Unfortunately I must point out in this connection that the psychoanalytic method inaugurated by Freud is in danger of falling into discredit through careless application. On the one hand the exaggerations of the master and his pupils have repelled many practitioners; on the other many of the patients have themselves become psychoanalysts, without being completely cured of their own trouble. What would one think of a hydrotherapeutist, expert though he be in his own specialty, who undertook a laparotomy? Analysis is comparable to a serious operation requiring a steady, experienced and skilful hand. Psychoanalysis does not permit dilettantism like hypnosis. Only from an experienced master may one learn the difficult art of psychoanalysis and in turn become a master of the art.
It is quite likely that the analysis of today will be ridiculed in the future as a raw beginning. Various subtleties and gradations remain to be uncovered by the future generations.
The psychoanalytic realm is not yet completely laid out.
How firmly I held to all the Freudian mechanisms so long as the deceptive proximity of the great founder confused my own understanding! How much I had to unlearn, correct, tone down, or underscore, overcome or forget, or see with a different eye, before I realized that we are as yet but at the beginnings of our knowledge and that we must use our present findings as but so many spring boards to enable us to reach a little farther out! Finally, each psychotherapeutist formulates in the end his own technique. The most important prerequisite for psychoanalysis—as for every scientific investigator—is to approach the subject without any preconceptions, to look upon every patient as a new problem and not to be surprised if one’s case does not fit in with one’s ready-made systems or if it disproves one’s favorite notion. For even the physician with years of experience is startled to meet so many new forms under which neurosis manifests itself.
But in spite of the variegated pictures, this bewildering variety of causes leading to the trouble, one thing remains true and unalterable: the neurotic’s unwillingness to see, that peculiarity which Freud has called repression, and the consequent psychic conflict. We must first appreciate that the patient’s mind is shattered over the hopeless character of his conflict, that for him the neurosis is a necessity,—something that enables him in one way or another to put up with his hardships,—something with which softly to hide his wounds on the one hand and on the other, show his suffering to the world; when we appreciate all that, we may gradually acquire the subtle skill of dissolving the ties and bringing the wound to light. We see the wound but the patient will not, cannot, see it. He may go so far as to claim that he has no wound and is well; that he was born with the ties that bind him; or else, that he came with that wound into the world.
These difficulties are in no psychoneurosis so great as in homosexuality. As I have already stated: the homosexual neurosis is a flight to one’s own sex induced by the sadistic feeling-attitude towards the opposite sex. It is the task of analysis to uncover the mental conflict which finds expression in this onesidedness and to enable the patient to see the cruelty trend which he has derived from the childhood of the race and has carried through his own childhood into his adult life. When the homosexual becomes aware of his bisexuality and sees the causes of his monosexual leaning we have accomplished the requisite educational task. Beyond that point the patient must help himself. If he is truly earnest about his desire to get well he will accomplish it without being pushed to it. If he lacks the inner will the situation is hopeless in spite of the analysis.
For that reason I am not in favor of the practical management of homosexuality as carried out by many physicians and particularly by some psychoanalysts. They urge the homosexual to adopt heterosexual ways, and consider the subject cured when he is able to have normal coitus a few times. Unfortunately unpleasant reactions often follow alleged cures such as are often claimed for persuasion-therapy and hypnosis. The homosexual abandons all further attempts and prefers his original monosexual attitude.
We may claim a cure only after the subject under treatment falls in love with a suitable person of the other sex. Potentia cœundi is not enough. He must be able to give up dividing the feeling-complex hatred—love between the two sexes—and to achieve the bipolar attitude “hatred and love” towards the opposite sex. Such a miracle only love can perform. Experience proves that the homosexual flees from the heterosexual love to save himself. The latter looms up in his mind as a test of power, in which he is anxious to come out the winner, even at the cost of doing away with his heterosexual partner. He must accept the subjection to woman implied in love and recognize that in true love both lovers rule and both obey. He must also learn to recognize the essential unity of erotism and sexuality. Only when the homosexual finds it possible to fix his erotism and sexuality upon the same goal, in a person of the opposite sex,—in other words, when he learns to love in adult manner,—have we the right to claim a cure. It is only then, at any rate, that the greatest healer of all ages, love, achieves its easy victory and the former patient, like all neurotics, thinks that mere chance has brought him face to face with his ideal. With that end in view the fixation on the family—through which the homosexual loses his erotic freedom, occasionally also the sexual—must be severed. I have brought strong proofs to show that we must transform the homosexual into a bisexual being, in order to cure him. Practical experience does not favor bisexuality. We must reckon with the fact that we live in a monosexual age. The homosexual must transpose his whole sexuality and must try to overcome or sublimate his one-sided leanings.
The necessary educational discipline takes a long time. The treatment of homosexuality therefore is a formidable task, both for the analyst and for the patient. The end-result of the treatment may not be known definitely for some years.
I have tried to describe the technique of the analysis in the individual cases. From those various indications the reader may form a picture of the difficulties. A systematic account of the technique of the analysis would require a volume in itself. Perhaps after finishing my Disorders of the Instincts and Emotions Series I may write such a work in order to acquaint with my experience the practitioners who want to grapple with the same problems.