Vicissitudes of the Transference in a Male Homosexual

This is a study of the course and development of a particular kind of transference in a male homosexual patient. In a survey of the literature on homosexuality, Wiedeman (1962) commented on the scarcity of material descriptive of the development of transference in the analysis of homosexuals.

Traced via the transference, the case material illustrates how fusion with an archaic maternal image has been utilized to ward off violent sadistic sexual drives. This is an example of "screen identity" (Greenson, 1954) in which a "good" introject is used to screen a "bad" one. In the material to follow, the hidden "bad" father introject begins to enter the material when the symbiotic attachment to the maternal transference image becomes weakened. The striving for return to the primary narcissistic union with the omnipotent mother unfolded as a powerful transference resistance, guarding the patient against separation anxiety, castration anxiety, and the whole gamut of the Oedipus complex.

Such primitive disturbances of object relationships are considered by Bak (1956) to be especially characteristic of perversions. He has indicated that the ego's ability to neutralize aggression is one of the major mechanisms in the larger ego function of differentiating or deflecting large quantities of aggression from sexuality. In the following case, such differentiation was severely impaired and, in particular, the phallic phase was weakened by oral sadistic drives.

The Patient

The patient was a 30-year-old Jewish professional man. He sought help with the problem of homosexuality at a time when he was suffering from the loss of a lover who had decided to get married. He had had several similar homosexual relationships previously. At the time of the initial interview he was thus lonely and somewhat depressed.

He experienced both homosexual and heterosexual fantasies, although his relationships had been predominantly homosexual. He practised mutual masturbation and fellatio w