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DISCUSSION: Dr. Aaron Stern summarized two major points, one explicit in terms of a theoretical psychodynamic construct, the other implicit in terms of the fundamental significance of learning relative to a given psychodynamic complex in successful therapy. The assumption that insight guarantees positive therapeutic results has not been corroborated by studies. The ego, rather than release of impounded drive flow, is the crucial agency in treatment. Dr. Stern questioned the methodology leading to formulation of the interactive system of the three basic motivational components as the etiological force in the psychic structure of the homosexual.
Dr. Lawrence C. Kolb noted that in the case cited neither the way in which the therapeutic change had occurred nor the actions of the therapist had been made explicit; he emphasized the need for changes in the superego and for the therapist to behave differently from past figures, thus helping the patient establish a different set of values. He assumed this had occurred in the treatment described by the authors. Dr. Aaron Karush spoke of the necessity for a self-rewarding system in setting new behavior patterns, emphasizing that identification with the analyst is crucial.
Dr. Ovesey restated that this is a formulation on psychodynamics, not on technique. It provides a therapist with an understanding of the unconscious motivations that impel the homosexual to flee from women and seek contact with men. Such an understanding enables the therapist to use emotional insight therapeutically.