For clients who struggle to accept their same-sex attraction and experience their homosexuality as ego-dissonant(1), the literature is clearly split between two major therapeutic traditions, both offering a ‘cure.’ Conversion therapy and gay-affirmative therapy, which the author has reviewed elsewhere (Kirby, 2008), each tend to respond with a limited, exclusionary choice to be either an ‘out’ gay or an ‘ex’ gay; to accept or reject one’s sexual orientation. On the one hand, there are those who argue that some variety of treatment – whether formal conversion therapy conducted by a professional practitioner or a self-help ‘ex-gay’ group – should be available for those who experience their same-sex attractions as incompatible with competing values or beliefs (Throckmorton, 2002; Yarhouse & Burkett, 2002).
On the other hand, proponents of gay-affirmative therapy consider antigay social stigma and internalised homophobia, not sexual orientation, as the primary motivator of those seeking to change their sexual orientation. These authors (e.g., Liddle, 1996; Schidlo & Schroeder, 2002) question the justification and ethicality of sexual reorientation when homosexuality is no longer considered a mental illness and highlight the potential harms to those who attempt conversion therapy.
The ongoing debate between conversion and gay-affirmative theorists about the appropriateness and efficacy of these psychotherapies has, however, rendered dichotomous explanations insufficient for some clients for whom neither model is appropriate. These individuals are unable to resolve perceived irreconcilable differences between sexual feelings and opposing values/beliefs which can stem from holding traditional values regarding marriage and family, or religious beliefs that view homosexuality as unnatural and immoral. More recently, emerging integrative solutions have begun to appear in the literature offering an alternative treatment option to such individuals who value competing aspects of their identity equally (Gonsiorek, 2004; Haldeman, 2004; Yarhouse, 2006).
However, as a first step I had a look at what Freud had to say on the topic, and this article examines his views on homosexuality in relation to his psychosexual developmental theory, whether he believed same-sex attraction was constitutional or acquired, and his thoughts on sexual reorientation.
As founder of the psychoanalytic school of psychology, Freud made numerous references to homosexuality (1905, 1908, 1909, 1910, 1911, 1914, 1920, 1922). Taken out of context, Freud can be portrayed as either virulently anti-homosexual (Nicolosi, 1991) or as a closeted friend of gays (McWilliams, 1996); this contradiction has been used to promote both sides of a polarised debate on the theory and treatment of homosexuality.
Freud’s view on homosexuality was certainly tolerant for its time. In 1930, Freud signed statements calling for decriminalisation of homosexual acts in Germany and Austria (Abelove, 1986). When asked whether one ought to undertake to cure homosexuals or make their lot easier by increasing society’s tolerance, he replied, “Naturally, the emphasis ought to be put on social measures” (Wortis, 1954, p. 56). Freud understood the burden to be lifted from homoeroticism primarily as a burden society had itself placed there.
Freud disputed degeneracy theories’ pejorative views (e.g., Krafft-Ebing, as cited in Drescher, 2001), asserting that humans were by nature bisexual. He believed homosexuality to be a variation of the sexual function produced by arrest of sexual development, and attributed homoeroticism to insufficient repression of the original bisexual disposition. Freud argued that a sublimated homosexuality was necessary for normal heterosexual function. Similarly, all homosexuals had some heterosexual feelings.
Yet, despite his view of constitutional bisexuality as the origins of homoeroticism, and efforts to protect homosexuals from social malevolence, Freud never asserted complete parity between homoeroticism and hetero-eroticism (Weeks, 1985). Freud understood homoeroticism as undesirable (if blameless) sexuality when it was the primary erotic orientation in an adult (Drescher, 2001; Murphy, 1992) and believed heterosexuality and reproduction to be the goal of sexual maturation (Freud, 1905, 1925).
Freud recognised homosexuality in people whose efficiency is unimpaired, and who are, indeed, distinguished by specially high intellectual development and ethical culture such as Plato, Michelangelo, and Leonardo da Vinci (Freud, 1905, 1935). He believed homoeroticism was not eo ipso a pathological condition, stating, “I am of the firm conviction that homosexuals must not be treated as sick people… wouldn’t that oblige us to characterize as sick many great thinkers and scholars whom we admire precisely because of their mental health?” (quoted in Lewes, 1988, p. 32). His resistance of pathological interpretation of homoeroticism is evident in the Dutch psychoanalytic association’s inquiry about whether a homosexual man should be admitted to psychoanalytic training. Freud declared, “We cannot exclude such persons without other sufficient reasons, as we cannot agree with their legal persecution… a decision should depend upon other qualities of the candidate” (quoted in Abelove, 1986, p. 60).
Psychosexual developmental model
Freud theorised that early childhood development was organised into psychosexual stages of libido, moving from oral to anal to genital stages. Adult sexuality was defined as penile-vaginal intercourse, and oral and anal sexuality were labelled immature vestiges of childhood sexual expression. Homosexuality could be due to a libidinal arrest (in the phallic stage) or failure to reach the final psychosexual stage of genitality due to a blockage of the energic force. Alternatively, an individual had reached the more mature genital stage but due to trauma reverted to an earlier stage. This was termed libidinal regression. For Freud, changing an individual’s same-sex orientation to a heterosexual one meant helping them ‘grow up’ through achieving a higher level of psychosexual development, rather than a ‘cure’ (Drescher, 2001).
Aetiological theories of homosexuality
During his lifetime, Freud posed four different theories of the aetiology of homosexuality (Lewes, 1988). In each, he addresses a different metapsychological issue in relation to homosexuality, i.e. libido and bisexuality (1905), narcissism (1910, 1914), projective mechanisms (1911, 1922), or unsatisfactory Oedipal resolutions (1920, 1922). Each theory refers to a narrowly constructed ‘hypothetical homosexual’, which Freud used to hypothesise different psychodevelopmental events possibly involved in the emergence of adult homosexuality (Drescher, 2001):
1. Homosexuality arises as a result of the Oedipus conflict and the boy’s discovery that his mother is ‘castrated’. This produces intense castration anxiety causing the boy to turn from his castrated mother to a ‘woman with a penis’.
2. In the Three Essays, Freud (1905) theorised that the future homosexual child is so over-attracted to his mother that he identifies with her and narcissistically seeks love objects like himself so he can love them like his mother loved him.
3. If a ‘negative’ or ‘inverted’ Oedipus complex occurs, a boy seeks his father’s love and masculine identification by taking on a feminine identification and reverting to anal eroticism.
4. Finally, homosexuality could result from reaction formation(2): sadistic jealousy of brothers and father is safely converted into love of other men.
While Freud believed the expression of homoeroticism has psychological origins, he did not believe psychoanalysis alone could solve the problem of homosexuality. He argued that explanation beyond this belonged to biology (Freud, 1920). As a result, Freud cautioned against seeing homosexuality as either unequivocally acquired or congenital (Murphy, 1992).
In Three Essays on the Theory of Sexuality, Freud (1905) separated sexual behaviour from gender, thus founding a radical and invaluable way of thinking about diversity of sexual experience and expression. However, Freud recognised that Oedipal theory, central to his project concepts, depended on maintaining what Sinfield (as cited in Davies & Neal, 1996) called ‘the cross-sex grid’(3). The cross-sex grid had its origins in 19th century Victorian dominance and oppression of the heterosexual family mode over all possible other modes. Although Freud acknowledged his own inability to completely enter this new discourse, it is this early concept of the separation of human sexuality from gender that forms the basis of many gay-affirmative psychoanalytic writers (Davies & Neal, 1996; Isay, 1986; Izzard, 2000; Roughton, 2002; Rubinstein, 2003)
In his Letter to an American Mother, Freud (1935) reassured a woman that her homosexual son was not ill: “Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation. It cannot be classified as an illness” (quoted by Anderson, 2001, p. 23). Drescher (2001) believes Freud used the term illness as a synonym for symptom formation, by which he meant the product of intra-psychic conflict. Freud went on to suggest analysis might help in a different way, “If he is unhappy, neurotic, torn by conflicts, inhibited in his social life, analysis may bring him harmony, peace of mind, full efficiency, whether he remains a homosexual or gets changed” (quoted by Grotjahn, 1951, p. 331). In this case, Freud does not view homosexuality as an illness – rather an un-conflicted expression of an infantile sexual wish. Neither does he believe it implies health (Freud, 1905, 1920). In suggesting the benefits of psychoanalysis, regardless of whether change occurs, Freud does not reject the idea of sexual reorientation outright, although neither does he seem optimistic. It appears that Freud was not so much invested in the outcome of the therapy with regard to sexual orientation as attending to an individual’s inner conflict in order to bring about peace of mind.
There is nothing in Freud’s notion of bisexuality that rules out the possibility of sexual reorientation. Some authors (Bieber et al., 1962; Nicolosi, 1991; Ovesey, 1969; Socarides, 1978) have assimilated Freud’s understanding that sexual gratification found in people of one anatomy at one point in life does not rule out later change in the intensity of direction of sexual desire. This hypothesis has come to form the basis of contemporary conversion therapies.
Opponents of conversion therapy (Drescher, 2001; Isay, 1989; Murphy, 1992) highlight Freud’s (1905) views on bisexuality in Three Essays on Sexuality, where he rejects the idea that individuals could be born with object choices already determined prior to psychosexual development. This seems to be aimed at those claiming homoeroticism to be an innate condition. Freud also rejects the ‘third sex’ view(4). Yet, in stipulating constitutional bisexuality in people, it seems hard to understand Freud saying something other than homoeroticism will come to the fore in certain persons independent of their psychic environment.
According to Wortis (1954), Freud claimed some people had a special susceptibility to homoeroticism. In Psychogenesis of a Case of Homosexuality in a Woman, Freud (1920) believed constitutional factors determined the intensity of the homoeroticism in an eighteen-year-old girl. While accepting this patient for the purposes of sexual reorientation, Freud noted that such a case was not attractive to psychoanalysis because it did not begin with the personal suffering of a divided personality. To the contrary, his patient did not suffer at all from her attraction to other women. Freud (1920) cautioned that removal of homosexuality was never easy and success found only in especially favourable circumstances, “and even then the success essentially consisted in making access to the opposite sex… thus restoring him to full bisexual functions” (p. 151). He concluded that, “to convert a fully developed homosexual into a heterosexual does not offer much more prospect of success than the reverse, except for the good practical reasons the latter is never attempted” (p. 151).
Freud did not think homosexuality was pathological in the sense that it was the consequence of degenerative physiology or psychology. He found homoeroticism compatible with normal psychological functioning and even associated it with elevated capacities and superior psychic and moral qualities. However, Freud did believe homosexuality represented stunted individual psychosexual development and from this perspective saw it as inferior sexuality in a mature adult. There is nothing in Freud’s writings to suggest that conversion therapy is desirable or successful. In fact, he suggests caution to those who pursue such a direction with an individual who is suffering from his or her sexual orientation. In most discussions regarding ego-dissonant homosexuality, Freud left the prospect open.
1. Ego-dissonant describes individuals who struggle to integrate their same-sex attraction with competing aspects of their identity. Dissonance stems from the words ‘dis’ meaning ‘lack of’ or ‘apart’, and the Latin ‘sonans’ meaning ‘sound’ or ‘accord’. Together they describe a ‘discord’ or ‘lack of agreement or consistency’ with the ego or conscious ‘I’ (Harper, 2001).
2. Reaction formation is a psychological defence mechanism in which one form of behaviour substitutes for or conceals a diametrically opposed repressed impulse in order to protect against it (McWilliams, 1994).
3. In Oedipal theory, the ‘cross-sex grid’ refers to bipolar explanations of genders and sexualities as ‘opposite’ to one another.
4. The ‘third sex’ view was that male homoeroticism resulted from a female mind in a male body. Female homoeroticism was the opposite.
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Andrew Kirby was born in Zambia and raised in Zimbabwe where he remained until he immigrated to New Zealand in 2003. On leaving school he spent five years in the allied medical profession, initially as an Orthostist and Prosthestist (measuring, manufacturing and fitting of artificial limbs and orthopaedic appliances) and later working in the pharmaceutical industry. At 23 Andrew formed a business partnership – establishing a recruitment and human resources consultancy – and spent the next 20 years developing his business into a regional operation throughout central and southern Africa. Whilst his business interests were primarily focused in recruitment and human resources, Andrew was also involved in establishing a successful advertising agency and owned a popular restaurant in Harare for several years.
Since moving to Auckland, Andrew undertook a master of health science degree in adult psychotherapy and now works as a psychotherapist. His clinical experience has been gained with the New Zealand AIDS Foundation and Auckland Sexual Health Service, and he runs a part-time private practice in Ponsonby