We therapists can be self-centered and overconfident. You know that old expression, “give a man a hammer, and everything looks like a nail?” Well, for many of us therapists, there is no problem that could not be solved if we could not just get it on the couch and subject it to our gentle, caring ministrations. Give us some space in a publication, or time on a podcast, and we’ll pontificate about anything under the sun.

In a way, Natasha Helfer Parker and her defenders are correct that religion and much of the mental health field are in conflict. Whereas religion is concerned with timeless and universal truths, behavioral science as it is practiced today centers largely around personal, subjective experience. Even in the empirical literature we refer to, what matters is what promotes “mental health” and well-being as we ourselves define it. If truth, or even someone else advocating for their understanding of truth, impinges on someone’s mental health, it is bad and wrong and needs to stop. And no other voice, or field, or authority is allowed to contest our understanding of well-being.

While I am disappointed in my colleagues who signed the letter decrying Helfer’s treatment by the Church, and swallowed Helfer’s claims whole (that she’s being held accountable for how she practices therapy rather than her hostile and critical public statements and behavior toward the Church), I can’t say that I’m surprised. Therapists are trained to believe our clients. We accept the stories they tell us because those narratives have immense power over their lives. In the therapist chair, these are useful skills. But immense damage can be done when we misapply these skills to other areas or fail to apply other skill sets critically to problems we and our clients are faced with. Something is not true merely because Natasha Helfer says it is. And in this case, her own earnest description of the conflict disseminated widely online is profoundly wrong, and even deceptive. 

Let me say it as clearly as I can: Natasha Helfer is not in trouble with the Church because the Church is trying to tell her how to do her job. She’s in trouble with the Church because she’s trying to tell it how to do its job. This has nothing to do with how she practices her profession, and everything to do with her public statements complaining about Church doctrine and Church leaders, all the while presenting herself publicly as an expert and authority on The Church of Jesus Christ of Latter-day Saints.

She permits herself to opine on all of these topics, many of which are well outside of her ambit because she has fallen prey to the all-too-common narcissism that afflicts many of us therapists. Namely, that we are preeminently qualified to explain what constitutes good mental health and well-being—in everyone, everywhere. Even in matters that properly merit evaluation by Church leaders and belong in a Bishop’s office, like questions of personal worthiness and what constitutes sin, we sometimes feel free to publicly weigh in. It’s no wonder, from this privileged position of vaunted expertise, that we might come into conflict with other systems of thought and institutions that make competing claims about what constitutes a good life. And as Helfer has made abundantly clear over the years, in her view, the Church’s doctrines and practices negatively impact people’s mental health, particularly in matters of sexuality. 

Even as she upbraids President Russell M. Nelson for harming her clients’ mental health, or is shocked that Elder Tad R. Callister (formerly of the Presidency of the Seventy) would share the Church’s position on sexual behavior with students at a Church-sponsored school, she also feels free to opine further on matters well outside her professional competence. For example, last year she wrote, “the true value of Christian theology is choosing relationship over ideology—every time.”

I am not a theologian either, but as a statement of theology, I find this lacking. That piece of pithy pablum is neither theology nor is it particularly Christian. It is also false, and she would know it if she gave it a moment’s thought. She would object, as would I, to telling a battered housewife to prioritize her relationship with her abusive husband over some abstract “ideology” that says she doesn’t deserve to be beaten and needs to leave immediately. It wouldn’t matter one whit to either of us that her husband says he wants to maintain a relationship with her. 

This pronouncement belongs on a greeting card, not in Summa Theologica, where it would get laughed out of any self-respecting seminary. It doesn’t even belong in a therapist’s treatment plan.

Like Helfer, I have clients who are not monogamous, and both partners are okay with that. Any therapist has clients engaging in behaviors they might consider wrong, but unless we determine it’s clinically relevant to the presenting complaint, we let it pass.  What I would not do, however, is what Helfer has done, hosting a podcast episode, purportedly for Latter-day Saints, on “ethical non-monogamy.” As a believing, orthodox Latter-day Saint, I believe adultery is still adultery even if you call it by a clever euphemism. It is confusing to imply otherwise by hosting a discussion of consensual adultery on the pseudo-authoritative “Mormon Mental Health Association” website.

Like Helfer, I have clients who deal with shame which harms their mental health. Sometimes that shame is debilitating. Helfer, like many of her colleagues at AASECT (the organization through which she is certified as a sex therapist), believes that we shouldn’t say any sexual behavior is wrong because that pathologizes a practice that is just a natural variation in human sexual behavior. (I hasten to add that there are many good and faithful Latter-day Saints who are members of AASECT yet who do not endorse their views on these and other matters.) These natural behaviors include kink, polyamory, same-sex sexual activity, various fetishes, and prostitution. All of these behaviors are included under the benign-sounding umbrella term, “sexual health.”

They don’t believe any of these practices are wrong, per se; only that there are healthy and unhealthy ways to engage in them. If some behavior is expressed in an unhealthy way, that is always because of some underlying pathology manifesting through the behavior. Some sex therapists recommend [unsafe link] masturbation as a tool to help reduce compulsive, unhealthy pornography use. And according to Helfer herself, pornography is a form of sex education for teens and adults. The goal of therapists aligned with this point of view isn’t to change these behaviors, but rather to reduce shame and increase acceptance, both among the clients themselves, and society at large.

But this is the sort of nonsense you have to have at least two letters after your name to believe. The sex offenders I have worked with, some of them guilty of rape, or sexual abuse of children, often have a lot of shame. Yet not one would suggest that we eliminate the laws which criminalize these actions so that sex offenders no longer feel shame. That’s because the people in charge at AASECT still think that rape and sexual abuse are wrong. But when it comes to BDSM, polyamory, kink, pornography, prostitution, and so on, what they really mean is, since we don’t think there’s anything fundamentally wrong with these behaviors, and since some people feel shame about them, no one else, not even religious leaders, should tell them it’s wrong. Since they believe these behaviors each have a healthy version available, any shame that results seems unnecessary. Or as Natasha Helfer puts it, having a clearly articulated standard of sexual morality “creates an artificial problem” (emphasis added). I think it would come as a surprise to most believing Latter-day Saints that the concepts of sin and the fallen nature of man would be considered artificial constructs to Helfer and many who think as she does. Most Christians rather tend to believe these notions are fundamental to our mortal experience.

Over countless sacred and beautiful moments in therapy with these sex offenders, they have shown me how it was possible to deal with shame without excusing their actions. In fact, they found that the best way to deal with their guilt and shame was to take total responsibility for it, free from all rationalizations, excuses, blame, and minimization. Tom Stranger, who raped a young woman when he was a teen explains this idea well:

When you own something and really square up to your culpability, I do think a surprising thing can happen. It’s what I call a paradox of ownership. I thought I’d buckle under the weight of responsibility. I thought my certificate of humanity would be burnt. Instead, I was offered to really own what I did, and found that it didn’t possess the entirety of who I am. Put simply, something you’ve done doesn’t have to constitute the sum of who you are. The noise in my head abated. The indulgent self-pity was starved of oxygen, and it was replaced with the clean air of acceptance—an acceptance that I did hurt this wonderful person…

The sex offenders I worked with also told me that the worst possible thing they could do to make a relapse more likely was to look at pornography and masturbate. To a man (and they were all men), they felt that this would make complying with the terms of their parole harder, not easier. Tuition at the school of hard knocks is expensive, but it’s very effective. Even though some of these men haven’t even graduated from high school, I think they possess more wisdom about how to deal with sexual behavior than the AASECT elite do with all their fancy degrees and prestigious research publications.

Of course, the issues of masturbation and pornography use are far less serious than criminal sexual assault, but the principle still applies: we can heal shame without undermining and casting off traditional moral standards. No question that shame often is one of the drivers of compulsive sexual behavior. But properly addressing this does not require us to tell our clients that there is nothing wrong with their behavior when their values tell them otherwise.  On the contrary, this is likely causing harm to some of them.

I also can’t let pass unchallenged the idea I have heard among some sex therapists that pornography is an effective way to learn about sex. I find this claim especially alarming, coming as it does from an organization dedicated to promoting health and happiness. (Needless to say, it’s probably not a coincidence that AASECT accepts funding from the pornography industry.) Pornography has absolutely nothing to do with healthy sexual expression—and teaches you nothing realistic about it within the context of an intimate relationship. Yes, pornography and sexual intimacy both employ the same anatomy, but they couldn’t be more different. It’s like saying just because pétanque and baseball both use a ball, you can become a good baseball player by watching other people play pétanque. If you view pornography, you will actually know less about how to function in a fulfilling sexual relationship than you did before you watched it. Just like you can watch hours of pétanque and still not have the first idea how to score a home run.

There is much in our beliefs as Latter-day Saints that we could justifiably consider to be “sex-positive,” but AASECT uses the term to smuggle in all manner of subversive ideologies and values in conflict with the teachings of Jesus. Rather than being value-neutral, groups like AASECT actively evangelize for behaviors like porn use and fetishes, and it inculcates hostility to traditional religion while ignoring far more common, but less transgressive sexual issues that clinicians regularly face. At least twice during AASECT’s annual conferences, they have sponsored [unsafe link] an event called “a taste of kink” where AASECT professionals were given the opportunity to participate firsthand in various dominance and submission activities.

Meanwhile, their professional neglect of other important issues continues. At this year’s AASECT annual conference, there are sessions about kink, black kink, transsexuality, cannabis use for “sexual health,” a tribute to a porn star, and multicultural genital grooming practices. Yet there is not a single session about vaginismus or early ejaculation, two of the most common sexual dysfunctions that therapists often see in their clients.

It is helpful for us to remember what therapists can do and what they can’t do. After all the ongoing abuses committed by the profession, after exposures of fraudulent research, and foundational studies retracted for failure to replicate, it is long past time we show a little intellectual humility in our “expert” pronouncements. It’s my job to help the client on the couch get better. It’s not my job as a therapist to tell “the Patriarchy,” or the Church, how they’re wrong and that its doctrines, beliefs, and practices must change. It’s also profoundly disempowering to tell our clients, as Helfer and others seem prone to do, that they don’t need to change, but that the rest of the world does [language warning]. We do our best work when we help clients build resilience and deal with the world as it is. While both clients and therapists can be agents of change in the world at large, our own healing cannot be held hostage waiting for 16 million Latter-day Saints to agree with us, not to mention most of the non-western world.

Finally, like Helfer, I meet with clients who are in same-sex relationships and engaging in same-sex sexual activity. They have various mental health and relational issues that they have asked me to help them with, and I do my best. I believe many of them lead better lives because of my interventions. However, unlike Helfer, I personally support Church teaching and doctrine on homosexual behavior. I believe that position articulates a civilizational and religious ideal that societies can and should encourage, as explained in the Proclamation on the Family. Yet because I respect my clients’ goals and values, I do not impose my own on them; I try to help them live their best lives according to their own beliefs and values. Our different beliefs on this matter need not and do not come up in therapy. 

Yet the way Helfer has advocated for her positions, as well as my colleagues who manifested their support for her positions, has placed professionals like me in a double bind. They suggest that Helfer’s beliefs about same-sex marriage, pornography use, and organized religion are mainstream positions that anyone wishing to comply with the professed ethics of our trade must not only help their clients with in therapy but also advocate for in public. So do I violate my conscience by voicing support for something I do not believe, or do I violate my ethics by staying silent? 

A simple solution would be to recognize that there are a variety of beliefs about these contentious issues and that we can each, as professionals of conscience, advocate for these different visions with respect and tolerance. However, Helfer and my colleagues who signed the letter do not make adequate space for a difference of opinion about this and other important matters of faith and values. 

I’m not the only one who sees increasing hostility to religion and traditional values in all of the mental health associations, so Helfer and her professional supporters might be correct that it is no longer possible to hold traditional beliefs about a host of important matters and be allowed to practice my profession. But I hope they are wrong, not only for my own professional standing, but even more seriously, for the people of faith who will never seek treatment in the first place, because they do not trust us to respect their deeply held beliefs. There is chilling new evidence emerging that even many LDS therapists end up steering their clients away from nourishing faith practices that they profess to share, often doing great harm in the process. I hope I am mistaken, but today I could not in good conscience refer any member who is wanting to be supported in following the covenant path to any of the clinicians who signed this letter of support. 

What too many mental health professionals don’t appreciate is that religion is every bit a core identity as other identities like race or sexuality can be. Different clients are going to prioritize different aspects of their identity and core beliefs. Joe Kort, therapist and gay activist, once wrote, “I spent the 1990s pressuring [men with same-sex attraction who are not seeking gay relationships] to come out of the closet and I feel like I did some damage to them. Many men who are deeply committed to their families … will never find happiness coming out as gay.” Just like sexuality, religious belief isn’t a switch you can just turn off and on at will. Therefore, suggesting that both clients and practitioners must change their religious beliefs presents some of them with an irreconcilable conflict, adding to their distress and professional insecurity.

If I am right, then it is not the Church disciplinary council that is doing the greatest harm to the profession. Instead, by making this a matter of national controversy, it is Helfer and her supporters who have. To give my active, faithful LDS colleagues who signed the letter the benefit of the doubt, as well as other signatories who support the traditionally religious, it’s entirely possible they added their name to the letter without carefully reading it or thinking through its implications. Given the harm it has done and continues to do, I respectfully ask them to reconsider their support.

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