Saturday, February 19, 2011

Homosexuality: Coming out of the confusion, by Sidney H. Phillips, M.D.

SIDNEY H. PHILLIPS, MD, is a training and supervising analyst of the Western New England Institute for Psychoanalysis; Associate Clinical Professor of Psychiatry, Yale School of Medicine.

Homosexuality: Coming out of the confusion, by Sidney H. Phillips, M.D. 
Unrequited Love Affairs
Cause of Inability to Form A Close Relationship
Dissociative Efforts Buries Deep
Double Shame
An Illustration of the Relentless Cycles of Everyday Life
Attraction & Disappointment
Hope & Despair
Excitement, Arousal & Grief

In this paper, Dr. Phillips describes the complications of how the historical context of social norms can significantly influence the classification of the components of homosexuality by clinicians causing them to be blind to their own biases. Mindful of our susceptibility to this kind of phenomenon, Dr. Phillips calls to task these biases that pathologize homosexuality simply because it is not consistent with heterosexuality and therefore to be classified as a mental disorder. He offers an alternative description of homosexuality from his clinical research that is consistent with other researchers of early childhood psychological development of children who grow up to be gay. 

When homosexuality is understood as a natural developmental process of human sexuality, what happens to the children who grow up to be gay? These children are often subjected to a kind of continuous harm that can be considered torturous being raised in a world where heterosexuality is considered the only accepted norm. A psychological harm is inflicted on these children throughout their early childhood developmental years that have lasting effects throughout their adult years having been raised in a social environment influenced by harsh antigay social and religious norms.

Dr. Phillips views homosexuality as a normal process of the variations of human sexuality. He has found as other researchers in this area have found that men in their twenties and early thirties who are openly gay report histories of remembering as early as 4 and 5 years of age and older being attracted to other boys and men, (Sidney H. Phillips, M.D., 2002, The Overstimulation of Everyday Life: II Male Homosexuality, Countertransference, and Psychoanalytic Treatment. Ann Psychoanal 30:131-45). These men report that in their midadolescence stories about their first loves, which they remember in “rich detail” and these stories obtained were “remarkably similar.”
They fell “head over heels” in love with a heterosexual boy. These sexually unconsummated love affairs went on for many months. The homosexual boy had to overcome some reluctance on the heterosexual boy’s part to permit greater and greater physical intimacy, especially sleeping in the same bed together. The heterosexual boy’s reservations were invariably overcome by the homosexual boy’s ingenious rationalizations and energetic persistence.

What was striking in all these stories was how both participants attended to and would not cross what seemed like a carefully constructed boundary against erotic behavior or dialogue. As long as all proceeded under the “innocent,” permissive guise of, mutual, close friendship, the relationships continued. These strange love affairs between homosexual and heterosexual adolescent boys predictably all ended the same way: the heterosexual boy eventually turned his attentions to a heterosexual girl. Stand by Me
Ann Psychoanal 30:131-45

Note: Please be aware that the clinical material presented here regarding the work and writings of Dr. Sidney H. Phillips is a simplification of a very complex process not easily explained in a few postings. For this reason, we supply an extensive list of references, as well as, links to national and international professional medical and mental health associations. Photo 

Dr. Phillips draws our attention to Richard Isay M.D., work describing a developmental pathway of a child who grows up to be gay. Dr. Isay describes this from his extensive research from the retrospective studies of gay men. Isay found that these gay men were able to identify the existence of an early homosexual orientation. They remember being 4 and 5 years of age having homoerotic fantasies, wanting the affection from their fathers, in the same way that a heterosexual boy child has heteroerotic fantasies, wanting the affection from their mothers.

An important factor that Dr. Phillips explains is how Dr. Isay continuously found with gay men in analyses that a major turning point came when these men remembered and could accept their affections for their fathers at 4 and 5 years of age. Isay reported that reaching this stage in analyses brought about the resolution of a number of related symptoms.

Dr. Phillips notes that Isay‘s findings did not follow along lines of the accepted theory, which was that a father who was distant or absent from his son was the contributing factor for his son becoming gay. Isay found from his research work that the expressions of affection that these gay men showed for their fathers, at 4 and 5 years of age were the key factor that caused their fathers to feel uncomfortable and withdrew from their sons. Isay clearly stressed that from his research that the "stereotypical" references made about fathers who are absent or withdrew from their very young sons was not the cause of their sons becoming homosexuals.

Fathers could withdraw for numerous reasons; however, I would heuristically think that they withdrew because of the influence of harsh antigay religious norms, which are manifested through social norms. Fathers could be uncomfortable with their own homosexual feelings and or be quite concerned about the future welfare of their sons’ knowing that as adults, how hostile society can be to homosexuals.

An example of this is most vividly portrayed in the movie "Brokeback Mountain." It takes place when Ennis and Jack are together again for the first time in 4 years, after first meeting on Brokeback Mountain. They are sitting around a campfire in the evening and Ennis is relaxing reclining back starring up at the stars. Jack looks over at Ennis and says to him, "Is there anything interesting up there in heaven?" Ennis replies with a very pleasant smile on his face "I was just sending up a prayer of thanks." This is a very tender moment in the film, which Jack is in a way proposing to Ennis. Jack tells Ennis that "... it could be like this always, just like this, always." Ennis's face loses its smile becoming strained as he turns his face away from Jack, looks down at the ground. Ennis then begins to soberly tell Jack about this vivid flashback he is having to his early childhood days growing up. Ennis describes for Jack this disturbing scene from his past how his father took him and his brother along this pathway in the country to show them the kind of violence that happens to adult men who lived together. The traumatic psychological effects from this event with his father appear to have remained vivid throughout Ennis's adult life. It is shown in Ennis's inability to form and be in a relationship, any kind of relationship, but particularly the one with Jack, to go with Jack, and build a life together. AUSCHWITZ - CHRISTMAS 2008 - A flashback far more severe than in - BROKEBACK MOUNTAIN
(Click on titles for links to author's paper)

by Ralph E. Roughton, M.D.

Sidney H. Phillips, M.D., 2002,
Ann Psychoanal 30:131-45

Oedipal Stage in Homosexual Boys

Dr. Phillips notes Richard Isay, MD. “… offered a major theoretical advance for reconsidering the development of gay men he proposed a developmental pathway specific to homosexual men that entailed an early homosexual orientation. He reported that gay men experienced homoerotic fantasies from at least age four or five years, a finding that is replicated in this study. He noted that this period of development is “analogous to the oedipal stage in heterosexual boys, except that the primary object of homosexual boys is their fathers” (Becoming Gay, The Journey to Self-Acceptance, 1989, p. 29).
A major stage of psychological development in early childhood is when in the mind of a heterosexual boy growing up, he wants his mother all to himself and resents having to share her with his father. In this child’s mind he has no concept of marriage or relationships. It is difficult to explain to this boy at this young age that his mother is married to his father. Hearing that he cannot have his mother all to himself, in the mind of this child, he will be upset. To give this boy hope for the future he will be told another fact of life, which is when he grows up he can find someone like his mother and he can marry her. This stage of psychological development is resolved successfully, if the boy learns to master his anger towards his father and his fear that his father will retaliate against him.

Unrequited Love Affairs

This same stage of psychological development in early childhood is true for the boy who grows up to be gay. The only difference is that this boy will want to have his father all to himself and resent having to share him with his mother. However, because of the strong social influence of antigay social and religious norms prevents this stage from being resolved successfully for many boys who grow up to be gay. A successful resolution of this stage for a boy who grows to be gay is the reverse of a heterosexual boy, which is that this boy has to learn to master his anger for and fear of his mother. Sidney Phillips, M.D. explains that this is the “necessary developmental framework” that when it is not resolved successful gives insights into why many homosexual adolescence boys have these “unrequited love affairs,” as explained in Part 2 of 10 of this series. These homosexual adolescent boys are attempting to rework a version of what was not successfully resolved with their fathers growing up (Scott J. Goldsmith, 2001, Oedipus or Orestes? Homosexual men, their mothers, and other women revisited. J.Amer. Psychoanal. Assn., 49:1269-1287).
He falls in love with a heterosexual adolescent boy as a displacement of his childhood love affair with his (heterosexual) father. Accordingly, it was of such vital importance to the homosexual adolescent boys in these affairs that the heterosexual boys returned their passionate love in depth even though it never encompassed a manifestly erotic dimension. An essential feature of these friendships for the homosexual boy was that they were deeply felt on both sides: The love was mutual even if the erotic attraction was not. These friendships were clearly an effort by the homosexual boy, in this adolescent version of this oedipal drama, to heal and repair the effects of the paternal withdrawal and /or repulsion during the original oedipal passions so poignantly described by Isay.

Basks in the Warmth of Another Male's Love

Even though ultimately not an erotic triumph, since in the dénouement the heterosexual boy always gets his girl, the homosexual boy –perhaps for the first and formative time in his life –basks in the warmth of another male’s love. Now we can understand how and why the erotic boundary is so carefully constructed and maintained in these affairs: It is an obvious repletion of the incest taboo but surely also an effort to avoid the erotic triggers to the original paternal retreat. It is not merely a repetition of the wish for the “full” oedipal triumph, though surely it is this, too. But it is also an expression of the homosexual boy’s deepest wish that someday, somehow, someone can love him wholly and completely without having to step lightly around the erotic perimeter (Sidney H. Phillips, M.D., 2002, The Overstimulation of Everyday Life: II Male Homosexuality, Countertransference, and Psychoanalytic Treatment. Ann Psychoanal 30:131-45, p. 133).

Cause of Inability to Form A Close Relationship

Dr. Phillips describes a case about a man who is 32 years old, who he calls Mr. E. Mr. E is successful in his occupation, openly gay, however, even though he was aware of his sexual gay feelings, as young as, 4 and 5 years of age, he was unable to have a relationship with another gay man. Mr. E had relationships like the ones, as described by Dr. Phillips in Part 3 (on this blog), falling in love with heterosexual men “and pined away for them.” This pattern of Mr. E’s behavior regarding his inability to form a relationship with another gay man had its beginnings in his early childhood years. At a very young age, when he and his younger brother by 2 years, slept in the same bed, until Mr. E left for college. Photo

Dissociative Efforts Buried Deep

In treatment, whenever Mr. E became aware of his sexual feelings, he was unable to talk about them. He would continuously respond that he has “gone blank.” Efforts to explore his reactions were met with more of the same, which lead to atrancelike quality of speech that one has just before falling asleep. As Mr. E’s treatment moved forward, it was discovered that his behavior was an enactment. Mr. E was repeating his experience; beginning at a very young age, feeling the “sexual arousal he had once felt in bed” sleeping with his younger brother and his immediate “dissociative efforts not to think about what he was experiencing.” In treatment, it was identified that Mr. E whenever he felt any sexual arousal towards his analyst he would repeat this same “autohypnotictrancelike prelude to falling asleep… of conscious but disavowed feelings and sensations of sexual arousal” as he did sleeping with his younger brother.

This work opened up to analytic scrutiny the oedipal longings rivalry, and disappointment that lay behind the overstimulated relationship with is brother, freed him to engage more deeply and passionately in his relationship with his partner, and made possible a planned and successful termination of analysis.

By the overstimulation of everyday life, then, I referred to the frequent experiences, for example, of homosexually inclined children and adolescents who are placed again and again in the company of the same gender parents, sibling, and peers in various degrees of undress or nakedness and the internal, subjective states generated by those experiences. It is a wholly different experience for a homosexually inclined boy to take a shower with his father or to sleep in the same bed with his brother than it is for a heterosexually inclined boy to do so. The homosexually inclined child or adolescents may be repeatedlyoversimulated by gender pairings that paradoxically were meant to protect against just such a risk (Sidney H. Phillips, M.D., 2002, TheOverstimulation of Everyday Life: II Male Homosexuality,Countertransferenceand Psychoanalytic Treatment. Ann Psychoanal30:131-45, pp. 133-135).


Dr. Phillips describes in his paper, The Overstimulation of Everyday Life: I, what it is like for homosexually inclined children growing up, like Mr. E, at a young age experiencing feeling sexually aroused. It causes a double sense of intense shame, and which happens repeatedly, for them, because of being placed in situations that are overstimulating for them (Sidney H. Phillips, 2001, The Overstimulation of Everyday Life: I. New Aspects of Male Homosexuality. J. Amer. Psyoanal. Assn., 49:1235-1267).

“For homosexual inclined children, this everyday overstimulation creates a double vulnerability to shame: They not only fear exposure of their sexual arousal, but they also dread exposure of the homoerotic source of their sexual arousal ... the ‘usual horror’ for the homosexual adolescent boy who lives in daily fear of exposure of his sexually aroused state in same-gender athletic locker rooms… the example of the homosexual boy contending with the psychology of the locker room illustrates Yorke’s (1990) point that the ‘awareness of an observer is a reflection of the link between shame, pride, and exhibitionism/voyeurism and the defense against them that underlie the need to hide (p.381).” (Clifford Yorke, MD, 1990, The Development and Functioning of the Sense of Shame. The Psychoanalytic Study of the Child, 45: Pp. 377-409, New Haven, CT: Yale University Press).
Relentless Cycles of Everyday Life

Attraction & Disappointment 
Hope & Despair
Excitement, Arousal & Grief

Dr. Phillips continues to elaborate, “on the inner, subjective states of homosexuals boys subjected to everyday overstimulation.
Their internal landscape is best described as a tantalized inner world of longing. Relentless cycles of attraction, hope, excitement, and arousal alternating with states of disappointmentloss despair, and grief give their inner world a unique form and content.

Dr. Phillips describes the complexities of this kind of sexual longing and desire that involves the use of defenses within the continuum of dissociation. This longing and desire oscillates between not being met in reality and then being played out in fantasy. He identifies this process as “ a closed emotional loop of failed grief andunintegrated loss,” a new psychoanalytic definition of longing.

…an affective state that stems from a repudiation, disavowal, and magical undoing of the loss of the unavailable object and the lack of integration of the pain, disappointment, and sadness accompanying that loss, resulting in a repetitive but derailed and incomplete process of grief. The defenses of magical undoing and disavowal operate against the integration of the pain of the loss. (Sidney H. Phillips, M.D., 2002,The Overstimulation of Everyday Life: II Male Homosexuality,Countertransference, and Psychoanalytic Treatment. Ann Psychoanal30:131-45, pp. 135-136).

Dr. Phillips points to Mr. E, as an example of this affective state, in Mr. E's attempts to avoid acknowledging his sexual feelings, he experienced towards his analyst during his treatment sessions. Mr. E was repeating in treatment, his response to the sexual arousal he once felt in bed with his brother, which was his dissociative efforts not to think about his sexual feelings, an"autohypnotictrancelike prelude to falling asleep." When this same behavior was repeated in treatment it signaled his "disavowed feelings and sensations of his sexual arousal toward the analyst." It demonstrated the effects of the relentless cycles of everyday overstimulation.

An Illustration of the Relentless Cycles of Everyday Life
Attraction & Disappointment
Hope & Despair
Excitement, Arousal & Grief

Dr. Phillips, from his clinical studies of gay men raised in social environments influenced by varying degrees of antigay social and religious norms, he describes how the normal stages of sexual development of children are then disrupted for children who grow up to be gay. A heterosexual child will experience the normal developmental stages of sexual arousal in early childhood years. However, because these developmental stages of sexual arousal fit with the socially accepted norms they are supported and understood by the adults in this child’s social environment. Most importantly, this child knowingly experiences this social sense of approval and affirmation. It helps to build this child's sense of well-being, sense of self and a healthy sense of self pride.

Early Childhood

In social environments influenced by varying degrees of antigay social and religious norms, these normal developmental stages of sexual arousal in early childhood years are seriously disrupted for a child who grows up to be gay. These disruptions depending on the severity that a gay child experiences them tend to have life long detrimental ramifications. The reason for this is that any child in early childhood years are solely dependent on the constant and consist love and approval of the child’s parents. The withholding of this love and approval for any child during these ages depending on degree can be traumatizing to the child (Henry Krystal, M.D, (1988) In tegration & Self-Healing, Affect, Trauma, Alexithymia (p. 167). It is here where the dissociative process begins, because the child feels so threatened and will do anything to regain the parent’s love and approval. Dr. Krystal best explains this process using an example of what happens when a girl of 3 ½ years of age is misbehaving “whining and making noises” in a car with her mother, who driving through “a swampy, desolate area… The mother, enraged, stopped the car and yelled, “Get out!”, whereupon the child became frightened and promised to behave. At this point, the child “demonstrated evidence of having been traumatized. She immediately allowed herself to be strapped into the front seat of the car and became a good frozen child. She was dramatically inhibited. Her over whelming fears of abandonment … were from the time of the marshland incident repeatedly played out in thinly disguised ways in the analytic treatment” … Krystal continues,

I said earlier that the child showed the adult type of trauma response because she was able to respond by blocking her affective response and one may assume, recognition. What would have happened if the mother had actually left the child in the desolate area and driven away? The blocking of affects might have continued for a while and become even more severe. It is more likely, however, that the child would immediately have started to call desperately for her mother and pleaded for forgiveness and rescue and perhaps promised to be good from then on. If she had not been rescued right away, her emotional expression would have become more and more violent, in the process the affects would have become mostly somatic and varied, and overwhelmed her with sheer pain. After a while she might have become exhausted, or stuporous, or slept for a while, only to wake up started, to resume her frantic affective pattern until the next point of exhaustion. (Henry Krystal, M.D, (1988) Integration & Self-Healing, Affect, Trauma, Alexithymia (p. 167).

A social environment influenced by varying degrees of antigay social and religious norms becomes disruptive of what are the normal developmental stages of sexuality for a gay child. Unlike the heterosexual child, who expressing normal age appropriate sexual arousal and then experiences a social sense of approval and affirmation from adults. This is not what happens for the gay child. The gay child expressing normal age appropriate sexual arousal is likely to experience in varying degrees forms of disapproval explicitly and or implicitly. This gay child will often feel a sense of overwhelming disconnect from a parent, and depending on degree, it will be similar to the what the 3 ½ year old girl described above, experienced. And so the gay child will promise to do anything to regain the love and approval of the parent. However, the important difference for the gay child is that the gay child did not do any wrong, except express what is the nature of this child’s sexual orientation. This gay child will be taught to go against what is this child’s true human nature. In essence this gay child will be taught not to trust his or her natural instincts of fondness for another human being. This form of child abuse is in ways similar to the Chinese foot binding of young girls' feet, but in ways it is worst.

The disruption that happens when a gay child feels what is a normal age appropriate developmental stage of sexual arousal has a twofold effect. This child out of sheer fear, will not only dissociate from the overwhelming experience of the event of losing parental love and approval but more seriously this child will dissociate from the very essence of his or her own human nature. Backwards clock

Worst this gay child will be taught that this severe inhuman behavior, that the child deny forever his or her core essence of expression of human love for another human being, to love and to be loved by another is socially, religiously and parentally sanctioned and praised. This is barbaric treatment of another human being, especially of a child. What happens to a child who is taught to deny loving and being loved from early childhood on? Can this cause this child to be intensive of having human compassion for others, as well as, for himself? Would this child treat others in the same inhuman and barbaric way he was treated all his life? Would this child even know what is the meaning of love? Would this child even be aware that his treatment of others is barbaric and inhuman, because from early childhood on, this child was taught that this kind of treament is love? This inhuman process of dissociation becomes automatic over time, as this child grows up, however, not without the harmful effects to this child and to others. Harry Stack Sullivan describes the details and effects of dissociative processes. It helps to explain how some prominent public figures who publicly condemn homosexuality and are then caught having sex with men in public restrooms (Clinical Studies in Psychiatry, 1956, p. 174).

A gay child out of fear over time will effectively internalize the antigay social and religious norms as expressed by his or her parents and other adults. However, this internalization will not stop, what is the normal human nature of this child. As a gay child matures and experiences normal sexual arousal, which, at first, can be unsettling for any child, but in addition, the gay child will immediately experience feelings of shame, because his or her feelings are the wrong kind. The gay child in order to stop these feelings of shame and their memories incorporates a number of defenses of dissociation. However, because the gay child’s sexual feelings are natural and normal, they cannot be effectively changed or forgotten, efforts to do so only cause relentless cycles of feeling arousal and shame, hope and despair.

Relentless Cycles of Disruption 

Dr. Phillips describes how these relentless cycles are disruptive for some gay adult men. He describes how a young gay man in his early twenties that even though he is able to come out to his parents, who eventually were accepting and supportive of their son, however, this gay man remained conflicted about his sexual orientation.

…he found himself unable to tolerate his own romantic and sexual yearnings of gay peers, several of whom had expressed explicit affectionate and sexual interest in him. Gradually, he describes his inhibitions and conflicts about initiating and sustaining sexually intimate relationships with other men. He felt ashamed of his sexual desire for other men and had chosen instead to surround himself with heterosexual male friends from high school and college for whom he secretly pined away. He recognized this pattern himself and thought it was related to his being afraid of his family discovering that he was gay. He hoped that he could “cure it” by “coming out” to his family. Their warm reaction had pleased him but failed to relieve his inhibitions and conflicts… Though he was aware of his attraction to and arousal by other boys and men since early childhood, he had been more troubled by this attraction since puberty. That other boys were starting to show an interest in girls made him feel threatened “that my friends would figure me out.” The furtive pleasure he took in masturbatory fantasies about male sport figures was staunchly in conflict with his Catholic upbringing and religious training. (Sidney H. Phillips, M.D., 2002, The Overstimulation of Everyday Life: II Male Homosexuality, Countertransference, and Psychoanalytic Treatment. Ann Psychoanal 30:131-45, pp. 137)

Dr. Phillips describes how this young gay man’s conflictual nature has deeper roots that began as a young boy idolizing his two-year older brother who he shared the same bedroom growing up. As a very young child he found himself ‘’curious about and aroused by his brother’s athletic body. He recalled when they were both in school how painful it had been that his brother had “spurned” him for male peers.” He recalls how rejected and hurt he felt by his brother leaving him. He begins to reveal what has been buried deep his unspeakable feelings he had for his older brother, as a very young child growing up sharing the same bedroom...

“But how could I be turned on by my own brother? It’s almost incest, for God’s sake, but worse," he exclaimed. The reference to God, I soon discovered, had been not trivial expletive. He began to quote verses from the Book of Leviticus and from St. Paul’s Epistle to the Romans which condemned homosexuality as an abomination that deserved the death penalty. Homoerotic incestuous desire, in his mind, was a “deadlier" sin than the heterosexual version (Sidney H. Phillips, M.D., 2002, The Overstimulation of Everyday Life: II Male Homosexuality,Countertransferenceand Psychoanalytic Treatment.

“Someday, maybe, there will exist a well-informed, well considered and yet fervent public conviction that the most deadly of all possible sins is the mutilation of a child’s spirit.” Erik Erikson

Kids Are Being Hurt!!!

SEXUAL ORIENTATION is less about sex and more about LOVE, being one with another human being - ATTACHMENT THEORY
Nothing in life is more precious than the intimate relationships we have with love ones.Healthy love relationships delight us give us confidence to take on challenges and support us in difficult times.

Groundbreaking Study Finds Family Acceptance of Lesbian, Gay, Bisexual and Transgender Adolescents Protects Against Depression, Substance Abuse and Suicidal Behavior in Early Adulthood – by Caitlin Ryan, PhD, December 6, 2010 - FAMILY ACCEPTANCE PROJECT
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