Faculty Bibliography

On May 1, 2004, the Association of Gay and Lesbian Psychiatrists (AGLP), with co-sponsorship from St. Luke's-Roosevelt Medical Center, The Haworth Press, and the William Alanson White Institute, organized an all-day conference in New York City entitled Homosexuality and Psychoanalysis: New Directions. The proceedings of the third panel focused on Clinical Perspectives.' The first contributor is Deborah F. Glazer, PhD, who discusses the impact of homoerotic desire and same-sex object choice on the intrapsychic world and the experience of one's self, including one's sense of adequacy in one's body based, gendered self, and the ability to feel sexual desire. Jeffrey R. Guss, MD, asks, What does psychoanalysis have to say about homosexuality?' He acknowledges that gay and lesbian therapists have much to say about gay life and therapy with gay and lesbian patients. Ann D'Ercole, PhD, shifts the focus to clinical work with same sex couples. She underscores the importance in the clinical work with same sex couples of attending closely to expressions of feeling different' as such feelings can often obscure shameful feelings that can infiltrate and contaminate a relationship. Scott Masters, MD, concludes the panel with clinical material from an ongoing treatment.

Anal sex between men has been constructed in many ways throughout the last century. In this paper, I describe three realms of discourse that have offered ideas regarding the meanings and motivations of anal sex: (1) Freud's exploration of anal erotism using classical psychoanalytic language, (2) a radical sex theorist describing transcendence and community through anal sexuality, and (3) a Lacanian perspective that questions the idea of the anus as passive. Recurrent themes regarding power dynamics, identity and gender are identified and explored, and the role of anal sex as cultural signifier is examined. (journal abstract)

The past 5 years have witnessed a great increase in the use of the stimulant drugs crystal methamphetamine and smoked cocaine (crack) as part of a pattern of hypersexual behavior inextricably interwoven with substance dependence among gay men. With these patients, the problems are not independent, and exist almost exclusively in the company of one another. The paper describes a framework for evaluating patients and assessing their readiness for treatment in office based individual treatment that is informed by psychoanalytic principles. Typical resistances at each stage of treatment are described, with clinical recommendations for management. Common transference and countertransference paradigms are described. The paper includes psychoanalytic exploration of the possible meanings of the experience of drug/sex addiction, abstinence and fantasies that often precede relapse.