Then, in the 1960s we entered the era of modern learning theory and the development of behaviour therapy or behaviour modification. Here the objective was not so much curing illness but modifying behaviour that was in some way unwanted. One of the more successful applications of this approach was the management of phobic anxiety, by means of a graduated exposure, combined with some form of relaxation (e.g. systematic desensitization). Attention was also paid to the possibility of modifying sexual preferences, reducing, for example, fetishism, transvestism or homosexuality, a chapter in this history which is of particular significance to me as, for a few years, I was involved in it. Soon after completing my training in psychiatry, I collaborated with Isaac Marks and Michael Gelder in the treatment of fetishism and transvestism using electrical aversion therapy (Marks et al 1970). Around that time, MacCulloch & Feldman (1967) and McConaghy (1970) reported success, at least in some cases, in reducing homosexual and increasing heterosexual responsiveness by means of aversion therapy. I was interested to see if I could replicate their findings, using what I believed to be a better aversive procedure. I reviewed this literature, including my own research (Bancroft 1974; see Haldeman 1994 for a more recent review), coming to the conclusion that aversive procedures were ineffective, but more positive techniques to gradually increase the capacity for heterosexual response and behaviour without trying to suppress homosexual interest, may have some value in those individual who wanted to change. This, however, was around the peak of the gay rights movement, which will be considered more closely below, and I was attacked for my contribution to 'brain-washing' homosexuals. This was a formative experience, cause me to reflect (Bancroft 1975). At no point had I considered homosexuality to be pathological, but stigmatization of homosexuality was still strong, gay rights had not yet achieved the breakthroughs that were to follow, and there were still many homosexual men (not women) who wanted to escape this stigma and sought help to do so. However, I also came to realize that, by pursuing this behaviour modification, I was unintentionally reinforcing the medical pathologization of homosexuality. I also became aware of a further problem. Since the start of the 20th century when clinicians like Schrenck-Notzing (1895), using hypnosis, and Moll (1911), using what he called 'association therapy', an early version of behaviour therapy, claimed some success in increasing heterosexual interest in homosexual men, there was concern that any evidence of the 'treatability' of homosexuality was evidence that it was acquired and hence sinful. Havelock Ellis (1915) concluded that any one who had changed as a result of such therapy could not have been a true homosexual in the first place. Masters and Johnson (1979), in their book on homosexuality, reported two series of cases: homosexual couples who were having sexual problems and who were given the same treatment as ysed for heterosexual couples, with good effect, and homosexual individual who presented with 'homosexual dissatisfaction' and an opposite sex partner (mostly wife or husband), the majority of whom, as a result of going through a treatment programme, were able to enjoy their heterosexual relations more than previously. They called their treatment 'conversion' or 'reversion' therapy, depending upon whether there had been any previous heterosexual interest. Clearly, as Master & Johnson (1979) emphasized, their sample was 'highly selected' (p. 392) and certainly not representative of homosexual men or women. Nevertheless soon after it was published, following a prosecution of a British politician with a homosexual history, one commentator cited Masters and Johnson's results as evidence that homosexuality was always 'learnt', and it was therefore justified to take steps to prevent it by fostering anti-homosexual values.
A challenge to the pathology model of homosexuality started to emerge in the 1950s with the work of Evelyn Hooker (1965), who used various psychometric test to compare homosexual to heterosexual men, contrasting with much of the work by psychoanalysts (eg Bieber et al 1962) by recruiting homosexuals who were functioning well in their lives, rather than those seeking clinical help for psychological problems. She found that such 'normal' homosexual men showed a variability that was indistinguishable from heterosexual men in terms of personality characteristics. Her findings were replicated in a series of studies by Siegelman (1972, 1974, 1978), and we will return to this literature in the later section on the personalities of homosexual men and women. It is noteworthy that this research was carried out by psychologists, not psychiatrists, and, according to Minton (2002), gave considerable encouragement to the emerging homophile movement.
Human Sexuality And Its Problems
By John Bancroft
