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Journal of the American Psychoanalytic Association
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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.

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