Sexuality in the Therapeutic Process

Our ideas about the therapeutic process are necessarily linked to our concepts of neurotic development. Our topic is the perennial question about the place of sexuality in the dynamic process of neurotic development. I don't believe we will ever get much agreement on this. One reason is that many of us still believe that our psychoanalytic terminology is necessary and helpful for our communication with each other. I believe, however, that it obscures communication and makes it often impossible. Most of our terminology consists of symbolic abstractions of very complex phenomena, which invariably have different meanings for different analysts. This is certainly true of such words as “infantile sexuality,” “sexuality” itself, or “instinctual forces.”

My own trend of thought on our topic is, I believe, best conveyed by giving you some of my thinking on a specific problem area in which I have been particularly interested.

I have been analytically raised in a period of strong reaction against the abuse in our literature of the term homosexuality and, particularly, latent homosexuality. Too often these terms were used with a smug air which implied wise dynamic explanation when at best the reference was only to a set of symptoms. Latent homosexuality was largely debunked as a result and homosexuality was regarded as a symptom which does not reflect a uniform dynamic structure but hides any number of neurotic constellations. Not only did I gradually become aware of certain elements of similarity in the therapeutic situation of patients with homosexual symptomatology, but I also suddenly found myself talking about a distinct group of patients as latent homosexuals. This brought me up sharply, with a considerable sense of shock, and I decided to find out what I really meant. I realized I was referring to a framework of a neurotic structure which was present in a number of patients with characteristics which I will presently describe. Some of them display overt homosexual symptom