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February 20, 1961. OBJECT CHOICE IN A CASE OF MALE HOMOSEXUALITY. Austin Silber, M.D.1
DISCUSSION: Dr. Paul Goolker emphasized that homosexuality represents a complex psychic formation involving both the impulse and the defense against it, and called attention to Glover's observation that perversion is not only the negative of the neurosis but also may be the negative of certain psychotic formations. Comparable to the pure neurosis, there is an unconscious repressed element related to avoidance of castration fear, despite the partial acceptance of the conscious element. Dr. Goolker suggested that the heterosexual component in Dr. Silber's patient was strengthened by the homosexual experience—'getting strength from the man' through the phallus. He stressed the difficulties in the treatment of homosexuals due to narcissistic and regressive traits coupled with primitive defense mechanisms which tax the flexibility and resourcefulness of the analyst.