Faculty Bibliography

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.