that have supposedly found the answer to preventing homosexuality and have the nerve to write about it... Can one of you research my problem? I want a cure for my attracted-to-jerks disease...



Now that is a book I would pay good money for... Unlike this crap!

I know... Humor...not my strong point!

[Jimmy · Rating 5 out of 5]

excellent book, definitely needed for those struggling with unwanted homosexual desires. This book was one of the key factors for myself in overcoming it. It is a book intended for men. If a woman has reviewed this book you can clearly disregard it, as the book would not pertain to woman at all. Many of the comments on here are from people who haven't read the book, and just want to state their uneducated, gay-affirming opinions... If you are a gay male and you read this book, even if you don't want to believe it, you would have no choice to believe it because thats how much perfect sense the book makes. When it talks about childhood experiences in where your attractions come from you will see you past in front of your eyes. Homosexuality comes from unmet sam sex needs as a child - for example, a father who neglects his son - classmates who reject another male peer - sexual abuse as a child - and a few other examples that can cause a boy to seek out affection in unhealthy ways. This is just the tip of the iceberg.. Same sex attraction can be diminished, and this book can be a very helpful start to you understanding where same sex attractions come from, and set you on the path to healing from it.

[E]

What the book blurb really says:

"Bringing together a Judeo-Christian anthropology mumbo jumbo with biological and psychodynamic pseudo bullshit theories of human development and sexuality, psychologist trained idiot Joseph Nicolosi details the therapeutic techniques scientifically proven to not work techniques of reparative therapy torture he has developed over the past twenty years years of wasted time."



Where this book really belongs:

[Tara♥ · Rating 1 out of 5]

[Alan · Rating 5 out of 5]

This book captures reality for many people who are now a "systematically ignored group, the non-gay homosexual ... same-sex attracted men whose deeply held values and sense of self prevent them from embracing a gay identity. (p. 119)" An important counterbalance to the current push to make this therapeutic approach illegal.

[Apollo · Rating 5 out of 5]

Dr. Nicolosi's book is very helpful in describing the feelings and mechanisms behind homosexual compulsion. Having actually read the book, unlike most if not all the suspiciously-similar 1-star reviewers, and also being homosexual, I can say that his theory makes sense. It is most certainly not the entire picture - but I think Nicolosi's work moves us significantly closer to understanding homosexuality.

One thing you need to do before reading this book is understand it's premises; You will have to adopt a new one to read it correctly. The premise is this: "Homosexuality is not the same as heterosexuality. It is a manifestation of something maladaptive or abnormal or a mechanism not serving it's purpose, a psychological illness." I know that today this would be a radical premise - it is completely the opposite of what we would deem "acceptable opinion". But this was the way we looking at it in the past; and we had good reason for it. For a very long time, homosexuality was classified as a sexual perversion, a maladaptive mode of the sexual instinct. This was because it had very similar symptomatology to other perversions. It was highly likely to correlate with other psychological issues in the individual. And also because there was evidence coming to light about the causal factors by the psychoanalysts.

Now, I won't go into why or how homosexuality became declassified as a disorder (when it was removed from the DSM, the book of psychological disorders, which literally defines what is and is not a psychological issue). Suffice to say that if you read the history thoroughly you would have to admit that it's removal was anything but rationally-motivated and scientifically-sound.

Once you do adopt the premise (that homosexuality is in fact a problem), the book will open itself to you. It will show you some of your habits. It will explain, in a rough way, some of your thoughts, emotions and behaviours. It shows you the causal pathway, as far as it is psychoanalytically understood, down the homosexual road you've likely taken. It describes recurring pattens: in the relationship between the homosexual boy and his mother, in the relationship between the boy and his father, as he grew up.

Nicolosi introduces a model of self-states (like four different states of your consciousness), and shows you how you move through each self-state from the Assertion state, through the Shame State, into the Grey Zone, and then into homosexual activity. He explains why this pattern arose - to avoid dealing with a traumatic reality in childhood. He explains that the homosexual urges are ultimately seeking authentic, masculine affirmation from other males - something tragically absent in the childhood of the homosexual boy. He describes the alienation felt by the boy, and how homosexual activity is an attempt to repair the wound and avoid the inner conflict.

Then he describes a method of procedure to help resolve the conflict - through body-work and going through the grieving process. This is done in the presence of an affirming male in the psychologist.

When you're done reading this you'll think well, was this really much of a surprise? The gay culture openly and self-deprecatingly admits to the prevalence of 'daddy issues' in the community. Most gay people know they have psychological wounds. I think many would deeply suspect something isn't right. Most of us just don't have the courage to admit it.

Nicolosi's work is one of the last islands in the sea of chaos about this topic floating around. There are others to read as well, Charles Socarides being another good author.

[Josh · Rating 3 out of 5]

I have a mixed response to this book. On the one hand, as a confessing Christian I share Dr. Nicolosi's belief that homosexuality is one (among many, in my view) of the ways that we have perverted God's gift of sexuality to destructive ends. From that perspective, I respect his courage in taking an unpopular stand and seeking to help men who desire to fight against homosexual temptations.

On the other hand, I find the psychological substructure of Nicolosi's work (a form of attachment theory that links present struggles to parental attachment in infancy/early childhood) to be flawed and inadequate. While I support his desire to help men with same-sex attraction, I believe his methods would ultimately prove unhelpful and should not be regarded as a truly Christian approach to counseling same-sex attraction struggles.

[AGandyGirl · Rating 1 out of 5]

[World Citizen · Rating 5 out of 5]

For a glimpse into our zeitgeist, into spirit of our modern American age, the below quote from “The Best of Joseph Nicolosi” will lead off this review of "Shame and Attachment Loss." It’s a quote from an interview between Dennis Prager, a conservative talk-show host, and Camille Paglia, a feminist activist and a lesbian. Says Paglia:

“Now you are not allowed to ask any questions about the childhood of gay people anymore. It’s called “homophobic.” The entire psychology establishment has shut itself down, politically….so all the sophistication of analysis, in being able to analyze the family background [is] gone.

That entire discourse is gone. Everything is political now. It’s really sick. It’s a sick and stupid way of looking at human psychology. We are in a period now of psychological stupidity. (The Best of Joseph Nicolosi, p. 5)

Reparative Therapy holds that homosexuality is learned, and if it can be learned, then it can be unlearned. It’s a psychological condition, and it develops over time with several factors coming into play. They are chiefly environmental factors – for example, a boy’s negative experiences with his father and male peers, which engenders a deep sense of shame in the boy, resulting in attachment losses of key figures in his life, figures necessary to his masculine identity and functioning. With such early childhood tragedies deeply embedded in his soul, the result will be homoeroticism, which is a temporary solution to a deeper emotional problem. Reparative Therapy relies heavily on a social-environmental model of the origin, development, and treatment of homosexuality.

With this being the case, and with well-documented studies to show that the healing of SSA (same-sex attractions) and homosexuality is a rock-solid reality, will Reparative Therapy be outlawed in the future? Will boys and girls, men and women, be denied the freedom to choose their own model of self-care in America?

As the Supreme Court contemplates a verdict, a second quote from the above book will be offered. It comes from Linda Nicolosi, the wife of Dr. Joseph Nicolosi:

“As with almost all psychological conditions treated in psychotherapy, however, complete change was not a common therapeutic outcome. Most clients reported satisfying changes which helped them understand the source of their conflicts, releasing them from compulsive sexual acting-out and giving them the tools to move on productively with their lives in a way that was consistent with their deeply held values. One could say they learned how to “reintegrate” their true, masculine selves instead of eroticizing that masculine self in another man (The Best of Joseph Nicolosi, p. xi).

Speaking of her late husband’s clinic and its influence on his clients, she reveals:

“Many marriages were saved, as men learned that they didn’t have to divorce their wives and claim a gay identity in order to be true to themselves. Addictions to gay porn were overcome, and some clients who never believed they would be able to marry were able to do so when they learned how to satisfy their ongoing male affectional needs in a non-erotic way. On my husband’s desk were many appreciative letters and photos from men who had gone on to marry and to have families” (The Best of Joseph Nicolosi, p. xi-xii).

Finally, noting the widespread impact of Reparative Therapy and the effectiveness of its techniques, she states:

“Members of the clergy – priests, ministers, rabbis – were enabled to understand their same sex erotic feelings, and to integrate them through a self-compassionate understanding so they could stay true to their vows. Confused teenagers who couldn’t understand their crushes on other boys gained a new perspective on the meaning of those desires and realized they didn’t have to be gay. Men who had been sexually abused were feed from the compulsive need to reenact their childhood trauma with another male” (The Best of Joseph Nicolosi, p. xii).

So widespread is Dr. Nicolosi’s influence that his books have been translated into ten languages including Arabic, Turkish, and Spanish.

Moving onto the review of Shame and Attachment Loss, Dr. Joseph Nicolosi, the founder of Reparative Therapy, states, “The push within my profession to outlaw treatment for unwanted same-sex attractions (SSA) is in striking violation of contemporary liberalism’s own professed commitment to diversity” (Shame and Attachment Loss, 4).

In the book, Dr. Nicolosi and other prominent members of the psychological community defend a diversity of worldviews as well as a client’s freedom to choose his or her own method of self-care. Nicolosi quotes a few brave men who’ve offered a dissenting point of view on the topic of therapy for unwanted SSA, noting that these men are “champions of gay rights and self-professed liberals [as well as] former presidents of the American Psychological Association” (4-5).

One past-president of the American Psychological Association is Dr. Robert Perloff. At a conference, Perloff stated:

“The individual has the right to choose whether he or she will accept a gay identity. It is his or her choice, not that of an ideologically driven interest group. To discourage a psychotherapist from undertaking a client wishing to convert is anti-research, anti-scholarship, and antithetical to the quest for truth” (5).

Dr. Nicholas Cummings, another past-president of the American Psychological Association, “has personally helped homosexual clients to reorient to heterosexuality” (5). Cummings stated:

“I remain fiercely dedicated to freedom of choice for all people, and especially in their right to choose the goals for their own individual psychotherapy. Patients should have the right to explore their own heterosexual potential” (5).

Robert Spitzer, M.D., a member of a team that helped to get homosexuality deleted from the diagnostic manual, maintained:

“Contrary to conventional wisdom, some highly motivated individuals using a variety of change efforts, can make substantial change in multiple indicators of sexual orientation, and achieve good heterosexual functioning” (5).

Finally, in 1918, Sigmund Freud wrote:

“We refuse most emphatically to turn a patient...into our private property, to decide his fate for him, to force our own ideals upon him...in the service of a particular philosophy. In my opinion, this is...to use violence [upon the patient]” (5).

Diversity of thought, diversity of worldviews, a diversity of options for self-care, and human freedom – these are hugely important in the free West and especially in America.

Dr. Nicolosi then takes us into the heart and soul of the book. He states, “Reparative theory holds that the origin of same sex attraction (SSA) is in unmet emotional and identification needs with the same sex” (7).

During therapy sessions, Dr. Nicolosi always says to his clients, “Rule number one is: Never accept anything I say unless it resonates as true for you.” If reparative theory doesn’t ring true for the client, then “he will decide to leave therapy after one or two sessions [and] may then decide to see a gay affirmative therapist, who will affirm his homosexuality as an intrinsic part of his identity” (7).

Even if a client leaves reparative therapy and decides to gay-identify, “the good therapist always conveys his complete acceptance of the client…even if we don’t agree with them, because we accept the person” (7).

How does Reparative Therapy Work? How is progress made to lessen or eliminate unwanted SSA and homosexual behavior?

At the end of the “Introduction,” Dr. Nicolosi lays down a foundation stone, gleaned from decades of research and private practice:

“In discussing their family backgrounds, over and over our clients tell us that they never felt known and loved for who they really are. This is not to say their families didn’t love them – most of their parents loved and wanted what was best for their children. But with this particular son, there was a disconnect…a malattunement. The majority of my clients say they never felt truly “seen” by their parents. And so it is the work of therapy to undo the shame, repair the attachment loss, and reconnect the man back to the gendered being he was designed to be” (12).

In Part I – “The Psychodynamics of Homosexuality” – we learn about “the influence of social-psychological factors in the development of homosexuality.” (16) We also learn that reparative theory has expanded to conceptualize homosexual attraction as more than a striving to repair gender deficits. We now see it more broadly as a striving to repair deep self-deficits” (16).

These “deep self-deficits” are voiced by clients, one of whom said, after six months of therapy, “The good news is that my problem is not my homosexuality. The bad news is that it’s about everything else!” (18).

Nicolosi interprets the “everything else” as the client’s “compromised style” of interacting with other men – that is, his difficulty in “relating in mutuality” with those men as well as the client’s need to present a “false self” to the world around him (18).

Another client explained “deep self-deficits” this way: “My problem is this low-grade emptiness in my life that sets me up for male attractions” (18).

In reparative theory, a few factors lead to the development of homosexuality, and they merge in unique ways for different people. Nicolosi states:

“Our model focuses on biological influences (a sensitive temperament), but more importantly on the parents’ failure to support the boy’s emerging identity. Negative child same-sex peer experiences play a role as well” (17).


Shame

The notions of shame and attachment loss are key in the development of unwanted SSA. In the literature of reparative therapy, homosexuality is seen as rooted in early childhood traumas. These traumas produce a deep sense of shame in a boy. This sense of shame (e.g., “I’m a bad person, I’m not wanted, and I’m unlovable”) causes a gender wound to open in the boy’s soul, a wound which, if unaddressed and left unhealed, will widen as the years go by. It’s the soil out of which homoeroticism grows, as he attempts to repair these gender and identity deficits through homosexual behavior.

“While it is apparent that society’s reaction to the homosexual condition produces shame,” Nicolosi says, “I believe the origins of the homosexual condition began with shame – specifically, in the person’s unsuccessful struggle for secure attachment and masculine identity” (19). For male homosexuality, this unsuccessful attachment would be a boy’s failure to adequately bond with his father at home and with male peers at school.

How does this sense of shame and a deep gender wound in a boy’s life play into acting out sexually later in life?

“A felt compromise of personal integrity prompts shame,” Nicolosi says, “which in turn prompts the need for self-esteem regulation (reparation), which in its turn, motivates the man to seek a same-sex erotic attachment. Thus a particular focus of reparative therapy is on helping the client reject shame to live [his] life in the assertive stance” (19).

In short, reparative theory sees homosexuality as “a narcissistic solution to a shame problem” (19). It’s a man’s attempt to attach himself to the male world, a world denied to him in early childhood. The homosexual attraction is an attempt to repair a male gender deficit as well as “a striving to repair deep self-deficits” (16)

What’s the goal for a client in reparative therapy? It will be for a man to no longer act out his past hurts and his “deep self-deficits” in a sexual way. It will be for a man to “experience those authentic feelings about his past while in the presence of the therapist” (20)

This is hugely important. During therapy, as the client reveals his past with the encouragement of his therapist, the client “reexperiences those early traumatic events, feelings, and associations while in the presence of an attuned other.” When this key moment arises, the client will gain new insights into his past, so that his “identified conflict” is seen in a new way. This past conflict from childhood, this shame-producing moment, now becomes “redefined and transformed” and is imbued with “a new, coherent meaning.” (20)


Attachment Loss

Many of Dr. Nicolosi’s clients report never having been “seen” by their parents. They were never “seen” for who they really are as boys and girls, as men and women. If a young boy fails to make a secure attachment to his father, then the boy’s self-identity and gender identity will be subverted (21).

The reasons a boy may experience an attachment loss with the father include rejection (perceived or real), verbal and/or sexual abuse, an emotionally cold and distant parenting style, all of which are explored in detail in Dr. Nicolosi’s published works.

The trauma of not being seen or loved in a deep and genuine way by the parents can cause a wounded ego in a boy. As a result, the boy constructs a “false self” to protect his ego from future hurts. This false self is adaptive in childhood but maladaptive in adulthood (21).

What’s maladaptive about the false self in adulthood? It becomes “a defense against the authentic exchange of feelings [and] cuts off all future opportunities for authentic attachment. The client must drop his defense of the false self in order to receive the male affirmation necessary for the resolution of his SSA” (21).


The Working Alliance

A key notion in Reparative Therapy is the “working alliance.” This refers to a trusting relationship between the client and a same-sex therapist. Here the client and therapist agree on the “goals and objectives” during the working alliance, with the client in control, defining the goals and objectives. The working alliance is also a relationship where “the therapist offer[s] a corrective experience to his client’s past emotional betrayals, allowing the client “to surrender his posture of anticipatory shame” (153).

While in a working relationship, both therapist and client work on an “identified conflict,” such as a past childhood trauma involving the father. In such a setting, the therapist will be able to regularly affirm to the client, “So we agree that this is a problem that you would like to work on for yourself today” (153).

For many clients, recalling the psychic maps of early childhood and adolescence, as well as peering through the dark cloud coverage of personal and social traumas, are key steps on the road to recovery from SSA and homosexual activity.

“In the end, then,” Nicolosi states, “clients discover that the hard work of therapy is not so much about removing all homosexual temptation as it is all about learning to develop personal and interpersonal authenticity. And it is about retracing the roads taken in childhood that brought them onto this unfortunate path” (23).

Throughout this four-hundred-page book are many profound quotes from clients in reparative therapy. One of them, when asked what he would say to other men in reparative therapy, stated to Dr. Nicolosi:

“I would say, ‘Don’t believe the gay agenda. Go with what your heart and mind are telling you. This life can never be authentic. If you’re on the path to change, don’t stop – don’t give up. This is so much more joyful than anything I ever did in my crazy, acting out days’” (23).

In reparative therapy, the healing of SSA occurs when the client works closely with “an accurately attuned same-sex therapist” and realizes the “ongoing (indeed, lifelong) necessity of close male friendships” (16).

Another client affirmed the main principle of reparative therapy this way: “When a real man sees me as a real man, then I become a real man” (16).

During his lifetime, Dr. Joseph Nicolosi had worked with thousands of men struggling with unwanted SSA. During his therapy sessions, he repeatedly heard the same childhood themes from clients, including “painful relational deception, betrayal and, ultimately, inconsolable disappointment.” His clients constantly complained of “feeling weak, inadequate and out of control, and demonstrate[d] a guarded stance toward life and relationships” (17).


Techniques: Grief Work

The book also offers techniques for the healing of early childhood traumas and hurts. One of them is grief work. This term, coined by Sigmund Freud, involves “helping the client abandon his defenses in order to face a deep loss.” Freud’s insights on grief “remain central to reparative therapy in that homosexuality and its associated symptoms are understood to be a defense against attachment losses incurred in childhood” (366).

Grief work puts the client in a position of “acknowledging and reexperiencing those core attachment losses, [and] it is in addressing those profound hurts that therapist and client encounter one another on the deepest level. At this level of human encounter, the healing begins” (17).

When a child has experienced a core injury, such as the core attachment loss of the father, resulting in a boy feeling unmasculine, defective, and unlovable, it is “so deeply unsettling that it feels like death. It is emotionally agonizing and physically searing.” Grief work will help the client to dig down into that “painful, despairing place where we therapists must, from time to time, return our clients” (363).

As a client advances in grief work due to therapy and journaling, there are “profound, durable treatment gains,” and when he can dig down into the strata of his early childhood, healing those shame moments and resolving his attachment losses, “the less he feels the need for homosexual behavior” (365).

With the deep gender wounds a client has suffered due to shame and attachment losses, homoeroticism is simply a cover for “the anguish of this profound loss and serves as a temporary – if ultimately unsatisfying – distraction from the tragedy of a core attachment injury” (366).

A client notes:

“In the grief work, I’m able to relive that pain and experience it in a safe environment rather than bury it and deny it and fear it. I’m gradually working this through now in a healthy way. I know now that we’re meant to feel the pain, not to bury it. And when I feel the pain, then my need to use the homosexuality to cover it up is so much less” (364).

Continued Below:

[M · Rating 1 out of 5]

Soooo. A book for the "non-gay homosexual... same-sex attracted" men who don't identify as gay because of their deeply ingrained values. Honey, the term you are looking for is "in the closet behind the closet". You may think antonyms are your friend, when in reality, you just came out.

Which brings us to what this book really is: redundant. A redundant waste of space where you could have told us what you really wanted to say: I'm not heterosexual, there is nothing I can do about it and that is juuust fine.

[Kim · Rating 1 out of 5]

Ignorance~ love is love~ I just can not even begin to start on how wrong this is to change how you are born, to change what you feel as if it is wrong to be gay or lesbian it's like telling someone to change color of skin. This book is so wrong.

[Theodore E · Rating 5 out of 5]

Critics of this book have a bias or have not read it. It is not "conversion therapy" as some falsely claim. It is trauma work to identify core shame injuries in delicate developemental stages involving both mother, father and the childs interpretation and perception of rejection abandonment real or perceived by ill equiped parents unemotionally attuned to the child and in disharmony with each other. Good psychology here which is not dependant on public opinion, cultural approval, or peer pressure. Activists forced and then infiltrated the american psychological association to erase decades of research experience snd expertise Not to mention cross cultural and historical common sense, theology, precidence, and even natural law.

[Pablo Sotomayor · Rating 5 out of 5]

Nicolosi da una explicación muy completa y fácil de comprender de las posibilidades causas de la atracción al mismo sexo. También muestra cómo se podría llevar un acompañamiento a alguien que quiere entender esa atracción y prefiere no seguirla.

Además ilustra con conversaciones muy aleccionadoras cómo van avanzando las personas que se acercan a pedir ayuda.

Me gustó mucho el libro. Agradezco la claridad de exposición.

[Tokyo D · Rating 5 out of 5]

This book is excellent. My life has been the textbook example of what Nicolosi discusses. Unfortunately we are in an era when nuanced discussion of sensitive matters is not allowed and only “affirmation” is considered okay. I recommend this book 100%.

Most of the bad reviews are from people who have not read it and should be deleted.

[Mohamed Say]

dhdgh

[Faris Al Khalaileh · Rating 3 out of 5]

It's for professional people, I'm not one of them the first chapters were amazing but then things become much more complicated

[Lee Su Pei · Rating 1 out of 5]

Thanks for sharing your opinion.
I also share mine.

[Mason Fraley · Rating 4 out of 5]

I don’t agree with everything Nicholosi says in here but the shallow and unproductive adolescent rage manifested in the 1 and 2 star reviews kind of vindicates his point lol

[Paul · Rating 5 out of 5]

I have never felt more understood

[Brandon · Rating 1 out of 5]

I ought to write a book on the "the psychodynamics" of clinicians who hate us same-sexers.