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Friedman, R.C. (1996). Affirmative Dynamic Psychotherapy With Gay Men.. Psychoanal Q., 65:827-829.

(1996). Psychoanalytic Quarterly, 65:827-829

Affirmative Dynamic Psychotherapy With Gay Men.

Review by:
Richard C. Friedman

The nine chapters in this book are primarily in the realm of psychoanalytically oriented psychotherapy, not psychoanalysis per se. Five were previously published as clinical papers, and four are new. The republished material has been well selected and includes contributions of Alan K. Malyon and Richard Isay which have been particularly influential.

In 1982, Alan Malyon pointed out that biased socialization leads to negative influences on psychological development via mechanisms of pathological internalization. From the psychoanalytic perspective, the term “internalized homophobia” he used to describe the internalization process was not felicitous. “Homophobia,” a word coined by Weinberg in the late 1960's, has itself been criticized since antihomosexual attitudes are only sometimes primarily attributable to unconscious conflicts; and even when they are, they do not usually lead to responses that are phobic in the technical sense of the term. Linking the concept of internalization with homophobia compounds confusion from a psychoanalyst's perspective. This regrettable terminology has acquired meaning through usage, however, and is presently widely accepted by clinicians treating gay and lesbian patients. Despite these reservations, the major concept that “internalized homophobia” refers to is valid. Indeed, the prejudicial antihomosexual social environment has been so virulent in so many countries during the past fifty or more years that underattention to its pathological consequences in the traditional psychoanalytic literature is itself worthy of scholarly scrutiny.

Almost ten years ago Richard Isay “came out of the closet” at considerable personal risk and remains the only senior member of the American Psychoanalytic Association who is openly gay. Isay is a member of two worlds which have been only tenuously bridged; the gay subculture and the world of organized psychoanalysis. Many psychoanalysts have realized that Isay's clinical views might well be uniquely informed on the basis of his own introspections and clinical experience.

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