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This paper is a response to five discussions of the author's book, Psychoanalytic Therapy and the Gay Man (PT&TGM). As per Vernon Rosario's historical account, the nature–nurture debate begun in the nineteenth century continues to be fraught with political implications to the present day. This paper contends that scientific and psychoanalytic debate parallels moral debates within the larger society insofar as each are concerned with whether same-sex behaviors should be regarded as deviant (illness) or as normal. This paper then takes up Bertram Cohler's contemporary perspective on the nature–nurture debate, particularly those biologizing psychoanalytic theories which reductionistically conflate the biological concept of sexual dimorphism with cultural, binary-gendered meanings of sexual feelings and behaviors.
In response to Donna Orange, this paper takes up the subject of intersubjectivity and mutuality in the clinical setting. Clinical attention to the emotional conclusions that patients have reached in making meaning of their lives is paramount in treatment. A clinical example drawn from PT&TGM illustrates the complexity of working within a hermeneutic approach
This discussion is respectfully dedicated to the late Stephen A. Mitchell, Ph.D., who helped create the language that gives this paper its voice.
Dr. Drescher is Training and Supervising Analyst, William Alanson White Institute, New York City; Chair, Committee on Human Sexuality, Group for the Advancement of Psychiatry; Editor-in-Chief, Journal of Gay and Lesbian Psychotherapy.
when extraclinical material is discovered which seems to be at odds with a patient's actual recollections of a traumatic event.
In response to Ralph Roughton, the paper reviews published anecdotal accounts by prominent gay survivors of the “old psychoanalytic war against homosexuality.” Operating as agents of the antihomosexual beliefs of the larger culture, analysts once put the social ideal of heterosexual hegemony before the analytic principle of respect for patient autonomy. The paper concludes by addressing R. Dennis Shelby's account of his own recent experiences with analytic teachers and supervisors as an openly gay psychoanalytic candidate. In his account can be heard the echoes of a psychoanalytic system that abused everyone who trained in it, regardless of their sexual identity. The abuses of the past have led to an intergenerational transfer of trauma within the psychoanalytic community which still needs to be addressed.