The Therapist's Authority and the Patient's Sexuality

Abstract

Since the 1973 American Psychiatric Association decision to delete homosexuality from its diagnostic manual, there has been an unprecedented social acceptance of gay men and women in both public and private arenas that was unimaginable during the era when homosexuality was considered a psychiatric illness. Nevertheless, treating homosexuality as if it were a mental illness has resurfaced as a controversial issue. Despite an increased tolerance and acceptance of same-sex relationships, there is still less than total acceptance. Among mental health practitioners, the rejectionist stance is embodied in attempts to remedicalize homosexuality as an illness or psychological deficit. Reparative therapy has recently come to define psychodynami-cally-oriented talking cures that try to change homosexual attractions into heterosexual ones. This paper attempts to demonstrate how a therapist's authority can be used to change a patient's attitudes toward his own same-sex feelings. Depending on the position of the therapist, a patient can become more comfortable with homosexual feelings, or the patient can learn to inhibit their conscious expression. This is a phenomenon that raises controversial, moral questions about the role of the therapist and the role of therapy.

Key Words:

• Psychoanalysis
• psychotherapy
• reparative therapy
• homosexuality
• countertransference
• homophobia