On the Analytic Therapy of Gay Men

  • Richard A. Isay
Part of the Critical Issues in Psychiatry book series (CIPS)


Most psychoanalysts assume that homosexuality reflects an unfavorable unconscious solution to developmental conflicts and that consequently the entire personality of the homosexual shows various disturbances. The pathological deficits attributed to homosexuals are numerous and varied, and I have selected only a few for illustrative purposes. Bergler (1957) wrote of six traits: masochistic provocation and injustice collecting, defensive malice, flippancy, hypernarcissism, refusal to acknowledge accepted standards in nonsexual matters, and general unreliability. “The most interesting feature of this sextet of traits,” he writes, “is its universality. Regardless of the level of intelligence, culture, background, or education, all homosexuals possess it” (p. 49). Homosexuals have been said to suffer from a large variety of ego defects (Panel, 1954, p. 344), including “primitive features of the ego” similar to those found in schizophrenia (Panel, 1960, p. 556) and sociopathy.1 Glover (1932, p. 230) suggested that homosexuality and other “perversions” “help to patch over flaws in the development of reality-sense.” Socarides (1968) wrote that approximately half of the patients who engage in homosexual practices have a “concomitant schizophrenia, paranoia, are latent or pseudoneurotic schizophrenics or are in the throes of a manic-depressive reaction. The other half, when neurotic, may be of the obsessional or, occasionally, of the phobic type” (p. 90). Most of the patients he labeled as schizophrenic would probably be classified in his later formulation (1978) as belonging to the class of Preoedipal Type 2, “suffering from a transitional condition lying somewhere between the neuroses and psychoses” (p. 58).


Sexual Behavior Sexual Orientation Basic Book Sexual Interest Homosexual Behavior 
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Copyright information

© Springer Science+Business Media New York 1986

Authors and Affiliations

  • Richard A. Isay
    • 1
  1. 1.Department of Psychiatry, Cornell Medical CollegeColumbia University Center for Psychoanalytical Training and ResearchNew YorkUSA

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