Kocharyan Garnik Surenovich, Doctor of Medical Sciences, Professor of the Department of Sexology, Medical Psychology, Medical and Psychological Rehabilitation of the Kharkov Medical Academy. presented the book “Shame and Loss of Attachment. Application of reparative therapy in practice ”. The author is one of the most respected and world-renowned specialists in the field of reparative therapy, the founder of the National Association for the Study and Treatment of Homosexuality (NARTH) - Dr. Joseph Nicolosi. This book was first published in the USA in 2009 under the title Shame and Attachment Loss: The Practical Work of Reparative Therapy.

In his book, Dr. Nicolosi discusses whether treatment of an unwanted homosexual drive is considered acceptable. In his opinion, the desire of some specialists to officially prohibit such treatment is strikingly contrary to the desire for diversity that modern liberalism declares. Indeed, a patient who suffers from having a homosexual attraction and wants to get rid of him has the right to receive appropriate assistance, since otherwise it would be a violation of human rights.

The opinion circulated by interested parties that conversion (sexually reorienting, reparative, differentiating) therapy, which was unsuccessfully tried to completely prohibit, since it supposedly cannot be effective and, moreover, is extremely harmful, is erroneous. This, in particular, is indicated by the results of the first specially planned large-scale study of the effectiveness of conversion therapy (examined by 882 people), which suggests that 45% of those who considered themselves exclusively homosexual changed their sexual orientation to completely heterosexual or became larger heterosexual than homosexual (J. Nicolosi, 2000). The experience of our clinical work, as well as many other specialists, also indicates the possible effectiveness of conversion therapy.

Dr. Nicolosi notes that an honest look at the homosexual condition reveals that, even without considering its many negative consequences for society, it is not a harmless expression of human diversity, but a condition characterized by emotional disturbances. In contrast to the point of view that all mental problems of homosexuals are associated with social disapproval, the author draws attention to the existence of problematic factors inherent in the homosexual state itself. As evidence, he cites the fact that elevated rates of psychiatric problems among homosexuals have not declined in gay-friendly cities like San Francisco or gay-tolerant countries like the Netherlands and Denmark.

There are many possible combinations of reasons for homosexual attraction. In each case, these factors combine in their own way. The author's proposed model for the formation of homosexual attraction focuses on biological influences (receptive temperament), but to a much greater extent on the parents' inability to maintain the boy’s emerging identity. A certain role is played by the negative experience of interactions with peers of the same gender. All this leads to a feeling of estrangement from men, in which a boy who is attracted to his own sex, considers other men mysterious and different from him.

Dr. Nicholas reports that in the society of other men, most homosexual men feel uncomfortable, and the reasons for this can be found in early childhood. This is due to the alienation of the father, typical for the development of a homosexual man and is rooted in the etiology of same-sex attraction. Men with the same sex desire seek intimacy with other men, as they seek to be healed of the wound that their father inflicted on them. They are in a constant search for close relationships with men, but at the same time they are afraid of these relationships. For a man trying to overcome his homosexual problem, it is important to establish and deepen healthy male friendships. The author believes that heterosexual friendships with those men who are sexually attractive to the patient give the greatest opportunity for healing.

More often than not, same-sex behavior is an attempt to restore a loose attachment to a father. The absence of this attachment is offset by homosexual activity, fantasies, and imagination. But not everything boils down solely to the lack of attachment in the father-son system. In a number of cases, the lack of attachment is probably rooted in the problems of adjustment in the “mother-son” system. The effectiveness of reparative therapy is enhanced by using methods that examine the early problems of mother and son attachment.

In the chapter devoted to counseling adolescents and the peculiarities of their correction, Dr. Nicolosi reports on the adverse influence of social factors on the formation of gender identity and the direction of sexual desire. We are talking about an increase in the number of students who consider themselves bisexual or homosexual, and an increase in the number of teenagers with a crisis of their sexual identity. The number of coming outs is also constantly increasing. He directly connects this with the increased popularity of “gayism” as a fashionable and conspicuous feature.

In his book, Dr. Nicholas characterizes the four phases of homosexual identity associated with certain age intervals, and also highlights pregender и postgender homosexuality, which are determined, respectively, in 80 and 20% of cases.

The first variant of formation is associated with family psychodynamics. In his opinion, the model of a family that “creates a homosexual son” is usually not able to confirm the boy’s male individuation at the stage of formation of his gender identity. (Individuation is the theoretical construct of analytical psychology, denoting human development through the integration of conscious and unconscious experience.) In his work, Dr. Nicholas often met a certain pattern of the family, which combines two models that violate gender individuation - the classic triple family and the narcissistic family. Together they form what he calls the triple-narcissistic family.

A triple family is a system that includes an overly tutelary mother and a critical / detached father. Characterizing the son’s personality in such a family, Nicolosi describes him as impressionable, timid, introverted, creative and imaginative. Mothers believe that compared with their other sons, these children have more sensitivity and tenderness, speech skills and a tendency to perfectionism are more pronounced. It is emphasized that although temperament is usually biologically determined, some of these traits (especially timidity and passivity) can be acquired. Such a sensitive and impressionable nature of the child encourages the mother to become attached to him, which deviates him from normal development along the path of normal individuation. Relations between father and son do not add up. The boy considers his father detached and critical, there is no understanding and productive interaction between them, which leads to a violation of the boy’s formation of male gender identity. He perceives the father as an unsafe / unworthy object of identification. Nicolosy’s patients often say: “I never understood my father.” "What he was, what he was not." "He always kept a low profile." "He was impregnable, like a monument."

The following factor also has an adverse contribution in this regard. Since the mother distinguishes her son from other male representatives, due to his psychological characteristics, which, in her opinion, make him better than other men, he does not need to achieve masculinity in order to take his place in the world. The scenario “My mom and I are against these strong aggressive male pests” makes it impossible to isolate the boy (his individuation), preventing him from internalizing the energy of masculinity necessary for him. The result is a boy's enthusiasm for that integral part of his identity, which he could not establish. He begins to look for her “somewhere out there” in the image of another man, feeling a romantic languor, which then acquires an erotic connotation.

Assessing the role of parents in the formation of masculinity, Nicolosi notes that a healthy boy knows and is glad that “not only I am“ I ”, but also that“ I am a boy ”. In some cases, parents actively punish him for male behavior because they consider him dangerous or uncomfortable. In other cases, when a boy was born with a sensitive temperament, they do not try to achieve the appearance of male identification, for which this particular boy needs special support. To confirm his point of view, Dr. Nicolosi refers to Stoller's statement that masculinity is an achievement, not a given. She is very vulnerable to mental trauma that occurs during the development and formation of men.

Prehomosexual boy, writes Dr. Nicolosi, experiences a break in affection with each parent in different ways. Usually he feels that his father is ignoring or belittling him, and his mother is manipulating or emotionally using him. Both parents can, in their own way, as far as possible for them, love the child, but during communication at a certain level they signal that his true “I” is unacceptable in one way or another.

When this loss of attachment is felt by a child who has grown up in the triple-narcissistic family system, his unmet needs remain, and this loss is stored in the memory of the body. As a result, the following sequence is built:

1) loss of basic attachment;
2) resulting from this gender deficit;
3) compensating for gender deficits through homosexual activity.

Homosexual acting out, writes G. Nicolosi, is a narcissistic defense against mourning due to the loss of genuine attachment to one of the parents. Working through mourning will inevitably encounter illusions and distortions, two powerful defenses. Illusions are false positive ideas that are driven by narcissism. An example of a typical illusion is the statement: “I am looking for a very beautiful woman who is sensitive to my needs and fully understands me. Only when I find one will I consider myself ready to marry. " In contrast, distortions are false negative ideas based on shame. They flow from the damaged self and lead to destructive, self-destructive and maladaptive behavior. An example of distortion is the following statement: "No girl will ever want me if she really knows me."

If the illusions and distortions that have their roots in childhood trauma remain unexplored, then there remains an excruciating void inside. Having experienced unpleasant emotions and painful bodily sensations in the presence of a therapist, the patient begins to feel good. As a result of repeated study of grief, a slow and gradual destruction of the fundamental basis of the unwanted homosexual acting out of the patient takes place, which fades into the background.

After the grief process, says J. Nicolosi, patients better understand people who have influenced their past lives. This process not only opens their eyes to the relatively significant members of their family, but also teaches them to treat them with the indulgence of an adult who refuses the desire that he had before so that people who directly entered his life are better or worse than they are actually. The result of this process is also the rejection of the unconscious feeling that everyone owes you, that people in the present life are obliged to compensate for your past grievances. The elimination of grief ends after a person gains the ability to abandon the illusions and distortions that he used to hide the pain of loss. After grief, he can live a much more sincere, transparent and realistic life.

The author characterizes the formation of the second option (post-gender type) as follows. He notes that the post-gender patient successfully completed the phase of gender identity, but later experienced another form of trauma for which homoerotic desire became a regulator of affect. Possessing masculine attributes and non-feminine manners, these patients seem to be “straight,” but at the same time they feel within themselves a disturbing need for masculine love. Postgender injury is usually caused by an older brother, father, violent peers and bullying at school. It can also arise as a result of sexual abuse or because of a disorganized "eccentric" mother who caused strong fear and anger, which the patient now spreads to all women and which prevents him from establishing a serious relationship with them. These men seem like “regular guys,” but are clearly not sure of their masculinity. The same-sex attraction of such patients is not driven by the desire to possess the masculine qualities of another man, but by the desire to relieve nervousness through men's support and comfort, which will reduce their anxiety.

The author reports on the evolution of his views on homosexuality. If earlier he believed that homosexuality was a substitute attempt to restore the deficit of gender identity, now he perceives it as something more: at a deep level, it is a defense against the deepest pain caused by the loss of attachment. The truth of this opinion, he notes, has been confirmed more than once by the men he consulted. Homosexuality masks the suffering of deep loss and serves as a temporary (albeit ultimately unfulfilling) distraction from the tragedy associated with the underlying trauma of the loss of attachment. Homosexual acting out, according to his understanding, is a form of reparation (restoration), which is an unconscious attempt to make up for a lack. Through attraction to his own sex, a man tries to fill the unmet affective need for attention, affection, approval from the representatives of the same sex, and also to eliminate the deficit of gender identity.

foreword Vyacheslav Khalansky, psychologist and psychotherapist.

Review Robert Perloff, former president of the American Psychological Association, professor emeritus at the University of Pittsburgh.

Review prof. Bilobrivki R. I., Head of the Department of Psychiatry, Psychology and Sexology, Lviv National Medical University Daniil of Galitsky.

Review Hermann Hartfeld, DRS, Theol., PhD.

Review Candidate of Pedagogical Sciences, Associate Professor Galina V. Katolik, Head of the Department of Psychology and Psychotherapy of the Ukrainian Catholic University, President of the Ukrainian Institute of Child and Youth Psychotherapy and Family Counseling, member of EAP.

Review Taras Nikolaevich Dyatlik, Chairman of the Board of the International Council for Evangelical Theological Education, Regional Director of Overseas Council Int. for Euro-Asia, head of the education development department of the Euro-Asian Accreditation Association.

Review Elena Yaremko, doctor of psychology, psychotherapist (integrative Christian psychotherapy); Ukrainian Catholic University.

Review Kocharyan Garnik Surenovich, MD, professor of the Department of Sexology, Medical Psychology, Medical and Psychological Rehabilitation of the Kharkov Medical Academy of Postgraduate Education

General information about the author, his articles and books (in the public domain) are presented on his personal website  http://gskochar.narod.ru

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The battle for normality - Gerard Aardweg

How is homosexual attraction formed?