The Reintegrative Protocoltm
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First published: Journal of Human Sexuality 2018, Volume 9, 59-69 The Reintegrative ProtocolTM Joseph Nicolosi Jr., Ph.D. 1 The Breakthrough Clinic, Westlake Village, CA The Reintegrative Protocol™ is a trauma treatment approach which uses the same method, regardless of the client's gender or sexuality, since its aim is to facilitate the resolution of trauma. However, clients often report spontaneous sexuality change as a byproduct of the protocol's repeated use. This paper will specifically examine the protocol’s application within the context of treating males presenting with same-sex attractions and will provide instructions for using self-compassion as a method of trauma resolution, as well as optional instructions for EMDR-trained psychotherapists who wish to use EMDR as a method of trauma resolution. Introduction treatment of a variety of clinical symptoms, particularly in mitigating negative responses to The Reintegrative Protocol™ is a versatile unpleasant events (Leary, Tate, Adams, Allen, clinical trauma treatment for males and & Hancock, 2007), the association between females, regardless of their sexuality. In the childhood maltreatment and subsequent following example I will specifically illustrate emotional regulation difficulties, and problem how the Reintegrative Protocol™ would be substance use (Vettese, Dyer, Li, & Wekerle, applied to males with same-sex attractions they 2011). It is also linked with increased wish to explore and will include optional psychological well-being (Neff, Kirkpatric, & EMDR instructions for therapists qualified to Rude, 2007). use EMDR therapy. Therapists not trained in A growing body of empirical research EMDR therapy may use the mindful self- also supports the safety and efficacy of EMDR compassion version of this protocol. therapy for resolving a variety of clinical A substantial volume of empirical disorders. Twenty-four randomized controlled evidence supports the psychological benefits of trials now support the positive effects of EMDR mindful self-compassion, for example its therapy in the treatment of emotional trauma demonstrated safety and efficacy in the and other adverse life experiences relevant to 1 J.J. Nicolosi Jr. is a licensed clinical psychologist and founder of The Breakthrough Clinic and Reintegrative Therapy®1. He became an EMDRIA Approved Consultant through the EMDR International Association and has at- tained his Feeling-State Addiction Protocol certification by Dr. Robert Miller. Special acknowledgment to Robert Miller, Ph.D. for his development of feeling-state theory and practice. Correspondence concerning this article should be addressed to Joseph Nicolosi, Jr., The Breakthrough Clinic, 128 Auburn Ct. #209 Westlake Village, CA 91362 E-mail: [email protected] clinical practice (Shapiro, 2014) and the appropriate to the situation” (Shapiro & Forrest, American Psychiatric Association has 1997, p. 25). Adaptive affects, such as recommended EMDR therapy for many patients fear about being too close to a cliff remained, (APA, 2004). EMDR therapy is widely viewed while inappropriate, maladaptive affects (for as an integrative approach with other example, the feeling of terror induced by therapeutic modalities (Shapiro, 2002). simply being exposed to the word “cliff”) According to EMDR therapy, overwhelming, spontaneously dissolved. dysregulating experiences in the client’s life This method of reprocessing is of great disrupt the ability of the client’s nervous system significance when the client and therapist to adaptively process, encode and store discuss such an important topic as sexuality. information related to the traumatic event, Religion, societal pressure, self-image and leading to the client’s trauma-induced irrational health concerns all come into play. maladaptive negative cognitions, propensity toward addictions and other PTSD symptoms Reintegrative Therapy® as distinct from so- (Shapiro & Forrest, 1997). The systematic called “conversion therapy” implementation of bilateral stimulation (most commonly administered through bilateral eye When some individuals hear how movements) is believed to contribute to the Reintegrative Therapy® can lead to changes in client’s adaptive reprocessing of these traumatic clients' sexuality, they sometimes assume it is events, and as a result, the client’s negative a so-called “conversion therapy”— a broad, ill- cognitions, propensity toward addiction and defined term used to describe efforts that other PTSD symptoms often resolve (Shapiro & “seek to change an individual’s sexual Forrest). orientation” (see S.B. 1172, 2011-2012). With proper EMDR therapy, changes in Reintegrative Therapy® itself and this protocol the client’s affects and cognitions are common, are categorically separate from “conversion with no ideological influence from the therapist. therapy” or “sexual orientation change For example, a therapist believing the client’s efforts” (SOCE) for several reasons. fear of heights is irrational never needs to argue First, Reintegrative Therapy® with or in any way coerce the client into the treats trauma and addictions. Changes in therapist’s own belief about what heights sexuality are a byproduct, not the goal. As constitute a danger to the client. In proper a consequence, Reintegrative Therapy®, EMDR therapy, rather than debate with the and the Reintegrative Therapy Association client about whether his fear of heights is (a 501(C)3 non-profit organization) take no appropriate or not, this topic can be bypassed stance as to whether homosexuality should by allowing the client to reach his own be considered a mental disorder. Second, conclusions as the trauma-induced components Reintegrative Therapy® methods are used with of the client’s memories and triggers resolve— no modifications related to the clients' or any fears which remain after the reprocessing therapists’ gender or sexual orientation. are considered ecologically sound. Examples of Providing a client with same-sex attractions this were noticed by the creator of EMDR the exact same protocol as a client with therapy, Francine Shapiro, when she noted heterosexual attractions helps bypass the that…. “EMDR would not desensitize a complicated ethical and religious “landmines” person’s negative feelings if they were related to the religiously and politically charged topic of sexuality. The client is free to come to females regardless of the client’s sexual his own conclusions about his sexuality. No orientation, male clients with same-sex ideological dogma by the therapist needs to be attractions have reported decreases in their introduced in order for the protocol to work. same-sex attractions and, for some clients, Third, Reintegrative Therapy® employs increases in their heterosexual attractions as a only established, evidence-based treatment spontaneous byproduct of its use, so this approaches (such as mindful self-compassion particular article will illustrate the protocol’s and EMDR), the same approaches used by other use when applied to a male in this population. clinics throughout the world that seek to treat The Reintegrative Protocol™, when trauma (as opposed to “conversion properly applied, allows both client and therapies” which seek to change sexual therapist to bypass every one of the four ethical orientation). problems which may arisen i “conversion therapy.” The client and therapist do not need Avoiding the pitfalls of “conversion therapy” to try to change the client’s attractions— the protocol involves exploring the client’s The Reconciliation and Growth Project (see attractions from a neutral stance of curiosity ReconciliationAndGrowth.org/guidelines), and then seeking to resolve the trauma an organization of mental health professionals memories which lie beneath with standard and academics from diverse sexual identity trauma treatments. The use of a treatment and religious backgrounds, seeks to foster protocol means the client and therapist do not “dialogue among people with differing need to adhere to any particular ideology or perspectives on faith-based values and causal model about sexuality, nor do they have sexual and gender diversity.” Among them to posit any particular moral, political or is Lee Beckstead, Ph.D., a member of the religious stance on the topic. The protocol- APA’s Task Force on Appropriate Therapeutic driven approach reduces and can even eliminate Responses to Sexual Orientation. The the therapists’ ideological influence in the organization highlights four specific client’s treatment. interventions they consider to be inherently The Reintegrative Protocol™’s four- unethical and potentially harmful when phase approach consists of history and addressing sexuality, gender and faith: evaluation, preparation, assessment, and 1. Fostering expectations of a specific reintegration. After describing the steps sexual orientation or gender identity involved in each phase, I conclude this article outcome with some theoretical discussion of the 2. Using direct or indirect coercion protocol’s approach. 3. Basing interventions on bias, unfounded theories, or prejudice Phase 1: History and Evaluation 4. Limiting the exploration of sexual 1. Obtain history, frequency and context orientation, gender and faith identity and of the client’s symptoms (for behavioral expression possibilities addictions, this is the addictive behavior). Though Reintegrative Therapy® is a 2. Evaluate the client for safety factors sexual orientation-neutral approach which that determine whether he has the coping skills employs identical methods