By Alan Blum, Ph.D., and Van Pfetzing, Ph.D.

The following article is the most clear description I’ve read yet on exactly how growing up homosexual in this homophobic world leads to psychological trauma. This idea and how to therapeutically treat such trauma through a psychoanalytic approach is well illustrated by the case example they provide. — Marston James

Abstract: Moving away from the historically dominant psychoanalytic position that views homosexuality as psychopathological, and informed by the burgeoning field of gay studies, the authors propose a new direction. Specifically, what can psychoanalysis illuminate about growing up gay in a homophobic society, and the effects of internalizations of this on the child that remain with him or her as a gay adult? For the purposes of this study, the development of the boy who will later become a gay man is the primary focus. Relying on concepts originally introduced by Freud in "On the Psychical Mechanism of Hysterical Phenomena: Preliminary Communication" (1893), we suggest that the gay man as a child is forced to manage, on his own, at a young age, a highly complex and enormously difficult situation that meets all the criteria set out by Freud as traumatic. A dissociation results, with potent ramifications for the gay adolescent and gay man. A more contemporary discussion of the concepts of trauma and dissociation (Davies, 1996) is brought in to broaden the discussion. A case example illustrating these ideas is presented. 

Freud had many things to say about homosexuality. In regard to the relationship between homosexuality and psychopathology, there are some ambiguities and conflicts in his writings. While his theoretical inroads into the etiology of homosexuality often imply psychopathology, other statements elsewhere are sometimes suggestive of a different viewpoint. His often-quoted statement to the American mother of a homosexual (1935) contains numerous ambiguities in this regard. In a less ambiguous vein, Freud's position in regard to  the suitability of homosexual psychoanalysts is most illuminating. In a letter to Ernest Jones (co-signed by Rank), he replies: "Your query, dear Ernest, concerning prospective membership of homosexuals has been considered by us and we disagree with you. In effect, we cannot exclude such persons without other sufficient reasons, as we cannot agree with their legal persecution. We feel that a decision in such cases should depend upon a thorough examination of the other qualities of the candidates" (1921, p. 9). 

One could further scrutinize the complexities and subtleties of Freud's theories on sexuality in general and psychosexual development to make a stronger case for the multiple points of view and conflicts inherent in his positions on homosexuality (see Schafer [1974] for an illuminating discussion related to this subject). Nonetheless, it is clear that subsequent psychoanalytic writers have almost uniformly accepted the unambiguous position that homosexuality is psychopathological. It is primarily only in recent years that some psychoanalytic scholars have systematically questioned and critiqued these formulations (Isay, 1985; Lewes, 1988; Schwartz, 1993; Frommer, 1994). Outside of the traditional psychoanalytic writings, within the new and burgeoning field of gay and queer studies, some relevant work has also been done (see especially Butler [1990]; Sedgwick [1990]). 

It is not these authors' intentions to review or critique the traditional psychoanalytic discussions on homosexuality (see Lewes [1988] for an exhaustive study of this kind). Instead, we propose to take as our starting point the assertion that homosexuality in and of itself is not pathological; and like heterosexuality, it is a complex expression of multiple personal and historical meanings. From here, we then ask: Is there something unique and important that a psychoanalytic perspective can contribute to the understanding of gay men and lesbians? In particular, what can psychoanalysis illuminate about growing up gay in a homophobic society, and the effects, internalizations of this on the child that remain with him or her as a gay adult? 

The gay-affirmative psychological literature (non-psychoanalytic) has been helpful in understanding and exploring what it is like being gay, growing up gay: being scapegoated, shamed, ridiculed, hiding, internalizing negative self-esteem, and managing, dealing with, and it is hoped, growing beyond, to an acceptance of oneself (see Clark, 1977; Cass, 1979; Malyon, 1981). As helpful and important as this literature has been, it is these authors' belief that a psychoanalytic perspective with its rich developmental orientation can add to and deepen this discussion. Instead of the psychoanalytic focus on etiology and attempted "cures," why not broaden the focus to include an endeavor to understand the difficulties and challenges of growing up a member of a scorned minority—and a minority that presents some unique developmental challenges at that? While not minimizing the problems of growing up as a racial, ethnic, or religious minority, growing up gay does present some different, unique issues of its own. 

At this point, we would like to both narrow down the subject to gay male development, as well as articulate some of the theoretical assumptions we are and are not making. By addressing developmental issues, we are opening up myriad important, complex, controversial issues raised by postmodern, constructivist analyses (e.g., gay studies among others). The deconstruction of developmental constants, particularly sexuality and gender, seen in this light as historical constructions inextricably bound up with linguistic and power relations, is central. The oppressive, constricting, and ultimately distorting nature of many of the psychoanalytic developmental theories that posited universals for women and gays have been justifiably and persuasively critiqued in this context (Domenici and Lesser, 1995). The reaction against essentialist assumptions ultimately leads to the current debate in this field about the whole question of development: whether one can talk about patterns emerging over time which can be characterized for particular groups or whether development is such a problematic construct that one ought only to deal with any one person's individual development. 

While sensitive to and appreciative of these concerns, we, in the same spirit as Corbett (1996), wish to take a look at the childhoods of gay men. As Sedgwick (1990) and Butler (1990) have so clearly brought to light, "not being queer" is a central organizing principle in our culture. Every young boy's experience is shaped and formed within this framework. The young boy, who later identifies himself as gay, is hence of great concern to us. Having begun his life within this "reality" has potent implications for his construction of his own sexual identity. Even if we move away from any suggestion of gayness unfolding, and more radically underline the fluidity and construction of one’s sexual identity, at the very least, the concept of "queerness" was initially formed within this primitive, polarized, hostile, feared context. All possible associations, tendencies, suggestions in this direction (whether in memory or reality), in whatever distorted childlike understandings, are part of one's history, now part of one's psyche. 

Having said all this, we would still like to talk about the childhoods of many gay men. As Corbett (1996) made clear in his descriptions of "girly boys," we are also not proposing anything universally applicable to all gay men, but attempting to give voice to the experiences many gay men relate about their childhoods, that often deepen and get elaborated on in the course of psychotherapy. Hence, we are primarily relying on retrospective accounts of gay men telling their stories through the lens of their current gay identity, which obviously shapes memory and meaning in many ways. We encourage researchers to study children directly in relation to these issues, realizing the complexity and sensitivity of the subject, as well as the importance. De Marneffe's (1997) recent study on children's genital and gender knowledge is an encouraging step in this direction. 

Gay men often report some awareness of “being different” that started fairly early in life, i.e., well before puberty, often as early as 4, 5, or 6 (Isay, 1989; Frommer, 1994). In looking back, they can appreciate and tie this feeling into their current differentiated and formed gay identity, but how do we begin to grasp the nature of the child’s experience of this? We would like to underline that this poignant feeling of "differentness" has multiple, complicated parts to it that vary from individual to individual. For some, it appears (retrospectively understanding it from an informed adult’s construction) particularly tied to one's gender-atypical behavior (Corbett, 1996). While this is the most common understanding and certainly the most conscious, overt, palpable one, we propose that many more complex processes are also going on in more subtle, less conscious ways. One such process is the lack of mirroring responsiveness to one's early, emerging sexual and affectionate expressions (Blum, Danson, and Schneider, 1997). These expressions are typically communicated to the child as injurious to the parents' sense of well-being, hence become a source of enduring inner conflict and guilt. Isay (1989), in a similar though more specific vein, suggests that it is the same-sex erotic fantasies centering on the father (often later repressed) that initially make these children feel so different and reprehensible. We suggest a larger, more fluid, and variable picture that certainly includes the father-son interaction and the father’s often uncomfortable (to put it mildly) reactions to the son’s emerging sexual and affectional expressions. While same-sex erotic fantasies are important, we include a broader array of affectional wishes, attachments, behaviors that make numerous people in the young boy's world uncomfortable. Here again, while gender-atypical behavior is often the most salient memory, due to our culture's overt, relentless shaming of it, we also suggest more subtle mirroring processes going on that communicate disapproval, lack of responsiveness, discomfort with aspects of affectional, attachment behavior. We are deliberately imprecise here in an attempt to not foreclose the discussion. 

If it is as difficult as it appears to talk about this from the adult's vantage point, imagine what it must be like for the young boy. As we have said, the proto-gay boy often, from an early age, has some beginning awareness of feeling different. He also, to varying degrees, begins to connect this differentness with something forbidden, terrible, unthinkable. This may perhaps come in a momentary flash or it may be a continual fear; it may be conscious or it may be primarily unconscious. The hatred, hostility, and vehemence with which people around him manifest when using words like faggot, sissy, queer, whether directed at him or others, coupled with his own undeveloped, distorted understanding of these terms, presents a unique situation. Unlike being black or Jewish, the gay man as a child is both typically alone with his “differentness,” as well as often unclear, confused, conflicted, horrified by “it.” Unlike the black child whose parents are typically also black or the Jewish child with Jewish parents and relatives, the proto-gay child typically not only does not have gay parents, but doesn’t even know what “gay” is except as a very nebulous and very negative thing. Extending the comparison for a moment to its limit, even the black child adopted by white parents has the potential empathy and help from his parents in identifying and valuing his “blackness”; the proto-gay child almost never has this. It (i.e., his “gayness”) either remains unnoticed to the outside world and is then “managed” internally alone with varying degrees of consciousness and unconsciousness. Alternatively, it becomes obvious to the external world (usually in regard to atypical gender role behavior) and is met with intense disapproval and ridicule, further increasing the shame and fear—all of which is almost always also “managed” alone. To understand what this complex management is all about, i.e., how it gets structured internally in the boy's psyche, now becomes the task of psychoanalysis to illuminate. Freud's concept of trauma, introduced in "On the Psychical Mechanism of Hysterical Phenomena: Preliminary Communication" (1893), and elaborated on by Loewald (1955), is relevant. It is here that Freud first defined traumatic as essentially any experience(s) that the individual is unable to cope with by "abreaction" or "associative absorption." Unable to (for various reasons and to varying degrees) react emotionally and/or thoughtfully to the traumatic event, the individual is then forced to keep its presence undigested and powerfully influential, albeit out of consciousness. 

Most of the conditions Freud posits as contributory to a trauma are indeed present for the proto-gay boy. Most of the conditions that could facilitate an energetic emotional reaction to the “events” are sorely lacking for this boy, whether it be an empathic other to share his feelings with or his own ability to appreciate the injustice of his situation. His numerous injuries, overt or covert, that often occur daily are “suffered in silence,” (All quotes in this paragraph are from Freud, 1893, pp. 8-9.) Whether he is overtly ridiculed for being different or covertly hears ridicule and rejection for being different in a way he suspects and fears he might be; or tries to prove to himself that he’s not different, these are all injuries that are typically suffered alone, silently, sometimes consciously, often unconsciously. Can this boy give “utterance to a tormenting secret”? It is unlikely for many reasons. Certainly as a child the “secret” is typically a secret to oneself; poorly understood, dimly realized, fearfully avoided, rationalized, reacted against. Hence, even the private emotional reactions Freud talks about often get aborted, e.g., tears, lamentations, rage, blowing off steam, thoughts of revenge. Can this boy “repay his injury” or must he “accept” it? Again, can he “correct” his “memory of humiliation” by “considering his own worth”? The above-mentioned tasks require very complex and highly developed capabilities, clearly beyond the capacities of most 5-year-olds. The ability to empathize with oneself and appreciate that the world’s rejection and ridicule is wrong, unfair, and hence have sympathetic tears or rage, while maintaining a consistent and reliable sense of self-esteem: who could expect a 5-year-old to accomplish this without enormous external support? 

As a result of this inability to react to and truly experience the traumatic event(s), the “experience(s)” then become subject to a “splitting of consciousness” or “dissociation” (Freud, 1893, p. 12). These traumatic experiences are laid down as unconscious memory traces (often somatic), powerfully influential, reactivated later in life. As Loewald (1955) points out, repression is a more integrated version, on the part of a more mature ego, of this more primitive mode of functioning (i.e., dissociation), where the ego originally never had the opportunity to digest or organize the “experience.” Hence, in the later therapeutic attempt at recovery of these childhood “memories”: 

“We are confronted, not with the recall of something forgotten, but with a creative event in which something for the first time can be put into words. The definite impression is that it never had been put into words, and more, that it never had been capable of being put into words because the original experience had taken place on a level of integration which did not render it available for preconscious, or conscious integration” [p. 210]. 

This is most articulately expressed and is extremely relevant to the early experiences of the boy we are trying to understand. 

More recently, Davies (1996a, b), in her attempts to revisit the concepts of trauma and dissociation within contemporary relational theory, speaks to a similar process. She posits a “relational unconscious,” primarily dissociatively based, which is “composed of mutually incompatible experiences of self in relationship to irreconcilable aspects of the other which cannot be maintained in simultaneous awareness, aspects of self-experience too emotionally overstimulating and cognitively disorganizing to be adequately encoded within the linguistic categorization of generalizable experience” (1996b, p. 198). 

A sense of “feeling different” is difficult enough, but when one intuitively senses that it might be related to some of the most taboo, frightening, despised images in our culture, as well as in one’s own family, then this is surely too emotionally overstimulating as well as cognitively disorganizing for the young proto-gay child. Going further with Davies’ formulation, it also highlights the mutually incompatible experiences of self in relation to the other: the boy who feels generally valued and approved of in his family, who hears his parents viciously talk about “faggots,” and who experiences, in very confusing ways, primitive discomfort and withdrawal by his father from him, at unexplained moments, repeated over and over again. 

In going still further, Davies' discussion of the unique nature of the trauma of sexual abuse underlines the enormity of the interpersonal contradiction confronting the child experiencing physical or sexual abuse. The child is forced to integrate irreconcilable emotional schemata: toxic, violent, out-of-control images of abuser-abused alongside more containable, emotionally modulated, verbally encoded representations of self and other. In addition, there are rarely words to describe or identify the events. Rarely are the abusive events ever discussed within the family. The child cannot speak of his abuse because he has no words, and if he were to try, he fears for the survival of the family. It is the “maddening sense of unreality” (1996b, p. 204) that is central and makes it especially vulnerable to dissociative processes: 

“Unlike the child whose parent is murdered before his eyes, the adult victim of childhood abuse has no verifiable proof of the events that so disrupted his early life. The child whose parent is murdered cannot dissociate the event because she must struggle with the reality of her parent's death every day of her life. There are others who corroborate the events that occurred, there are words to describe these events, and people discuss little else for a long time. Coming to terms with the reality of the trauma does nothing to jeopardize the young child’s connection to the remaining caretakers in the family. And when this child awakens in the morning, nothing has returned to the way it was before.The most powerful testament I can offer is to the essential importance of an observing other who “bears witness” to the traumatic events and helps to modulate affect states, process information, and verbally encode experience” [1996b, p. 206]. 

And this is precisely what the proto-gay child is lacking: an “enlightened witness,” as Alice Miller (1990) has called it. He typically has no empathic other who can help him to modulate affect states, process information, and verbally encode the particular “experiences” we've been addressing. It is only many years later, as an adult in a trusting relationship with an enlightened witness, that the emergence, containment, encoding, and integration of this whole area of experience can truly begin. 

Some readers may object that we are going a bit far in comparing the obvious horrors of child sexual abuse to the more subtle abuse of the proto-gay child. Perhaps, but we need not forget that the very same parents who comforted the boy when he was sick, who were proud of him for his accomplishments, who calmed him when he was upset—some of these very same parents throw the adolescent out of the house and completely abandon him when he reveals his homosexuality to them. While some parents are obviously kinder, no proto-gay child is completely devoid of fears like this. What's worse, like the victim of sexual abuse, he also, on some deep levels of his psyche, believes that he deserves it. 

Trauma and its resulting consequences of dissociation, as originally described by Freud and elaborated on in a more contemporary context by Davies, appear to be a helpful way of understanding aspects of the complex development of some proto-gay boys. An implication of this developmental perspective is a focus on how the unarticulated trauma that gets structured internally remains with and affects the gay adolescent and adult. It leads to a deeper look at unconscious issues, as well as the acting out of the unarticulated trauma. For example, the “coming-out” process, identified in the gay-affirmative psychological literature as so essential to the development of the gay adolescent or young adult, can now be seen in an even more complex and multileveled way. The very gradual process of beginning to identify oneself as gay, to slowly accepting oneself as gay, and simultaneously disclosing this identity to others is an enormously complex process that touches one to the core. It is not merely a series of discrete events leading to increasing self-disclosure (as gay) and reduced isolation and emergent support (as important as all of this is). An implication of our proposed formulation is that the sophisticated gay adult within a large urban gay community, who is “out” to himself and others, still has a very rich developmental history. He has laid down internal structures that do not easily vanish or change even with the more current overt support from his community. Even overt support from his family of origin, now finally available in the best of cases, does not “make up” for the early deprivation. In other words, there is still much internal work to be done; the emotional sequelae of lifelong deprivation, isolation, and humiliation do not resolve themselves through social intervention alone. 

The following is a case discussion to illustrate some of the major themes of this paper. A 38-year-old gay male attorney, Bud, comes to treatment with an agitated depression of two years duration following the breakup of his first homosexual relationship. The patient encountered his former lover at a meeting where he found himself tongue-tied, unable to converse, ashamed, and embarrassed. Bud spent several weeks preoccupied with whether he was “really loved” during this six-month relationship or deceived, manipulated, and exploited. Specifically, he wonders if he was taken advantage of financially. The evidence in support of this position is sparse. As we explored this more deeply, painful insecurities emerged about his own self-worth. This attractive, professionally successful gay man was intensely critical and judgmental of himself. Bud compared his own appearance, intelligence, success, and status with that of other individuals. This accounting would always leave him feeling deficient and lacking. His attractions were toward those whom he idealized. He could not register even the more blatant cues when someone he idealized expressed an interest in him. He concluded that no one desirable was attracted to him. 

It became clear that Bud felt himself defective and at risk of exposure if he were to become emotionally intimate with another person. Naturally, this issue became central to the transference. His self-sufficiency and detachment pervaded our sessions together. He talked compulsively with little awareness of the therapist's presence; in fact, he typically seemed stunned by any comment from the therapist. It was as if he were in the consulting room alone. His erratic attendance further amplified the detachment and distancing that were so characteristic of his life. These transference issues were explored deeply and gradually. 

A first awareness of relatedness to the therapist, many months down the line, was his expectation of exploitation, reminiscent of his fears regarding his ex-boyfriend. Over time, these defenses and fears regarding relatedness, which he was originally completely unaware of, began to soften. As this occurred, affect states emerged in primitive, disjointed, and frightening ways. The therapist had to tolerate a lot of “not knowing” during this period. Gradually, transference-countertransference patterns manifested themselves, also infusing the therapeutic space with semantically unencoded aspects of his internal world. Both patient and therapist struggled to get to know and value what were clearly vitally important aspects of the patient's inner life that had for so long been dissociated—that had originally been too emotionally overstimulating and cognitively disorganizing to have been encoded. No adequate words or schemas to represent these early experiences had ever developed for this man. Help in containing and modulating the intense affects had also never been present. 

Over time, the intense affect states became labeled and understood as neediness, vulnerability, and wishes for attachment. Initially through the transference- countertransference enactments and more gradually through the recovery of memories, it became clear that these feelings were deeply intertwined with the threats, rejection, and humiliation that had pervaded his childhood. His resulting internalized sense of defectiveness and crippling shame was central. 

Gradually we were able to reconstruct his immersion in a hostile environment at school, subjected to spoken and unspoken criticism, and left to parents who embodied achievement and desirability with no acknowledgment of his own struggles and shortcomings. His parents had been the picture of an ideal couple to the outside world. His father was a successful physician and decorated veteran of World War II. He exuded enthusiasm, confidence, and capability. Bud’s mother was beautiful, sociable, and admired. Their desirability in the community contrasted with his own ostracism. Bud existed in their shadow. Until he excelled as a swimmer in his final two years of high school, his father showed no interest in Bud. Bud felt swimming was his first success in a masculine pursuit. Despite this success, Bud felt defective and was left alone within this experience. He still felt it best to avoid exposure to others and to shield himself from the barrage of hostility and hatred directed toward him. He did not have the means to articulate his experience in this isolated and traumatized state. 

One cold rainy day later in the treatment, the patient enters the consulting room with a comment about the “wonderful” weather. He lapses into a quiet reflective reverie, which contrasts with his usual pressured speech. His associations lead him to memories of his first year in elementary school. On a rainy day, he would feel snug and safe inside the schoolroom focused on a solitary project. As he experienced the comfort of this memory, he identified a dreadful foreboding that intrudes and carries him to further painful recollections. He could feel comfort within the classroom because he had a secured place. His performance in this structured space spared him the threatening exposure he knew awaited him outside. He vividly recalled a classmate’s sudden punch to the stomach that took his breath and left him beyond words or tears. The sensation itself immobilized him with no point of reference to organize the experience. The punch was delivered as a challenge to fight and he was disparaged with an unknown word— “sissy.” He recalled repeated abuse that left him with a deep sense of alienation, shame, and hurt. He felt himself to be undesirable and different from other children. This sense of “differentness” was poorly understood, dimly realized, and fearfully avoided. He had a secret that he must hide or he could lose everything in an instant. His social interactions were conceived around self-protection: Never allow anyone to detect his difference, even though he could not identify the defining qualities of his difference. His world had begun to shrink by the early age of 5. He was not free as the other children appeared to be. He had identified a life or death task that he sensed but could not articulate. 

During this phase of the treatment, the therapist had a series of three dreams that involved this patient. In the first dream, the therapist awoke anxious and full of dread. He had transgressed the therapeutic boundary and had some vague sense of sexual contact with this patient. In the dream, he felt that he would be punished and reported to the State Licensing Board for unethical behavior. With some reflection, the therapist recognized that the dream had an erotic tone with no explicit sexual content. Furthermore, this type of dream was without precedent for the therapist. 

The second dream presented the therapist and patient walking together with warm feelings between them. There seemed to be an unexpressed erotic component, as if an unexperienced passion existed between the two. 

The therapist's third dream occurred about sixteen months after the previous dreams. The patient was crawling over the therapist, up one side and down the other, as if trying to feel the therapist’s entire body using the patient’s own body. Upon awakening, the therapist was startled to recognize the connection between this dream and his earlier dreams. At this point, he could finally identify this dream sequence as a communication from the patient regarding the patient’s dissociated cravings for love, tenderness, attachment, and physical contact. The dissociation was expressive of a deep, painful deprivation; all yearnings for contact and tenderness had been squelched by a terrible fear of punishment and annihilation. 

Bud's psychotherapy ultimately provided the opportunity to experience the range of feelings, along with the traumatic circumstances, which had been too painful and disturbing to recollect alone. In fact, his functioning had seemed to depend on forgetting these emotional wounds. Yet as he did remember, he began to experience his own aggression in a freer, more direct way. He recognized how alone he had been as a child and adolescent. This was not to say that he had not had friends or, at times, even been popular. The popularity was based on who others thought he was. He cultivated an image to exclude those very sexual emotional aspects of himself that were not mirrored in childhood. He replicated the same aversion to himself that he had been subjected to from an early age. He lived with constant vigilance and anxiety about being found out. Whom could he have turned to for understanding and support? 

The patient consistently began to recall years of accumulated ridicule and ostracism. He dreamed that he was in a social situation in which a young boy was exhibiting a snake. He attempted to move away surreptitiously rather than risk drawing attention to his terror of the snake. He maintained his composure on the surface, yet the boy sensed his distress inside and aggressively forced the snake in his direction. He panicked, attempted to flee, but the boy flung the snake toward him. The snake clung to his shoulder. He awoke terrified. 

His associations to the dream amplified the long-standing fear he had been left to manage alone throughout his life. The snake-boy recalled the all-powerful and idealized masculinity represented by exhibitionistic aggressiveness that he felt belonged to other boys and not himself. They could do whatever they pleased. They could be inconsiderate. They could hurt others at a whim. They were unafraid. The patient felt the dream represented his struggle to hide his fear of discovery as different. No one else in the group reacted to any difference in him, but the young boy sensed it, pursued him, and exposed his vulnerability to everyone else. 

This dream reflected a turning point in the treatment. It vividly and concretely portrayed his origins. The realization of his utter and complete isolation finally penetrated him in a deeply personal way. He knew at that moment that there was truly no one he could have turned to for understanding and support. These experiences as a child were finally becoming organized, understood, and affectively real. As he recognized his plight, he began to feel compassion for himself. Gradually, the compassion replaced the shame that had been so pervasive. Concurrently, his anger began to replace fear, the other dominant affect of his life. 

Bud took a roommate into his home. This was his first shared living experience in over twenty years. It became clear in the treatment that Bud had a fantasy love life with his roommate. As he acknowledged these feelings, his shame and fear were mobilized. He anticipated and feared the therapist’s critical judgment. It became apparent that his roommate did not reciprocate these feelings. Bud decided to share his struggles with his roommate, who did not reject him but acknowledged the limits of the relationship. These unrequited feelings blossomed into an intense passion that interrupted Bud’s typical isolated activities of watching television and video pornography. He began to socialize, partly to manage the intensely emergent pain of his unsatisfied cravings for love. For several months, the therapist worked actively to interpret Bud’s shame and sense of defectiveness that unconsciously aborted his initiative toward reaching out to others. As he began to experiment sexually and socially, Bud found that he craved physical contact. His desire to touch and hold was enormous and felt overwhelming at times. This was reminiscent of the therapist's earlier dreams. 

His dissociated traumas had isolated him from huge areas of his inner life which threatened a recapitulation of helplessness and despair. He had held an aloof contempt for his childhood vulnerability. There was no tenderness for himself as a child. He had longed to achieve adulthood as rapidly as possible to escape, or at least limit, his exposure to further abuse. 

All these defenses were necessary for his survival as a young child, but left him cut off as an adult from his own emotional world. Consequently, emotional relationships and intimacy threatened to activate his dissociated traumas. Vulnerability, tenderness, the fear of being found out, these were the very things he had worked assiduously to avoid. The patient's deep longing for an intimate loving relationship could finally be articulated now that the splits were healed. 

Seven years after his treatment began, the patient could acknowledge the damage he suffered at the hands of others while growing up. He could feel the reality of the terror, sadness, humiliation, and hurt, but now with compassion for himself. These feelings, as well as the specific memories associated with them, no longer activated a deep shame and sense of deficiency which he must hide. He could show himself for who he is, imperfections and all. 

This integration brought him to realize that he had abused and hurt the one person he had loved so dearly. He had subjected his boyfriend to a harsh, critical scrutiny and pushed him away. He could now tolerate the love that had threatened him then, so many years before. These moments of realization brought tender tears of pain for all the suffering and loss they had both endured. The poignancy of these recognitions was in contrast to his look of utter disbelief when it had originally been suggested that his boyfriend had really loved him. 

This man had begun treatment as a very detached, disconnected, self-sufficient individual whose relatedness to others was severely impaired; his dissociations were pervasive and had rendered him a shell of a person. Over the years of treatment, as he began to finally truly experience for the first time, the pervasive traumas of his life as a proto-gay child, he became present, real, connected to himself and the therapist, in ways that had been impossible earlier. 

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