Chapter Outline
Introduction
There have been enormous changes in society’s attitudes to variations in sexuality and gender over the last 50 years, and this has required a rethinking of traditional psychoanalytic ideas. I describe the world of psychology and psychoanalysis in the 1950s, 60s and 70s and the prevalent attitudes toward sexuality and psychopathology at the time. Conformity and stereotypes in matters of sex and gender during the McCarthy era started to give way to new ideas of freedom and individuality. At the time, psychoanalysis, which had once been in the forefront of progressive thinking about sexuality, became instead a bastion of conservative ideas on sex and gender.
SECTION I: PSYCHOANALYSIS, SEXUALITY, AND PREJUDICE
The first half of the book explores in depth the relation of society, religion, science, and psychoanalytic practice in relation to gender and sexuality.
Chapter 1: Homosexuality and the Rorschach test
A prime example of the conformism that took hold of psychoanalysis in the 1950s and 1960s was the way many psychoanalysts who are prominent today, such Otto Kernberg, Roy Schafer, and Martin Bergmann, were occupied with finding ways to “diagnose” homosexuality using the Rorschach test. This occurred when a national priority was to root out homosexuals from the government and the military. Nevertheless, there were incidental but useful findings from these studies, not all appreciated at the time, such as the independence of gender identity and sexual orientation.
Chapter 2: Psychoanalysis in and out of the closet
In this largely autobiographical chapter, I describe my discovery of my own homosexuality and my coming to terms with the anti-homosexual bias of society in general and the psychoanalytic world in particular. I gradually relinquished secrecy in these matters and came to use my own experience to help change the prevailing psychoanalytic viewpoints, while expanding my own sense of freedom. This chapter outlines many of the main issues that are explored in more detail in the rest of the book.
Chapter 3: The experience of hating and being hated
In 1992, I organized a conference to explore the experience of hating and being hated that brought together a broad range of psychoanalysts – two black women, gay and Jewish men, and a man whose father had been involved with the Nazis. My introduction to that conference identified the ways some psychoanalysts in the past fought intensely against prejudice – notably, Freud, who in the Interpretation of Dreams inveighed against anti-Semitism, and Harry Stack Sullivan, who combated homophobia, racism, and other forms of bigotry. There was a resurgence of racial and ethnic persecution in the 1990s. I called for contemporary psychoanalysts, many of whom were escapees from Nazi persecution, to join resistance to institutionalized bigotry.
Chapter 4: Homophobia in psychoanalytic writing and practice
In 1993, I wrote a critique of two published psychoanalytic case reports in which a homosexual man and a lesbian were pressured to convert to heterosexuality. I identified the prevalent biases in interpretation by the psychoanalysts and the subtle coercion involved. It is, to my knowledge, the first detailed critique of such case reports, which were common in the psychoanalytic literature until that time. I describe the test of “bias reversal” which reveals unconscious prejudices.
Chapter 5: The interaction of societal prejudice with psychodiagnosis and treatment aims
The National Association for the Research and Treatment of Homosexuality (NARTH) sought to sustain and revitalize the psychoanalytic tradition of pathologizing and treating homosexuality. This chapter is my response to their arguments, identifying the fundamental interaction, in psychiatric and psychoanalytic history, between societal prejudice and judgments of psychopathology with respect to Jews, women, blacks, and other groups. The lopsided diagnosis of Gender Identity Disorder in Children is a primary contemporary example of prejudice infiltrating clinical judgment. I refocus attention on the problem of group hatred rather than on the pathology of victims of such hatred.
Chapter 6: The closeting of history
In this chapter, written especially for the book, I show how it has been common to hide the homosexuality of important historical figures, including musicians, writers, artists, scientists, politicians, and psychoanalysts. For example, I identify texts from Plato that have been mistranslated to hide their acceptance of same-sex love and attempts of contemporary musicologists to obfuscate Schubert’s homosexuality. This distortion of history leads people to be ignorant of the importance of homosexuals in shaping civilization past and present, and deprives young gay people of role models.
Chapter 7: Selective inattention and bigotry
Based on the film Trembling Before G-d, I discuss the effect of religious bigotry on gay men and their families. I recount my own struggles with Jewish religious strictures about sexuality, such as vilifying masturbation and most unconventional sex practices. I identify the similarity of major orthodox religions in persecuting gay people. Catholic pronouncements against condom-use have exacerbated the spread of AIDS, and Muslim countries still punish homosexuality and adultery with the death penalty. Such bigotry conflicts with essential religious tenets, including the words of Jesus.
SECTION II. SEX, GENDER, AND THE GOOD LIFE
In this section of the book, I extend the principles of the first part of the book to rethink broader ideas about sexuality – conceptions of masculinity and femininity, perversion and normalcy, sexual variation, danger and pleasure, and love and marital fidelity,
Chapter 8: Maleness and masculinity
This chapter analyzes prevalent concepts of maleness and masculinity, as shaped by societal biases, and show how these biases distort how homosexual and heterosexual men understand each other. I identify aspects of male identity that are seen as essential and inborn, but which vary in different regions and historical periods. For example, there is a tribe in New Guinea that requires young men, in order to develop their masculinity, to perform fellatio on older men. I discuss “gender mischief,” in which artists play with illusions of gender and sexuality in ways that identify presumptions, sometimes wrong, about what is essential to gender identity and sexual orientation. I analyze examples of gender mischief in the film The Crying Game and in the opera Der Rosenkavalier.
Chapter 9: Disgust, desire, and fascination
This chapter explores presumptions about sexuality – namely, what is disgusting and what is pleasurable, by examining the “Eew! factor” of Muriel Dimen. Sexual excitement and disgust are closely related, and each can be converted into the other by unconscious factors, as demonstrated in both clinical studies and in the novel Lady Chatterly’s Lover. Small changes in context can change “Eew!” into “Wow!” Practices that were called perversions 100 years ago are now seen as mainstream, normal, and desirable. The chapter also explores more arcane sexual practices and neurobiological research on sexual excitement, including olfactory studies of vaginal fluid in hamsters and humans.
Chapter 10: The gay Harry Stack Sullivan: Interactions between his life, clinical work, and theory
The career of the great psychoanalyst Harry Stack Sullivan is re-examined. Sullivan’s homosexuality has been subjected to “The Closeting of History” identified in Chapter 7, and this has distorted our understanding of his theories and clinical achievements. In this chapter, I analyze Sullivan’s writings on sexuality and explain his neologisms, such as “synstomixis” and “pugisma.” When understood, these writings reveal Sullivan’s precise and progressive thinking on sexuality, and outline a radical way for interpersonal and relational psychoanalysts to work with sexual issues. It also changes our understanding of Sullivan’s treatment of schizophrenia and his theory of dissociation.
Chapter 11: AIDS
AIDS compelled me to become a specialist in the psychological effects of a fatal illness that struck men in the prime of life. Psychoanalysis helped us understand the irrational processes that brought out delusional ideas about HIV and its transmission, which I attempted to correct. AIDS also opened up psychoanalytic understanding of sexuality, stigma, and prejudice, and their effects on physical and psychological well-being.
Chapter 12: Intimacy, pleasure, risk, and safety
The AIDS epidemic changed our understanding of sex, danger, and self-protection. At the turn of the 21st Century, however, there was an alarming abandonment by young people of safer-sex precautions and increased rates of HIV transmission. In this chapter, I analyze the psychological factors leading people to embrace high-risk sexual behaviors and, at times, to deliberately acquire HIV (so-called “bug chasers”). Risk, intimacy, and pleasure have subtle interactions that are often unconscious. Punitive approaches sometimes paradoxically increase risk-taking, while encouraging hope for sexual satisfaction within an intimate relationship can promote safer behavior. I also show how a change in societal resistance to same-sex marriage could encourage safer sex practices.
Chapter 13: Love, sex, romance and psychoanalytic goals
Stephen Mitchell entitled his last book, “Can Love Last?” I ask, “Should love last?” and “How do intimacy, safety, and passion affect one another?” I analyze the variation in history and in different cultures of the interaction of love, sex, romance, and marriage. Marriage has not always been tied to romantic love, and cultural norms can differ widely as to how sexual satisfaction fits into life. Social and religious ideas have shaped psychoanalytic views of normal sexuality in different eras. I identify ways that psychoanalysis could change its fundamental assumptions about sexual practices, marital arrangements, and the “good life.” I also discuss cases of marriages in which passion had waned but became revitalized through changes in character, using examples from my clinical practice as well as from films like Belle de Jour.
Chapter 14: Polymorphous without perversity: A queer view of desire
This is a further exploration of psychoanalytic concepts of normative sexuality and their effect on the clinical treatment of people with unusual forms of sexuality. It is possible that psychoanalysis could acquire a new vitality today by becoming once again a more queer science. I propose that we define mental health in terms of a person’s own happiness – whether the person’s mental functioning provides satisfaction and integrity. I elaborate on sexological conceptions of the “lovemap” and “sexprint,” and describe progressive clinical work with male heterosexual crossdressers and coercive heterosexual voyeurs. Psychoanalytic findings about sexual variation have implications for public policy; they conflict with proclamations on normalcy issued by the Presidential Committee on Bioethics.
Chapter 15: Erotic and Anti-Erotic Transference
Erotic transference is usually thought to mean when the patient “falls in love” with the analyst, but it includes all reactions of the patient to the analyst’s bodily presence. It also may include the patient’s being unattracted or repulsed by the analyst, which is the “antierotic” transference. A common error in working with erotic transference is the “tranposition interpretations” in which the analyst says, in effect, “You don’t really feel that way toward me but are displacing feelings you had toward someone in your past.” If the erotic transference is explored more than interepreted, the patient may learn valuable information about his or her particular pattern of erotic feeling and experience.
Chapter 16: The political is psychoanalytic: On same-sex marriage
The debate on same-sex marriage is one of the most vehemently contested of contemporary social issues. I use psychoanalytic concepts to analyze irrational arguments, based on “natural law” and the Bible, analogous to arguments that once attempted to support slavery. Societal prejudice causes mental suffering. Same-sex marriage would hurt no one, and bring much happiness and security to same-sex couples and their children.