PSYCHOANALYSIS AND ITS DISCONTENTS
A gay patient’s reflections
BY MALCOLM FARLEY
Illustration by Tati Nguyễn
Starting in the fall of 1980, I sequestered myself four mornings a week in a windowless cubicle beneath a Saks Fifth Avenue in suburban Philadelphia. I’d just begun my freshman year at Temple University. The purpose of my voluntary, underground ordeal, which demanded the unusual sacrifice of so much free time? Freudian psychoanalysis. Specifically, I hoped therapy would help straighten my “crooked” sexuality.
Yet, after four years of rigidly orthodox head-shrinking (more “orthodox” than any protocol ordained by the Master, I suspect), I remember shockingly little. When my therapy petered out in 1984, I didn’t morph into a heterosexual, either.
My psychoanalyst, whom I’ll call Dr. R., was warm and sympathetic, at first. She smiled frequently and seemed motherly. Her office was a paradigm of studied, chromatic banality: beiges, toffees, and creams. The walls were covered with what would now be called fiber art: tapestries and carpets, each exhibiting a variety of yarny fringes and furry impastos. I faced away from her during our sessions, lying on a couch.
Shortly after we began therapy, I suggested that her décor evoked a giant vagina. I also asked if her vertical carpeting was an attempt to mimic Freud’s collection of primitive art. I don’t recall her reacting to these provocations, but perhaps she chuckled. I do remember that if I could get her to laugh during a session, I felt I had somehow notched a victory. That’s because silence was my single most vivid recollection of Dr. R.
As a blabbermouth, I had no trouble talking, particularly for the first three years, filling the void of Dr. R.’s impassiveness with inane chatter about Freud’s ideas—I’d read The Psychopathology of Everyday Life and The Interpretation of Dreams in my parent’s library the year before—and amateur explanations of my own dreams and nightmares.
At the beginning, I had inchoate expectations of a psychological Journey to the Center of the Earth, à la Jules Verne, with fantastical discoveries at the end. But soon enough, I became apprehensive. Dr. R.’s monastic wordlessness distressed me more and more as my therapy progressed. Partly, this was because I came from a highly verbal family where not talking was a sign of extreme anger or deep, sustained resentment.
But my naive fantasies of self-transformation were also based on the tattered mass-market paperback I’d discovered at seventeen in an attic bookcase: Dr. Robert Lindner’s 1956 bestseller, The Fifty Minute Hour: A Collection of True Psychoanalytic Tales. The edition my parents owned, from the early 60s, featured a lurid scarlet cover and a painting of a naked woman with her back to the viewer and lush brown hair that fell to her waist. In deep distress, she held her head in her left hand. The image was strangely compelling. Lindner’s quote on the cover was equally melodramatic:
I am a psychoanalyst. I meet and work with murderers, sadists, sex perverts—people at the edge of violence—and some who have passed that edge. These are their stories as they told them to me: searching, revealing, perhaps shocking. But they are the raw stuff of life itself, and therefore these people are not beyond help.
I remember one case history about a female patient (perhaps the woman depicted on the cover?) whom we might now call a sex addict, and another, entitled “Come Over, Red Rover,” about a radical whom Lindner “cured” of an “anti-social” Communist Party affiliation.
Lindner portrayed himself as a heretical Freudian superhero capable of engineering dramatic change in his analysands. Perhaps Lindner’s book appeared crude and self-glorifying to his psychoanalytic peers or a more sophisticated general audience. As a teenager, however, I found his stories enthralling and his iconoclasm pleasantly disturbing. I glossed over the fact that his wonder cures conveniently reinforced 1950s phobias about the “Red Menace” and female promiscuity. Quite consciously, I hoped Dr. R. would “fix” me just as Lindner claimed to have done with his patients. Absent a miracle, I was desperate to uncover sexual feelings for women buried deep in my unconscious. Perhaps that would be enough to make me seminormal, I told myself.
At the same time, a darker, more rebellious part of me wished an adult would tell me my attraction to men was OK, that it didn’t make me a freak, a “sex pervert … on the edge of violence or beyond,” or an anti-American extremist.
At the very least, I desperately wanted Dr. R. to be like my image of Dr. Lindner—a talkative, combative, challenging presence in my analysis. Alas, Dr. R.’s taciturnity made her an absence, instead. (Did this mean I unconsciously desired a male analyst, rather than a female one? I’ll leave that to the experts to decide.) Maybe her silence was meant to elicit my transference, but her apparent neutrality (did she condone or condemn homosexuality?) could not, by its very nature, meet either my developmental needs as an adolescent queer or my political necessities as the closeted member of an oppressed minority.
The trouble over my sexuality—and my failure to live up to ideal boy-ness—had started early, inside the family. My mother often expressed dismay that I acted out fantasies with stuffed animals (a lion and a koala bear were favorites) or that I played hopscotch with the neighborhood girls. Normal boys didn’t act this way, she intimated with increasing frequency and intensity. Finally, at her wit’s end, she promised to get me a cat (she hated pets) if I promised to stop my “girly” behavior.
School was no better. When I entered first grade, other boys started to torment me relentlessly for reasons I couldn’t fathom. True, I read books constantly (even in class, when I wasn’t supposed to), I was bad at sports, and I liked girls at an age when other boys didn’t. These behaviors triggered an atavistic tribal disgust in many of my male classmates.
My bullies would taunt me with some of the nastiest slurs any boy could hurl at another: “sissy,” “faggot,” and “pussy.” When I told them to shut up or demanded they leave me alone, they would “call me out”—which meant I was supposed to meet them after school for hand-to-hand combat. I had no desire to fight any of them, of course. I just wanted to escape. So, I quickly found several “secret” exits from our large, World War I–era school building and evaded my tormentors every time—a small victory of brains over brawn.
In the late 60s and early 70s, I don’t think any of us understood these antigay and misogynistic insults. What did being a “faggot” really mean? I doubt my first-grade Furies had any clue what homosexuality involved. Nor did I. It was a more “innocent,” if violently homophobic, era, long before the media and the internet—including web-based pornography and hookup apps—made homosexuality more public and accessible, both to gay men and their enemies.
Antibullying programming and resources, such as those now maintained by the American Psychological Association and the National Institutes of Health, were not even “motes in the eye of God” back then, either. Indeed, most of the teachers and administrators in the Lower Merion public school system ignored the atrocious bullying occurring daily, right in front of them. Unfortunately, this publicly enacted cruelty extended far beyond my own sad situation. Other boys and girls—deemed “different” or “peculiar”—suffered too. One girl, named L., was viciously teased because a serious heart condition had turned her skin purple and made walking difficult. Other targets, such as C., W., and F., were simply geeks like me. They wore thick glasses. They read books. Already bullied, they’d grown fearful of other kids, which only encouraged further bullying. (I suspect I experienced Dr. R.’s silence about my same-sex attraction as a repetition of this larger social injustice.)
Some of my worst tormentors would chase me home after school and try to beat me up. (In the 60s and 70s, we walked to and from elementary school in the suburbs, which may seem surprising to many adults and children today.) It took me about 15–20 minutes each way. When my parents asked about bruises or cuts or mud on my clothes, I’d spin a story about a fall in the gym or a misstep over a curb. Since I was a klutz, they apparently thought my excuses were plausible or at least convenient, requiring no further investigation. In any case, concealing the source of my misery was paramount. How could I reveal the shameful things other boys were saying about me? Would my parents believe me or blame me?
Even as a sixth grader, though, I felt my pariah status was unfair. Was it my fault I’d been born “wrong?” After a school psychologist visited my classroom, I sought her out and asked for help. Apparently, she called my parents and recommended treatment for me. But nothing came of my valiant attempt to protect myself after my family, community, and school had failed to keep me safe—the most basic promise to a child any society should honor. Many years later, my mother confessed that she and my father had nixed the psychologist’s suggestion but wouldn’t tell me why. Perhaps they were embarrassed or worried about the cost.
“The case of the homosexual in society may, in fact, offer a particularly compelling argument for revising Freud’s ideas about when and how a sufferer needs to adapt to social norms and when she may need to seek ways to force society to meet her needs.”
By the time I reached thirteen or fourteen, however, I realized my bullies had been all-too-prescient. I was a “faggot.” My overtly erotic crushes on various boys—in school, in the neighborhood, in the summer classical music programs I attended, or in the antinuclear group I joined, full of sexy guys in their twenties with beards, ponytails, earrings, and lots of pot—had made that all too clear. These experiences aroused, terrified, and enraged me. How could little first-grade thugs—transforming year-by-year into a smaller but nastier cadre of twelfth-grade goons—have seen into my darkness more clearly than I had?
Many years later, when I read Michel Foucault’s The History of Sexuality: An Introduction, I remember nearly jumping out of my chair at this passage:
Nothing that went into [the homosexual’s] total composition was unaffected by his sexuality. It was everywhere present in him: at the root of all his actions because it was their insidious and indefinitely active principle; written immodestly on his face and body because it was a secret that always gave itself away.
Foucault’s description of the homosexual’s ineradicable, involuntary identity seemed to explain my ostracism as a child so precisely that it spooked me. Provocatively, Foucault claims that the budding field of nineteenth-century psychiatry helped invent “the homosexual,” as a medicalized identity for individuals, in contrast to an earlier religious animus against sodomitical acts.
But it’s hard to articulate the anguish I felt in the moment, as I first became conscious that my attraction to men was explicitly sexual and romantic. It was as if I’d belatedly grasped a Delphic pronouncement about my inner nature—and my fate—that everyone else had understood ages before. I was both doomed and stupid.
I narrated my sad history to Dr. R., of course. I also talked quite explicitly about my current sexual fantasies, my painful romantic infatuation with a sexually ambiguous boy one grade ahead of me, and my desperation to become “normal.” She always seemed sympathetic in a cloudy, subverbal way. She never told me my feelings were “wrong” or “bad,” at least. But I don’t recall her saying anything supportive, either.
My disenchantment with her detachment grew acute during my fourth year in psychoanalysis. I stopped speaking much in treatment. Most of the time, I was bored out of my skull. I began to arrive late to our appointments. My resentment made our sessions almost unbearable. Yet Dr. R. didn’t change her approach in any way, even as the symptoms of my frustration mounted. Towards the end, we often just sat together in total silence for fifty minutes, my parody of her silence becoming an ultimate defiance. When Dr. R. and my parents started to argue about her fees, I used their quarrel as a pretext to end my analysis.
Was my fear—that Dr. R. might, deep-down, view same-sex attraction as a “mental disturbance”—completely unwarranted? After all, the American Psychiatric Association didn’t completely remove homosexuality from the DSM until 1987, long after its declassification as a mental illness in 1973. Did her failure to provide what is now termed “gay affirmative psychotherapy” mean she shared, to some degree, the homophobia in the culture around her? It’s not an unreasonable question.
Alas, it’s hard to answer. Reading Freud, experiencing psychoanalysis first-hand, and sixty years of living have taught me hard lessons about the radical unreliability of memory and interpretation. So, I attempted to contact Dr. R. for this article and check my recollections and impressions against hers. Unfortunately, I was unable to obtain a response, a silence which feels—ironically, if unfairly—all too predictable.
However, I am certain that Dr. R. graduated from medical school in 1969, far from the epicenters of gay life in New York City and San Francisco. When she trained as a psychiatrist, the DSM still classified homosexuality as a full-blown mental illness. Moreover, hostility towards gay men was deeply entrenched in twentieth-century American culture. The 1969 Stonewall riots, and the subsequent gay liberation movement, had had little impact on the Main Line—the starchy, affluent, and nominally liberal Philadelphia suburb where I grew up and where Dr. R. practiced.
In fact, antigay bigotry still permeated my community. While I was in junior high, the older siblings of friends whispered about how school authorities had shut down the high school theater department’s production of Cabaret—directed by a senior who later became an openly gay Off-Broadway playwright—because it included simulated lesbian groping among the chorines. Later, as a high-school junior, I monitored my school’s reaction to two courageous, defiant, and flamboyantly out seniors who endured constant derision from their classmates. At the end of the school year, they tried to attend the senior prom together. School administrators forbid them entry. The discrimination they endured exacerbated my own secret shame.
On the positive side of the ledger, my aborted psychoanalysis did formalize an innate tendency to introspection. The habit of self-talk has proved invaluable in a lifelong struggle with depression and anxiety. It has also enabled me to understand the unconscious motivations of others, a particularly useful skill in relationships—and for a writer, I might add.
To my surprise, the most important therapeutic insight I took away from Dr. R. had little to do with “fixing” my homosexuality. Instead, I discovered that the institutionalization of my severely disabled eldest brother, Jeffy, when I was five or six, had had a major effect on my development. Despite her apparent detachment, Dr. R. did help me uncover my buried reactions to this seminal episode. I learned that I’d interpreted Jeffy’s removal from the family as a punishment. My combative relationship with my parents, afterwards, derived in no small measure from the anger I felt at Jeffy’s heart-rending exile in a state home “for the incurable,” and the fear my parents might banish me, too.
Now, after many decades as an openly gay man, and several stints in other forms of psychotherapy—the most successful of which combined Freudian theory with cognitive therapy—I believe the inadequacy of my psychoanalysis was much bigger than Dr. R.’s inflexible treatment protocol or her lack of empathy for a budding suburban queer boy.
It would be like picking a low-hanging apple off the Tree of Knowledge of Good and Evil to point the finger at Freud himself. Surely, an accuser might insist, Freud must be guilty of the replication of socially sanctioned homophobia in the treatment he recommended for neurotic individuals, some of whom “suffered” from homosexuality. Yet Freud seems to have been considerably more sympathetic to homosexuals than the European culture around him, with its antigay penal codes, cruel social ostracism of visible offenders like Oscar Wilde, and the early-twentieth-century scandals involving gay military officers like Eulenburg in Berlin and Redl in Vienna.
For example, in 1934 Freud wrote to the mother of a gay man, with admirable delicacy, seeking to dissuade her from trying to “cure” him:
Homosexuality is assuredly no advantage, but it is nothing to be ashamed of, no vice, no degradation; it cannot be classified as an illness; we consider it to be a variation of the sexual function, produced by certain obstacles to sexual development. … By asking me if I can help, you mean, I suppose, if I can abolish homosexuality and make normal heterosexuality take its place. The answer is, in a general way, that we cannot promise to achieve it.
While Freud’s letter echoes the calumny that homosexuality is abnormal, and rightly wouldn’t satisfy the LGBTQI community today, his attitudes towards homosexuals seem pretty “advanced,” at least towards the end of his life. It’s also hard not to feel, from his letter and his many case histories, that Freud’s attitude towards those suffering from mental distress—whatever its causes—is warm and empathic, rather than blandly observant as Dr. R. seemed to be.
No, if I had to put my finger on a damaging assumption in classical Freudian theory, it would come to rest on a more fundamental issue—one that many others have pointed out before. Namely, Freud’s therapeutic method seeks to help patients adapt their inner needs to a fixed reality principle, regardless of their social situation. In Civilization and Its Discontents, his late masterwork from 1930, Freud does make passing allusions to ethnic or religious bigotry as sources of psychic damage. (The psychological effects of discrimination by class, gender, race, and sexual orientation go unacknowledged, however.) But, by and large, he seems to believe that individuals in society are like deep-sea creatures who all feel the same extreme pressure from the superego’s patriarchal aggression, extreme libidinal inhibition, and a profound cultural “Unbehagen”—or malaise—at the bottom of the ocean.
Surely one thing we all know about primate social organization, however, is that some individuals live closer to the surface and the sun. They have more access to the means of production and reproduction than others, and therefore experience less libidinal inhibition. For bottom feeders, on the other hand, the libido may be the least of their worries. Survival itself may be at stake.
The case of the homosexual in society may, in fact, offer a particularly compelling argument for revising Freud’s ideas about when and how a sufferer needs to adapt to social norms and when she may need to seek ways to force society to meet her needs.
For example, John Boswell, in his introduction to Christianity, Social Tolerance, and Homosexuality, suggests a uniquely toxic interaction between homophobia and individual mental health:
Gay people are for the most part not born into gay families. They suffer oppression individually and alone, without benefit of advice or frequently even emotional support from relatives or friends. This makes their case comparable in some ways to that of the blind or the left-handed, who are also dispersed in the general population rather than segregated by heritage. …
… The history of public reactions to homosexuality is thus in some measure a history of social tolerance generally.
Boswell published his book in 1980, the year I started my psychoanalysis. It would have provided Dr. R.—and scores of other psychoanalysts—with a very clear picture of the psychological challenges specific to gay adolescents in that particular moment in cultural history. It might have also suggested something other than silence as the most efficacious response to my confession of homosexuality in the basement of a Saks Fifth Avenue department store. Alas, I’m almost certain Dr. R. never heard of Boswell’s book. She wouldn’t have been trained to seek it out, either.
While the tolerance American society has accorded to the LGBTQI community expanded dramatically after 1980—profoundly affecting the etiology of mental distress among us, young and old—the recent repoliticization of LGBTQI identity and the revival of homophobia suggests just how fragile such tolerance may be. The pendulum of social acceptance for us has swung back and forth many times across history and different cultures. Such wild cultural mood shifts suggest a problem with civilization itself, not with LGBTQI individuals.
Even Freud, contemplating the intractable unhappiness of civilized “man,” tentatively asks at the end of Civilization and its Discontents,
May we not be justified in reaching the diagnosis that, under the influence of cultural urges, some civilizations, or some epochs of civilization—possibly the whole of mankind—have become neurotic? … For a group all of whose members are affected by one and the same disorder … we may expect that one day someone will venture to embark upon a pathology of cultural communities.
Might “one day” be today? Might “someone” be contemporary psychoanalysts? I’d suggest we must all reenvision the old therapeutic Ananke as a new, double-headed Necessity: both to look deeply into the individual psyche and to gaze outward at adverse conditions that may require social diagnosis and social treatment, as Freud suggested nearly a century ago. ■
Malcolm Farley is a poet and essayist. His work has appeared in the New York Times Book Review, The Paris Review, and The New Republic. He has won residencies at MacDowell, VCCA, and the Vermont Studio Center.
Published in issue 57.3, Fall/Winter 2023