1. Psychogenesis of Homosexuality & Treatment Protocols Copyright © Melvin W. Wong, Ph.D. 1996-2002 Melvin W. Wong, Ph.D. Licensed Clinical Psychologist ChristianMentalHealth.com 220 Montgomery St., Suite 1098, San Francisco, CA 94104 Tel (510) 475-1475 Fax (510) 475-1473

3. 200 Subjects Who Claim to Have Changed Their Sexual Orientation from Homosexual to Heterosexual Robert L. Spitzer, M.D. Chief, Biometrics Research and Professor of Psychiatry, Columbia University 1051 Riverside Drive, Unit 60, NYS Psychiatric Institute New York, NY 10032 (Presented at the APA: American Psychiatric Association Meeting: May 9, 2001, New Orleans, U.S.A.)

4. Sexual Attraction Scale Mean (100 = same sex, 0 = opposite sex)

5. Exclusively Homosexual BEFORE Exclusively Heterosexual AFTER 42% 46% 17% 55%

6. “Markedly” or “Extremely” Bothered by Depression 43% 47% 1% 4% 1% 4%

7. Change effort was “Very Helpful” in… …feeling more [masculine, feminine] 87% …developing nonsexual relations with same sex 93%

8. What are the causes of Homosexuality?

9. Reference One Homosexuality: A New Christian Ethic Elizabeth R. Moberly, (1983 56 pages) Published by James Clarke & Co, Cambridge England British Pound 2.95 (USD $ 9.00)

10. Homosexuality: A New Christian Ethic Shifts focus of debate from symptoms to root causes Psychoanalytic Interpretation “the homosexual condition involves legitimate developmental needs, the fulfillment of which has been blocked by an underlying ambivalence to members of the same sex.”

11. Homosexuality: A New Christian Ethic She sets the separation between “homosexual-orientation” from “homosexual-activities” “homosexual-orientation” from “homosexual-activities” She coined the term “ Defensive Detachment”

12. “Same-Sex Ambivalence” “An Approach Avoidance Conflict” For Males and Females Male and Female Homosexuality

13. “Defensive Detachment” Why Defensive Detachment?Why Defensive Detachment? From “Attachment” theory of John BowbyFrom “Attachment” theory of John Bowby With Attachment, there is DetachmentWith Attachment, there is Detachment How a child-toddler learns autonomyHow a child-toddler learns autonomy –Identity Formation and Development –A Dynamic process of Attaching-Detaching The “Psychological-Birth” of an infantThe “Psychological-Birth” of an infant

14. Family Tree Diagram Father Son-1 Son-1 Mother Daughter Son-2

15. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son separates from mom for psychological individuation successfully

16. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son attaches with dad for Gender-Identity formation sucessfully

17. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son separates from mom for psychological individuation successfully

18. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son attempts to attach to father for Gender- Identity formation

19. Unhealthy Relationship Begins Father Son-1 Son-1 Mother Daughter Son-2 Son’s attempts to attach to father was rebuffed and he experiences rejection and hurt

20. Unhealthy Relationship Defensive Detachment Begins Father Son-1 Son-1 Mother Daughter Son-2 Son’s attempts to defend against more pain from rejection by defensively detaching from father’s relationship emotionally

21. Reference Two Reparative Therapy of Male Homosexuality A New Clinical Approach Joseph Nicolosi, Ph.D. (1991, 355 pages) Published by Jason Aronson Inc. New Jersey, London $32.00

22. Reparative Therapy of Male Homosexuality “Reparative” Homosexuality as a “Reparative Drive” “Defensive Detachment” Failure of the Father-Son Bond Failure of the Father-Son Relationship

23. Reference Three The Psychological Birth of the Human Infant Symbiosis and Individuation Margaret S. Mahler, Fred Pine & Anni Bergman (1975 308 pages) Published by Basic Books, Inc. Publishers, New York (Hardcover USD $45 Paperback $22)

24. The Psychological Birth of the Human Infant Symbiosis and Individuation Beginning of Gender Identity is 21 monthsBeginning of Gender Identity is 21 months –Boys turn to fathers to gender identify (p. 106) –Boys struggles with castration anxiety Task of becoming a separate individual for little girls are more difficult than boysTask of becoming a separate individual for little girls are more difficult than boys –Girls turn to mother upon discovery of sexual difference –Girls blame, demand, ambivalent toward mom

25. Gender Identity Disorder: Age of Onset “By late adolescence or adulthood, about three- quarters of boys who had a childhood history of Gender Identity Disorder report a homosexual or bisexual orientation, but without concurrent Gender Identity Disorder.” (DSM IV)“By late adolescence or adulthood, about three- quarters of boys who had a childhood history of Gender Identity Disorder report a homosexual or bisexual orientation, but without concurrent Gender Identity Disorder.” (DSM IV) Most of the remainder reports a heterosexual orientation, also without concurrent Gender Identity Disorder.Most of the remainder reports a heterosexual orientation, also without concurrent Gender Identity Disorder. The corresponding percentages for sexual orientation in girls are not known.The corresponding percentages for sexual orientation in girls are not known.

26. Gender Identity Disorder: Age of Onset “Onset of Cross-Gender Interests and activities is usually between ages 2 and 4 years” (DSM IV)“Onset of Cross-Gender Interests and activities is usually between ages 2 and 4 years” (DSM IV) Average age for a clinical referral is 3.5 yrs (Rekers, G.)Average age for a clinical referral is 3.5 yrs (Rekers, G.) Only a very small number of children with Gender Identity Disorder will continue to have symptoms that meet criteria for Gender Identity Disorder in later adolescence or adulthood.Only a very small number of children with Gender Identity Disorder will continue to have symptoms that meet criteria for Gender Identity Disorder in later adolescence or adulthood. Most children with GID display less overt cross- gender behaviors with time, parental intervention, or response from peers.Most children with GID display less overt cross- gender behaviors with time, parental intervention, or response from peers.

27. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son separates from mom for psychological individuation successfully

28. Healthy Relationship Father Son-1 Son-1 Mother Daughter Son-2 Son attempts to attach to father for Gender- Identity formation

29. Unhealthy Relationship Begins Father Son-1 Son-1 Mother Daughter Son-2 Son’s attempts to attach to father was rebuffed and he experiences rejection and hurt

30. Unhealthy Relationship Defensive Detachment Begins Father Son-1 Son-1 Mother Daughter Son-2 Son ’ s attempts to defend against more pain from rejection by defensively detaching from father ’ s relationship emotionally

31. Unhealthy Relationship Defensive Attachment Begins Father Son-1 Son-1 Mother Daughter Son-2 Son has no choice but to re-attach with mom for emotional security

32. Unhealthy Relationship Defensive Attachment Continues Father Son-1 Son-1 Mother Daughter Son-2 Son has no choice but to re-attach with mom for emotional security Forming Defensive Attachment

33. Unhealthy Relationship Defensive Attachment Intensifies Father Son-1 Son-1 Mother Daughter Son-2 Son generalizes defensive detachment to defensively attach to girls and women: Non- aggressive & softer

34. Unhealthy Relationship Defensive Attachment Intensifies Father Son-1 Son-1 Mother Daughter Son-2 Father becomes a stanger Generalization intensifies. Father becomes a stanger Girl 1 Girl 2

35. Unhealthy Relationship Defensive Attachment Intensifies Father Son-1 Son-1 Mother Daughter Son-2 Men are unfamiliar Generalization intensifies. Men are unfamiliar Girl 1 Girl 2 Girlfriend

36. Unhealthy Relationship Defensive Attachment Solidifies Father Son-1 Son-1 Mother Daughter Son-2 Men are objectified- curious-sexualized Girl 1 Girl 2 Girlfriend Grandma

37. Unhealthy Relationship Defensive Attachment Solidifies Father Son-1 Son-1 Mother Daughter Son-2 Men are objectified- curious-sexualized Girl 1 Girl 2 Girlfriend Grandma Aunt 1

38. Specific Male Treatment Issues (Copyright © Melvin Wong, Ph.D. 2000) Ideations: Reduction of Intrusive Thoughts Explain thought origin, validation not encouragement –Desperate crave for intimacy and acceptance Develop insight into precusors of thoughts: HALT Re-interpret to reframe the meaning of the thoughts –Neediness and affirmation needs Re-direct thoughts with more competitive thoughts –Accountability partner-tell a friend Medication: SSRI’s (Selective-Serotonin-Reuptake Inhibitors) –Fluoxetine:Prozac, Sertraline:Zoloft, Paroxetine:Paxil

39. Specific Male Treatment Issues (Copyright © Melvin Wong, Ph.D. 2000) Behaviors: Reduce Mastubation & Acting-Outs Goal is to reduce frequency and intensity Check-in with client weekly: Accountability –How did it feel afterwards? “Good but bad!” Reduce stimuli: No Cyperporn, chats, media Positive-Negative reinforcements –Commendations, Loss of spouse, rubber-bands Medication: Prozac, Zoloft, Paxil help

40. Specific Male Treatment Issues (Copyright © Melvin Wong, Ph.D. 2000) Relational: Increase Male non-sexual friendships Reduce same-sex pedestal effect of males –Develop insight of over-adulation and devaluation Develop courage to befriend attractive males –Sexual-attraction desensitization, ego-stability –“I’m one of the guys!” “I can’t believe I belong!” –Learn to keep relationships: reduce jealousy Group meetings-activities with guys –Attend regular self-help groups: EA, SA’s, Exodus

41. What is Healing & Recovery? Presence or Absence of SSA “Orientation”? –Realistic Expectations: Some Traces of SSA –Memories Can’t be Completely Obliterated, But Emotions Can Reduce Significantly Degree or Intensity of SSA’s? –Overwhelming vs. “In Passing” “Non-Dwelling” The Recovered vs. The Strugglers –Addiction Cycles: Presence or Absence? –Intrusive Thoughts –Preoccupation & Obsessions –Secret vs. Honesty Litmus Tests: Stressful Times, Unstructured Times

42. Religious Support Groups Exodus International (North-America) ExodusNorthAmerica.org ChristianMentalHealth.com National Association for Research & Therapy for Homosexuality narth.com Regeneration Books (Exodus Member) 410-661-4337 Courage (Catholic) 212-268-1010 Parents and Friends of Ex-Gays Pfox.org Evergreen International (Mormoms) Evergreen-intl.org