Homosexualities: Psychogenesis, Polymorphism, and Countertransference

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This latest volume in the Psychoanalysis and Women Series for the Committee on Women and Psychoanalysis of the International Psychoanalytical Association presents and discusses theoretical and clinical work from a number of authors worldwide. It clearly demonstrates that there is no typical development of homosexuality and that each individual's object-choice can only be grasped by examining their psychic history. While the therapeutic work requires no special adaptation of technique, countertransferential difficulties which may arise and stem in part from cultural representations about gender differences are fully explored. The book includes a unique retrospective view by Ralph Roughton over three time points which charts changes in considering the analyst's response within the wider cultural context.

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Chapter One: Gender as Heritage of the First Qualitative Differentiation

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Paul Denis

The question of gender is, today, a central topic in many psychoanalytic and psychopathological studies. Stoller (1964), by focusing on the very early organisation of what he called “gender identity”, has profoundly changed our ideas about identity building in girls and boys.

The gender identity nucleus in Stoller's view

For Stoller (1964), gender identity development—to be masculine or to be feminine—is built on what he calls “gender identity nucleus”. The latter consists of the conviction that his or her sexual assignation is anatomically and eventually psychologically correct and that it is the first step toward the individual's eventual gender identity. Yet, is it legitimate to speak in terms of “conviction” at such early stages in psychic development? We think that it is more correct to consider such a conviction as the result of the whole developmental process.

Stoller also expresses something curious, that gender identity has nothing to do with any role or object relation. What we understand from this statement is that gender identity is independent of sexual object choice. It is true, for instance, that a very feminine woman with a clear feminine gender identity can chose a homosexual or heterosexual love object. Nevertheless, this independence is only relative and a very firm gender identity may lead to a specific object choice or to a specific kind of role in the social area. In a sense, Stoller's statement indicates the narcissistic value of gender identity, which is independent from object choice.

 

Chapter Two: Male Homosexuality in Analytic Treatment

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Jacques André

Florent

Florent's sexual life seems to be a classical example of Freud's “On the universal tendency to debasement in the sphere of love” (1912d). “Classical”, in the sense that Freud is trying to define a generic pattern of male sexuality: “Where they love they do not desire and where they desire they cannot love” (p. 183). A rather dismal view of men's sexual life, reduced to a binary opposition: tenderness with one woman versus sensuality with the others. This is the stuff of most novels; an example is Kundera's Tomas in The Unbearable Lightness of Being:

Making love with a woman and sleeping with a woman are two separate passions, not merely different but opposite. Love does not make itself felt in the desire for copulation (a desire that extends to an infinite number of women) but in the desire for shared sleep (a desire limited to one woman). (1994, p. 24)

Freud is convinced that for the “man of culture”, it is extremely rare, if not impossible, to have the “highest psychical estimation” and experience the “greatest intensity of sensual passion” with one and the same woman. The common solution is to split that which cannot be joined together. With “my dearest darling wife”, sexual activity “is capricious, easily disturbed, often not properly carried out, and not accompanied by much pleasure” (p. 182)—what a sinister account of marital life! But with the other woman, the “mistress”, “sensuality can be freely expressed, and important sexual capacities and a high degree of pleasure can develop” (p. 183). However, this is at a very high price, that of “psychic debasement”, the only solution allowing the doing away with “refinement in their modes of behaviour in love” (p. 183).

 

Chapter Three: Discussion of “Male Homosexuality in Analytic Treatment”, by Jacques André

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Giovanna Ambrosio

I should like to thank Jacques André for the many stimulating points that he has put forward; it was very interesting and constructive for me to compare the differences in the way Jacques and I deal with the main issues. Although I fully agree with his final remark when he states, “There is no prototype of homosexuality, be it masculine or feminine”, I think that homosexuality has become a kind of “umbrella word” under which we find a variety of different psychopathologies. Very often patients—men as well as women—come to us and the first thing they do is announce their homosexuality as though presenting us with a visiting card that will guarantee them a pseudo-identity. Others come asking for help about contingent problems, loudly proclaiming their homosexuality as the healthy and resolved part, almost as though it were a narcissistic support or a phallic prolongation. Certainly, my clinical experience has helped me to understand so far that, in most cases, declared homosexuality seems to have little to do with sex and desire but, rather, with defence organisations and areas of confusion at different levels. My comments will privilege psychic aspects and I shall leave aside sociocultural, legal, or political considerations.

 

Chapter Four: The Two Analyses of a Gay Man: The Interplay of Social Change and Psychoanalytic Understanding

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Ralph Roughton

The interplay of social change and psychoanalytic understanding is demonstrated by how we have dealt with homosexuality, more than by any other issue—more, even, than female psychology. For example, Freud was a leading voice against the repressive forces of his day, in particular against laws that criminalised homosexual behaviour (1930). In a newspaper interview in 1903, he stated categorically, “Homosexual persons are not sick.” By the 1980s, however, the American Psychoanalytic Association had become the most conservative and tradition-bound of the mental health organisations, our theories and our attitudes reflecting the thinking of decades past. Social change had left us far behind.

Consider, for example, the early homophile organisations, the Stonewall uprising that catalysed the modern gay rights movement, the growing acceptance of gay men and lesbians in mainstream culture in the 1980s, the formation of a cohesive gay community to fight the AIDS crisis, and the rise in academia of gay and lesbian studies. Nothing in our professional literature or in any discussions at our national meetings would indicate an awareness of this social upheaval as a progressive current.

 

Chapter Five: The Same and the Other: Homosexuality in Adolescence

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Monique Cournut

If there is no such thing as a baby without the mother, then there is no such thing as an adolescent without the environment, be it hostile or favourable, or both. I felt this was a subject to which I could make a contribution. As I worked on the text, the entire theme began to seem much more complicated to me. Would it be too broad or too specific? Did addressing homosexuality in the adolescent girl pose the risk of establishing too rigidly particular times and movements, moreover, in only one sex? I turned to Winnicott for help, taking from Selected Letters (Rodman, 1987) a fragment of a letter addressed to a man:

I wonder whether you can make use of this idea. Everybody is bisexual in the sense of the capacity to identify with man and woman…I think that the study of man's identification with woman has been very much complicated by a persistent attempt on the part of psychoanalysts to call everything that is not male in a man homosexuality, whereas in fact homosexuality is a secondary matter or less fundamental and rather a nuisance when one is trying to get at man's woman identification. (p. 155)

 

Chapter Six: Discussion of “The Same and the Other: Homosexuality in Adolescence”, by Monique Cournut

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Juan-Eduardo Tesone

It is difficult to discuss a chapter, since one attends not only to what the author writes, but also to what is not said: not words, but something glimpsed between the lines…a space where one may feel authorised to listen, but not exempt from the risk of deforming the author's thoughts with one's own vision or with perspectives opened by the reading. This is what the rich, condensed, and polysemic text by Monique Cournut produced in me.

It would first be worthwhile to underscore that the plural chosen for the theme of this book indicates the multiplicities of forms taken by homosexual object choices.

Monique Cournut, in writing about homosexuality in female adolescents, has chosen a suggestive title: “The same and the other”, that is to say, the pair identical/different. Her title, like a bright polyhedron, reflects multiple facets that illuminate our debate.

From the outset, her reflections consider difference as a basis constitutive of human beings: “The duality of the same and the other is worked out in the human psychic apparatus, externally by the sense organs, but also by internal messages which are transmitted by the drives”. This means that, from the beginning, perceptive sensory reality is conditioned by the subject's internal world.

 

Chapter Seven: The Obscure Object of Desire

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Ferhan Özenen

As Joyce McDougall (1992) points out, psychoanalytic theory considers the homosexual component of the libido to be an integral part of every human being's psychic structure. In Three Essays on the Theory of Sexuality, Freud writes that “…all human beings are capable of making a homosexual object choice and have in fact made one in their unconscious” (1905d, p. 145).

Vicissitudes of libidinal development blur what we mean by the terms “homosexuality” and “heterosexuality”, and further complicate the question of feminine sexuality. From the perspective of the mother–infant dyad, which forms the basis for later object relations, two questions appear as two sides of the same coin: why and how does the girl detach from her first object of desire, the mother, and find her way to the father? Also, how is the original attachment to the mother retained in a woman's female object choice?

Keeping in mind the complementary nature of these questions, I would like to think about libidinal object choice in women and how the homosexual component of libido is integrated into adult personality. Starting with an overview of Freud's 1920 article, I will examine more closely female sexuality and homoerotic desire through theoretical considerations and examples from literature and clinical experience.

 

Chapter Eight: Inside Sisyphus's Nightmare: Destructive Narcissism and Death Instinct

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Raquel Cavaleiro Ferreira

Joel was thirty years old when he first came to see me. He called me about nine years ago, with a sense of urgency in his voice, telling me his analyst had sent him to me because he needed to work with a female psychoanalyst. This seemed somewhat strange and my first impulse was to say no. However, I noticed a kind of hopelessness in him (behind a polished and cold voice), which meant he expected me to say no. Something about that made me reconsider this refusal.

Joel was a vulnerable, pleasant-looking young man, although very short-sighted. He dressed formally with attractive and well-matched colours. He thanked me for agreeing to see him, but told me that he did not have much hope, if any. He felt that he had been sent away by the other psychoanalyst but did not want to talk about it. Since the age of twenty, he had seen various therapists without results. He knew that he always chose male analysts and could not see why he would do better with a female analyst.

 

Chapter Nine: Discussion of “Inside Sisyphus's Nightmare: Destructive Narcissism and Death Instinct”, by Raquel Cavaleiro Ferreira

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Martina Burdet

Raquel Cavaleiro has reflected on multiple issues that arise in the transferential–countertransferential process established between herself and Joel, a patient with a narcissistic identity disorder. Joel had been marked by early narcissistic traumas that resulted in extremely difficult work for the analyst in the transferential–countertransferential space.

As it is impossible to comment fully on the complexity of a case that surpasses all that could be said about it, I have privileged my reflection on some of the sexual characteristics of the patient. Joel considered himself to be homosexual. I will centre my discussion on certain aspects of his sexuality, a sexuality that operated as an act of compulsive discharge and was of a defensive nature. I will also reflect on the status of the object of discharge and its relationship with the primary objects, which was essentially incestuous (Racamier, 1995).

Death drive

As the three analytic sessions presented by Raquel Cavaleiro indicate, Joel had gone through a melancholic crisis after his mother's death. From the beginning, he seemed to be prisoner of a fortunate contradiction, highlighted by the analyst. If this contradiction had not existed, the patient would never have had the opportunity to undergo analytic work. On one hand, he wished to stand out aesthetically and intellectually and, on the other, he felt like a “non-existent person”, without being able to communicate and longing for solitude. What had driven him to analysis was precisely this dread of no-relationship, “disobjectalisation” in André Green's (2005) sense and “desire for no desire” in Piera Aulagnier's (1975) sense.

 

Chapter Ten: Homosexuality and the Parental Figures

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Ester Palerm Mari and Teresa Flores

Analytic work with a female homosexual patient has, in view of the transference and countertransference relationship and of what was experienced in the here-and-now of the session, led us to question the type of object relations that the patient developed, and the impact they have had on the patient's capacity for differentiation and autonomy. The patient's presenting problem was her difficulty in decision-making, although what appeared to be her real challenge was accepting and defending her own desires. To uphold one's own desires, one must first feel oneself to have been accepted and loved. It is in this way that good internal objects can be introjected. These objects provide the strength necessary to tolerate the disappointment that follows upon failure to be the other person's ideal object. They also enable us to contain the aggression awakened when upholding our own identity. In the case of the patient presented here, early loss of all family support compounded the process of differentiation and self-confirmation, thereby accentuating the intricacies of this process.

 

Chapter Eleven: The Two Faces of the Medallion

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Ayşe Kurtul

As she walked into my office for the first time, A looked much younger than her thirty years, almost like a college student with no distinct characteristics that caught the eye. She was referred to me by a colleague whose daughter worked in the same school as A.

As she started talking about why she was here, two things struck me. One was that she avoided eye contact and rarely looked at me. At times, she would close her eyes and press her eyelids together for some time as she spoke. When I said something, she either closed her eyes again, or looked at me with a startled expression as if she realised just now that I was there with her. The other, which startled me a little, was the fact that her tone of voice and the particular way she spoke was the exact replica of the way my friend's daughter, F (the same friend who referred her to me), spoke and moved.

A's boyfriend of seven years, C, who worked abroad for the past two years of their relationship, was being relocated back to Istanbul and he proposed that they move in together. This proposal created considerable anxiety in A. She could not sleep at night, had heart palpitations during the day, and complained that she was feeling jumpy.

 

Chapter Twelve: Discussion of “The Two Faces of the Medallion”, by Ayşe Kurtul

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Ingrid Moeslein-Teising

We very much thank Ayşe Kurtul for sharing her case with us. It is always a special opportunity to look directly into the scene of an analytic ongoing process—and a challenge at the same time.

While this case emphasises several points, I shall focus particularly on “homosexualities”. Of course, this case reminds us of Freud's case of female homosexuality (1920a), which is discussed widely in other chapters in this book.

In trying to understand the patient, I first want to discuss some theories of the homosexualities of women, starting with female development. My discussion is based on these theories.

We remember Freud's basic assumption of constitutional, innate bisexuality, in which, as we might view it today, the cross-gender or trans-gender identifications fall victim to repression along with the formation of a heterosexual gender identity, but in which cross-gender identifications nevertheless remain in the unconscious. The fundamental bisexual object choice of early childhood enables a person later to change his or her object choice, as one possibility is lived and the other does not vanish, but is only suppressed and comes back to life in certain constellations (see also Quindeau, 2013a,b).

 

Chapter Thirteen: A Woman Looking for a Woman

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F. Göver Kazancιoğlu and Elda Abrevaya

When I1 started to prepare this paper, a study done by the anthropologist, Walter Ong, immediately came to mind. Ong, in his paper, “World as view and world as event” (1969), wrote as follows on existence and the transitional subjective experience:

When I walk alone through a dark wood at night and hear what I know is the branch of one tree rubbing against another in the breeze, I cannot keep my imagination from persistently suggesting that the noise is the voice of some living being, and indeed of some person who, being otherwise unknown and of uncertain intent, may well wish to harm me. (p. 647)

My fantasy, says Walter Ong, is the existence of others around us. He continues as follows:

Every infant is initiated into an awareness of himself from the beginning in a context of persons who mediate the exterior world to him, and he can never after release himself from that context. Where persons are missing, he projects them. (p. 647)

 

Summary: The Clinical Chapters: Some Concluding Thoughts

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Elda Abrevaya

In contrast to times when existing cultural representations of gender and sexuality led analysts to consider that homosexuality should be treated as a pathology, the theoretical and clinical work presented in this book clearly demonstrates that there is no special technique to be adapted to homosexual patients. The same psychoanalytic principles apply to all types of patients. However, for the heterosexual analyst, the analytic work with a homosexual patient can create some countertransferential difficulties, contributed to in part by his or her cultural representations about gender differences and requires their working through. As Ralph Roughton underlines, the analyst has to work with his assumptions and beliefs about what is sexually normative and be aware of his prejudices against homosexuality.

As we summarised in the Introduction, when the cases presented in this book were reviewed, we noted that there is no typical development of homosexuality. In each of them, the object choice can only be grasped by examining its psychogenesis, that is, the psychic history of the subject and its vicissitudes. When we examine Raquel Cavaleiro's male analysand, or Ayşe Kurtul's and Ester Palerm's female analysands, we note that they had consulted the analyst not for conflicts in the sphere of their sexual choice, but for their suffering from narcissistic wounds and depression. In the case of Cavaleiro's and Kurtul's patients where the relation with the object was undifferentiated, it does not, therefore, seem possible to speak of homosexuality as a sexual choice, as Martina Burdet would suggest. Here, confusion with the object is accompanied by other defences, such as infantile megalomania, or perversion. The object is significant to the extent that it provides narcissistic satisfaction.

 

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