Homosexuality and Paranoia

The problems of manifest homosexuality and paranoia in men and, more specifically, of their relations to each other awakened my interest when a homosexual man and another man with a classical paranoid psychosis applied to me for treatment at almost the same time. The prospect of carrying out psychoanalysis proper with a manifestly homosexual person is generally considered rather poor. As for paranoiacs, most authors are of the opinion that they are unanalysable. As both men gave the impression of being highly motivated and able to cooperate, I nevertheless decided to start analysis with both of them.

The reason why my findings and provisional conclusions (neither of the analyses is terminated as yet) may have some interest is my observation of a certain void in the scientific discourse of Scandinavian analysts. During recent years the psychoanalytic notion of perversion – which includes manifest homosexuality – as a specific category of personality organization seems to have virtually faded away. It may be true that it is rather rare that perverse or psychotic persons undergo analysis, but this should not lead us to believe that we may forget all about their existence without considerable loss to our conceptions about human character in other areas. Psychosis and perversion are types of personality organization to be placed side by side with neurosis, even if the latter most often serves as the prototype in our theoretical thinking.

First a very brief presentation of the two analysands I am going to use as examples.

H, as I will call the homosexual analysand, is 25 years old and lives alone. Since he was 13 he has led an active homosexual life with a great number of occasional sexual contacts and a few

Paper read to the Swedish Psycho-Analytical Society, November 30, 1981.

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more lasting relationships, mostly with men somewhat older than himself. He has no formal education and has maintained himself by varying unqualified employments, but aesthetic and creativ