It’s late evening on February 8 when my phone buzzes with a news alert indicating psychologist Dr. Charles Silverstein had passed. I would normally swipe these alerts away but I was waiting for a friend anyway and figured I would see what this was all about. I learned about an important part of both queer and psychology history.
Dr. Silverstein, himself a gay man, treated LGBTQ+ clients at a time when homosexuality was defined as an illness in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Conversion therapy at the time – a now widely opposed practice whereby practitioners try to “change” the sexual orientation or gender identity of queer and trans people– was common. But Dr. Silverstein resisted these practices, treating LGBTQ+ patients in an affirming manner. In fact, it was thanks to Dr. Silverstein and others’ advocacy that the American Psychological Association finally removed “homosexuality” from the DSM in February 1973. It is worth noting that Dr. Silverstein was a graduate student at the time - risking a great deal professionally by speaking out.
As a lesbian with OCD, reading about Dr. Silverstein gave me pause. How different might my relationship with psychology, and cognitive behavioral therapy specifically, have looked if not for brave psychologists like Dr. Silverstein?
Living elders in our queer community would have been met with pathologizing, shame-centered responses to their sexuality and gender identity by some in this profession. Of course, exclusion from the DSM surely didn’t eliminate conversion therapy – thousands of queer people are still subjected to the abusive practice today. It was recently banned in Canada but most US states have no such law on the books. Nonetheless, removing the “homosexuality” diagnosis from the DSM proved critical for tackling homophobia within mainstream psychology. Thanks to the work of Dr. Silverstein and others, CBT treatment for a variety of mental illnesses, including OCD, has improved. In fact, the Association for Behavioral and Cognitive Therapies (ABCT) recently made Dr. Silverstein the inaugural recipient of the Charles Silverstein Lifetime Achievement Award in Social Justice.
Today, I am grateful to psychologists, researchers, and advocates in our community who fight for improved treatment for LGBTQ+ people living with OCD. Authors of research like the recent publication Call to Action: Recommendations for Justice-Based Treatment of Obsessive-Compulsive Disorder With Sexual Orientation and Gender Themes are raising the bar for those of us who are queer or trans and live with mental illness. One of the authors, Dr. Caitlin Pinciotti, is now leading the first ever survey for LGBTQ+ people with OCD.
It is thanks to treatments like ERP and ACT that fall under the CBT umbrella that I was able to reclaim my life from OCD. Acknowledging some of the harms of the practice’s past does not negate that, and rather helps us improve treatment outcomes for more people.
Thank you to Dr. Charles Silverstein for his contributions to the field and to those doing the work now.
Justine De Jaegher is an IOCDF advocate living in Ottawa, Canada. She is involved in both the Faith and OCD and LGBTQ+ IOCDF special interest groups, as well as the Diversity, Equity, and Inclusion Action Council.
For more information on the IOCDF LGBTQ+ SIG, click here.