Jack Drescher. Journal of Gay & Lesbian Psychotherapy. Volume 5, Issue 3-4. 2002.
Introduction
“Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation; it cannot be classified as an illness; we consider it to be a variation of the sexual function, produced by a certain arrest of sexual development …” — Sigmund Freud, Letter to an American Mother (1935)
Although psychoanalysts have proffered and claimed homosexual conversions since the time of Freud, a recently coined term, reparative therapy (Nicolosi, 1991), has come to generically define talking cures that claim to change an individual’s homosexual orientation to a heterosexual one. Although other treatment modalities such as aversion therapies and psychosurgery have also promised to “cure” homosexuality, the history of reparative therapies has become inexorably linked with that of psychoanalysis. The strident positions of reparative theorists and practitioners (Bayer, 1981; Socarides, 1994b; Socarides et al., 1997; Drescher, 1997, 1998a), and the tacit acquiescence of their less ideological colleagues, have earned psychoanalytic theory its present mythic status as an implacable foe of lesbian and gay identities. This view persists despite a growing number of authors who criticize the antihomosexual bias of psychoanalytic theories within a psychoanalytic framework (Morgenthaler, 1988; Friedman, 1988; Lewes, 1988; Isay, 1989; O’Connor & Ryan, 1993; Glassgold & Iasenza, 1995; Domenici & Lesser, 1995; D’Ercole, 1996; Kiersky, 1996). The perception that psychoanalysis is intrinsically hostile to homosexuality led the reviewer of a book affirmatively reformulating psychoanalytic theory and practice with lesbians and gay men (Domenici & Lesser, 1995) to skeptically muse: “Some of the contributors discuss how they are readapting or selectively using psychoanalysis so that its inherent antigay bias is eliminated. If that bias is eliminated, what is left?” (Marrow, 1996).
This paper reviews the history and theoretical assumptions of psychoanalytically-oriented practitioners, beginning with Freud’s juvenilization of gay people to the later analysts who pathologized and attempted to change samesex attractions. The evolution of reparative therapists from medically concerned practitioners into antigay political activists is also discussed.
Freud
“It is not for psycho-analysis to solve the problem of homosexuality.” — Sigmund Freud, Psychogenesis of a Case of Homosexuality in a Woman (1920)
Although he never dedicated a major work solely to the subject of homosexuality, Freud’s contributions on the subject range across a period of almost twenty years (1905, 1908, 1909, 1910, 1911, 1914, 1920, 1923). The contradictions in his voluminous works make Freud’s position opaque to the casual, modern reader. Attempts to find “the real Freud” are too often motivated by those who seek his agreement with their own point of view. When diametrically opposed camps claim Freud as a theoretical ally, it confirms Bayer’s (1981) assertion that “The status of homosexuality is a political question, representing a historically rooted, socially determined choice regarding the ends of human sexuality” (p. 5). Taken out of the historical context in which he wrote, and depending upon the author’s selective citations, Freud can be portrayed as either virulently antihomosexual (Nicolosi, 1991) or as a closeted friend of gays (McWilliams, 1996). This section is an attempt to offer a portrait of Freud’s complex position in the historical context in which he theorized and lived.
Freud’s attitude toward homosexuality was tolerant for its time. He signed a statement calling for decriminalization of homosexual acts in 1930s Germany and Austria (Abelove, 1986). This action was based on his belief that people should not be treated as criminals if their behaviors originated from a “psychic disposition” beyond their control. Unlike today’s reparative therapists, Freud did not believe that criminalization and social opprobrium were acceptable therapeutic tools. He also empathically noted, “It is one of the obvious social injustices that the standard of civilization should demand from everyone the same conduct of sexual life–conduct which can be followed without any difficult by some people, thanks to their organization, but which imposes the heaviest psychical sacrifices on others” (Freud, 1908, p. 192). In disputing degeneracy theory’s (Krafft-Ebing, 1886) pejorative views, Freud observed that homosexuality is “… found in people whose efficiency is unimpaired, and who are indeed distinguished by specially high intellectual development and ethical culture” (Freud, 1905, p. 138).
Freud believed a sublimated homosexuality was necessary for normal heterosexual function. Similarly, all homosexuals had some heterosexual feelings. There was no social equivalent of “coming out” in Freud’s era and so he never expressed an opinion on that subject. However, one can surmise he did not believe overt homosexual behavior was socially acceptable. Freud scolds a patient who asks why people shouldn’t express their homosexual feelings as well as their heterosexual ones:
Normal people have a certain homosexual component and a very strong heterosexual component. The homosexual component should be sublimated as it now is in society; it is one of the most valuable human assets, and should be put to social uses. One cannot give one’s impulses free rein. Your attitude reminds me of a child who just discovered everybody defecates and who then demands that everybody ought to defecate in public; that cannot be. (Wortis, 1954, pp. 99-100)
A significant difficulty in understanding Freud’s work stems from the fact that when discussing homosexuality, he is primarily elaborating other theoretical concepts such as libido and bisexuality (1905), narcissism (1910, 1914), projective mechanisms (1911, 1923), or unsatisfactory Oedipal resolutions (1920, 1923). Because each is addressing a different metapsychological issue, Freud’s four theories of homosexuality (Lewes, 1988) are often contradictory. Each uses a narrowly constructed hypothetical homosexual (Drescher, 1998b) to make a different theoretical point.
Moreover, Freud’s position on homosexuality cannot be understood in the language of the contemporary debate about homosexuality. In fact, his original intent is sometimes obscured when his opinions are brought into the modern controversy. For example, in a posthumously published Letter to an American Mother (1935), Freud reassured a woman that her homosexual son was not ill. In the late 20th century it is argued that lesbians and gay men are not ill and their homosexuality is defined as intrinsic to their nature (LeVay, 1993; Hamer & Copeland, 1994). It follows, according to this argument, that lesbians and gay men should be accorded minority status and full civil rights.
Although similar arguments were made by Magnus Hirschfeld (Bullough, 1979) in Freud’s time, they were not germane to his letter. Freud was using the term illness as a synonym for symptom formation, by which he meant the product of intrapsychic conflict (1926). Homosexuality was not defined as an illness because it was thought to represent the unconflicted expression of an infantile sexual wish (Freud, 1905; 1920). However, although an arrested libidinal development was not an illness, neither did Freud believe that it implied health (Drescher, 1996b). In Freud’s view, one could still justify psychotherapeutic intervention to transform a person’s sexual orientation.
Freud theorized that early childhood development was organized into psychosexual stages of libido. This hierarchical ordering of pleasure moved from oral to anal to genital stages. It placed genital (heterosexual) intercourse above the former, more infantile forms of gratification. Adult sexuality was defined as genital-genital (penile-vaginal) intercourse and oral and anal sexuality were labeled as foreplay or immature vestiges of childhood sexual expression. Homosexuality could be due to a libidinal arrest or failure to reach the final psychosexual stage of genitality due to a blockage of the energic force. An alternative explanation was that an individual had reached the more mature, genital stage but due to trauma reverted to an earlier stage. This was termed a libidinal regression. For Freud, changing an individual’s same-sex orientation to a heterosexual one meant helping them achieve a higher level of psychosexual development. Rather than a cure, effecting a sexual orientation conversion was seen as a metaphor for helping the patient grow up. Thus, in qualifying his reassurances to the “American Mother,” Freud explained that illness was not a necessary criterion for change:
By asking me if I can help, you mean, I suppose, if I can abolish homosexuality and make normal heterosexuality take its place. The answer is, in a general way, we cannot promise to achieve it. In a certain number of cases we succeed in developing the blighted germs of heterosexual tendencies which are present in every homosexual, in the majority of cases it is no more possible. (Freud, 1935)
In Psychogenesis of a Case of Homosexuality in a Woman (1920), Freud documents a reparative therapy attempt. This is his only reported case in which he is nominally charged with changing someone’s sexual orientation. His patient was an eighteen-year-old girl who had fallen in love with an older woman. Following a stern rebuke from her father, the young woman attempted suicide. She was subsequently brought by her parents for psychoanalytic treatment to change her sexual orientation. In the paper, Freud pointed out the difficulties in achieving the father’s goal for his teenage daughter:
. . . parents expect one to cure their nervous and unruly child. By a healthy child they mean one who never causes his parents trouble, and gives them nothing but pleasure. The physician may succeed in curing the child, but after that it goes its own way all the more decidedly, and the parents are now far more dissatisfied than before. In short, it is not a matter of indifference whether someone comes to analysis of his own accord or because he is brought to it–whether it is he himself who desires to be changed, or only his relatives, who love him (or who might be expected to love him). Further unfavorable features in the present case were the facts that the girl was not in any way ill (she did not suffer from anything in herself, nor did she complain of her condition) and that the task to be carried out did not consist in resolving a neurotic conflict but in converting one variety of the genital organization of sexuality into the other. Such an achievement–the removal of genital inversion or homosexuality–is in my experience never an easy matter….In general, to undertake to convert a fully developed homosexual into a heterosexual does not offer much prospect of success than the reverse, except that for good practical reasons the latter is never attempted. (p. 150)
Freud hypothesized that the young woman’s early oedipal rivalry with her mother was reactivated in puberty when her parents had another child:
It was just when the girl was experiencing the revival of her infantile Oedipus complex at puberty that she suffered her great disappointment. She became keenly conscious of the wish to have a child, and a male one; that what she desired was her father’s child and an image of him, her consciousness was not allowed to know. And what happened next? It was not she who bore the child, but her unconsciously hated rival, her mother. Furiously resentful and embittered, she turned away from her father and from men altogether. After this first great reverse she forswore her womanhood and sought another goal for her libido. (p. 157)
Freud called his lesbian patient a spurned man-hater, labeled her dreams as “false and hypocritical” (p. 165), and disparaged her as a feminist who suffered from penis envy (p. 169). He claimed her transferential animosity toward men was an insurmountable obstacle that forced him to end the treatment and exile her lesbian desire (Kiersky, 1996). He advised the family to have the young woman continue with a female analyst. No report of the existence, success or failure of any subsequent treatment is known. However that report was irrelevant to Freud’s purposes, because the aim of this paper was to further expand upon his previous psychoanalytic theories. In fact, the unsatisfactory outcome of the case only confirmed the correctness of Freud’s views that homosexuality was not a neurosis, but a difficult-to-treat psychic disposition.
Reparative Therapy’s Gilded Age
“The psychiatrists were always in desperate need to find a biological foundation for homosexuality; in their fight against barbaric, medieval laws, naturally they picked upon inherited homosexuality.” —Sandor Rado (Roazen & Swerdloff, 1995)
Despite Freud’s pessimism about changing homosexual motivations to heterosexual ones, analysts persisted in seeking ways to do so. Psychoanalysts were in the vanguard of redefining socially denigrated behaviors in psychological terms and consequently generated the hope that medical intervention might be able to change them. When psychoanalysis reached its highest influence in psychiatry and academia during the 1940s and through the 1960s, many gay men and women voluntarily sought psychoanalytic treatment for their same-sex feelings (Duberman, 1991; Isay, 1996).
Although Freud’s libidinal model offered little hope for converting homosexuality, psychoanalytic opinion began to change. After Freud’s death in 1938 (Jones, 1961), psychoanalytic theories proliferated that differed significantly from his own but that nevertheless remained within the mainstream of the psychoanalytic movement (Greenberg & Mitchell, 1983). These new paradigms offered alternative explanations for same-sex attraction that created “therapeutic possibilities.” In the post-Freudian psychoanalytic world, the theories of Sandor Rado laid the foundations for what would later come to be called “reparative therapies.”
Rado
Rado’s (1969) theory of homosexuality grew out of the refutation of Freud’s belief in psychological bisexuality. Rado believed the theory of libidinal bisexuality was based on a faulty analogy with anatomical bisexuality. That is, underlying Freud’s theory was the later-disproved 19th-century belief in embryonic hermaphroditism, the hypothesis that the potential to become an anatomical man or a woman was present in every embryo (Rado, 1969, pp. 215-216). However, after Rado deconstructed Freud’s biological metaphors, he succumbed to the same epistemological snare. He too relied upon the physiological and evolutionary models of his own era as concrete metaphors for psychological experience:
In adaptational psychodynamics we analyze behavior in the context of a biological organism interacting with its cultural environment. The human organism, like other living organisms, may be defined as a self-regulating biological system that perpetuates itself and its type by means of its environment, its surrounding system. From this it follows that life is a process of interaction of the organism and its environment….In the theory of evolution, the crowning achievement of eighteenth and nineteen-century biologists, adaptive value is a statistical concept which epitomizes reproductive efficiency in a certain environment. This is strongly influenced by the type’s ability to survive. Hence, “more adaptive” means more able to survive and reproduce. (1969, p. 4, emphasis added)
Rado declared, with great authority but without any supporting scientific research or evidence, that heterosexuality is the only nonpathological outcome of human sexual development: “I know of nothing that indicates that there is any such thing as innate orgastic desire for a partner of the same sex” (1969, p. 210). Starting from that unproven, but firmly-held assumption, he offered the following theory of homosexuality’s etiology:
The male-female sexual pattern is dictated by anatomy…by means of the institution of marriage, the male-female sexual pattern is culturally ingrained and perpetuated in every individual from earliest childhood… [homosexual] pairs satisfy their repudiated yet irresistible male-female desire by means of shared illusions and actual approximations; such is the hold on the individual of a cultural institution based on biological foundations…Why is the so-called homosexual forced to escape from the male-female pair into a homogenous pair?…the familiar campaign of deterrence that parents wage to prohibit the sexual activity of the child. The campaign causes the female to view the male organ as a destructive weapon. Therefore the female partners are reassured by the absence in both of them of the male organ. The campaign causes the male to see in the mutilated female organ a reminder of inescapable punishment. When… fear and resentment of the opposite organ becomes insurmountable, the individual may escape into homosexuality. The male patterns are reassured by the presence in both of them of the male organ. Homosexuality is a deficient adaptation evolved by the organism in response to its own emergency overreaction and dyscontrol. (pp. 212-213)
Bieber
Bieber, Dain et al. (1962) conducted a psychoanalytic study that they claimed confirmed Rado’s theory of homosexuality: constitutional factors were insignificant and parental psychopathology was the cause of homosexuality. They examined 106 homosexual men and 100 male heterosexual controls in psychoanalytic treatment to identify family patterns presumed to be responsible for homosexuality. The authors’ initial assumptions were consistent with the theory they subsequently claimed to confirm: “We have selected the patient-mother-father unit for analysis…We believe that personality for the most part is forged within the triangular system of the nuclear family. It follows then that personality maladaptation must also be primarily rooted here” (pp. 140-141). “We assume that heterosexuality is the biologic norm and that unless interfered with all individuals are heterosexual” (p. 319). “We consider homosexuality to be a pathologic biosocial, psychosexual adaptation consequent to pervasive fears surrounding the expression of heterosexual impulses. In our view, every homosexual is, in reality, a ‘latent’ heterosexual” (p. 220). They claimed that of their 106 homosexual men, “29 patients had become exclusively heterosexual during the course of psychoanalytic treatment. The shift from homosexuality to exclusive heterosexuality for 27 per cent of the H[omosexual]-patients is of outstanding importance since these are the most optimistic and promising results thus far reported” (p. 276).
Socarides I
Socarides contests Freud’s view that homosexuality is a developmental arrest and redefines it as conflictual. His conflict model suggests therapeutic interventions to bring unconscious struggles into awareness in order to reduce homosexual symptoms. He reshapes Freud’s (1926) metapsychological constructs and claims that homosexuality is a neurotic condition in which the libidinal instinct has “undergone excessive transformation and disguise in order to be gratified in the perverse act. The perverted action, like the neurotic symptom, results from the conflict between the ego and the id and represents a compromise formation which at the same time must be acceptable to the demands of the superego…the instinctual gratification takes place in disguised form while its real content remains unconscious” (Socarides, 1968, pp. 35-36). Because homosexuality is now defined as a compromise between intrapsychic forces, it meets the psychoanalytic definition of an illness. His claims, like Freud’s, are neither provable or unprovable since the metapsychological constructs of id, ego and superego are not subject to direct observation and can only be understood inferentially.
Socarides holds the parents of gay men and women responsible for causing homosexuality. The recent emergence of his gay son from the closet (Nagourney, 1995; Dunlap, 1995) adds poignancy to his 30-year-old description of the fathers of homosexual men: “The family of the homosexual is usually a female-dominated environment wherein the father was absent, weak, detached or sadistic” (Socarides, 1968, p. 38). Socarides also claims a psychoanalytic conversion rate of 35% for his homosexual patients (1995, p. 102).
Ovesey
Ovesey’s (1969) work approaches the post-modern sensibility in his explanation of how categories of masculinity and femininity are socially constructed:
The social order is so arranged that status accrues to men solely by virtue of the fact that they are men. The polarities of masculinity and femininity are identified respectively with positive and negative value judgments. Masculinity represents strength, dominance, superiority; femininity represents weakness, submissiveness, inferiority. The former is equated with success; the latter with failure. It is true that these values are cultural stereotypes that express primarily the historical prejudices of the men in the culture. However, it would be safe to say that men and women alike make use of them in appraising each other’s behavior. (p. 76)
Men who have dreams or fantasies in which they appear submissive to or dependent upon other men are not necessarily experiencing homosexual feelings, but pseudohomosexual ones. These feelings are symbolic of competition and status issues commonly found in heterosexual men. Despite his awareness of how cultural forces value masculine attributes while feminine ones are denigrated, Ovesey treats male homosexuality’s low cultural status as a fact of nature that requires no further deconstruction. In fact, he warned that “those who lack conviction that homosexuality is a treatable illness, but believe instead that it is a natural constitutional variant, should not accept homosexuals as patients” (p. 119).
In Ovesey’s approach to treating male homosexuality, we see the standard recommendation of reparative therapists to abandon neutrality or objectivity and function as behavioral therapists: “There is only one way that the homosexual can overcome this phobia and learn to have heterosexual intercourse, and that way is in bed with a woman…Sooner or later, the homosexual patient must make the necessary attempts to have intercourse, and he must make them again and again, until he is capable of a sustained erection, penetration, and pleasurable intravaginal orgasm” (pp. 106-107). In order to achieve these goals, the reparative therapist becomes a dating consultant for the patient:
Most homosexuals do not move readily toward women. More often, the patient protests that he is not ready for sex with a woman. He is, of course, right. The therapist should reassure him that for the present he is only asked to see women socially, to date them; nobody is asking that he jump into bed with them. Later, when he is comfortable with a date, he will begin first to neck, then to pet, and eventually go even further, but certainly not now. If the patient is at all serious about treatment, he will accept this compromise and gradually, with some pressure from the therapist, if necessary, begin to go out…. There is a place, just as in the therapy of other phobias, where the patient may be threatened with termination if he unduly procrastinates about entering the phobic situation. In other words, the homosexual patient should be given an ultimatum for insufficient efforts to perform heterosexually…(pp. 120-121)
Contemporary Reparative Therapy: Traditional Values for a Postmodern Era
“We refused most emphatically to turn a patient who puts himself into our hands in search of help into our private property, to decide his fate for him, to force our own ideals upon him, and with the pride of a Creator to form him in our own image and see that it is good…we cannot accept (the) proposal either–namely that psycho-analysis should place itself in the service of a particular philosophical outlook on the world and should urge this upon the patient for the purpose of ennobling his mind. In my opinion, this is after all only to use violence, even though it is overlaid with the most honorable motives.” — Sigmund Freud, Lines of Advance in Psycho-Analytic Therapy (1918)
Rado’s adaptational model of homosexuality dominated American psychiatry until a year after his death in 1972 (Roazen & Swerdloff, 1995). In 1973, the American Psychiatric Association deleted homosexuality from its Diagnostic and Statistical Manual (Bayer, 1981). Although Rado’s theory is no longer the dominant mental health paradigm, it continues to surface in new forms.
Contemporary reparative therapists must contend with the fact that the terms of scientific and social debate have shifted. They have had to grapple with five significant factors that their predecessors did not: (1) Their patients and potential patients are aware of affirmative identities for lesbians and gay men as that community’s public visibility increases; (2) there is a growing, significant scientific and social science literature that defines homosexuality as a normal variant of human sexuality; (3) rigid categories of masculinity and femininity are being increasingly deconstructed by feminist and queer theorists; (4) there is a growing body of research on antihomosexual attitudes; and (5) homosexuality’s diagnostic status as an illness has been rejected by conservative psychoanalytic organizations. Despite these cultural changes, the theoretical formulations underlying reparative therapies have changed little since the time of Rado. However, as the following section illustrates, reparative therapists have modified their rhetorical strategies in their adherence to traditional approaches to homosexuality. They have also moved beyond rhetoric to significant political action.
Siegel: The Neocon
In the reparative therapy literature, Siegel (1988) prefaces her work by presenting herself as an accidental tourist, for whom “a series of coincidences placed me into the position of analyzing twelve women who thought they had ‘chosen’ homosexuality as a lifestyle” (p. xi). She identifies herself as a reparative therapy neoconservative, a former liberal whose clinical experiences have led her to regard her previous, more tolerant beliefs as part of an idealistic youth that she has disavowed for a new, albeit unpopular, truth:
My [lesbian] patients had convinced me on an irrational level that there was indeed a choice for them…To be a liberal and liberated woman and yet to review homosexuality as the result of untoward development seemed at times a betrayal of all I then believed. But viewing my patients through the lens of psychoanalytic thinkers and clinicians soon showed me that allowing myself to be seduced into perceiving female homosexuality as a normal lifestyle would have cemented both my patients and myself into a rigid mode that precluded change of whatever nature. (p. xii)
In her treatment of twelve lesbian patients, Siegel claims more than half became “fully heterosexual.” She defines homosexuality as preoedipal in origin. In the Radoite tradition, she believes her patients “tried to heal their defective body images by seeking others like themselves” (p. 8). She bases her work on the theories of Socarides (1968, 1978), to whom she dedicates her book. Like Socarides, she uses Mahler’s (et al., 1975) model of separation and individuation as universal metaphors of normal development.
As reparative therapy increasingly moves away from the scientific mainstream, its mystical presuppositions become more apparent. Siegel, for example, defines the psychoanalytic concept of narcissism as “an energy” which allows individuals to adapt to “the reality of life, what I have called Lebensbejahung, the cathexis of life” (p. 21). In the tradition of classical psychoanalysis, she interprets from what she believes to be an objective position and has an inflated sense of her own capacity for neutrality. She presents her clinical narratives as historical facts that she has unearthed in the course of analysis. Her approach is somewhat formulaic, marked by a belief that all her patients go through similar “stages” of transference phenomena. She would have her readers believe she had no preconceived ideas about homosexuality or heterosexuality and came to her eventual conclusion that homosexuality is pathological through a scientific process of observation. It is beyond the scope of this paper to address the influence of the analyst’s beliefs on the narratives that emerge in a patient’s treatment and the subject has been addressed elsewhere (Drescher, 1996a). However, Siegel’s clinical approach appears to undermine her own attempts to position her work among self-psychology and intersubjective theorists, given their emphasis on co-constructed narratives.
Nicolosi: The Moral Majority
Psychoanalytic theorists traditionally couched their moral condemnations of homosexuality within scientific and pseudo-scientific metaphors. The Radoite tradition, in particular, anthropomorphized the concept of evolution, turning it into a force of nature that “expected” individuals to behave in ways for which they were designed. Consequently, the will of the deity was replaced by the will of evolution in psychoanalytic literature. This approach is embodied in the work of Kardiner:
… sex morality is not an arbitrary set of rules set down by no one knows who, and for purposes that no one understands, but is what man found expedient in his long evolutionary march, his social evolution…If we find a culture, such as our own, that not only has survived but has to its credit the highest accomplishments ever recorded for man, then the patterns of morality–or the mores by which it governs the relations of the constituents to one another–must have a high degree of effectiveness…at the time sex custom entered recorded history, it already was more or less settled. Monogamy, for example, was an established custom in the Homeric legends…we can assume that “human nature” has certain constant features and that human interaction, within certain limits, can be predicted on the basis of man’s biological make-up…. What is more certain is that in man the capacity for love is more extensive owing to the fact that human infants need the proximity of protecting parents for a longer period than do any other mammals. This dependency is the nucleus about which the emotion known as love develops. (Kardiner, 1955, pp. 22-31)
One can only wonder what Kardiner understood about the relationship between Achilles and Patroclus in The Iliad. This moralizing tendency within psychoanalysis did not go unobserved and was subsequently embraced by religious institutions that traditionally condemned psychoanalytic thought. Thus, in a document entitled The Norms of Priestly Formation, homosexuality is ironically described in heretical psychoanalytic terminology: “The existence of a close link between emotions and sexuality and their interdependence in the wholeness of a personality cannot be denied, even though these two things are diversely understood. In order to talk about a person as mature, his sexual instinct must have overcome two immature tendencies, narcissism and homosexuality, and must have arrived at heterosexuality” (National Conference of Catholic Bishops, 1982, p. 167).
Nicolosi’s (1991) approach marks a significant shift in the reparative therapy literature. This reparative therapist offers a deliberate fusion of spiritual and psychoanalytic thought:
Each one of us, man and woman alike, is driven by the power of romantic love. These infatuations gain their power from the unconscious drive to become a complete human being. In heterosexuals, it is the drive to bring together the male-female polarity through the longing for the other-than me. But in homosexuals, it is the attempt to fulfill a deficit in wholeness of one’s original gender. (pp. 109-110)
In addition to the Radoite theory of homosexuality, Nicolosi draws on literature from the field of pastoral counseling. He offers a religious treatise on homosexuality thinly disguised as a scientific document. In the new religious cum scientific paradigm, mental health is defined as conformity to traditional values and norms. Nicolosi’s reparative therapy “acknowledges the significance of gender difference, the worth of family and conventional values, and the importance of the prevention of gender confusion in children” (p. 23). He criticizes contemporary normal variant theories of homosexuality with the fervor of a religious fundamentalist. In doing so, he argues not as a scientist, but as a preacher:
The logic of the following assumption has always eluded me: because perhaps 4 percent of all people are homosexual, then homosexuality must be a normal variation of human sexuality. The fact that it occurs in other cultures and in subhuman species, under certain conditions, is also seen to prove its normalcy. Such logic would be equivalent to concluding that since a given percentage of people will break a leg skiing each winter, then a broken leg is a natural condition and one should not attempt to avoid it. (p. 132)
Nicolosi’s misuse of psychoanalytic concepts to buttress his moralizing approach has been criticized elsewhere (Drescher, 1998a, b). His entire work is characterized by an idealization of heterosexuality, the use of denigrating stereotypes of gay people, and a tendency to treat his own biases as universal truths:
Gay couples are characteristically brief and very volatile, with much fighting, arguing, making-up again, and continual disappointments. They may take the form of intense romances, where the attraction remains primarily sexual, characterized by infatuation and never evolving into mature love; or else they settle into long-term friendships while maintaining outside affairs. Research, however, reveals that they almost never possess the mature elements of quiet consistency, trust, mutual dependency, and sexual fidelity characteristic of highly functioning heterosexual marriages. (p. 110)
Socarides II: The Comeback Kid
Socarides is the perennial reparative therapist who keeps going and going. He was a prominent opponent of the American Psychiatric Association’s decision to delete the diagnosis of homosexuality from its Diagnostic and Statistical Manual and a leader in the opposition’s clamor for a referendum on the decision. Bayer (1981) remarked, “It [was] rather remarkable that the same psychiatrists who had charged the APA’s board with an unscientific and unseemly capitulation to political pressure now invoked the referendum procedure” (p. 142). After losing that political battle, Socarides and other psychoanalysts continued to maintain that homosexuality was always pathological. As a result, while other psychiatric organizations assimilated their lesbian and gay members, psychoanalytic institutions continued to maintain discriminatory policies in training and promotion of lesbian and gay analysts (Drescher, 1995).
In his public announcements, Socarides has amazingly tried to portray himself as a defender of gay rights. In this Orwellian approach, he is referring to an individual’s right to seek treatment to change a homosexual orientation: “The homosexual must be granted freedom from persecutory laws as well as full civil rights–and this constitutes an integral part of our approach to homosexual individuals…while we ask for civil rights, we also ask for the legitimate psychiatric rights of homosexuals to seek help for what they correctly feel is a disorder” (Socarides, 1994a).
However, despite Socarides’ often-repeated opposition to antigay discrimination, he and other reparative therapists filed affidavits in support of Colorado’s antigay Amendment Two (Socarides, 1993), which was eventually overturned by the Supreme Court. That law would have prevented any municipality from offering civil rights protections specifically to lesbians and gay men. Furthermore, in the case of Campbell v. Sundquist (1995), Socarides submitted an affidavit as part of the state’s unsuccessful defense of Tennessee’s Sodomy laws. His actions are consistent with the reparative therapy belief that social opprobrium must be reinforced if gay men and women are to be motivated to change their homosexual orientations.
In 1991, the American Psychoanalytic Association issued a nondiscriminatory statement regarding the acceptance of lesbian and gay candidates and the promotion of training and supervising analysts in their affiliated institutes (Isay, 1996). This was a de facto repudiation of Socarides and his view that homosexuality was always a sign of psychopathology and serious mental illness. However, the rejection of his life’s work by the psychoanalytic mainstream did not deter Socarides from seeking out other forums to continue expounding his views. These have included editorials in politically conservative newspapers (Socarides, 1994b; Socarides et al., 1997), a book written for a nonprofessional audience that recycles his pathologizing theories and demonizes his political enemies (Socarides, 1995), and starting an organization of his own with himself as its first President.
NARTH
Diminishing professional interest in their approaches has led reparative therapists to form their own organization: The National Association for Research and Therapy of Homosexuality (NARTH). To avoid any repetition of the embarrassment and defeats they experienced in the clinical, scientific and political debates in other professional organizations, NARTH’s officers have taken the position that it is unacceptable for current and potential members to publicly question the group’s belief that homosexuality is an illness. To disagree would undermine the organization’s raison d’être of providing an environment in which reparative therapists do not have their pathologizing beliefs challenged:
NARTH is an association founded to study homosexuality. We make the assumption that obligatory homosexuality is a treatable disorder. Our members hold many variations of that essential view.
The NARTH officers may opt to deny or remove membership when an individual’s written statements or public speeches show a clear antipathy to this position. We do not always choose to exercise this option, but will do so when, in our judgment, a potential member is likely to be disruptive because he or she is blatantly opposed to our goals.
Our criterion of discrimination is philosophical; we do not…discriminate on the basis of sexual orientation. In fact, many of our members are ex-gays or homosexual people in a state of transition toward heterosexuality. (NARTH, 1996)
Agreement with NARTH’S prevailing dogma appears to be the primary criterion for membership, not an individual’s professional background. The heretical belief that homosexuality is a normal variant of human sexuality is unwelcome and those who articulate that view risk excommunication if they voice it publicly. However, neocon converts to NARTH’s beliefs, ex-gays and potential ex-gays are always welcome. These organizational approaches are consistent with the activities of a fundamentalist religious denomination, not a scientific association.
In the current political climate, NARTH’s dogmatic views have been marginalized in professional and scientific organizations. It is uncertain if NARTH will have some future impact on clinical practice and thought in those mainstream mental health professions that presently accept homosexuality as a normal variant of human sexuality. For the present, however, reparative therapists have demonstrated their willingness to ally themselves with religious denominations that condemn homosexuality. Because they are unable to find reputable scientific support for their positions, these antihomosexual religious organizations have turned to reparative therapists to treat their flocks and to provide a veneer of modern respectability. NARTH, in turn, appears to be emulating the tactics of creationists who obscure their increasingly fundamentalist religious political agendas behind scientific and pseudo-scientific language (Tiffen, 1994). Antihomosexual politics make strange bedfellows and Freud, the devoutest of atheists (Gay, 1987), would find this wedding of psychoanalysis and fundamentalism astonishing.
Conclusion
“There is no point telling people who have difficulties that they are ill.” — D. W. Winnicott, Talking to Parents (1993)
This paper reviewed the history of psychoanalytic theories of homosexuality and therapies designed to change a homosexual orientation to a heterosexual one. The evolution of one branch of psychoanalytic theory into an antihomosexual political movement illustrates the permeability of boundaries between clinical issues and political ones. The deletion of homosexuality from the Diagnostic and Statistical Manual has led to increased political activism and a rightward swing of reparative therapists. In removing the diagnostic label of illness, antihomosexual political, religious and mental health forces were de prived of an important tool of repression. The growing political activism of reparative therapists underscores how much actual repression was previously wrought by the diagnostic label itself. In their open support of antigay legislation, reparative therapists have moved from the traditional psychoanalytic center and have been embraced by conservative religious and political forces opposed to homosexuality. In doing so, they have apparently adopted religious organizational practices themselves, preaching dogma and stifling dissent. The increasing marginalization of reparative therapists from the psychoanalytic mainstream illustrates how psychoanalysis per se is neither gay-affirming nor condemning, although psychoanalytic practitioners may fall into either of these categories.