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This paper discusses the psychoanalysis of a young homosexual woman. The paper traces the change in the young woman, Sara, from being “obsessed” with a girlfriend, ambivalently attached to her mother, and hostilely related to men, at the beginning of treatment, to the point of termination of her treatment where she emerges a significantly changed woman who warmly engages in heterosexual relationships and with a new capacity for orgasm.
The general psychodynamic picture is one of neurotic development based on central unresolved conflicts. Conflicts over sexuality and aggression are internalized in a personality whose structuralization suggests she did reach the oedipal level. Early difficulties surrounding fear of loss of her mother and her mother's love influenced each successive stage of development so that loss is a leitmotif throughout. In the case of Sara, homosexuality is seen to be richly overdetermined with preoedipal and oedipal factors contributing to its development which made it impossible for her to successfully resolve the Oedipus Complex.
The paper represents direct dialogue between patient and analyst, dream material, free associations, and reconstruction of an event based on a childhood memory central to the patient's sexual conflict. A shift in the resistive stance of the patient is illustrated with examples of the working through of gender issues, transference, and interpretations of genetic and dynamic material, including obsessive-compulsive defenses.