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I feel that a discussion of this topic, The Meaning of Homosexual Trends in Psychotherapy, should begin with a definition of the key terms, “meaning” and “homosexual trends.”
In psychiatry, the term “meaning” refers to motivation for behavior which, in neurosis, is unconscious. Using this definition, we can restate the topic for discussion in the form of a question: What are the unconscious, motivational ideas that produce homosexual trends in psychotherapy?
Next, let us turn to “homosexual trends.” If we define “homosexual trends” as narrowly as possible, the term would mean the expression, during psychotherapy, of thoughts, feelings, and dreams from which the therapist infers that the patient has a desire to carry out a sexual act with a homosexual partner for sexual satisfaction. We could then answer our question by saying: Homosexual trends are motivated by homosexual desires. This, on the surface, seems obvious and rather ridiculous, and if that is all there were to it, there would hardly be any need for this meeting, and we could all go home.
Actually, the situation is much more complicated than that. The trouble comes from the fact that most psychiatrists, operationally, do not define “homosexual trends” so narrowly. Instead, they mean by “homosexual trends” not only an erotic desire to satisfy a sexual need with a homosexual object, but they also use the term to encompass any desire by the patient to get love from, be protected by, be dependent on, be submissive to, force domination upon, and seek physical, especially genital, contact with a person of the same sex.
Our question now can finally be stated as follows: What are the unconscious motivations that produce in psychotherapy the various fantasies operationally subsumed under the heading of “homosexual trends”?
Due to lack of time, my answer to this question will deal with male patients only, but the psychodynamic principles I shall use are equally applicable to women.1 Those psychiatrists who use the instin