Disgust, Desire, and Fascination—Psychoanalytic, Cultural, Historical, and Neurobiological Perspectives Commentary on Muriel Dimen's Paper (original) (raw)

Gay-Friendly Psychoanalysis and the Abiding Pleasures of Prejudice

Studies in Gender and Sexuality, 2018

Psychoanalysts in North America have mostly rejected the theory that homosexuality in men is "caused" by developmental arrest. Most have also rejected the belief that the Oedipus Complex is the main determinant of adult sexuality (a belief that used to be the very foundation of psychoanalytic thinking). Today's "gay-friendly" psychoanalysts deplore the mid-20th-century analysts who, in the name of bedrock Freudian principles, pathologized homosexuality and believed they could "cure" it. However, the author argues, this wholesale expulsion of a giant body of mainstream theory has two downsides: It pressures us to fudge our clinical perception when we encounter that rare patient who actually does fit the profile of the "sick" homosexual of the past. And it lets us elide the likelihood that fashionable moralism and self-interest may still be distorting our clinical judgment today. I begin with a story about keeping a secret from a supervisee: Several years ago I supervised the first year of treatment of a young man whose presenting complaint was "a problem with incompletes." Eric, the patient, had been referred for therapy to avoid expulsion from college; in two years he had finished fewer than one-third of his courses. "I've always been this way," he told his therapist. "I know I have the talent to do really well but I have zero motivation to work at anything. I start every semester with enthusiasm-like, THIS is going to be the semester I really shine! But then somewhere around week 4 I get bored, or frustrated, and something sets in where I just stop going to class." Something similar happened in his close relationships: He would lose interest in friends, and his one important romantic relationship-a girlfriend he was together with for two years-was "sort of in a twilight state at this point. I know I don't want to break up with her, but it hasn't really felt like a romance since the first few weeks." The therapist treating him at the college clinic was perplexed. "I can't figure out what makes Eric tick," she said a few times. We set about trying to figure out what Eric DID care about: He had reported being treated in high school for "major reactive depression" triggered when a foreign student whom he had become close friends with moved back to Ecuador. "Boy or girl?" I asked the therapist. "Boy." And what classes has he passed? "Dramatic arts," she said. "It's his minor." "Could Eric be gay?" I asked the therapist. "I've brought up the possibility," the therapist said. "He denies it. He says he's uncomfortable around gay people-he was in a gay bar once and he panicked. He felt that all the men around him would want him to 'be the girl.'" In addition, there was no reason to believe that Eric would keep it a secret: He had a gay brother, 15 years older, who had been out "forever" and who was accepted and beloved by both parents. About a year into the treatment the patient mentioned that he was in the habit of carrying a knife-every day at school and almost any time he left the house. The therapist asked why, and the patient launched into a complex matrix of evasions that boiled down to paranoia and preoccupation with

Healing the gays: a brief history of how homosexuality became an illness

In a Christian symposium about conversion therapy practices through a religious approach, a so called 'ex-gay' claimed about himself: 'I felt it [where 'it' stands for sexual conversion from homosexuality to allegedly gained heterosexuality] it was what I had to do in order to gain a right to live on the planet.' The necessity to find a cure to our sexuality is basically due to social consent to an heteronormative perception of reality, of a life that must be considered as conventional by society and, thus, far from any kind of 'diversity' (Haldeman, 1994). This means that homosexuality is perceived as an illness from that kind of society that stigmatizes it, or something undesirable. As psychiatrist Bieber in 1962 said, homosexuality must be considered as a pathology, and consequenty it cannot be compatible with a happy life, and again, Nicolosi later will say 'I do not believe that gay lifestyle can ever be wealthy nor that the homosexual identity can ever be completely ego-syntonic" (Nicolosi, 1991, p. 13). Since homoeroticism is then an undesirable condition, there have been many ways to contain it. Gay people are induced to feel uncomfortable with their sexual orientation, and this is because of many different reasons: the social stigma and devaluation of homosexuality, gender roles of wives and husbands, religious values that make their sexual orientation incompatible with their beliefs, low self-esteem due to their homoerotic impulses, etc. The scope of this essay is to give a general introduction to how the practices of sexual conversion have developed throughout psychiatric history and how homosexuality has become an illness to cure, but at the same time I will try to examine the progress obtained from LGBT rights in order to recognize homosexuality not as a deficit to medicalize, but as a variable in human sexuality. Furthermore, after this research I am induced to think that the mixture of the boundaries between those which were considered as medical practices of conversion (and also the political and religious beliefs of those who worked in order to enact these conversion) are the living proof of how this system of adequacy to an heterosexual society had rather more moral than medical necessities. Especially in a span of time that goes from the 40s to the 70s of 20 th century, many medical practices were enacted in order to cure homosexual men and lesbian women who felt inadequacy with their sexual orientation. These treatments, that will all be considered as being part of the project of the so called 'sexual conversion therapy' or also 'reparative therapy', seeked to 'bring back' to the norm all the gay subjects exposed to it. A lack of faithful empirical data and the declassification, in 1970's, of homosexuality as a mental illness will gradually reduce trust into these therapies from the mainstream medical establishment.

Gay Patient, Gay Analyst: Is It All About Sex? Clinical Case Notes from a Contemporary Freudian View

Journal of Gay & Lesbian Psychotherapy, 2006

This paper charts a portion of the psychoanalytic therapy of a gay male patient with a gay male analyst. The therapist discloses his sexual identity at the time of referral but otherwise works within a contemporary neutral framework. The case material shows how a patient uses the disclosure of the analyst's sexuality to fortify stereotypical views of what it means to be a gay man, and to avoid the potentially traumatizing exploration of their differences. Analysis of the patient's defense strategies eventually allows him to accept a more complex view of himself, of his relationships and of what it means to be a gay man.

Homosexuality: how therapists can help?

Open Journal of Psychiatry & Allied Sciences, 2015

The American Psychiatric Association removed homosexuality from its list of mental disorders in 1974. Before that, for more than a century, homosexuality and bisexuality were assumed to be mental illnesses. Studies have shown that there is no difference between homosexual and heterosexual individuals with regard to psychological functioning. However, an effect of stress related to stigmatisation was observed in the cases of homosexuality. Such kind of stress may increase the risk of suicide attempts, substance abuse, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), and emotional distress. Findings of researches have suggested that there is a need for better education and training of mental health practitioners in this area. Therefore, in the present paper, few cases of homosexuality are discussed in the context of effect of stigmatisation and aspects of intimate relationships in these individuals. Further, the role of psychologists/professionals as therapists in providing their help to homosexual clients has also been presented.

Problems of sexual expression in adult gay men: A psychoanalytic reconsideration

Psychoanalytic Psychology, 1997

Though most psychoanalytic theorists have embraced homosexuality as pathological, Freud's views were less definite, more complex, and more conflicted in this regard. Rather than assuming that factors intrinsic to homosexuality underlie aberrant patterns of adult sexual expression, we explore extrinsic factors that impinge on gay men at developmentally critical periods of life, which may underlie nonnormative sexual expression. Specifically, we suggest that early caretaking environments fail to receive, affirm, and encourage same-sex libidinal attachments and expressions; moreover, such expressions are often met with shame, threat, or direct attack. Frequently, the result is the massive shutting down, compartmentalization, or both, of adult homosexual expression. Case studies are presented to illuminate this formulation. The psychoanalytic therapist who ignores the impact of developmental failures and impingements on gay men often unwittingly reenacts these, with the effect of supporting dissociative and repressive mechanisms that impair healthy adult homosexual expression. Homosexual object-choice has been the focus of much study and exploration by psychoanalysts, beginning with Freud. One primary question has dominated this Requests for reprints should be sent to Alan Blum, PhD, 1 Goose Cove Road, Bath, ME 04530. This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

A Review of the Medical Consequences of Homophobia with Suggestions for Resolution

Purpose: This review highlights the effects of homophobia, the antipathy or disdain for gay men and lesbians, which is a widespread response to this largely unfamiliar and previously hidden segment of society. Data Sources: Peer-reviewed and non-peer-reviewed journal articles, published and unpublished survey reports, current newspaper coverage of events, U.S. census data, are all integrated to produce an overview of societal, psychosocial, and medical consequences of homophobia. Data Synthesis: The available information has been analyzed from a psychiatric, medical, and sociocultural perspective in order to provide an update on the known science about homosexuality and the medical effects of homophobia. Conclusions: The medical and psychological effects of homophobic prejudice are profound on the developing self-concept of youths as well as adults who recognize a same-sex orientation. Medical practitioners are not immune from societal prejudice and may demonstrate disdain for gay men and lesbians as patients. Patients perceive this disdain, which alienates them from the medical system, reducing utilization of screening modalities, risking higher morbidity and mortality from infections, cancers, and heart disease. Being gay or lesbian is not genetically or biologically hazardous, but risk factors are conferred through homophobia. Therefore, the process of homophobia-the socialization of heterosexuals against homosexuals and concomitant conditioning of gays and lesbians against themselves-poses a legitimate health hazard. Governmental, institutional, educational, and medical resolutions of homophobia are discussed which would improve the quality of medical care provided to gay men and lesbians, and have a favorable impact on the health and quality of life of this population. bisexual people. Early psychoanalytic constructsoften working from a priori assumptions of psychopathology in all people who were not heterosexualsand poor research methodology-often studying only mentally ill gay men and lesbians-cast homosexuals as mentally ill, immoral, untrustworthy, unreliable, and lacking in integrity. As a result, gay men and lesbians developed a hidden subculture for emotional

Alternative behavioral approaches to the treatment of homosexuality

Archives of Sexual Behavior, 1976

Radical changes in attitudes toward homosexuality in American society are integrated into a new perspective for the therapist confronted by a client who engages in homosexual behavior. The traditional mandatory attempt to eradicate homosexual behavior has been expanded into three options, any one of which may be pursued by the therapist at the client's request: (1) modification of homosexual in favor of heterosexual behavior, (2) enhancement of homosexual behavior, and ignoring of homosexual behavior if it is functionally unrelated to the presenting symptoms. Therapists' negative attitudes toward clients who engage in homosexual behavior are such as to abrogate expanded options and may result. in therapeutic efforts at modification of homosexual behavior in defiance of the client's expressed wishes. Contrary to current professional belief, careful analysis and the use of appropriate techniques such as systematic desensitization, orgasmic reconditioning, and training in heterosocial skills generally obviate the necessity for aversive procedures in those instances where homosexual behavior is to be modified in favor of heterosexual behavior. Three case histories are presented illustrating the use of each of the expanded options described above. part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission of the publisher.

SHAME, DISGUST, ANGER AND REVENGE: HOMOSEXUALITY AND COUNTERTRANSFERENCE

British Journal of Psychotherapy, 2001

ABSTRACT Homosexuality has a central place in the history and development of psychoanalysis. Freud correctly identified‘difference’ as a starting place for an investigation into the dynamics of sexuality. Unwittingly he also instigated thinking that raised, among some analysts, a desire for curative action. The absence of insights from the countertransference debate influenced psychoanalytic thinking for a period, obscured the benefits that might accrue from the analyst's recognition of his intrinsic bisexuality and, more recently, fuelled a popular reaction which argues that homosexuality is not a matter for psychoanalytic investigation but a healthy extension of the personality. The profession similarly has been divided. This paper contends that homosexuality should remain an area for psychoanalytic consideration. There are transference and countertransference issues to examine that include shame, disgust, anger and revenge.While such emotions and reactions are not unique to the area of homosexuality they may lead to particularly destructive effects if left unobserved in our work and in ourselves.