Recent discussions on homosexuality and discrimination have focused the ambivalence with which our organization has dealt with the issue (Joanna Chapin's “Committee on Social Issues,” TAP 25 4; Executive Council and Meeting of Members in Washington). Most of our members oppose discrimination in principle, and yet some adhere to a theory that treats homosexuality as a priori evidence of arrested development.
In May 1991 by unanimous vote, the Executive Council adopted a Statement on Homosexuality: candidates and all grades of faculty are selected on the basis of “interest in psychoanalysis, talent, proper educational background, psychological integrity, analyzability and educability, and not on the basis of sexual orientation.” In May 1992, with endorsements by the Association's officers and the Board's Coordinating Committee, and with only six dissenting votes in the Council, this statement was amended to include training analysts.
This position statement has met with dissent from members who apparently see it not simply as opposing discrimination but as rewriting theory and bowing to political pressure from outside. As the Council member who introduced the amending motion in May 1992, I would like to give my perspective on these questions.
In making that motion, I stated that the issue is not the etiology and development of sexual orientation. That is far too complex and controversial a subject to be decided by debate and vote at this time. Rather, the issue is one of discrimination, including discrimination against some of our own members. Adopting the statement does not obligate us to accept anyone as a candidate or to appoint anyone as a training analyst who is not qualified. It simply says that homosexual orientation is not of itself sufficient reason to exclude an individual from consideration on the basis of his/her qualifications.
If this seems a radical position, it is almost identical with the one advocated by Freud in 1921 when he wrote to Ernest Jones that homosexuals should not be excluded from becoming psychoanalysts “without other sufficient reasons” and that the decision “should depend upon a thorough examination of the other qualities of the candidate” (quoted in K. Lewes, Psychoanalytic Theory of Male Homosexuality, New York: Simon & Schuster, 1988, p. 33).
There has, of course, been pressure to adopt such a statement, beginning about twenty years ago; but it has come from our own members and from our Committee on Social Issues. From the discussion in the Council meeting, it seemed clear that the vote was a stand against discrimination, not a fearful response to outside political pressure.
This newly stated policy, however, does raise questions about a theory that links homosexual orientation with personality defects. Although Socarides, quoted in the Chapin article, may find serious narcissistic disorders and important ego deficits in all of the homosexual patients he sees, that generalization is not upheld by the clinical experience of many other analysts, nor by any data other than accumulated clinical cases of defined patients. At present there is no credible evidence from any systematic controlled study that there is any greater degree of psychopathology in homosexual people than in heterosexual people.
Such studies are considered irrelevant by some analysts because they lack in-depth assessment of unconscious conflict. However, that limitation applies to both groups alike. On the other hand, our case study method does give intimate knowledge of our individual patients' minds; but, in constructing theory from this data, we run the risk of selectively finding what we seek, or making unwarranted generalizations from nonrepresentative populations, and of confusing coexistence with causation. When two analysts with extensive experience treating homosexual patients come to opposite conclusions about etiology, then we can either make ad hominem accusations or else question the methodology of generalizing from an idiosyncratic patient sample. The Council's vote, I believe, reflects an awareness that we do not yet have the answers on sexual orientation.
People with severe narcissistic pathology and ego deficits are probably not suited for analytic training—whatever their sexual preferences. But homosexual orientation should no longer be taken as presumptive evidence of such pathology. That is our official position. But adopting a position does not by itself eliminate prejudice.
There is need for a study group on sexual orientation to work toward some resolution of our polarized theoretical positions. Although it would be unrealistic to expect consensus at this time, it could be useful for a group to collect, evaluate, and summarize the clinical and research studies available and to publish an annotated bibliography similar to the one on women's issues.
In addition, there is need for a committee or task force to address the educational, administrative, and social effects of discrimination and to offer advice and consultation to our institutes. We shouldn't need a gay caucus or a political action committee, just a group of our members who believe that the time has come for The American Psychoanalytic Association to eliminate bias, to reevaluate its theory, and to learn from the clinical perspectives of the gay, lesbian, and bisexual analysts who undoubtedly exist among our respected members.
Ralph Roughton, M.D.