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Journal of the American Psychoanalytic Association, Vol. 49, No. 4, 1187-1217 (2001)
DOI: 10.1177/00030651010490042101

Four Men in Treatment: an Evolving Perspective On Homosexuality and Bisexuality, 1965 To 2000

Ralph E. Roughton

240 Halah Circle Atlanta, GA 30328, Ralphroughton{at}aol.com, Emory University Psychoanalytic Institute, Emory University Department of Psychiatry and Behavioral Science

The author surveys his work with gay and bisexual men and his evolving clinical understanding, spanning a thirty-five-year period from 1965 to 2000. Four cases are discussed briefly, one from each decade, to illustrate the changing clinical approach, and the following conclusions drawn: (1) sexual orientation and mental health should be approached as independent dimensions; (2) heterosexual orientation is not a required outcome for successful analysis; (3) an analytic process focused on uncovering a presumed "pathological etiology" inevitably distorts the process and obscures more relevant analytic needs; (4) unrecognized heterosexist assumptions and unfamiliarity with norms of gay men's lives pose special barriers to analytic work with gay men. Ongoing self-analysis and self-education are necessary to reduce interferences that keep analysts from listening to their gay patients with open and unbiased attention.


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R. E. Roughton
Rethinking Homosexuality: What It Teaches Us About Psychoanalysis
J Am Psychoanal Assoc, September 1, 2002; 50(3): 733 - 763.
[Abstract] [PDF]