Psychoanalysis and sexual fantasies.

Psychoanalysis began as a depth psychology, heavily based on the sexual experiences and memories of patients. A long-term treatment, utilizing a free association method, psychoanalysis has provided a window onto the meanings and functions of fantasy, including sexual fantasy. Although psychoanalysis has produced some scientific research, the field has tended to rely on observational data collected from individuals studied in depth. Sex research on the other hand, carried out by investigators from different disciplines is based on empirical investigation. Each field has made contributions fundamentally important to the other. In this article, we review psychoanalytic ideas about human sexuality and distinguish those that have been invalidated by systematic research from those that remain useful. Perhaps, the single most important revision of psychoanalytic theory during the past century was concerned with the psychological development of girls and women. We separately discuss the development of the sexes, and stress the need for bridge building between psychoanalysis and sex research.

Private psychotherapy patients of psychiatrist psychoanalysts.

OBJECTIVE: The characteristics of private psychotherapy patients of medical psychoanalysts are described. METHOD: A structured interview was administered to 51 medical psychoanalysts. Patients' demographic characteristics, historical features, and other clinically relevant aspects of behavior were assessed. RESULTS: Of 575 patients, 88% had at least one axis I disorder and 46% had at least one axis I and one axis II disorder. Treatment duration varied from less than 6 months to more than 6 years. Forty-three percent of the patients were also treated with psychotropic drugs. CONCLUSIONS: The patients in this cohort met the criteria for DSM-IV psychiatric disorders, had lifetime histories of major psychiatric disturbances, and were not the "worried well."

Female homosexuality: classical psychoanalytic theory reconsidered.

The psychoanalytic theory of female homosexuality occupies an unusual position in modern psychoanalytic thought because it continues to be influenced by models of the mind that have largely been discarded in other areas of psychoanalytic psychology. Psychoanalytic ideas regarding female homosexuality are considered here from an historical perspective. It is suggested that modern psychoanalytic theory about sexual orientation in women must include recent contributions on the psychological development of women, the psychoanalytic psychology of male homosexuality, and relevant extraanalytic observations.

An empirical study of the beliefs of psychoanalysts about scientific and clinical dimensions of male homosexuality.

Eighty-eight clinical psychoanalysts responded to a questionnaire that assessed their theoretical beliefs about homosexuality. Questions were designed to asses agreement or disagreement with a model that homosexuality is pathological. Most psychoanalysts endorsed a nonpathological model, although their responses were sometimes inconsistent. We discuss the significance of these findings.

Bias towards gay patients by psychoanalytic clinicians: an empirical investigation.

Results of an empirical investigation of psychoanalysts' attitudes towards and clinical assessment of gay patients are reported. The study employed matched-vignette methodology; analysts rated their reactions on the Semantic Differential to homosexual and heterosexual patients with identical histories. They also rated degree of impairment in psychological functioning on the Global Assessment of Functioning and made DSM-III-R diagnoses. Results indicate that psychoanalysts maintain a subtle but significant negative bias towards homosexual patients, particularly those that have serious psychopathology. A negative bias towards the mentally ill in general also emerged. Suggestions for future studies and implications for training clinicians are discussed.

Biology and the oedipus complex.

Recent observations in the behavioral and neurosciences have raised questions about the ubiquity of the oedipus complex as well as about its significance for psychological development. The authors argue that the construct Freud called the oedipus complex in males is best examined in its component parts. One component--the incestuous wish--does not occur in all individuals. Another component--the boy's urge to engage competitively with other male figures, including the father--does appear to be biologically based in testosterone's effect on the brain and to be manifested in childhood rough and tumble play behavior. It is proposed that reexamination of the oedipus complex in light of recent findings about the brain and behavior is indicated and that play, in particular, can usefully be considered as a separate developmental line.

Neurobiology and sexual orientation: current relationships.

Despite great progress in the neurosciences, our understanding of the determinants of sexual orientation is incomplete. The authors review for the clinician/neuropsychiatrist studies pertaining to the formation of sexual orientation in the following areas: hormone effects on sexual behavior (animal and human); the complicated relationship between gender identity, gender role, and sexual orientation in humans; cross-cultural studies of homosexuality; behavioral observations in pseudohermaphrodites and offspring of mothers treated with hormones during pregnancy; brain studies of homosexual and heterosexual individuals; and genetic studies. The authors conclude that human sexual orientation is complex and diversely experienced and that a biopsychosocial model best fits the current state of knowledge in the field.

Psychoanalysis, psychobiology, and homosexuality.

The potential role of biological influences in human sexual orientation was considered more seriously during the early phases of psychoanalysis than in the years since World War II. Recently studies of homosexuality and heterosexuality in the neurosciences have attracted widespread attention both in the scientific and lay communities. The salience of these new data for psychoanalytic theory and practice is just beginning to be explored. In this article, we review research on sexual orientation in the following areas: genetics, crosscultural studies, studies of development in individuals with abnormal prenatal hormone exposure, childhood play patterns, and brain studies in both nonhumans and humans. Differences between male and female homosexuality are explored. We propose that psychoanalytic theory can grow and profit from a careful consideration of new findings in the psychobiology of sexuality, and that the interaction between mind and body is the appropriate purview of psychoanalysis.