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Friedman, R.C. (1997). The Homosexualities And The Therapeutic Process. Edited by Charles W. Socarides and Vamik D. Volkan. Madison, CT: International Universities Press, 1991, 315 pp., $47.50.. J. Amer. Psychoanal. Assn., 45:298-303.

(1997). Journal of the American Psychoanalytic Association, 45:298-303

The Homosexualities And The Therapeutic Process. Edited by Charles W. Socarides and Vamik D. Volkan. Madison, CT: International Universities Press, 1991, 315 pp., $47.50.

Review by:
Richard C. Friedman

The Homosexualities and the Therapeutic Process consists of fourteen chapters, in addition to a brief introduction by the editors. The book is focused almost entirely on the psychoanalytic and psychotherapeutic treatment of men. Only one of the chapters and an occasional clinical illustration in the others refer to women.

Most contemporary clinicians, regardless of theoretical framework, recognize that homosexual patients as a group manifest a range of psychopathology that is more or less comparable to that of heterosexual patients (Hooker 1956; Saghir and Robins 1973; Friedman 1988; Isay 1989; Gonsiorek and Weinrich 1991). The cases in this book, however, depict patients who are integrated at a low borderline level (Kernberg 1984), are pathologically narcissistic, or are otherwise comparably impaired. These patients, mostly men, are not only unrepresentative of gay and lesbian people in the general population; they are unrepresentative also of homosexual patients seen in clinical practice.

Although the clinical vignettes are for the most part well written, they tend to neglect some important issues. One of these is psychoanalytic diagnosis of the whole patient. The reader is likely to be presented with a patient manifesting many borderline symptoms (and perhaps numerous other symptoms as well). No detailed, methodical approach is taken toward diagnosis of character pathology in these vignettes. The impression is frequently conveyed that all of the patient's symptoms are a function of the homosexuality.

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