Emerging Views On Gender and Sexuality

Reclaiming The Primitive Mind

Sidney Phillips took the primitive mind as his topic, reflecting on changes in his thinking as it has become accepted that sexual object choice and psychopathology are separate dimensions with no intrinsic link, contrary to earlier psychoanalytic thought. Now Phillips finds himself freer to consider more primitive aspects of the personality, even in otherwise high-functioning patients, as described in his remarks.

In the late 1980s, I contemplated organizing a panel on homosexuality and called Richard Isay to invite him to participate. I told him that the basis of my presentation would be a complicated case of a gay man with a perversion. Before I could further explain the nature of the patient’s unusual perversion, Isay angrily shouted at me that he wouldn’t take part in any panel that referred to gay people as being perverse. He asked me if I knew that the etymology of perversion meant “against the self,” and said that he would have no part in thinking of gay people that way. As disoriented as I was by his intense reaction to what I had said, fleetingly and silently I formulated the question, “Isn’t it possible to have a perverse symptom or character whether heterosexual or homosexual?” But I was still a candidate at the time and felt so intimidated by his anger that I concluded that I must have said something terribly wrong and quickly got off the phone.

Isay called and apologized the next day, and told me that he was writing a book and wouldn’t have time to participate in the panel. I later realized he must have been working on his landmark book, Being Homosexual: Gay Men and Their Development (1989). Writing that groundbreaking book meant confronting decades of mainstream psychoanalytic theory that regarded homosexual individuals a priori as perverse or seriously disturbed, and constructing a workable theory that differentiated itself from that prejudice while locating itself within an analytic frame. So Isay must have been exquisitely sensitized to the biased use of the word perversion in the same sentence as gay or homosexual. The implicit message sank in: To conceive of lesbian and gay patients as perverse is a product of unanalyzed, internalized homophobia furthering long-standing psychoanalytic stereotypes and prejudice—don’t do it!

I think this was a politically savvy imperative, even if now I view it as theoretically misleading. One way homosexuality came to be accepted and acceptable within APsaA was by gay and lesbian psychoanalysts emphasizing that we can be emotionally healthy, neurotic, object-related, oedipally organized, analyzable people. The shibboleth for this view was Cohler and Galatzer-Levy’s idea (2000), used with credit several times in papers by Roughton (2001, 2002), that issues of psychopathology and mental health are independent of sexual orientation. A flurry of papers were written demonstrating that gay and lesbian psychoanalysts can think and write as sane, perceptive psychoanalysts about neurotic, analyzable gay and lesbian patients. This was an effort to refute the insistent and prejudiced views of an earlier generation of American analysts who considered gay and lesbian people across the board to be severely ill, nearly psychotic, perverse, unable to engage in meaningful, loving object relations, and unanalyzable.

The earlier theoretical distortion was to view the serious psychopathology in some gay and lesbian patients as due to their sexual orientation. If your psychoanalyst regards your sexual desire and attraction as the central problem to be “treated” or “relinquished,” the ensuing iatrogenic damage is difficult to distinguish from the patient’s original dilemmas (Drescher 1998, 1999). Here at APsaA, Roughton led us in this laudable refutation—in which many of us took an active part—and it was a meaningful, timely, substantive corrective. And all of us, including Roughton, stood on the shoulders of Mitchell (1981), Leavy (1985), Lewes (1989), and Isay (1989).

Two decades of clinical work since then repeatedly illustrate to me how often high-functioning patients have aspects of their personalities that are primitively organized and include perverse elements. Perhaps it is time for another corrective. Perhaps the time has come to reclaim the primitive parts of our personalities as a way of helping our patients and ourselves have deeper, more thorough analyses. The prejudicial mainstream psychoanalytic view of gay and lesbian people as severely disturbed, held for so many decades, may have had a peculiar effect on contemporary analysts. Could it have induced us to see our patients through rose-colored glasses that keep us from grasping the depth of their psychopathology? Psychoanalysts may fear being considered homophobic if they frankly describe significant psychopathology in their gay and lesbian patients. Of course, gay and lesbian patients may suffer with severe disturbances just as any patient may. This is implicit in Cohler and Galatzer-Levy’s idea that mental illness and health are independent of sexual orientation.

I could point to many places in the literature where I think psychoanalysts may have understated the difficulties of their gay and lesbian analysands in order to appear to be avoiding old stereotypes; it seems fair to examine my own writing to illustrate this. In “The Overstimulation of Everyday Life: I. New Aspects of Male Homosexuality” (2001), I wrote about the ways that Western heterosexual culture surrounds the homosexually inclined boy with a climate of erotic overstimulation that powerfully affects his adult development and sexual adaptation. I illustrated this idea with the case presentation of a homosexual man who shared a bed with his younger, eventually heterosexual, brother from childhood through adolescence. In analysis, the patient revealed with great embarrassment his sexual excitement toward his brother. He recalled many nights lying in bed surreptitiously watching his brother fall asleep and longing to touch him. As the patient grew older, he fell in love with a series of heterosexual men who participated in emotional and some physical, but not overtly erotic, intimacy. The patient always hoped the relationship would become deeply romantic and erotic, but it always frustratingly ended the same way, with the paramour turning his attention to a woman.

As the analysis deepened, the patient’s feelings for me tilted in a subtly sexual direction. When I addressed this shift in session, the patient would begin talking in a dreamy, singsong manner and fall asleep on the couch. The overstimulation he experienced for years sleeping in bed with his brother came back to life in the analytic session with me. Analysis of the patient’s transference enactment—repeatedly falling asleep on the couch—gradually revealed the psychic impact of this everyday overstimulation: the creation of a tantalized, inner world of longing that had a long-standing neurotic effect on his love life.

Here is a dream the patient reported a few years into his analysis:

We were lying next to one another on the couch. Or maybe we were both in sleeping bags. I was lying here on the couch, and you were lying right next to me on the floor. Then the scene changes and we are in the room next door. We are in bed together. I’m taking your shirt off. We’re kissing, and it’s very passionate. We are interrupted by a knock on the door. The cleaning people are coming in. Then we are back in this room, and you are going through a big pile of papers, and we aren’t talking [Phillips 2001, p. 1246].

In discussing the analysis of this dream in my paper, I mention “certain preoedipal elements involving body narcissism that commonly emerge in the analyses of homosexual men” (p. 1247)—for example, the reference in the dream to our “both being in sleeping bags” as derived from a fantasy of intrauterine life as twins that at times was manifested in a twin transference. While I mentioned this more primitive aspect of the patient’s emotional life, I emphasized that the twin transference and the mirror image of the man’s body, the doubling of the body, was not evidence of a narcissistic personality but rather was a higher-level defense against castration anxiety.

In reconsidering this case in light of further clinical experience, I think the patient exhibited powerful needs to intrude into and take possession of me, to insist that we were the same (twins), or, if we were different, to reverse our relationship (he was doing to me, undressing me, rather than my doing something to him), all so as not to have to acknowledge my separateness. Viewing this material now, I wonder whether the reference to the interruption by the cleaning people referred to a sense of triumph about being inside the bedroom and a projection of a sense of the excluded, the dirty, and those of lower status outside the room. The shift from the consulting room to another room and then back to the consulting room suggests a splitting-off of experience. What is actually transpiring in the analysis is split off and projected into the other room with the bed. There he’s undressing me; he’s the dominant, active penetrator. It’s passionate, intense, and full of feeling. This whole aspect of his mind is sequestered and “cleaned up” in the consulting room, as suggested both by the cleaning people and by the stack of papers. Could that “big pile” be a reference to the perverse, anal universe where living, heterogeneous experience is flattened and homogenized into lifeless excrement? This was certainly consistent with his emotionally arid, detailed associations and his obsessional style.

Of course, there may be other, more familiar determinants to this bias. The most obvious one is that most psychoanalysts struggle against awareness of primitive mentation and affect—psychotic-level anxieties, paranoid ideas, sadistic triumph, and so on. It is well known that psychoanalysts sometimes avoid these experiences in themselves by insistently locating (interpreting) them in their analysands. Surely it is just such a mechanism that led to the original antihomosexual bias in psychoanalysis.

It seems likely to me now that this underconsideration of the primitive aspects of my patient, and implicitly of myself as his analyst, was partly the product of the culture in which my paper was conceived and generated. Lesbian and gay psychoanalysts were fighting against an active prejudice that viewed us as too sick to become psychoanalysts. The important corrective initiated and carried forward by Ralph Roughton, standing on the shoulders of others, was the idea that gay and lesbian individuals are no more or less disturbed than anyone else, that we can analyze and be analyzed, love and be loved—in short, that we are human. I suggest in these brief remarks that this vital corrective may have inadvertently influenced our analytic vision and understandably interfered with our grasping more primitive aspects of our patients and ourselves.

Recovering from Iatrogenesis, Flirting with Irrelevance, Celebrating Bisexuality

The next contributor, R. Dennis Shelby, remarks: Can we think about the future without reflecting on the past? All of us have been part of this great adventure with our presence and participation in APsaA, at home at our institutes, in print, in our consulting rooms, and in our lives generally. We cannot separate the academic from the personal—academic, not political, because ultimately we demanded that homosexuality be dealt with in the format of fair and reasonable academic debate and the progression of knowledge. Disagreement leads to that progression, and over the years many of us have disagreed. It is not an insult to disagree, though it can be uncomfortable; a clash of perspectives draws out assumptions and makes them visible for all to ponder.

The past ten years or more can be summed up as a process of recovery from iatrogenesis—a condition inflicted on a person by a medical or, in our case, psychological procedure. Many bright and creative clinicians contributed to our clinical understanding of this iatrogenic process. Drawing on Heidegger, we can say that at the least the social meanings supported by analytic theory created a wrinkle, a rift, if not a jagged tear, in our everyday assumption of being-in-the-world. Being an openly gay candidate added a layer of complexity to training, and many gay and lesbian candidates were called upon to publicly question the work of senior analysts. As the first openly gay candidate at my institute, I encountered a range of treatment, including outright attack, as when my supervisor told me, “Dr. Shelby, your homosexual problem is having a negative influence on your case.”

After several weeks of painful wrangling, one of my control cases had decided not to abort but to become a mother. In supervision I related my weariness and relief that a decision had been made by saying, “We are having a baby.” With great joy and a flourish, the supervisor scribbled something on the pad I had come to dread. I gently inquired about the nature of his excitement. With great solemnity, he replied that my ability to imagine a heterosexual arrangement was a great accomplishment and boded well for the analysis. Despite that burden, I and others graduated, continued to research and publish, and became training analysts and leaders in areas other than gender and sexuality.

While we have been developing, publishing, researching, graduating, marrying, becoming parents, and assuming leadership positions, the process of social change continues, with the demise of “Don’t ask, don’t tell” and the progressing and regressing of marriage equality. Books and papers that were so on the edge of knowledge about sexual orientation and gender a few years ago are now out of print. Last summer, I was totally dismayed that my advanced elective class, “Sexuality, Sexualization, and Orientation,” yawned at Butler, Chodorow, Young-Bruehl, Corbett, and Phillips, only perking up slightly at Layton. One student asked me to explain the significance of what I was teaching, saying, “None of us knew there was a time when being gay was such a big deal.” I wonder if the psychological stance we developed to manage the rift—questioning, writing, debating—might no longer be needed to the degree it once was. Who are we if we are not standing in opposition to an unseen but periodically manifested social/psychological force? If we take postmodernism seriously, then we have to acknowledge that gay, lesbian, and bisexual are ultimately just concepts, solid at the core, fuzzy at the edges; we have personally and collectively created a set of temporal and context-bound ideas about what it means to be gay. I wonder if the thing we have constructed, the gay-lesbian psychoanalyst, is becoming irrelevant in some ways; but remember that the work of neurosis is timeless, the “gay uncle” transference (Shelby 1994) is still germane, and the threats are not past.

The last part of my comments deals with celebrating bisexuality:

My dear Wilhelm

The first leisure time in the New Year belongs to you—to clasp your hand across these few kilometers and to tell you how glad I was to have your recent news from the family room and study. That you have a son—and with him the prospect of other children; as long as the hope for him was still a distant one, I did not want to admit either to you or to myself what you would have missed. Your kind should not die out, my dear friend; the rest of us need people like you too much. How much I owe you: solace, understanding, stimulation in my loneliness, meaning to my life that I gained through you, and finally even health that no one else could have given back to me. It is primarily though your example that intellectually I gained the strength to trust my judgment, even when I am left alone—though not by you—and, like you, to face with lofty humility all the difficulties that the future may bring. For all that, accept my humble thanks! I know that you do not need me as much as I need you, but I also know that I have a secure place in your affection.

Your

Sigmund [Freud 1896, p. 158]

Could it be that the necessary focus on homosexuality resulted in a broader psychological defensive retreat from embracing and acknowledging bisexuality and its importance in everyday life?

Freud’s idea was that the child develops deep emotional bonds with its parents before knowing what gender is, and that this love of the father and mother is transformed into femininity, masculinity, camaraderie, brotherhood, sisterhood, motherhood, ideals, and love of country, all precursors of the distinctive emotional interest that emerges late in the phallic stage and the object choice that sets up the oedipal constellation. But few children develop without experiencing a breakthrough of sexual impulses in the midst of the intense bonds of childhood. We do not know why Radó (1940) so severely denounced the theory of bisexuality, but we can guess. The focus on distinctive interest (Freud 1917) takes center stage developmentally, and has been the focus of our work, but vast reservoirs of affection and the buildup of memories, hopes, and expectations remain.

For the past ten years I have been on a side adventure as a reserve officer with the Porter County Sheriff’s Department. What I did not anticipate was just how much I would learn about the importance of bisexuality, the possibilities that that theory holds, and how little we appreciate it. The concept of “man crush” has become common in the vernacular, but I was not prepared for the series of man crushes that ensued. A man crush between a straight guy and a gay guy? Is such a thing possible? Is it a man crush if it’s between a gay cop and a lesbian cop?

It did not take long for me to discover that the “brotherhood” could be orientationless and genderless, that good performance in the nexus of tragedy and destruction—a quick action that prevents the injury or death of a fellow officer, the reuniting of a lost child with her mother—quickly overrides other concerns. All of this led me to the idea that some people can “play” with their bisexuality and some cannot. Could it be that every man crush is another form of that familiar idea of refinding the object? And why can some brotherhoods not play with their bisexuality, attacking instead? Nor was I prepared for the jealousy of wives and boyfriends: “You’re going to the ball game, then the two of you are going to work all night together. Are you also going to curl up under a blankie and take a nap?” Maybe. In full disclosure, I had to deal with my own inhibitions and accept butt slaps and hugs. More than once, when overhearing phone conversations, my boyfriend accused me of flirting, to which I replied, “They started it.” I am not saying that all of this is devoid of concern over the emergence of that distinctive interest. More often than not, when things get too close to the sexual, anxiety does emerge and is dealt with, often in such a subtle way that it takes a psychoanalyst to notice.

Toward the end of his career, Freud did shift to an even better idea, that libido and that distinctive interest were but subsets of Eros and its function of uniting and binding. Perhaps as social change continues to unfold, recovering from iatrogenesis may include reclaiming our bisexuality along with the distinctive interest that social and developmental forces have caused to take center stage. Social change may necessitate our periodic reflection on just what we feel the nexus of gay and lesbian is, and the nature of the world that is colored by that rift in our everyday assumption of being. I am proposing not a forgetting but rather a process that Loewald (1972) described as involving memory and memorializing, integrating and claiming.

In conclusion, I acknowledge several generations of psychoanalysts, all in different phases of life, training, and practice, creating legacies in print and by deed. Just as Ralph Roughton must accept his role of avunculus, we must as well. No psychoanalyst lives forever, but our legacies in print and deed live on. We have created a different history to pass on; hopefully we will pass it on with generosity, selfless concern for the younger generation, and admiration for the contributions they are making and are yet to make.

Gay Male Desire and Sexuality in The Twenty-First Century

In reflecting on psychoanalysis and lesbian, gay, bisexual, and trans (LGBT) lives, Gary Grossman considered the variety of cultural changes over the past two decades that impact LGBT people.

As a gay man working as a psychotherapist since 1979 and as an analyst since 1997, I am particularly interested in how cultural shifts have affected the gay men I have seen in treatment. The four phenomena I want to discuss are HIV/AIDS, increasing societal acceptance of homosexuality, the prevalence of overt hostility toward LGBT people, and the impact of social media. Each of these cultural elements has had a significant impact on gay male identity and sexuality, but psychoanalysts have yet to fully direct their attention to understanding the various psychological effects of such societal and cultural developments. In particular, I think a gay man’s discovery, experience, and expression of his desire and sexuality have been significantly influenced by these developments and are evident in many of the problems brought into treatment by our gay patients.

Every gay man must reckon with the reality of HIV—both gay men who were sexually aware and active before the discovery of AIDS and HIV, and gay men who became sexually aware and active post–HIV awareness. HIV infuses gay sexuality with danger and risk; sex, danger, risk, and anxiety are intertwined for the younger generation of gay men, despite the fact that the danger of HIV has become less overt. Although there is more societal acceptance of LGBT people, as evidenced by the presence of LGBT characters in television and film, openly gay media personalities, recognition of same-sex marriages, the lifting of “Don’t ask, don’t tell,” and greater attention to bullying and its consequences, there is still significant societal hostility toward LGBT people. Although people are coming out at earlier ages and parents may be more empathically attuned and comfortable with a child’s same-sex erotic attachments, proto-gay children will also be exposed to overt vitriolic hostility toward, and rejection of, LGBT people. Anti–marriage equality campaigns abound, and large sections of the world continue to be dominated by anti-gay attitudes. When a child’s emerging sexuality and desire are contested, ignored, denied, hated, or maligned, that child’s sexual development will be significantly affected.

As the popularity of relating and communicating via social media has increased, I have become curious about the effects of internet dating and hookup sites on gay men’s sexual behavior and relationships. Websites such as Manhunt and mobile social networking applications such as Grindr provide easy access to finding sexual partners while minimizing social inhibitions and anxieties. Previous generations of gay men relied on participation in social situations to meet other gay men, requiring at least a minimal level of comfort with one’s sexuality and familiarity with gay venues and meeting spaces. Internet technologies have increased the ease of access and connection, including sexual connection, with other gay men, especially benefiting the socially inhibited, as well as altering the levels of safety and danger. I am interested in further understanding the impact, the psychological meanings, and the consequences of this greater ease of social and sexual connections.

We must pay attention to the patients we see in our offices and the experiences they bring to us, especially encounters in which our countertransference anxieties are heightened and may complicate treatment. An example is seen in working with a gay patient, whether HIV positive or HIV negative, who engages in risky or unprotected sex. A patient who describes his high-risk sex presents unique challenges, including managing the tensions between our own anxieties about the patient’s dangerous behavior and safety, our wishes to help and protect, and our interest in maintaining a safe analytic space. There is significant potential for foreclosure and retreat.

There is an abundance of nonanalytic literature on risky sexual behavior, including studies of barebacking and public health efforts to promote safe sex. However, psychoanalytic contributions are limited (but see Cheuvront 2007; Cohler 1999; Cole 2007; Dean 2009). There was poor attendance at the Meet the Author program at the 2004 APsaA meeting in New York when Gilbert Cole (2002) was featured. Could it be that people were not interested in the experiences of an HIV-positive psychoanalyst? Did the subject stir too much anxiety? Risky sex may too easily be assumed to represent a patient’s self-destructive wishes. But labeling unsafe sex as self-destructive may lead to pathologizing the person engaging in that behavior. The cultural shift in psychoanalysis away from a pathological model of homosexuality may be limiting psychoanalytic exploration of gay patients’ experiences that stimulate anxiety in the analyst.

Although it will require psychoanalytic inquiry with each patient to discover the various meanings and functions of that patient’s sexuality, there are several possible meanings of risky sex that warrant our consideration. First, engaging in high-risk behavior can be a consequence of defenses such as denial of risk, absence of anxiety as a danger signal, rationalization, or perversion. Second, risky sex can be the result of unconscious fantasies—of omnipotence, of being protected and cared for, of merger and loss of self, of one’s destructiveness. Risky sex can be related to internalized homophobia, and be a reflection of unconscious self-representations as unlovable, undeserving, defective, wrong, bad, corrupt, guilty or criminal, dangerous, or repulsive. Similarly, risky sex can involve internal object-representations that are aggressive, rejecting, repulsed, punitive, condemning, or frightened.

Risky sexual behavior may be reflective of an addiction—ecstatic experience imbued with compelling desirability. Each time the patient does not become infected after engaging in risky sex can reinforce magical fantasies of omnipotence and fuel the wish to repeat and recapture the sense of power and invulnerability. Lastly, there is a correlation between substance use during sex and increased risky sexual behavior, which is further influenced by “sensation seeking”: the anticipation that drugs and alcohol will increase the pleasure of sex as sensation enhancers. As psychoanalysts, we recognize the complex interplay of internal and external factors that influence an individual’s psychological, emotional, and sexual development. Now that we no longer presume that same-sex desire reflects development gone awry, we are in a better position to discover and understand the varied meanings and functions of gay male desires and sexualities, and the clinical challenges we encounter.

Constant Cravings and Dangerous Secrets

Susan Vaughan used her personal experiences over the past twenty years as a basis for reflecting on the many changes in how APsaA, psychoanalysis in general, and the culture at large view homosexuality, as well as her very clear vision for what work remains to be done. She has been an active force in bringing about many of these changes, sometimes at personal cost to herself, and hopes to help others have an easier time when they encounter similar pathologizing responses. Her remarks follow.

The year was 1992. It was December. Bill Clinton had been elected but not yet taken office. Bosnian Serbs declared independence, and Paul Simon became the first major artist to tour South Africa after the end of apartheid. At the winter meetings of APsaA, I first met with Ralph Roughton to talk about some “issues” that had come up in my interviews as part of my application for psychoanalytic training. I had gotten in, one of the first two openly gay candidates set to start training in the fall of 1993. But it had been traumatic. So traumatic, in fact, that I later realized it was the first and last time I had ever dissociated. I literally did not remember the fifty-block walk home in the cold rain after my first interview, during which the interviewer had looked at me as if I had three Axis I diagnoses, ten Axis II diagnoses, and possibly two heads, and stated that she needed more time to assess my suitability for training. Why didn’t I work on “it” for a week in my analysis (whatever “it” was, I thought) and meet with her again next week? As I left, I thought I must be the world’s most masochistic person ever for agreeing to go back. Seeing me come in freezing and crying, my partner of six years, now my wife, angrily referred to Columbia Psychoanalytic as Seabrook United Methodist Church, my childhood suburban Texas church of conservative Republican Methodists.

“Why do you come all the way to New York just to put yourself back there? It’s a sick compulsion, a repetition. They make you miserable,” she said, hugging me. But the problem was, I really really wanted to be a psychoanalyst. I’d gotten a taste of psychoanalysis in residency, and as a well-regarded chief resident I seemed to have a chance after so many talented gay others had quietly tested the waters and been dissuaded when inquiring about applying openly. I was beginning to understand the price of my dream. I dreaded my meeting with this warm, fatherly guy named Ralph Roughton, because I knew it would mean instant waterworks when I talked about the traumatic parts of the interviewing process, but I was heartened that someone, someone straight and married no less, had spoken so eloquently on behalf of gay men and lesbians earlier that week at the meetings. It had been a wild scene, a room packed with psychoanalysts, some of whom lay down on the floor when the voting on a nondiscrimination statement began, just to be sure there was no way they could be counted as voting against it. But would I drown in the wake as the big flagship of American psychoanalysis slowly changed course? There was so much internalized homophobia needing to be undone, both within me and within APsaA. I was out, but ashamed, and the song that I sang all year that year, and that I played incessantly, was k.d. lang’s Constant Craving (1992), which seemed to express my pain and my desires and my longings:

Maybe a great magnet pulls

All souls towards truth

Or maybe it is life itself

Feeds wisdom to its youth

Constant craving has always been

Those first five years were both exhilarating and exhausting. We battled Charles Socarides until we realized that his day was over, that we were the new norm, and that battling him simply gave him a platform he would otherwise lack. Of course we still dreaded the possibility of being trapped alone with him and some of his ever-present henchmen in the elevator at the meetings, and reported Socarides sightings, but were pleased when his gay son, Richard Socarides, was appointed to the Clinton administration. It seemed that there had indeed been a sea change, a sea change in who kept quiet. Once it was the decent folk with broader, more open minds about gay men and lesbians, and now it was the Socarides crowd whose homophobic views were out of favor. One of our most time-intensive projects in the early years included visiting thirty-three of the approximately forty APsaA institutes for weekend-long conferences in which we presented cases, told our personal stories, and tried to build bridges between psychoanalysts and the greater gay and lesbian mental health community, hurt and angry as they were about the long-prevailing prejudices that had excluded them from APsaA institute training. People were generally interested, engaged, ready for change, and actively looking to welcome their first gay or lesbian trainee. We all worked long and hard on a comprehensive bibliography, still posted on the APsaA website (Grossman 2007), of suggested readings and possible course outlines. We included fiction and film suggestions, feeling that it was crucial to convey how aspects of gay and lesbian experience felt, and how eager our gay and lesbian patients and we ourselves were to simply be ourselves, our genuine selves. We met with the presidents and other brass of APsaA to share our perspectives. Might we not want to take a proactive stance on gay and lesbian parenting, we wondered with them, soon after Florida gave custody of a young girl to her father, a convicted murderer, rather than to her lesbian mother? We began to address the shame of another group—the psychoanalyst parents of gay men and lesbians who had been taught they were to blame for their children’s sexuality.

Amid this work, training ticked by. But it would take me years to realize how much my training and my first analysis were perverted by the pain of having to educate everyone else around me while trying to keep myself afloat. The psychic space needed for analytic reverie was simply not there. Instead I stared out the window at the Hudson River at the tugboats at play rather than listening to the deadening process class leader who felt that a gay male patient was being seductive in wearing biking shorts to a session with his straight male therapist. Maybe there was another possibility, I replied. Maybe he had biked to the session and that’s why he’d worn biking attire. Why did none of my classmates and friends, many of whom had known me and my partner for years, say a word, I wondered? Didn’t it bother them, or bother them on my behalf at least? But even with these problems, there were more of us at the meetings, more cases, more learning, more friendship, more receptions and great dinners and late nights out with new friends from all over the country.

By 1998 I had graduated, and I became the second chair of the Committee on Lesbian, Gay, Bisexual, and Transgender Issues. My first daughter was on her way. As chair, one of the first things I wanted to do was honor Ralph Roughton, and we started the Ralph Roughton Paper Award for the best paper of the year on a gay or lesbian topic. In addition to honoring our founder and leader, who made things safe for us all and then later came out himself, we wanted to create a new and badly needed literature on gay and lesbian life experiences and psychoanalytic work with gay and lesbian patients. I was proud to receive the award for a paper I wrote with my supervisor, Elizabeth Auchincloss, asking whether we needed a new developmental theory about gay and lesbian patients (Auchincloss and Vaughan 2001). No, we concurred, simple open-minded analytic listening not only would suffice, but was actually preferable, especially to new, bad theory. We took on what we saw as some fundamental errors in thinking that dogged psychoanalysts trying to make new theory, looking at how our errors in thinking had led us to so misunderstand and mistreat gay men and lesbians. I felt things had changed, were on course, were even ahead of schedule compared to where I had imagined things would be. For example, I was shocked to find that my own twenty-fifth anniversary year coincided with the passage of gay marriage in New York State. Life and work seemed good, on track, no longer a struggle.

But in the fall of 2011 I was suddenly shaken out of my complacency. When Columbia Psychoanalytic was confronted with a transgender trainee, the same psychoanalytic forces that seek to quash and extrude what is not understood were suddenly, horribly, seemingly instantly, afoot. It was 1992 with a difference. This was a familiar psychoanalytic reaction of fear and pathologizing, of biased judgment replacing listening and understanding and neutrality. But now there were enough people who had seen this before. Springing into action were all the good people who were able to slow down and talk and think and challenge anxiety-driven pathologizing ideas. I had no doubt when I was asked for remarks for this occasion that they had to be about trans as the new gay, the next frontier in the work facing us.

Like the many groups before us that have gained civil rights and gone on to help other groups, it is not only a challenge, but a necessity. Further, it is something that goes back to the very origins and deep meanings of psychoanalysis itself. Progress will really be possible within psychoanalysis when we realize that even the most heteronormative, seemingly straight among us are also queer, and that that is the main lesson of Freud’s thinking on sexuality. Of course, Freud, ever the dyspeptic, took a dim view of progress overall, once remarking, “What progress we are making. In the Middle Ages they would have burnt me; nowadays they are content with burning my books” (Jones 1957, p. 194). The reason for such a psychoanalytic pyre is surely what is in those books, which contain the truth that we are all queer. That message is the great truth of psychoanalysis, its greatest gift as well as its greatest challenge, something we learn and forget and relearn and rediscover and repress over and over again in our personal and professional lives. But it is keeping this focus on the queerness of all humans, of all of our identities and sexualities, our feelings and fantasies and behaviors, that allows us to tap into the powerful understanding that psychoanalysis can offer us all when properly understood and applied.

Another important understanding implicit in Freud’s work is that secrets—from others and from ourselves—can be dangerous in that they are a barrier to self-knowledge and an integrated sense of identity and often a source of deep-seated shame and self-loathing. Twenty years after k.d. lang wrote Constant Craving about being lesbian, Clarence Bucaro (2012) wrote Dangerous Secret, a song about the experience of a trans friend:

She says, “I’m not the person everybody thinks I am

I’ve always felt like this, could you understand?

Is it gonna be the end or a brand new start?

Will I find open arms or a broken heart?”

She’s been keeping such a dangerous secret

Like holding to a loaded gun

She’s been keeping such a dangerous secret

And she wishes she could tell everyone. . . .

Psychoanalysis helps us appreciate a crucial commonality across humans, a deep longing within each individual to become his or her genuine self, as well as the high cost of having to keep important aspects of the self secret, sequestered, and split off. Our constant cravings and dangerous secrets are something we all share. Whatever our gender expression or sexuality, psychoanalytic understanding can help us gain an invaluable sense of personal integrity and authenticity.

Conclusion

Ralph Roughton remarked that he was deeply honored by the richness of these essays, and thanked the contributors for taking up his challenge. He noted that though we are standing on the shoulders of those who came before, it is rewarding to bask in the accomplishments of those who come later.

As Prudence Gourguechon said in her plenary address (2011), the Committee on LGBT Issues (now the Committee on Gender and Sexuality) sets the standard for APsaA for this kind of advocacy work. And I would add that that applies not only to the results produced by the committee, but the manner in which the committee worked together as a group and then presented its proposals for approval by APsaA. One other important characteristic that has made all the difference, I think, is that the committee’s well-deserved image has been one of mature judgment and firm advocacy, while still recognizing that we are part of a larger organization. The committee has shown respect toward others and been able to elicit cooperation, rather than simply angrily protesting and alienating people.

There were times for angry protest, and some people needed to be alienated. But they are mostly gone now. Since fairly early on, we have been fortunate that APsaA’s leadership has been supportive and primarily just needed to be educated and have their awareness raised. The committee recognized that and worked with the leadership in a highly productive and mostly amiable way. It has gained a level of respect for the committee and its mission that is really admirable. I congratulate all of you for creating and maintaining that quality of relationship. It has served our cause well.