But it is plain that the number of homosexuals will not decrease. On the contrary. I am of the opinion that under certain conditions the extreme polar tension between man and woman will always drive to homosexuality certain individuals possessing the requisite bisexual predisposition and that the number of homosexuals will increase. Since I look upon homosexuality as a neurosis, a morbid condition, if one insists on the term, I am decidedly opposed to the policy of penalizing the homosexual, and against those legal proscriptions which have been and are the cause of much misery. It is a striking fact that in France and Italy homosexuality plays a lesser rôle than in Germany, for instance, although in those countries the offence is not so severely penalized. Dangers and prohibitory laws often excite the strongest attraction and the neurotic is the very person who likes to become a martyr. Homosexual relations or acts, carried on under mutual understanding and with the consent of the parties thereto, should not come under the province of penal law, as provided in the Codex Napoleonis. The latter penalizes only public nuisances (outrage à la pudeur) that is, acts committed in public or carried on in the presence of witnesses; the Code Napoléon penalizes coercion and protects the minors and the feeble-minded.
With these provisions the requirements of our current ethical standards are fully met. I cannot conceive the State compelling the homosexuals to reproduce. Although I do not accept Tarnowsky’s viewpoint that their offspring is degenerate,—because personal observation has often convinced me of the contrary—I look upon the rise of the homosexual neurosis as a sort of social instinct. The homosexual possesses an endopsychic perception of his asocial tendencies. He feels himself beyond the pale of society and does not care to adjust himself into the social order with regard to his sexuality. His struggle against reproduction is perhaps best for society. Considering the strength of his sadistic inclinations we can appreciate that through his voluntary sterilization in certain cases he renders society a genuine service.
The question rises whether it is advisable to clear the homosexual’s path towards woman through psychoanalysis. That brings up the chief question whether homosexuality is at all amenable to therapy.
My personal experience has convinced me that here and there psychoanalysis is successful in effecting a cure. But only under certain conditions. The homosexual must be genuinely willing to be cured. He must actively desire a change in his leaning.
But experience shows also that this will to health is found only in the lighter forms of homosexuality in which latent sadism does not dominate the condition.[[50]] That in a certain sense the homosexual of this type is curable I am in a position to affirm on the basis of my personal experience. The cure proceeds spontaneously but it may be hastened through psychotherapeutic endeavor.
The proper psychotherapeutic method can never be hypnosis. What may we expect hypnosis to accomplish so long as the homosexual himself remains in the dark regarding his false attitude, so long as he has not learned to acknowledge openly the repressions against which he has fought so long? Contrary to Krafft-Ebing, Schrenk-Notzing, and Alfred Fuchs, I have never met with a lasting cure through hypnotic treatment. We must accept with greatest caution the statements of homosexuals claiming to have been cured by us.[[51]] Case 62 recorded in this work, illustrates that there are some homosexuals who in order to please the physician and conclude the treatment with flying colors, claim they are well without having changed in the least their deeply rooted feeling-attitude. Moll’s association therapy I am also unable to accept. That method of treatment consists of the systematic development of normal and the equally deliberate destruction of the perverse, associations. Moll, who has proposed this therapy and given it that designation, has the homosexual cultivate deliberately feminine company so as to come strongly under the specific female influences, he regulates the subject’s reading and helps him overcome the homosexual phantasies. The subject must think of “normal pictures” only, before going to sleep and thus influence his dreams in the proper direction.[[52]] But one must not think, as Moll concludes, that the heterosexual dream pictures which follow are due to the association therapy. The pictures thereby are merely rendered bewusstseinsfähig, tolerable to consciousness. They were always present. But the patient lacked the courage to acknowledge them.
I do not mean to deny a certain relative value to the association method. It is certainly not an advantage for the homosexual who earnestly strives to get cured to continue to frequent homosexual circles and to have constantly dinned into his ears the assertion that his condition is inborn and hopeless. I have quoted some cases showing that latent homosexuality may become manifest through contact with and the example of homosexuals while the heterosexual leaning may be disturbed thereby. But I did not intend to suggest the advisability of any compulsory measures for restricting the homosexual’s freedom of action or social intercourse. I have already expressed myself clearly against compulsions and punishments. It is advisable to urge the homosexual anxious to get cured to give up contact with homosexual circles.
But that the association therapy alone is capable of effecting a complete cure I cannot but doubt. The subject must first learn to see himself clearly and to recognize the source of the evil against which he is fighting. We must bear in mind the many subjects with whom repressed sadism is the true cause of the fear of woman. Such subjects must first consciously overcome their sadism, they must recognize that the fear is a ridiculous attempt at protecting themselves against leanings which under normal conditions never break through.
The first condition for the successful cure of homosexuality is adequate self-knowledge. That can be accomplished only through persistent psychoanalysis. The physician must devote himself to the subject for some months until the side-tracked leanings which the patient has stubbornly overlooked are brought into the field of consciousness and clearly acknowledged. The subject is like a person with torticollis looking constantly in one direction and avoiding a turn of his head on account of the pain. This mental torticollis must be overcome. The homosexual—if he is to get well—must be able to turn his gaze unrestrictedly over his whole mental horizon.
That is by no means a simple task. It is an achievement challenging the whole medical art, requiring insight, diplomacy, sympathy, friendliness, and patience. But few physicians are fitted for the task. Perhaps the opposition to psychoanalysis would not be so sharp if it were practiced only by competent psychotherapeutists and experienced professional men possessing the requisite tact. The physician is like the sculptor engaged in the task of bringing forth a certain form out of raw material.