Applications of SIT to Pastoral Care
This past year I have had the opportunity to speak to several seminary students, and I have another similar talk coming up. For the most recent talk, I had been asked to provide two lectures. One was on the etiology of sexual orientation; the other lecture was on whether orientation can change. At the end of the second lecture, I introduced the Sexual Identity Therapy (SIT) approach to working with people in my clinical practice, and I was reflecting with them on how it might be adapted for pastoral care.
I assume that pastoral care is different than professional counseling in any number of ways, but one way would likely be that there is more direction, more of a sense of a normative endpoint or something toward which the person is to move. I don’t know if all pastoral care providers function in this way, but it is an assumption I have about the nature of pastoral care.
In any case, this reminded me of the difference between telic congruence and organismic congruence as defined in the APA Task Force background document on appropriate therapeutic responses to sexual orientation. Recall that telic congruence has to do with who the person wants to become and aligning one’s choices with that, while organismic congruence has to do with aligning one’s choices with who one experiences oneself to be.
It would seem to me that most pastoral care would rely more on telic congruence and have some say in what that congruence ought to look like. In contrast, much of mental health care has probably been based more on a sense of organismic congruence, but some clinicians may recognize the difference and may work with people who are interested in either type of congruence outcome.
An implication, then, might be that pastoral care ends up adapting SIT by not having as much of an open-ended quality to the various ways in which congruence might be experienced. Again, I don’t know that this is the case, but I would be interested in how pastoral care providers approach their work and consider these different ways of understanding congruence. It would seem to impact how sexual identity and religious identity conflicts are navigated.
SIT and the Multicultural Movement
On Friday, November 6th, I’ll be heading up to Chambersburg, Pennsylvania, for the Christian Association for Psychological Studies East Region Conference. The conference theme is actually on marriage and family, but I will be giving a presentation with two team members from the Institute for the Study of Sexual Identity (ISSI) on the topic of multicultural competence and clinical practice with sexual minorities. The multicultural movement has emerged as a significant reference point for working with diversity issues in clinical practice, and the services that are provided to sexual minorities are also included in that discussion.
The presentation we will be giving will offer Sexual Identity Therapy (SIT) as an alternative to the often-polarized therapy options under consideration with religious sexual minorities: gay affirmative therapy and reorientation therapy. We will note the inherent limitations in both of these models and offer a third option, SIT. The presentation will then explore (and briefly critique) the multicultural movement and its approach to sexual minorities, as well as the place of SIT as a client-centered, identity-focused approach that is consistent with what is best about the multicultural movement as applied to multiple aspects of diversity, as is often found when working with religious sexual minorities.
Update on Presentation on Mixed Orientation Couples
The presentation at AACC on working with mixed sexual orientation couples went well. Many in the audience had a stake in the topic. We stayed for an hour to talk to people in such marriages – sexual minorities and their spouses – as well as parents and various clinicians. I had thought of this as a niche specialty, in a sense, so I was surprised by how many people had seen such couples.
Here is the link to the pdf of the PowerPoint slides. You’ll note that we went over some of the research on the experiences of mixed orientation couples. From the studies we’ve seen so far, not many attempt to stay together, and fewer report doing so over time. This may be due somewhat to sampling, but it is sobering. We highlight the characteristics of couples that do stay together – characteristics like flexibility, cohesion, social support, and so on.
We then offer the P.A.R.E. model as our suggested approach to working with mixed orientation couples (Provide sexual identity therapy; Address ‘interpersonal trauma’; Foster resilience through marriage counseling; Enhance sexual intimacy). It begins with SIT, which is in part psychoeducational for both the sexual minority and the spouse. I see this work as primarily individual counseling for the sexual minority and lasting a minimum of about one year. There is a lot involved here, but you can imagine that the sexual minority is sorting out identity considerations that impact self-perception and his or her understanding of the marriage. At the same time (or beginning later), the spouse can work through ‘interpersonal trauma’ often associated with instances in which the spouse feels that trust has been broken. This varies considerably and can be related to disclosure versus discovery, among other considerations. This work is done primarily with the spouse and can create a context for forgiveness (regardless of whether they choose to stay together). We mentioned a couple of different forgiveness protocols that may be relevant here, such as those by Worthington, Enright, and DiBlasio. My experience has been that this is about a year-long process.
Now the couple is in a position to make a decision about the future of their marriage (if they haven’t already). For those who want to work on their marriage, we offer suggestions based upon the current literature on characteristics of couples that appear to be more satisfied in their relationship (foster resilience through marriage counseling).
We included a fourth stage, enhancing sexual intimacy, as this was reported as an important issue for many couples in some of the studies we reviewed. We closed with a case study that illustrated these different principles for providing sex therapy.
BTW: I will close with this – we are actually still conducting a study of mixed orientation couples. Here is the invitation to participate if you know someone who would be appropriate:
A new study is being conducted on mixed orientation marriages, which are defined as a marriage where one individual experiences same sex attraction and the other does not. The purpose of the study is to understand the characteristics of these marriages and the experiences of individuals in them. Participants can be currently in a mixed orientation marriage or have been previously. If you or someone you know fits this description and would like to share your experience, participants are needed! The survey can be accessed online by going to www.mixedorientationstudy.com. The study is completely anonymous and confidential; however, participants are given the option of sharing limited contact information in order participate in future follow-up studies, if desired. Your participation would be greatly appreciated!
