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Homosexuality throws into question a fundamental tenet of psychoanalysis - its implication that one cannot desire the sex with whom one identifies. This impossibility, according to psychotherapists Noreen O'Connor and Joanna Ryan, is entailed by the theory that Oedipal desire for one parent involves identification with the other. Psychoanalysis accordingly deems lesbian desire only possible provided the lesbian identifies as a man. Or, if she identifies as a woman, it characterises her desire as pre-Oedipal, pre-genital, and as therefore not really sexual. Either way it reckons lesbian identity or desire spurious and hence necessarily pathological.
O'Connor and Ryan proceed systematically to demonstrate the operation of this maxim in a variety of psychoanalytic texts, beginning with Freud's and Helene Deutsch's lesbian case histories. They at least acknowledged some diversity in lesbian desire. Not so Karen Horney, Ernest Jones, Melanie Klein, Hanna Segal and other post-Freudians. These analysts variously characterise it as defence against desire for the father, or as pre-Oedipal regression, understood by some as involving refusal to know about, or envious attack on, the parental couple and their creativity.
This implies that lesbianism involves borderline psychosis. But, write O'Connor and Ryan citing examples from their own practice, this is by no means an inevitable feature of lesbianism. They likewise provide clinical vignettes to dispute Joyce McDougall's characterisation of the lesbian as identified with her father.