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This collection of papers on the psychoanalytic treatment of male and female homosexuality is a rich source of clinical material with minimal theorizing. Socarides is well known for his authoritative psychoanalytic writings on sexual deviations, and Volkan, who holds similar interests, has made seminal contributions on borderline disorders and the application of psychoanalytic therapy and psychoanalysis to seriously ill patients. The most interesting aspect of this volume is the application of psychoanalysis to the treatment of mostly very disturbed patients. With one or two exceptions, the 14 chapters in this collection represent writings from 17 individuals well known for their contributions in the areas of sexual perversions and sexual deviations.
The influence of Socarides on the overall conceptual foundations of the book is clear. His position, always a multidimensional one, considers the phenomenon of homosexuality as a spectrum disease on the very healthiest end of which oedipal conflicts dominate while, at the other end, much more serious disorganization is present, particularly the inability to differentiate self- from object representations. At the midpoint of this spectrum are what he calls dominant preoedipal conflicts. This approach spans the major psychoanalytic schools of thought including the ego psychology model, in which libidinal development and neutralization of aggression is prominent; the object representational model, in which relational defects are critical; and the self-psychological approach, in which defects in integration of self-representations are central. The psychoanalysts contributing to this volume would probably vary considerably in the degree in which they classify themselves as classical or more flexible in psychoanalytic technique.