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July 1963

Psychotherapy of Male Homosexuality: Psychodynamic Formulation

Author Affiliations

From The Psychoanalytic Clinic for Training and Research, Department of Psychiatry, College of Physicians and Surgeons, Columbia University.

Arch Gen Psychiatry. 1963;9(1):19-31. doi:10.1001/archpsyc.1963.01720130021003

Introduction  The purpose of this paper is to describe a theoretical approach to the treatment of male homosexuality. We will focus on the narrow but definitive therapeutic goal of establishing and maintaining pleasurable heterosexual behavior in a homosexual patient. We will not be concerned at this time, therefore, with many related problems, such as family constellations, personality types, diagnosis, criteria for treatability, failures in treatment, and prognosis. We will limit ourselves to the formulation of a compact psychodynamic framework within which any homosexual deemed suitable for psychotherapy can be fitted, understood, and treated. We will then demonstrate the clinical utilization of this framework through the description of three successfully treated cases with follow-ups of five or more years. Our formulation will be made in adaptational terms without recourse to Freudian concepts of instinct and energy. The reasons for dropping these concepts have been

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