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The widening scope of psychoanalysis has resulted in increased effectiveness in the treatment of perversions. “We have learned that some preoedipal problems do yield to analysis and that the manifestations of oedipal and preoedipal pathology can be intertwined” (Solomon, 1982). We have also learned that paying attention to self-pathology can add another facet to the understanding of those cases that have been stubbornly resistant to psychoanalytic therapy (Kohut, 1979; Kohut & Wolf, 1978).
Our theoretical understanding of homosexuality began with Freud's description of the relationships between infantile sexuality, perversions, and neuroses and the role of the castration complex in the formation of many of the perversions (Freud, 1905). An addition to this understanding was the appreciation of the significance of the aggressive drive and its role in the development of the concept that a narcissistic object choice can be a defense against destructive wishes toward the object (Arlow, 1954).
The psychology of the self has further expanded our understanding of these issues. Goldberg (1975) has described how a perverse erotic experience can serve to master painful affects and Stolorow and Lachmann (1980) have described how perversions can serve to stabilize fragmenting self and object representations.
In the clinical field the technical handling of many perversions has been enhanced by the understanding of archaic idealizing and mirroring selfobject transferences (Kohut, 1971). In this chapter I would like to illustrate how the emergence of these transferences, the reactions to empathic failures, and the working through and resolutions of these transferences allowed for the successful analysis of a case of male homosexuality.
The case to be presented is that of a 47-year-old professional man, highly accomplished in his field, consulting me because of homosexuality of 30 years duration. Married, with three children, his homosexuality had been confined to discreet, long-term r