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Ralph Roughton, M.D.: Perhaps you can
imagine what it is like to prepare for this discussion this morning thinking
that you are the third speaker and going to be followed by Barney Frank
who will be the finisher and then suddenly to find yourself in that role
of the finisher. I promise you that I will not try to mimic Barney, but
suggest that you watch him on the evening news tonight.
Dr. Chodorow has given us
a very clear psychoanalytic understanding of the dynamics of homophobia
placed in the context of cultural factors and of gender identity issues.
I agree with her. I see homophobia as essentially an attempt to cope with
threats to masculinity by splitting and projecting outward onto external
objects which are then denigrated and attacked, in short an insistence
that "I am not like that." When we speak of internalized homophobia, we
refer to the shame, denigration and anger turned inward onto the self
of the homosexual individual either as a re-internalization or from the
absorption of homophobic attitudes in the environment and then identifying
with the hated and feared object. The primary emotion is shame, but a
whole gamut of inhibitions, loss of self esteem, depression and self-destructive
behavior often follow.
My focus in this presentation
moves from the individual internal dynamics to institutionalized homophobia
and its effects, specifically the history of anti-homosexual prejudice
in the theory, policies and practice of the American Psychoanalytic Association
and to a brief description of the remarkable changes in this organization
in the 1990’s. Although I will be discussing organized psychoanalysis,
I will also be speaking from a more personal perspective, not an easy
task in this cavernous room and with this elevated structural separation
from you, the audience-- it is a bit intimidating.
Homophobia, both my own internalized
homophobia and that of our culture, kept me confused about my own sexuality
for much of my life and kept me hiding in the closet for most of my life.
It is a mark of the astonishing changes occurring in our culture and within
psychoanalysis and concurrently in my own internal resolution of conflicts
that last week I voluntarily allowed my coming out story to be told in
Erica Goode’s excellent article in the New York Times and today
here I stand in the Grand Ballroom of the Waldorf along with Paul because
I am a gay psychoanalyst. Some might call this a manic defense or a counter-homophobic
maneuver. I think it represents serious progress in the resolution of
whatever it was that went on in this organization and in psychoanalysis
that made it not only unsafe, but unthinkable, that made the words homosexual
psychoanalyst virtually an oxymoron.
Paul Lynch has referred to
his experience of becoming a psychoanalyst. Mine was vastly different.
When I began psychoanalytic training in 1967, I had already been in analysis
for three years. Neither I, nor my analyst, thought to question my stated
wish to rid myself of the homosexual part of myself and we were working
toward that goal. I was accepted in the institute because the only question
asked in my interviews about homosexual feelings was easily answered with
the ambiguous "oh, it has come up in my analysis, but does not seem to
be a problem." It was not pursued further. That training analysis and
the subsequent second analysis each ended with a period of what I think
of now as a pseudo-cure measured by behavioral control and sublimation,
but no real change in wish or desire that lasted. Nevertheless, I suspect
that both analysts, if they had been asked to fill out a survey of successful
changes of sexual orientations through treatment would have included me
in that group.
In my institute classes,
the assumptions that homosexuality was a disorder and could be treated
went unquestioned. This was in the 1960’s. I learned to be skeptical about
the value of theories in psychoanalysis and have maintained that skepticism
ever since. I will not go into my internal conflicts and struggles, but
through the years, by keeping quiet about my real self and relying on
a public quasi-false self, my psychoanalytic career advanced. I eventually
became a training analyst and then director of my Institute for a five-year
term and was quite active in the American, including appointment as the
first chair of the Committee on Issues of Homosexuality. (And by the way
Paul, I did not choose that name either!) I had suggested the idea for
such a committee hoping -- and it was borne out -- that they would ask
me to chair it. Thus, with this background, it came as a surprise to many,
but not all, that when I decided two and one-half years ago that the time
had come for me to acknowledge to my colleagues the part of myself that
I had kept hidden, the response both in my local institute and in the
American has been warm, positive, and deeply gratifying. Would it have
been the same ten years ago? I doubt it.
Now to this meeting. I assume
that our audience today comes largely from two groups: One group of mostly
straight analysts and one group of mostly gay and lesbian mental health
professionals. I belong to both groups, as do an increasing number of
us, but I make this separation because I want to speak as a psychoanalyst
to our gay and lesbian colleagues about where psychoanalysis went wrong
on homosexuality and how it is changing. And I want to speak to my straight
analytic colleagues about how we analysts misunderstood and -- however
well meaning we may have been -- we nevertheless caused harm. My aim is
the further resolution of the wide gulf and profound anger that developed
between these two groups. Resolution requires acknowledging the past.
As Bishop TuTu says of his work on the Truth and Reconciliation Commission
in South Africa, healing requires that we admit past wrongs. In the American,
we took an important step when Marvin Margolis as President of the American
in 1997 acknowledged in a letter to the New York Times that old
psychoanalytic assumptions about homosexuality were mistaken and that
this had undoubtedly kept many qualified individuals from becoming psychoanalysts
themselves. Notice that I am not saying anything specific about homophobia
in our organization, not because I do not think it exists. Elisabeth Young-Bruehl,
in her book The Anatomy of Prejudices, questions whether understanding
of the dynamics of homophobia in the individual can be usefully applied
to large organizations. She also says that perhaps in small organizations
that are relatively homogenous this can sometimes be done. I decided that,
instead of going down that route and getting into an intellectual discussion
about group dynamics and trying to understand the effect of homophobia
at that level, I would keep this more personal and try to talk about what
I think happened and what went wrong, even if we do not understand the
full dynamics of group behavior.
I share Elisabeth Young-Bruehl’s
skepticism about facile and reductionistic explanations of organizational
character. I believe that the anti-homosexual prejudice operating in the
American results from a number of sources and that some people might argue
that all of these factors that I will be discussing are simply derivatives
of the basic dynamic of homophobia that Dr. Chodorow has outlined for
us in many individuals. I will not argue that point because I do not really
see how we can arrive at an answer in this short time. I would like, however,
to list briefly some factors that I think contributed to the problems
in this organization.
First, the height of interest
in determining the presumed pathological etiology and the therapeutic
zeal for treatment of homosexuality occurred in the fifties and sixties
when psychoanalysis was in its glory days of expanding to include a wide
scope of problems. I wonder to what extent this was spurred by the wish
to use this also on homosexuality, i.e., to include yet another "untreatable"
condition.
A second factor I believe
is our reliance on a development theory, in fact, our wedding to a developmental
theory that had no provision in it for an individual to be both homosexual
and emotionally mature. A third factor that I consider is the psychoanalytic
reliance on the case study method as data for theorizing and the disdain
for comparison studies of non-patient populations that almost universally
show no greater degree of pathology in homosexuals then in heterosexuals.
The result of this was a conflation of the psychopathology observed in
some homosexual patients with the sexual orientation itself. More and
more we are coming to accept the idea that sexual orientation and mental
health should be regarded as independent dimensions of an individual’s
life.
A fourth factor is, I think,
what was at one time the general conservative position of psychoanalysis
and the tendency in this country toward a moralizing tone that many analysts
had. A fifth factor is the interest that came from certain individuals
who were particularly involved in studying homosexuality and also from
the Association’s and the profession’s uncritical acceptance of their
reporting of what, from today’s perspective, we would see as seriously
flawed methodology and misinterpreted conclusions. So I wonder what effect
this kind of reporting of such methodologically flawed studies would have,
i.e., what is the effect of homophobia in individuals who do this kind
of work and gain a reputation in our organization? A sixth factor is much
larger than recognized until recently. Unlike the important initiative
from some women analysts in challenging psychoanalytic theories about
female development and psychology, there were no openly gay and lesbian
analysts who could serve this same function on this issue. A similar point
can be made about the social and professional relationships of analysts.
In general, analysts in our organization led a rather sheltered existence
until recently, and many analysts did not know, or did not know that they
knew, any gay or lesbian people as individuals but only knew them as patients.
Now, what happened to begin
the process of change? Richard Isay deserves credit for his persistent
efforts in the late 1980’s and early 1990’s to get the leaders of the
American to address the issue of anti-homosexual bias and specifically
the effect of having virtually no gay or lesbian candidates in training
or openly gay faculty. Eventually, against the strong opposition from
a few members and reluctant action by the leadership, in 1991, a non-discrimination
statement on homosexuality was adopted and amended in 1992 to include
training and supervising analysts. In 1992, the Committee on Issues of
Homosexuality was formed to identify areas of anti-homosexual bias and
to work with institutes and the American toward opening up its institutes,
changing attitudes, policies and curriculum.
What are the results? Now
we know that there are probably at least forty openly gay and lesbian
candidates in training in the various institutes around the country, probably
about fifteen openly gay or lesbian faculty members and two training analysts.
There may be more whom we do not know. Our committee holds workshops,
makes consultative visits to institutes and societies and, in May of 1997,
the first welcoming reception for gay and lesbian participants in our
meetings was held. The Executive Council has funded a study carried out
by the Committee on Scientific Activities to survey all of the literature
on homosexuality, both psychoanalytic literature and related fields and
to evaluate the validity of the various studies. That study just had its
final review by the Committee at this meeting and will be published in
book form by the University of Chicago Press. Bertram Cohler has done
the major work on this project and is the editor of the book.
Then, one year ago, the Executive
Committee voted, with only one negative vote and one abstention, to endorse
the Marriage Resolution sponsored by the Lambda Legal Defense and Education
Fund. The resolution calls on states not to pass laws which prohibit marriage
between same gender couples. I am not sure how many of our straight analyst
members realize how very, very important that was, not only in support
for the gay community, but in beginning to change the very, very negative
attitude towards the American and towards psychoanalysis. In summary,
I would say to go from a bitter fight over adopting a simple non-discrimination
policy statement in 1991 to endorsing this marriage resolution in 1997,
is remarkable progress. But I want to say also to our gay and lesbian
colleagues that these measures of progress do not adequately portray the
depth of changed attitudes and interest and support that is so clearly
expressed to me and other gay and lesbian candidates and members by such
a large number of our own members.
Now I want to speak to our
straight analyst colleagues. In reviewing our history, we might ask how
we got off of track. After all, Freud had a very tolerant attitude toward
homosexual individuals. When trying to explain same sex object choices
in his developmental theory, he was never able to formulate a satisfactory
explanation, and many of his statements are quite ambiguous; but he categorically
stated, more than once, that homosexual individuals are not sick. Psychoanalysts
who followed Freud were so wed to making the ill-fitting theory work that
many abandoned psychoanalytic principles of neutrality, shaped their observations
selectively to fit the theory, and generalized from a few disturbed patients
to attribute generalized pathology to all homosexuals.
My friends, we caused harm.
First, we created situations that either denied acceptance for analytic
training or intimidated those who might apply, so that generations of
gay men and lesbians who might have become analysts in our institutes
did not. When I met with a group of gay psychiatrists in the Association
of Gay and Lesbian Psychiatrists a few years ago to tell them of the changes
that were coming in the American, the pain and anger in that room was
palpable. As one middle-aged psychiatrist told me, with barely controlled
emotions, "You have to understand people’s lives were affected." Another
way that we have caused harm is in the biased theories and clinical writings
in our literature. Much of this passes quickly by even our well-intentioned
faculty members who are so embued in the heterosexist cultural and unexamined
assumptions. But our gay and lesbian candidates are pointing these out
to us, and most of the institutes are responding by re-examining their
curriculum and using some of these gay and lesbian candidates as advisors
or members of the curriculum committee.
There is another way in which
much harm has been done which I will only mention, because it is worth
a whole panel discussion itself -- that is, treatment approaches that
are based on the assumption that homosexuality is a disorder and can and
should be treated. If you think for a moment, if you go into treatment
and someone says to you that they will help you overcome this thing, but
first you must acknowledge that it is really bad and it is a part of you
and something to be expunged, I wonder how successful and helpful any
such treatment can be.
As Warren Blumenfeld says
in his book on homophobia, "We are all born into a great pollution called
homophobia which falls on us like acid rain." I like the sentiment that
we are all affected by homophobia, but we must also acknowledge that we
have had an active part in harming ourselves as an organization by our
own anti-homosexual bias and heterosexist assumptions. We have not only
deprived those who wanted to become psychoanalysts of that opportunity,
but we have deprived our organization and our profession of many bright
and talented people. We have also hurt ourselves by creating a public
image of psychoanalysts as strongly homophobic.
Two or three years ago when
I was in New York, I attended a Broadway play by Larry Kramer in which
a passing reference in the dialogue of the play was made to someone going
to a psychoanalyst. The audience hooted and jeered at just the mention
of a psychoanalyst. Another example to which I think we should pay attention
is that in 1993, when the issue of gays in the military was the hot issue
in Washington and all of the other mental health professional organizations
-- the two APA’s, the Social Worker’s Organization, the Nurse’s Organization
and others -- formed a coalition to support the Clinton Administration
in its attempt to overturn this policy of the Military, they did not even
ask the American Psychoanalytic Association if it would like to join this
coalition. They just assumed that we obviously would not.
Professor Gomes has talked
about how religion is usually the first source that people use to justify
bigotry and oppression. I am afraid that we have to acknowledge that psychoanalysis
and some psychoanalytic writings may very well be the second source that
people turn to. I think that we can begin to change that now. We still
have a small group of members who work vigorously to oppose civil rights
initiatives that would protect gays and lesbians, who are also a growing
number of our own membership, from the very real discriminations that
we potentially face.
In concluding, I want to
say to our gay and lesbian colleagues -- and I can speak from my own personal
perspective -- that the American, while not yet perfect, is now a welcoming,
gay-friendly organization. I want to acknowledge those leaders of this
organization who over the past few years have been important supporters
and champions of this change: Bernie Pacella, Larry Chalfin, Judy Schachter,
Marvin Margolis, Don Rosenblitt, Bob Pyles, and Dick Fox. These are presidents,
presidents-elect of the Association and chairs of its Board of Professional
Standards. All have been particularly helpful to us. Now to my psychoanalytic
colleagues, a personal note: thank you not only for tolerating me, but
for warmly accepting me, and not only for accepting me, but for honoring
me as you have today. I believe that we are a better organization for
opening our doors and, I even dare to say it, for opening our hearts to
those that we closed out for too long. Thank you.
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