Failures Alternate with Successes
Finally, the patient needs to be permitted to “come up short” sometimes due to the realistic constraints of his life. For instance, “I know it feels good when you achieve both goals on a daily basis but there’s more to life than these goals: there are other demands, the need to reward yourself from time to time, and there are limitations upon your energy level. When you fall short of the goals, it’s important to remind yourself that there are other successes that day and another chance tomorrow to work on them.” These interventions attempt to instill in the patient a broader perspective for judging his masculinity.
No discussion of these problems would be complete without adequately addressing how homosexual fantasies disturb the lives of these men. The experience has taught me to treat such fantasies as very distinct from the behavior patterns and goal-setting that I have outlined thus far. My rationale is based upon the view that these fantasies grow out of the deep frustrations and unmet needs for masculine affection that occur during early childhood. Initially, these fantasies are attempts to compensate for this deprivation, and in time, other determinants reinforce their continued presence. Therefore these fantasies cannot be overcome in the same manner that these men overcome passivity and avoidance–that is, through assertiveness.
The reliance upon the fantasies subsides as the patient passes through the phallic-narcissistic phase of therapy and is rewarded by the therapists’ admiring comments and a fuller sense of masculinity. Yet even with the most ideal outcomes, it is my belief that residual homosexual fantasies will emerge from time to time through the lives of these men. Therefore I believe that it is critical not to over-focus upon the presence of the fantasies in order to allow the evolution of the masculine self to take place.
By ascribing great importance to the presence or frequency of the fantasies, the therapist may inadvertently sabotage that process by communicating to the patient that no matter how masculine he behaves on the outside, he remains homosexual inside. One man who I had been treating for a few years made the following observation about he importance of realistic expectations: “I’ve come to accept that there is a homosexual part inside that I may never be able to get rid of. But maybe I can learn to live with it. The other day I was at the swim club with my wife and sons. A man in a very tight bathing suit walked by and I caught myself staring and beginning to have fantasies. But just as quickly, I stopped myself, told myself it was not such a big deal, and dove in the water. And it didn’t ruin my day.”
This man’s experience captures what I see as the most realistic goal of psychotherapy of ego-dystonic homosexuality: the growth of a strong masculine self-image that provides for a satisfying heterosexual adaptation which is not jeopardized when there is a periodic intrusion of homosexual fantasies.
Yet I am aware that many men will have great difficulty embracing a goal that falls short of the total eradication of homosexuality from their inner and outer lives. In fact, I am often confronted by much disillusionment when I present this view at the beginning of therapy. Still, I believe it is a critical intervention in this type of work because it anticipates the fantasies, and attempts to demystify their meaning. If this is not accomplished, patients may easily give up hope even if they are progressing, due to the significance they have placed upon the lingering remnants of homosexual fantasy life.
Demystification begins by providing a new meaning to understand the fantasies. These men have felt stigmatized by their fantasies and have often understood them to signify their homosexuality. Yet they are typically relieved when I supply an alternate construction that weaves together the theories of early childhood development in boys, the circumstances of their early childhood, and the subsequent impact of internal and external forces.
For instance, the man most recently referred to recounted how his fantasies originated from the images of fathers and sons portrayed by such shows as “Lassie” in the early 1960’s. He recalled having been five or six years old and soothing himself to sleep by imagining that he was the little boy receiving the paternal affection depicted on the TV program. Although these memories were recalled by him with great sadness and emptiness, he accepted his earlier dependency upon those fantasies due to the coldness and detachment of his father.
From this point of departure, I attempted to demystify the later homosexual fantasies through clarifications such as the following: “Deep down your fantasies serve as a security blanket in the same way they did when you were five. At that age your heart ached for your father’s strong arms to hold you, but sensing his rejection, you turned away and inward in an attempt to create your own good father image. This helped you to endure his emotional detachment but laid the groundwork for your dependence upon fantasies for soothing your pain. With the onset of adolescence, you feelings of masculine inadequacy were intermixed with sexual urges, and once again you turned to your fantasies for soothing your pain. But this time, you had no choice other than to construct them in a blatantly sexual style due to the phase of life you were in. Heterosexual fantasies would not provide any type of relief and refueling, since you were still stuck in the arms of the good father, not ready to let go and too scared that you would not make it as a man.”
Richfield, S. A. (8 February 2008). The Treatment of Ego-Dystonic Homosexuality: The Development of a Masculine Self-Image., from http://narth.com/docs/richfield.html
