I would like to share some clinical insights gleaned from psychotherapy with patients struggling with same-sex attraction. These observations highlight the importance of understanding the specific psychological meaning of symptoms and the necessity of resolving problems regarding the patient’s sense of self before attending to gender identity issues.
David was a 26-year-old single, religious male struggling with same-sex attraction. David’s father was critical and rejecting and his mother was over-involved. David was also expected to mold himself in a matter that met his parent’s unmet emotional needs rather than have his parents adjust themselves to meet his unique developmental needs (Broucek, 1991; Miller, 1996).
During one session David expressed amazement that his friend Samuel had to struggle not to lust after pretty women. The cause for David’s amazement wasn’t that someone could lust after women. Rather it was the fact that Samuel was not particularly good looking. “What makes him think that a pretty woman would ever agree to be intimate with him!?” he wondered. This amazement reflected the superficial nature of the attitudes and relationships in David’s family. There was neither emotional depth nor an appreciation of the multifaceted nature of human motivations, needs and emotions. In such an atmosphere, the idea that someone might very well like you for internal, non-superficial reasons, such as personality, character, sense of humor etc. seemed impossible. (David’s mother once reacted to my suggestion that her daughter sounded depressed by showing me a picture of her daughter. “How can she be depressed? She’s beautiful!”) Likewise, growing up in a very critical family makes it very difficult to imagine that someone would overlook minor flaws because of their appreciation of other qualities.
Not surprisingly, David’s ideas regarding attraction to others were also totally superficial. In spite of being intelligent, knowledgeable and articulate, years of criticism and rejection by his father made it difficult for him to believe that anyone would be interested in him for anything other than his body. (As a result he became extremely anxious over the earliest signs of thinning hair.)
David couldn’t lust after females, but not because he inherently wasn’t capable of desiring females. Rather, it was because he couldn’t imagine them desiring him. The source of this belief wasn’t, at its root, gender related. In fact, as a result of his father’s lack of interest in him (as a separate individual) it was difficult for him to believe that anyone would be interested in him. However, since he had some same-sex sexual experiences in high school, he could imagine males being interested in his body.
Another interesting feature in David’s same-sex attraction was the underlying motivation for his sexual interest in males. What “turned him on” was the fact that he could get them to desire him, rather than his desire for them. (The sexual component was necessary because he needed concrete evidence of their interest in him.) For someone who never felt cared for by his parents, being desired for any reason could be quite a powerful experience.
A related feature of his attraction was that he was primarily interested in males whom he perceived to be (based on their external appearance) very religiously devout. The subconscious reasoning went as follows: This very religious person obviously has no sexual desires (!). If he, none-the-less, is willing to have a sexual relationship with me, it must be that he really cares about me. The fact that, in David’s imagination, someone was more concerned with his (David’s) needs than his own was in sharp contrast with his experience with his parents.
At times David found himself attracted to low status, disheveled looking males. This surprised him, especially since he was so focused on external appearances. Further exploration revealed that when David was feeling particularly unlovable, he would be convinced that a high status, good-looking person would never take an interest in him. He would then have to settle for an object of interest that he considered a “safe bet.” The primary purpose of David’s sexual acting out was to feel wanted by someone – a feeling he was sorely lacking. The enhancing of his masculine identity was secondary.