Friday, February 8, 2008

Conversion Therapies - My Three Shrinks

My Three Shrinks invited Dr. Chris Kraft from Johns Hopkins Hospital, clinical director for sexual behavior's consultation, to speak about conversion therapy. From Wikipedia I get this refers to methods aimed at changing gay, lesbian, and bisexual people's sexual orientations to heterosexual, or at eliminating or diminishing same-sex desires and behaviors. My first reaction: is this for real?

Kraft is a clinical psychologist, specialized in issues of sexuality and gender. He starts the subject by posing it as a question: "What can you do for people who feel uncomfortable with their sexual orientation?" There are conversion therapies - this is very controversial - but it is still used and tried. And there is a demand. Traditionally this is about homosexuality, but also other paraphilias. Of course this is culturally defined. Homosexuality used to be defined as a problem and in certain subcultures it still is. In such a constellation there is need for treatment.

What do you do as a clinician? Especially if you do NOT perceive the sexual tendency as wrong? The therapist could send the client to shop around until he finds a doctor with the same set of values. The clinician can even say this is not an option for treatment. One would not want to be at the mercy of the client's definitions and alternately the client had better not be at the mercy of the therapist's definitions.

Conversion therapy distinguishes between emotions, fantasies and behavior. The therapy is directed to the behavior and this has been reported to work. (There are statistics) It is really hard and rare that emotions and fantasies have changed. For paraphilias that are still widely considered problematic such as exhibitionism and pedophilia conversion therapy is the way to go.

Kraft's explanations are clear and the panel's questions are so as well. The light conversation style makes for very relaxed listening, hence the podcast allows for a very low threshold peek into the complicated and sometimes too technical world of psychiatry.

My Three Shrinks Podcast,
Psychology, psychiatry and the brain,
David Lukoff at Shrinkrapradio,
Morality as a brain function.

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