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This collection of fourteen papers by seventeen contributors expands the perspective of its senior editor, who has long maintained that homosexuality is an analysable phenomenon. Homosexuality is seen as a result of discoverable developmental failures and as a symptom of inner conflict. Consequently, the exploration of the problem in a psychoanalysis can enable a suitable patient to resolve conflicts, resume development, and achieve heterosexual functioning.
Other current opinions dispute this perspective. Some writers hold that homosexuality, though arising initially from distorted concepts of a person's own masculinity or femininity, or from constitutional factors, may be compatible with high-level object relationships and deep commitment to a sexual partner. Thus, treatments which approach homosexuality as pathological may be superfluous or harmful. The authors of this collection would disagree (while stressing the importance of tact and respect for the patient's autonomy), but the book is not explicitly polemical.
Ten papers are organised around one or two cases, considered from the point of view of one aspect of theory or technique. The case descriptions are generally clear and vivid and most of the papers focus on men. Ellen Siegel, however, presents a carefully detailed theory of women homosexuals, with a focus on the evolution of a particular case, and William Meyer and Charles Keith present a female-to-male transsexual. Siegel's and Ira Brenner's papers contain especially valuable material on the analyst's countertransference.
Howard Levine's case shows that homosexual behaviour may serve to regulate self-esteem. Even with a patient who expresses the desire to change his orientation, a preliminary period of analysis devoted to understanding this homeostatic function may be needed before homosexual issues can be directly explored. (Jerome Blackman makes a similar point, but chiefly by elaborating the theory of the instinctualisation of ego functions a