Clinical Material: Brian

Brian, now 35, has been coming to once-a-week therapy for nearly four years. He lives in a small northern town in a flat he is buying, close to the home of his parents. He comes from what he sees as a typical English family: ‘people’, he says, ‘who never talk to each other about anything meaningful’. He has a brother, four years older than him, whom he greatly admires, a successful, confident man, married with children. Brian said he saw himself as ‘lonely, gawky and gauche’. I noted that I saw him as pleasant, smiling and likeable.

He said he was doing a course for which therapy was essential. It later emerged that it was advised but was not compulsory. He summarized his problems as difficulty in making relationships, lack of confidence, and an inability to confront, and when he really started to talk he said it would be ‘like a watershed’. At this point he was tearful and distressed and showed a depth of emotion that has rarely been repeated.

In the second session Brian said, ‘Things have come to a head.’ He had had a very emotional weekend with his ‘girlfriend’ (here he indicated quotation marks with his fingers). She said she wanted to marry him and have children, but he said, ‘It won't happen’. I queried, ‘You don't want to be with her?’ He reiterated, ‘It won't happen’. The only sexual involvement had been kisses and hugs, but they did nothing for him. I said, ‘What are you telling me?’ Brian replied, ‘I am gay’. The hinted at watershed did not materialize.

Brian was a virgin, had no sexual experience, but was emphatic he was gay; he had known in his teens. In my initial notes I had commented that he ‘seemed virginal, as though aspects of his life were unlived’. He repressed his sexuality because it was so unpleasant, horrid, he didn't want to be like that, he wanted to be normal. He envied his brother's good family life. He dare not look ahead, he didn't want to face being