The Meaning of Homosexual Trends in Therapy: A Round Table Discussion

Homosexual Trends involve phenomena observed in heterosexuals and include: preoccupation with homosexuality; anxiety in the presence of homosexuals; inappropriate, unprovoked hostile attitudes to homosexuals; undisguised homosexual activity in dream content; homosexual fantasies; and some attitudes and behavior observable among overt homosexuals. Thoughts about being or becoming homosexual are frequently obsessional and are usually accompanied by anxiety which varies in intensity among different individuals from relatively mild states of discomfort to the agitation seen in homosexual panic. Homosexual trends seem to occur more frequently in men than in women and are associated with much greater anxiety. I have treated many male patients who have had severely distressing, recurring, obsessional fears about being homosexual (fears which sometimes even led to threats of suicide) but I have seldom observed the same severity of reaction in female patients.

An active heterosexual life is not precluded by homosexual trends. Most patients with such problems are not sexually aroused by members of the same sex and memories of homosexual arousal are usually absent. The absence of specific erotic responses distinguishes heterosexuals with homosexual trends from overt homosexuals and emphasizes the difference in basic adaptation. In a research study published under the title, Homosexuality—A Psychoanalytic Study of Male Homosexuals,* a comparison sample of heterosexual patients was scored according to the frequency and intensity of homosexual trends which were categorized as “none,” “mild,” “moderate,” “severe.” Of the heterosexual sample, 41 % were free of homosexual problems;17 % had mild problems; 15 % had moderate problems; and in 27 % of the cases, homosexual trends were severe. We compared heterosexuals with moderate or severe problems to the homosexual sample on variables