Natasha Helfer, aka The Mormon Therapist, has been accused of apostasy and summoned to a disciplinary council in her former stake. The charges are (paraphrasing from Natasha’s statement):
- Support for same sex marriage (correct, but also not grounds for discipline according to stated Church policy)
- Destigmatization of masturbation (correct)
- Stances on sexually explicit materials / pornography as discussed in sex treatment (correct, although possibly misunderstood)
- Critical of Church leaders (requested that leaders educate themselves on these topics to prevent undue harm, in accordance with her professional licensing and training–see her statement I’ve quoted here)
- Accusation that she has encouraged patients to leave the Church (denied)
The gist of this conflict between Natasha’s view of her professional ethical responsibility and the Church’s view of these issues is summed up here, or you can listen to her own words here:
Inappropriate sexual shame harms individuals. When Churches and religious communities reject sexual health principles, supported by decades of research and science, the community suffers. This has tragic and violent ramifications. Violence is either turned inward (self-loathing, substance abuse, mental disorder symptoms, and suicide as just some examples) or turned outward (discrimination, harrassment, sex crimes, and hate crimes). The statistics are dire. The anecdotal evidence coming from just my clinical practice is dire, and I have felt compelled to speak to these issues. I do not believe that educating and speaking publicly about how our communities are being harmed or could be helped is critical. I actually see it as my ethical responsibility.Natasha Helfer in a Zoom statement responding to the disciplinary summons
Her stake president has allowed that statements from patients and other supporters will be accepted as additional evidence, although Zoom participation will not be permitted, and evidence from “members in good standing” will be given more weight. Natasha intends to participate in person. Her council is scheduled for April 18. Her hope is to retain her membership in the Church, and also to advance the cause of sexual and relational health in the Church based on an accurate understanding of current psychological science and practice.
Can an LDS therapist give advice that contradicts current Church teachings that are harmful for that individual patient? When it comes to preventing that harm in the community, do a therapist’s ethical obligation to help the community outweigh the Church’s desire to control the narrative? I posit that there is high tolerance for therapists treating patients behind closed doors according to professional norms, but much lower tolerance for criticisms of cultural norms within the Church and policies that they aren’t yet ready to change.
Neither Pastoral Nor Anti-Psychology
The Mormon Church is not anti-psychology, and it is not uncommon for church leaders to refer members to LDS therapists for personal or marital counseling; this practice is more progressive within the Church, perhaps due to having an unpaid clergy, than in many other conservative faiths. However, the Church’s policy stances and culture are not always primed to lead to positive psychological outcomes, and in some cases are the source of the harm that needs to be remedied through therapy.
Church leaders, as the gatekeepers of therapy referrals, are often tasked with providing pastoral care without professional training, and their instincts can be disastrous when confronting members who are in emotionally fraught or psychologically distressing situations, including external or relational problems like rape, incest, abuse, or harrassment or internal problems like sexual orientation, gender dysphoria, depression, suicidal ideation or actions, compulsion or self-loathing. Questions in worthiness interviews, particularly if they are embellished by a leader’s personal views, can exacerbate feelings of shame and guilt that are more dangerous for some individuals than others. Even in cases of spousal or child abuse, Church policy has always been against leaders recommending divorce as an option. When it comes to recommending therapists, bishops are at best a caring, but flawed filter, one that can add to the distress of the individual if mistakes are made. Bishop referrals are certainly not required for members of the Church who seek therapy, but they are not trained in psychology and may be uneducated about when to refer to a therapist.
Additionally, some leaders are more focused on their role as “judge in Israel” and will apply that filter to conversations where pastoral care is needed, creating undue trauma for individuals. There are many, many examples of victims of sexual assault being treated as if they have a worthiness issue, blaming them for their assault and punishing them, leading to further distress and trauma. This is a byproduct of lack of expertise and skill in handling sexual issues, as well as blind spots of all-male leadership interviews. Abusers have often been protected by leaders who misunderstood or minimized the impacts to victims and instead focused on protecting or remediating those who harmed them (e.g. focusing the victim to forgive their unrepentant attacker).
All this is to say that while the Church broadly desires to work with therapists and to respect psychological science, we are still not very successful at training local leaders to understand the role of therapy and to use it effectively when it appears to challenge their understanding of Mormon cultural norms.
Personal vs. Systemic Reform
There seems to be a libertarian streak in the Church that leads to framing problems in terms of individuals rather than systems. For example, the Church’s anti-racist statements are about individuals choosing to be racist rather than the systems that hold back people of color; culturally, many church members disagree that systemic racism exists, let alone needs to be addressed. In BYU’s report on racism, the observation was made that the admissions team believed that they should not actively seek to recruit more BIPOC representation, but instead needed to be “race-blind” in reviewing applicants, not acknowledging the higher difficulty level for BIPOC applicants that resulted in worse outcomes per applicant than special consideration and/or support would have provided.
In general, psychologists can fly below the radar because what happens in therapy stays in therapy. The Church doesn’t appear to have a problem with that “silent partner” model: 1) Church principles and doctrines work fine for a majority, 2) those in psychological or relational distress can be referred to LDS therapists to resolve issues that could be caused by their being an exception to that “ideal,” 3) we don’t really know what therapists say or advice in private sessions due to confidentiality, and 4) this gives everyone the benefit of being able to deal with the fact that therapists are probably undoing harm and distress caused by the Mormon community and culture without really challenging that culture or the leaders who create it, or at least not forcing church leaders to reckon with it before they are ready.
I don’t think it’s any secret that most LDS therapists would counsel patients in ways that are similar to Natasha’s public statements (if that isn’t something local leaders are aware of, perhaps it’s a contributing factor to her disciplinary council); therefore, the problem for the Church is that her stances are public. She is advocating on behalf of her patients. Her problem is one of prevention rather than cure; it’s OK to cure psychological distress, but not OK to prevent it through education and systemic change. Likewise, it’s OK to treat individuals as broken when the system doesn’t work for them, but not to address the broken system that has contributed to their negative outcomes.
When Diagnosis Creates Dysfunction
If corrective lenses didn’t exist, people who need them would be barred from societal participation that requires the ability to see things. They would be treated as illiterate. They might be stigmatized as lacking intelligence. They would be barred from many employment opportunities. These same harms occured when we (historically) stigmatized learning disabilities like ADHD, left-handedness, or when we apply pseudo-scientific explanations to race or being a woman. All of these have been considered conditions that lessened one’s ability to function credibly in society.
All cultures struggle to accept differences and to make accommodations that create equality. Church culture can be intolerant of different types of families structures, as was recently discussed in the last conference. Accommodation was just announced giving single Church members greater access to leadership roles, increasing their participation and value to the organization, and decreasing the stigma of being single in a Church that prizes marriage and family so much. The Church has made some advances toward accepting LGBT members, although this progress has been slower than society at large (where it happened quite suddenly creating additional pressure as LGBT people felt freer to be open and honest about themselves with family members and in society). Allowing for LGBT church members to have an equal experience in the Church requires normalization and destigmatizing this difference. The stigma is what creates dysfunction in relationships and in individuals. There’s been progress, but not enough to prevent the harms we are seeing consistently among this vulnerable population and their families.
When we diagnose something normal as a dysfunction, it is inherently harmful. Part of the role of therapists, and their ethical obligation, is to help individuals who have been harmed in this way to understand that they are normal, that their traits are not something to be fixed or cured.
An Institutional Learning Curve
Institutions and those who run them have difficulty learning and accepting new information, especially when they have a track record of success based on a time when that information was not necessary. This is particularly true the older we get.
There needs to be some space for leaders (and institutions) to catch up to changes in society while at the same time protecting those within the flock from institutional harm. Taking a page from therapists, we should seek to “first, do no harm,” and we need to extend our understanding of harm to include psychological harm as well as physical harm , relational harm as well as individual trauma.
Are there ways to neutralize the harm to LGBT people (and normal sexual behaviors) in the Church without dramatically altering Church policies? I think so. Here are a few ideas, the first of which was already done (yet imperfectly followed):
- Prohibit asking sexual questions in worthiness interviews beyond “Do you obey the Law of Chastity?”
- Allow women to interview girls and women which would yield big improvements in understanding vs. blaming victims of abuse
- Provide better / additional training to local leaders in when and how to refer to therapists, allowing therapists to handle issues like abuse, marriage counseling, gender dysphoria, LGBT concerns, etc. (rather than minimally trained lay leaders)
- Switch to LGBT affirming terminology within Church culture; quit tolerating LGBT bashing at Church universities and within our congregations and classes
- Greatly increase representation of women to identify some of these huge blind spots for male leaders who tend to understand sexuality from a male perspective
- Engage with trained psychologists to review handbooks, terminology, and leader training gaps; implement their reasonable suggestions.
- Do we really need adult men asking children and teens about masturbation which is a normal part of human sexual development?
- Can we update our understanding of pornography to quit calling things addiction that aren’t?
- Can we find a way to give LGBT people the same dignity and acceptance that we give cisgender Church members? (e.g. allowing public affection between LGBT couples)
- As a matter of principle, can we stop excommunicating people who don’t want to be excommunicated?
Psychologists pick up the pieces when things go wrong; as a result, their focus is on how to resolve problems, not happy talk about what’s going well. Within psychology, there is “normal” psychology, as well as “abnormal” psychology. In prior decades, homosexuality and gender dysphoria were considered “abnormal” and treated as things to be overcome and changed. If you treat psychology that is normal behavior as if it’s abnormal, then you will create pathologies and distress that cause adverse outcomes. Someone who would otherwise be mentally healthy will instead be distressed. Relationships that could have been functional will become dysfunctional.
In the current situation, the Church’s sexual ethics are at conflict with society at large and our current understanding of mental and sexual health (creating more freedoms for LGBT people, and more sexual health and education in general, plus less tolerance for abusive relationships). As Jung put it, “That which we resist, persists!” The more we focus on sex, the more we create sexual dysfunction in the membership and marriages. While that may be great job security for therapists, including Natasha, it would be better to prevent psychological problems where we can, to allow members and families to flourish in the gospel.
Church policies (just like social policies) do constantly evolve with greater understanding; I’ve seen it happen many times throughout my 53 years! I’m sure the real experts could help with these improvements if only we would let them and not push them out.
- Is it reasonable to expect the Church to allow experts to contradict Church policy publicly in their fields of expertise when it is for ethical reasons?
- Can these harms be avoided or are they the byproduct of forces larger than Church culture? Should the Church alter its stances to avoid harming Church members? How much and how soon? What would you recommend be changed?
- Is it sufficient for therapists to treat individuals who have been harmed or are they obligated to attempt to also prevent needless systemic harm?
- Does Church discipline aimed to squelch “apostasy” inevitably backfire (Streisand effect), or is it effective because “insiders” are protected from challenging ideas even though “outsiders” see it as a negative reflection on the Church (e.g. hurts conversions and growth, but helps retention)?
 Reputable psychologists would call conversion therapy psychologically abusive, even if physically abusive practices are avoided (e.g. electric shock therapy). The Church’s opposition to it seems to rely on physical harms more than psychological harms.