SOME PROBLEMS IN THE TREATMENT OF HOMOSEXUALITY

K. FREUND

Psychiatric Clinic, Karls University, Prague*

INTRODUCTION

All attempts to determine whether any of the methods of treatment applied to cases of homosexuality do have a therapeutic effect, suffer from the fact that the diagnosis is pathological erotic adjustment relies almost exclusively on verbal exploration. This fact is particularly disturbing in the therapeutic situation where the patients are inclined to deny certain facts in order to appear as cured and therefore to avoid any further treatment, which is often regarded as undesirable by them. On the whole, there does not appear to be any method of treatment the efficacy of which could be said to be very apparent and the proportion of cases of homosexuality where - with or without treatment - heterosexual adaptation is reached appears to be very small.

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It appeared probable that all the therapeutic measures considered to be efficacious in the case of homosexuality depended on a common principle. This principle consists of the discouragement of homosexual activities and the encouragement of heterosexual activities. (It is also possible that we should add to this the method of devaluating homoerotic desires and to encourage heterosexual desires, in so far as desires can be separated from actual behavior.) This assumption was strengthened by the fact that there appeared neither very strong qualitative nor quantitative differences between the outcomes of treatments relying on non-verbal, non-explorative psychotherapeutic pro-cedures, and those of a psychoanalytic type. This served as justification to carry out a treatment of homosexuality and to attempt to discover its efficacy, which in simplified form represented the main principle of therapeutic effectiveness previously isolated. It has been shown that the efficacy of this simplified treatment does not appear to be very different from that of other types of treatment of psychotherapeutic nature.