classical symbol-formation, primitive defence mechanisms and the layer beneath them both, the containing function of the body ego as identified by Esther Bick in her notion of the skin as container. Each of these levels has its moment for each individual, but for the analyst to confine himself to one level would amount to reductionism.
In the second paper, containment is also a theme: the early containment by the mother and its relationship to the containment of food in bulimic conditions. Patricia Marsden relates eating disorders to the myth of Demeter and Persephone in which we can see the unresolved struggles of early infancy that are reactivated in the adolescent changes into sexual maturity. Mother and daughter are threatened by both separation and fusion so that Persephone's ritual descent into the underworld and reappearance signify an enactment of primitive oral fears and sexual anxieties simultaneously.
In a third paper about primitive level functioning, Michael Leibowitz introduces a new concept, protective-identification. In the early states of extreme dependency, the infant's terror is of abandonment by its objects. To protect itself from this possible trauma, the infant identifies with its object, through an oral assimilation, creating a narcissistic defence that allows a sense of stability and survival.
Then, the contribution by Sherly Williams addresses the difficulties of the 'ends and endings' of therapy: 'end' has a dual meaning as both the aims and purposes of therapeutic work as well as the conclusion of a relationship. Williams discusses these aspects and their interconnections.
Freud introduced us to the idea of our hi-sexuality, firmly insisting on its presence in all of us. In his essay on Leonardo da Vinci, Freud says'. . . that everyone, even the most normal person, is capable of making a homosexual object choice, and has done so at some time in his life, and either still adheres to it in his unconscious or else protects himself against it by vigorous counter-attitudes'. Re went on to theorize homosexuality within his system of thought, and it became part of psychoanalytic custom that a full analysis include analysis of the patient's homosexuality.
Freud's acceptance of the homosexual orientation was further shown in a letter in 1935, in which he says, 'Homosexuality is assuredly no advantage but it is nothing to be ashamed of, no vice, no degradation; it cannot be classified as an iHness; we consider it to be a variation of the sexual function produced by a certain arrest of development', and 'if he is unhappy, neurotic, torn by conflicts, inhibited in his social life, analysis may bring him harmony, peace of mind, full efficiency, whether he
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remains a homosexual or gets changed'. Freud, also, in 1930, signed a public appeal to decriminalize homosexual practice.
If subsequent thinking since Freud appears to be more ridden with prejudice, and this seems to be so, it may be because of conditions in the general culture. In recent psychotherapy debate, it is questioned whether a homosexual is capable of mature love and concern for other people and depressive position functioning, whether he or she can contain pre-oedipal sadistic impulses, whether a perversion exists. These questions, of course, also apply to heterosexuals and their developmental arrests. Now that more homosexual people are coming into therapy and are applying for training in psychotherapy programmes, our position needs to be thought through and examined for prejudice. Arising also are the questions of whether it is preferable for homosexuals to have homosexual therapists and for heterosexuals to have heterosexual therapists. The notion of universal bi-sexuality would seem to settle this question, but it may well be a matter of individual sensibility.
In this issue, four papers on homosexuality look at various aspects of the question. Darren Wolf speaks of his personal experiences upon encountering psychoanalytic literature: of finding, when first reading Freud, a language and vocabulary for his sexuality and of being introduced, via Foucault, to ideas of the legitimacy of a homosexual identity. In the second paper, Houston MacIntosh reports further on his survey of American psychoanalysts who treat homosexual patients, looking at two main attitudes: firstly, whether they believe that homosexuals can change their sexual orientation through analysis and, secondly, if their homosexual patients received significant therapeutic benefit, and the relationship between these two factors. The longer the patients were in analysis, the more likely they were to receive significant therapeutic benefit and to change sexual orientation. The analyst's expectation of change was also relevant. The third paper by Mary Lynne Ellis addresses sexual identity within a social and historical context and, at the same time, draws attention to the uniqueness of individual experience. In two case studies, a female and a male patient grapple with their sexual selves in their struggle for identity. The last paper by Steven Mendoza discusses the concept of genitality and the suitability of homosexuals for psychotherapy training, arguing that homosexuals are capable of genital love and can be as healthy as heterosexuals and no more likely to be fixated in sadistic, paranoid positions.
In the face of so much 'Freud bashing', it is gratifying to see an article in the December 1996 Scienufic American entitled 'Why Freud isn't dead'. It reports recent research, pointing out that, although psychoanalytic outcome studies have flaws, other therapies fare no better: controlled trials of cognitive-behavioural therapy have not demonstrated its superiority to other treatments, nor have drug treatments been shown to be more effective than talk therapies. So there we have it.
©Jean Arundale. Mounted by Chris Evans (Email:C.Evans@sghms.ac.uk) on 21.iv.97, last updated 23.iv.97