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The case in question is that of a man whose illness started with symptoms of breathlessness and choking. During preanalytic treatment he lost these symptoms and became an overt passive homosexual. Subsequently, during his first six months of analysis, he became an active homosexual. Finally, at thirty-two, he had his first heterosexual experience.
Thorner tries to show that manifest homosexuality can take the place of another symptom. By the symptom of breathlessness the patient defended himself against the fear of being swallowed (by his mother). In the phase of passive homosexuality he himself became the person who swallowed, thus using a different defense mechanism to deal with the same anxiety situation. One characteristic of his active homosexual phase was that his partners were persecutory rather than love objects—unconsciously externalized internal perseuctors, invested with his own projected anxieties. By recognizing these anxieties, he made the first step toward his first heterosexual relationship. This coincided with a strong positive transference in which he identified himself with the good father and thus obtained the father's penis, an achievement beyond his reach in his homosexual relations.
Although this first (and apparently only) heterosexual relationship did not last long, his homosexual activities changed: they lost their compulsive character and became more infrequent. There was also improvement in other areas, such as in his reality-testing ability.
At the end of the paper Thorner discusses the interrelationship between feelings of persecution and homosexuality.