Eros in a Gay Dyad: A Case Presentation

Before reading my presentation, I would like to share some thoughts I have had since originally distributing my report to discussants. I will be discussing my work with a gay psychotherapy patient, Tim, who presents provocative material, and may stir a variety of reactions. I chose to present the process of the therapy and my thought processes as openly and honestly as possible, in the hopes that it could foster further thought and discussion about psychoanalytic process, some of which may be specific to issues of homosexuality, and some of which may be more generalizable.

Tim is a 33-year-old gay man seen by me for psychotherapy intermittently over the past year and a half who has been considering psychoanalysis. Tim was referred to me for evaluation by his internist, who had seen him for concerns about his sexual performance. He reported that whenever he had sex with someone else, he felt extremely anxious and had great difficulty maintaining an erection and reaching orgasm. He also described panic symptoms during sex consisting of muscle tension and tunnel vision. He could masturbate successfully when alone, and no medical explanation could be found for his sexual dysfunction. Tim reported that this had been a difficulty every time he began a new relationship, and he had just begun dating John two months prior to our meeting. He described intermittent depressed mood but no significant depressive symptoms. His only prior experience with psychotherapy had been for one month