Shame and Attachment Loss: The Practical Work of Reparative Therapy

List of Figures and Tables Foreword by H. Newton Malony Foreword by Robert Perloff Acknowledgments IntroductionPart 1: Psychodynamics of Homosexuality1. Overview: Advances in Reparative Therapy2. Family Dynamics3. Homosexuality as a Shame-Based Symptom4. Homosexuality as a Repetition Compulsion5. Homosexuality as a Reparative DrivePart II: Treatment: Affect-Focused Therapy6. The Primacy of Affect7. The Body8. Reparative Body Work: The Concept of the Two-Triangle Sequence9. Reparative Body Work: Working the Two-Triangle Sequence10. The Double Bind11. The Double Loop12. From Double Bind to Double Loop13. The Scenario Preceding Homosexual Enactment14. Working Through the Scenario Preceding Homosexual Enactment15. Journaling16. Counseling Teenagers17. Male Friendships18. Relationships with WomenPart III: Grief Work19. The Role of Grief Work in Reparative Therapy20. Approaching the Core Injury21. Defenses Against Grief22. Homosexual Enactment as the Opportunity for Grief Work23. Resolution of Grief: A Life Without Illusions and Distortions Appendix: Eye Movement Desensitization and Reprocessing Therapy Notes References Index

\ William J. Abraham"For those who have freely made up their mind to find a different way forward in dealing with the challenges of homosexuality, this book is a godsend. Joseph Nicolosi has provided a first-rate manual that tackles the issues head-on, that works from the best evidence available and that is rooted in years of therapeutic practice. We have long needed a book like this: respectful of human choices, realistic in its central claims, clear about its theoretical foundations, aware of relevant objections and robust in its proposed clinical solutions. Every pastor and therapist, whatever their personal theological or moral commitments, should have this book in their library. They owe this to all those who are reaching for an alternative to the sexual ideology of our culture; they also owe it to the demands of common honesty and of intellectual virtue."\ \ \ \ \ Janelle Hallman"In this groundbreaking book, Nicolosi, a pioneer in the field of reparative therapy, introduces clinicians to the influence of shame and attachment loss within a same-sex drive. By integrating multiple theoretical bases, Nicolosi has developed and effectively presents a fresh and comprehensive framework for understanding and treating male SSA. The techniques and strategies discussed within this cutting-edge work not only guide therapists in their work with homosexual strugglers but also will provide insight into many other clinical cases. This is a must-read and an essential resource for any counselor's library. It will have a lasting impact on how the scientific and professional mental health communities view and comprehend homosexuality."\ \ \ Neil Whitehead"Dr. Nicolosi's latest book is, as ever, a continuation of insightful writing based firmly on his clinical experience. Although the basic therapeutic approach has stood the test of time, it has been refined in the light of experience. Many myths about reparative therapy are refuted by this book, and no one reading it could believe any longer that such therapists are primarily motivated by anti-gay feelings. Considerable care of clients is clearly evident in the many transcripts included. The approach is refreshingly non-doctrinaire. Although the book is intended for therapists, there is also much here that would deepen the understanding of nontherapists. Even critics who abhor this type of therapy might find their opinions modified if they read this book."\ \ \ \ \ Roger Sonnenberg"I have just finished reading this book, and I only wish there had been such research and words of hope earlier in my ministry in counseling homosexuals. Nicolosi's book offers a refreshing cool cup of reason and hope on one of the most heated topics today. This is a must-read not only for the homosexual who is struggling over his sexuality but for every parish pastor, counselor and therapist. As a university professor of graduate studies in family ministry, it will be on my list of required textbooks."\ \ \ \ \ George A. Rekers"As an internationally recognized clinical expert on reparative therapy for unwanted homosexual attractions, Dr. Joseph Nicolosi has written a theoretically sound, clinically insightful, intellectually brilliant and highly compassionate practical book that will no doubt become a standard professional reference for psychologists, psychiatrists and other mental-health clinicians treating individuals troubled by their homosexual impulses. This book is not only psychologically sound and theoretically insightful, but it is consistent with the Judeo-Christian theological understanding of the creation of humans as male and female and the normality of close emotional, nonsexual relationships among men."\ \ \ \ \ Benjamin Kaufman"As readers have come to expect from Dr. Nicolosi, Shame and Attachment Loss: The Practical Work of Reparative Therapy again is an enormous contribution to making the complexities of homosexuality and its treatment more coherent for parents, therapists and anyone concerned about cultural issues. Dr. Nicolosi continues his pathway of contributing clinically and philosophically in the traditions of a scholar."\ \ \ \ \ A. Dean Byrd"In this richly detailed book, Dr. Nicolosi shares his experiences of many years working with same-sex-attracted men who want to diminish their unwanted attractions and develop their heterosexual potential. Nicolosi is convinced that the world's great religious traditions are right: humanity was designed for gender-complementary coupling. The mental-health associations must respect this viewpoint; to do otherwise would be a gross violation of worldview diversity as well as the client's right to freedom and self-determination."This new book is a rich source of information—written by an astute clinician whose work with same-sex-attracted clients has been groundbreaking, beginning with his 1991 book, Reparative Therapy."\ \ \ \ \ Jeffrey Burke Satinover"For the therapy of unwanted same-sex attraction, very few people have had the depth of experience and wide-ranging success of Joe Nicolosi. A master in the field has here distilled that experience equally for the professional and the interested layperson. Every genuinely open-minded therapist should be familiar with the important insights that Dr. Nicolosi provides. This book can and should likewise provide the foundation for courses that train interested professionals in the art and science of helping to reverse homosexuality and restore heterosexual desire and functioning to those who seek such changes."\ \ \ \ \ Nicholas A. Cummings"In the current contentious and divisive climate that surrounds the treatment of homosexuality, the well-being of thousands of patients is at stake. Therefore, it is imperative that militant attempts at censorship and ideologies that would limit open inquiry be set aside in the interest of clinical integrity. The right of the patient to choose his or her therapeutic goals is paramount, and attempts to stifle the patient's freedom of choice are not only egregious but also contrary to the basic commitment of all health care itself."For this reason, even though I disagree with some cause-and-effect relationships proffered in this book, Dr. Nicolosi's point of view must be part of the equation in an honest, open deliberation until we arrive at ultimate scientific and clinical fact. In my over sixty years of practice as a psychologist I have seen many conditions, both medical and psychological, that were once regarded as incurable to now be readily treatable. In this early stage of the heated debate on the treatment of homosexuality and same-sex attraction, to prematurely remand all homosexuals to an unchangeable lifestyle would be a disservice to the worst order."\ \ \ \ \ H. Newton Malony"I would like to take this opportunity to recommend to you the publication of this important volume by Dr. Joseph Nicolosi. Having served in the education and training of therapists for many years, I commend his work for the following reasons. First, although reparative therapy has been maligned by some in Division 12 (Clinical) of the American Psychological Association, it has not been rejected as a therapeutic modality for those seeking to change their sexual orientation, especially Christians or other religious or morally motivated persons."Second, while there is currently a strong emphasis on empirically validated treatment modalities, all approaches initially began as theories which were clinically applied long before they were subjected to controlled clinical studies.Reparative therapy as described in Nicolosi's volume is one such modality.Empirical validation will be the next step in its development but it should not be discounted merely for being at this stage in its development."Third, reparative therapy, as detailed by Nicolosi, is not presented as a therapeutic cure-all nor is it presented as a model that explains each and every incidence of homosexuality.Reparative therapy is offered as a hopeful remedy grounded in one environmentally significant determinant—namely, family interaction. It is also offered as an option for religiously motivated persons who are seeking some alternative to the view that they cannot change.In summary, Nicolosi is making room for the social-environmental hypothesis. His theories are a significant upgrading of the classic psychoanalytic model, one that accords well with classical Judeo-Christian teachings. Although in our current atmosphere there may be some risk in the publication of this book, I welcome Nicolosi's bold and valuable contribution to psychotherapy in the hope that it would influence the field to become more balanced in its approach."\ \ \ \ \ Stanton L. Jones"Nicolosi brings extensive professional clinical perspective and deep immersion in the historical literature in this area to his reflections on work with individuals experiencing unwanted same-sex attraction.This volume offers fruitful clinical hypotheses for exploration.Nicolosi shows balance in acknowledging possible biological and psychological contributors to causation, in exploring what full informed consent for consultation entails, in respecting appropriate clinical boundaries in professional consultation, and in acknowledging the experiences of those who find such work unproductive as well as those reporting success."\ \ \ \ \ Johanna Tabin"Joseph Nicolosi has achieved in this book what could only be the culmination of decades of clinical observation and scholarly integration of what is known today about the origins and treatment of homosexuality when it is not ego-syntonic. The popular press fosters an idea that the reason for rejecting homosexual impulses must be traditional social disapproval. Objective scientific study says otherwise. Nicolosi uncovers complex shame- and attachment-based motivations behind homosexual behavior, and provides clinical examples to show how reparative work can be freeing to those with the courage to explore sources of pain so long hidden from consciousness. For those in the field who want to hold on to prevailing notions about homosexuality, Shame and Attachment Loss is a book to avoid. But anyone who does read it will be rewarded with a cogent understanding of personality development and family dynamics and our need to take the psychotherapeutic journey with each individual as a fresh adventure."\ \ \ \ \ Arthur Goldberg"A legend in the world of gender affirmation, Joe Nicolosi devoted much of his professional career to educating the Western world that a change of sexual orientation is possible. Having written three other books on the subject, Nicolosi offers us this latest book, Shame and Attachment Loss: The Practical Work of Reparative Therapy, which represents his most recent insights and personal growth in understanding and treating those with unwanted same-sex attractions. Initially conceptualizing homosexual attraction as a striving 'to repair gender deficits,' he now sees it more broadly as a striving 'to repair deep self-deficits' and as a 'defense against trauma to the core self.' From this profoundly insightful premise, the text principally addresses mental-health professionals and faith-based ministry leaders to explain the psychodynamics of homosexuality, its treatment modalities, and the role and resolution of grief in Reparative Therapy. Not only are brilliant new insights found throughout this volume, but it shows how the Judeo-Christian worldview is aligned with practical psychological techniques for healing. I recommendthis 'must-read' bookto anyone who cares to learn about either the causes or treatment of homosexuality. The library of every mental-health professional, ministry leader and individual concerned about the sexual confusion that runs rampant in today's world should include this book."\ \