Homosexuality

Recent revision of previously accepted psychoanalytic theories and practices about homosexuality have been profound. My book, Male Homosexuality: A Contemporary Psychoanalytic Perspective (Friedman, 1988) influenced this paradigm shift. Subsequently, Jennifer I. Downey and I have continued our work on psychoanalysis and sexual orientation (Friedman and Downey, 1993, 1995; Downey and Friedman, 1998). The circumstances that led to my 1988 book, however, not only place our own contributions, but also much about this phase of psychoanalytic thought, in historical perspective.

In the 1970s it had become apparent to me that generally accepted psychoanalytic ideas about male homosexuality were invalid. I was influenced in my thinking at the time by my work with the DSM-III (American Psychiatric Association, 1980) Committee, my psychoanalytically informed research on homosexuality, and my experiences as a candidate at The Columbia Psychoanalytic Institute.

Soon after Robert Spitzer led a successful effort to delete homosexuality as a diagnosis from the DSM, I became a member of an advisory committee to the DSM Task Force on Human Sexuality. At that time the psychoanalytic community was involved in a struggle with the DSM Committee about the appropriate theoretical substructure of the entire psychiatric nomenclature. The previous two editions of the DSM had been based on psychoanalytic theory. The third edition of the DSM, however, was influenced by Kraepelin much more than Freud, and utilized a descriptive, atheoretical stance toward psychopathology. Rather than framing illness in terms of unconscious, maladaptive, irrational motivations, it was conceptualized in terms of suffering and disability.