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I would like to address myself to psychosocial psychiatry and its particular relevance in the treatment of the homosexual adolescent. This subject is a reflection of a changing culture and adolescent psychiatry's recognition of such change. The case vignettes which follow may serve the purpose of noting societal changes and their effect in the therapeutic environment.
Taken from my files is the history of a 17-year-old young man seen in consultation in 1966. The adolescent was referred to me because of “homosexual problems.” His parents’ antagonism and hostility toward their son because of his “illness” led W. to my office. I was the family agent making an effort to “change” this young man's sexual orientation. A publication of mine addresses itself to the theme of the analyst as an agent of our social milieu. Clearly, our therapeutic work demonstrates that our interpretations, and my efforts, on behalf of this young man and others a decade ago or so were directed towards what our society expected of him, his family and his psychiatrist.
Approximately eight months ago I was called by a 16-year-old adolescent who decided to see me in consultation because of feelings of sadness. When I saw him in consultation he told me that he was homosexual, felt erotic attraction to males, and had discussed this with his family. They themselves initially were upset with his sexual orientation: at the same time they were accepting of him as a person and felt that what was critically important was his development as a human being. His sexuality could be viewed as an expression of a part of himself and not necessarily as just evidence of total disturbance. Our work was time limited because this young man's depression centered around a rejection by his male lover. As we reconciled ourselves to the sense of loss and abandonment that this young man experienced, it became quite evident that he had no interest to explore other parts of himself—especially his homosexuality. It would appear to