Shrunk to Fit : THE PSYCHOANALYTIC THEORY OF MALE HOMOSEXUALITY <i> by Kenneth Lewes Ph.D. (Simon & Schuster: : $19.95; 301 pp.) </i>

It is an ironic paradox that many psychoanalysts who profess to be most loyally devoted to the theories of Sigmund Freud are nevertheless among the strongest advocates of the view that homosexuality per se constitutes a mental disorder. Yet Freud himself clearly did not consider it so, stating that it can occur “in people who exhibit no other serious deviations from the normal . . . and who are indeed distinguished by specially high intellectual development and ethical culture” and adding: “Wouldn’t that oblige us to characterize as sick many great thinkers and scholars of all time, whose perverse orientation we know for a fact and whom we admire precisely because of their mental health?”

The author of “The Psychoanalytic Theory of Male Homosexuality,” Kenneth Lewes, a psychoanalytically trained psychologist, set himself the challenging test of reviewing almost every psychoanalytic article and book written about male homosexuality. Unhappily, his review has covered a rather dismal record. Almost without exception, the early psychoanalysts (and most contemporary ones) who wrote about homosexuality made the egregious error of generalizing from small samples of emotionally disturbed homosexual patients to the homosexual population at large, and (assuming that all homosexuals were essentially alike) of filling their pages with stereotypic conclusions about “the homosexual” and the “homosexual personality.”

But, even worse, not recognizing their own built-in emotional biases, almost all of them (with a few honorable exceptions) not only took it for granted that homosexual behavior was “unnatural” and needed to be “cured” but sometimes commented about their homosexual patients in ways that revealed a shocking contempt for them. Thus, Dr. Edmund Bergler, the most important psychoanalytic “expert” on homosexuality in the 1950s, wrote: “Homosexuals are essentially disagreeable people . . . (displaying) a mixture of superciliousness, false aggression, and whimpering . . . subservient when confronted with a strong person, merciless when in power, and unscrupulous about trampling on a weaker person.” In a similar vein, Dr. Charles Socarides, considered one of the leading contemporary psychoanalytic authorities on the subject, has written: “Homosexuality . . . is filled with aggression, destruction, and self-defeat, and is a masquerade of life . . . (involving) only destruction, mutual defeat, and exploitation of the partner and the self.”

Little wonder that Lewes, at one point, can’t help shedding his scholarly dispassionateness, exclaiming: “It is shocking that Bergler’s colleagues let such . . . attitudes go without rebuke. Such intemperance severely compromised psychoanalytic discourse about homosexuality . . . and sullied the psychoanalytic tradition of sympathy and tolerance.”

As Lewes outlines the evolution of psychoanalytic theories about homosexuality, he winds his way through an intricate and abstruse maze of often mutually contradictory concepts. There are long passages dealing with esoteric speculations attributing the origins of homosexuality to the search for the lost penis in the father, regression to orality or anality, castration anxiety, incest guilt, incomplete separation from the mother, narcissistic identifications, and even to “testicular anxiety” and an infantile fear of losing feces! Regrettably, Lewes himself contributes to the confusion by assuming that there are “different kinds of homosexuality”--i.e., normal, psychotic, borderline, etc., failing to understand that homosexuals can develop the same variety of mental disorders that heterosexuals do and that these do not constitute different “homosexualities” any more than they do different “heterosexualities.”

It was not until the 1970s that psychoanalytic formulations about homosexuality began to take an entirely new course, with the recognition that not all homosexuals were mentally ill, that their love for one another could be as fully developed and genuine as that between heterosexuals and that they were capable of living stable lives and functioning responsibly and honorably, often in positions of high trust. These views were abetted by a number of significant new research reports on non-patient homosexual populations, among them a classic study by Dr. Evelyn Hooker, a UCLA psychologist, demonstrating that careful psychological testing of a group of non-patient homosexuals revealed no demonstrable pathology that differentiated them in any way from a matched group of heterosexuals.

Pressures began to develop in the psychiatric community to remove homosexuality from its listing as a mental illness in the American Psychiatric Assn.’s Official Diagnostic and Statistical Manual. A historic debate ensued within the APA, with psychoanalysts leading the polemic on both sides. Irving Bieber, a psychoanalyst who had published an influential group-research study of male homosexuals in analytic treatment (a study that encountered severe methodological criticism because all of the subjects were, a priori, emotionally disturbed individuals), and Socarides fought strongly against the deletion. Robert Stoller, Richard Green and this reviewer, all from Los Angeles, played important roles in urging the change. This view finally prevailed when the APA Board of Trustees, in 1973, voted to delete homosexuality from the list of mental disorders. Unhappy with this outcome, Bieber and Socarides pushed for a national membership referendum on the issue, and, to their surprise and chagrin, a majority of the psychiatrists voting upheld the board’s decision.

Lewes’ book is not one for the general reader. Its greatest appeal will be to psychoanalytically-oriented professionals and highly sophisticated lay people. His approach is a broad and tolerant one, although he is clearly more fascinated with classical Freudian libido theory than are many contemporary psychoanalysts, whom he pejoratively labels “revisionists.” For the student of homosexuality, however, the greatest weakness of the book is its failure to give any inkling of the exciting new biological findings about the origins of variant sexual orientation--e.g., the growing body of research evidence that a significant proportion of male homosexuals are biologically predisposed at birth to become homosexual by virtue of variations in the degree to which they have been exposed to circulating male sex hormones during their intra-uterine development. These variations, although not causative in and of themselves, appear to have a fateful effect on the male child’s subsequent temperament, life experiences and interpersonal relationships and to favor the development of a homosexual orientation. In such children, homosexual inclinations from early life on are as “natural” as heterosexual inclinations are to most other males and are definitely not a matter of “choice.”