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Drescher's monograph opens with the following statement: “Psychoanalytic Therapy and the Gay Man is not just a book about doing psychotherapy with gay men. It is also a chronicle of the historical state of relationships between two controversial cultural movements of the twentieth century: psychoanalysis and the political struggle for gay rights” (p. 2). This book would have been more successful had it confined
its aspirations to its first goal: doing psychotherapy with gay men. Drescher, a gay psychoanalyst trained at the William Alanson White Institute in New York City, presents a perspective about psychotherapy that follows upon and complements that of Richard Isay.1,2 When discussing scientific/theoretical issues pertaining to homosexuality, however, Drescher abandons the tone of the professional psychotherapist and becomes polemical, often stridently so.
Drescher as clinician advocates standard psychoanalytically informed therapeutic practices, such as forming a bounded therapeutic alliance, exploring the many meanings of behavior, and avoiding premature closure. His approach seems eclectic but heavily influenced by Sullivan, Winnicott, and the object relations school. A topic he discusses in a particularly helpful way is the psychology of the gay adolescent. A common misconception of therapists who are not experienced in working with gay men and youth is that it is not possible to know that one is really gay until full adulthood. Teenagers often have difficulties understanding their sexual desires; during adolescence many who are not actually gay experience homosexual feelings, and these patients must be distinguished by clinicians and treated differently from those who are in fact gay. Drescher's insights about gay adolescents are helpful in that regard. Drescher also instructively utilizes Sullivan's ideas about dissociation and selective inattention in illuminating the deleterious effects of being “in the closet”—hiding one's sexual identity from others.
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