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February 5, 1963. A PSYCHODYNAMIC FORMULATION FOR PSYCHOTHERAPY OF MALE HOMOSEXUALITY. Lionel Ovesey, M.D.; Willard M. Gaylin, M.D.; Herbert Hendin, M.D.
The authors describe a theoretical approach to the treatment of male homosexuality with the admittedly narrow focus of a 'definitive therapeutic goal of establishing and maintaining pleasurable heterosexual behavior in a homosexual patient'. The motivational basis for homosexual and pseudohomosexual behavior is described as threefold: homosexuality, dependency, and power. The latter two are considered nonsexual though using genital organs to achieve their aims whereas the former component, homosexuality, utilizes sexual gratification as an end goal.
The homosexual motivation is based on fear, derived from parental discipline particularly in regard to sexual behavior, or from nonsexual intimidation that interferes with assertion and assumption of the masculine role. Subsequent heterosexual desire in the growing male is felt to be dangerous with fantasied punishments of castration or death, thus reviving earlier fears, inhibiting normal sexual expression, and resulting in the 'safer' homosexual object choice. Other solutions for the same infantile conflict may be impotence, fetishism, and exhibitionism. Homosexuality may be viewed as a symptom, a defense against castration anxiety by phobic avoidance of the female genitalia.
The dependency motivation is nonsexual and in the adult is an indication of adaptive failure. The wish to maintain the earlier mother-child relationship is projected onto other adults. The resultant failure of assertion, stemming from earlier inhibitions, is misinterpreted as a failure in the masculine role, and hence as a castration. Magical repair of this failure is based on the equation breast equals penis and consists of the magical incorporation of the penis through sucking or per anum.
The power motivation is a denial of weakness (dependency) in the non-assertive male and is acted ou