New Quotations/Comments

Page
8
7
6
5
4
3
2
1

740-731

740.

In the first two years of analysis the patient was subject to "spells
of confusion." These would begin with severe tension headaches in the back of his neck, sometimes extending to the front. Occasionally they were one-sided and migrainous in nature. At these moments he felt he might "crack up," fragment into a "million pieces." He lost a sense of direction and felt disoriented. Lights could appear blindingly bright. The room might shift somewhat and he would become frightened. "I feel terribly sick, as if I'm going to crack up. It's a sort of terrible fright and then a compulsion to homosexual activity. Somehow, it's like I'm going to be destroyed or as if I'm going to be attacked. I'm in terrible danger. Shivers and shudders will shake my body and I'll get into bed, pull the covers over my head and curl up like a fetus. It feels like if I don't then go to a homosexual activity - I do it for my self-preservation. At that point I'm at my breaking point. If I don't I may go insane. It's not an indulgence at all. I have to do it. I might explode or I'll go crazy. It's as if all time and space are mixed up, as if things are shifted and I am in the deepest, direst trouble."

Homosexuality, Charles W. Socarides, M.D., New York - Jacob Aronson - London, 1978, pp. 260-261.

The analysand in the above-quoted case very emphatically declares that if had attempted to deny and repress completely his powerful homosexual urges, he would have become "insane." "It feels like if I don't then go to a homosexual activity - I do it for my self-preservation. At that point I'm at my breaking point. If I don't I may go insane. It's not an indulgence at all. I have to do it. I might explode or I'll go crazy."

Unfortunately, too many other tortured, bisexually-conflicted souls who have not been privileged to have had access, unlike this analysand, to the highly beneficial - sometimes literally life-saving - effects of psycho-analytic psychotherapy, do reach this "breaking point" and do "explode" and "go crazy," often with horrific consequences to all concerned.

In every case of a person "running amok", or one who succumbs to a murderous frenzy and consequent rampage, it is invariably their intense but severely repressed "bearded lady" conflict which is the triggering factor and direct cause of their paranoid schizophrenic breakdown. Examples of the many terrible tragedies resulting from these "running amok" cases are chronicled almost daily in newspaper, radio and television reports - witness particularly the Columbine and Virginia Tech school shootings, only two out of a multitude of horrendous blood-baths which have occurred in the past and all the new incidents which will continue to materialize with sickening regularity in future news reports. [For more background information on this particular analysand, please refer to # 739.]

739.

     He was aware of his "terrible fear" of normal men but felt superior
with homosexuals. He felt "terribly vulnerable" with boys who made fun of him for being effeminate, although, in fact, he did not appear feminine. "I can vividly remember every remark about my being effeminate or unmasculine. All the remarks in prep school tortured me terribly and the awful guilty feeling that I might give myself away."
     Fears of effeminacy seemed to vanish when he was required to enter the navy after his failure in graduate school. But he had a "year of decline" in the navy, where he worked in a mess kitchen, experiencing homosexual wishes and deeply fearing his effeminacy and homosexuality. He then engaged in a "calculated career" of homosexuality. He was away from home, had lost his social status, and wanted revenge on the navy. He could now be quite "coldly effective" and "felt unusually happy, although I still had to work in the scullery."
     In the evenings he drank a great deal and became "completely animal." He said, however, that homosexuality "saved my sanity. Before, at college, I had reached the end of the world, awful fear. Then I suddenly failed my exams. Then the underlayer of fear, uncertainty, came, that I was going to be at the mercy of people once I got into the service and would have no way to protect myself."
   Campbell's adaptive mechanisms were not sufficient to maintain him while in the navy. He regressed and became ill, suffering a severe pneumonia which kept him hospitalized for three months in a critical state. He then had an intense outbreak of homosexual behavior which he no longer fought. In the homosexuality he felt his sanity was preserved. Homosexuality neutralized severe projective anxieties bordering on paranoidal symtomatology, quieted his general distrust, and defended against extreme aggressive outbursts. He had not, on any occasion, become overtly psychotic.

Homosexuality, Charles W. Socarides, M.D., New York - Jason Aronson - London, 1978, pp. 254-245.

Campbell was a boy/man suffused with such urgent and powerful homosexual feelings that they had made his life a psychic nightmare during the time he was attending preparatory school and college. Later, while in the navy, he finally ceased his desperate and futile attempts to deny and repress these overwhelmingly insistent homoerotic cravings and embarked on a "calculated career" of relieving them by becoming "completely animal."

The great importance of Campbell's experience, as reported here by Dr. Socarides, lies in the fact that it proves once again the stunning truth of Sigmund Freud's famous dictum that the etiological source of all paranoia, now commonly referred to as paranoid schizophrenia, is invariably to be found in a complex of repressed homosexual desires and feelings, in both men and women, regardless of age or social background. And, as Campbell had so starkly reported, homosexuality "saved my sanity." By this he meant he fully realized he would have descended into total madness had he not found the will, and the immense courage, to allow himself irrevocably to experience and satisfy his deepest and most urgent homoerotic sexual and emotional needs.

As Dr. Socarides states, Campbell's ultimately complete acceptance of his powerful homosexual drives "neutralized severe projective anxieties bordering on paranoidal symptomatology, quieted his general distrust, and defended against extreme aggressive outbursts. He had not, on any occasion, become overtly psychotic." Thus it can be truthfully posited here that the cure for all functional mental illness - the "bearded lady" disease - is for the afflicted sufferer to cease all resistance to his or her theretofore deeply repressed and denied homosexual cravings and phantasies and abreact, or discharge, them either by means of intense masturbatory activity or else in actual human partnerships, as did Campbell. [Reference here specifically Quotation/Comment 528 in "Schizophrenia - The Bearded Lady Disease," in its own link on this website.]

Homosexuality "SAVED MY SANITY." These three words should be engraved in stone, for they provide us with the key to the understanding of, and consequently the cure for, that ever-present, ever-deadly scourge of mankind - common madness.

738.

Perversions generally imply the dominance of pregenitality in the sexual function. This regressive feature is common to all perversions and involves the denial of heightened castration anxiety and marked bisexual identification. The ambivalent cathexis of the object with preponderance of destructiveness is a corollary in the pregenital stages. The role of sadism in the formation of perversions has lately been more and more emphasized by several authors (Klein, Glover, Gillespie, Greenacre) and we may add that emphasis in our etiological thinking has shifted from the traumata of the phallic phase to the traumatic influence of the pre-phallic era. This shift has taken place - though by no means in explicit connection - simultaneously with our greater attention to the role of aggression in mental functioning and in pathology as well. (p. 231)

Clinical experience indicated that, in cases of multiple perversions, traumatic overstimulation occurred in the undifferentiated phase, thereby affecting both drives in their undifferentiated state simultaneously. Physiological dysfunctions threatening survival, and the disequilibrium of mother-child relationships (Greenacre) in this early phase, seemed to be present in several cases of perversion. Its sensory consequences, forming identification, were also described by Greenacre in rich detail in relation to fetishism. One may surmise, however, that at least some of these findings cannot be restricted as the determinant of fetishism only, especially since we rarely encounter perversions in isolation. Whereas in fetishism, the uncertainty of body image and especially the confused sexual identity may be most striking, the vagueness of body periphery, of the boundaries of the body-self, may well be a substratum of all perversions. It certainly plays a much greater role in sado-masochism than has hitherto been emphasized. (p. 233)

Perversions in which the above-described genetic history is discernible show a clinical closeness to schizophrenia, or else the patients have schizophrenic symptoms at the same time. In such cases, it is almost impossible to make a clear distinction between the schizophrenic identification and defenses and those underlying the perversion. Their frequent coexistence shows the fluidity of these mechanisms in one individual. One may say that, in schizophrenic symptoms, the regression to undifferentiation has taken place and that the partial narcissistic object relationships in the perverse symptoms are reparative attempts. They seem to represent different forms of defenses against the unneutralized aggressions threatening the object. It is not too unlikely to assume that, in schizophrenic manifestations due to the undifferentiation of both bad a good objects and libido aggression, a more extensive withdrawal from the object world takes place than in perversions where by splitting of the self a narcissistic object relation can be maintained. (p. 234)

It is obvious that the exhibitionist reassures himself against castration. The acting out of this aggression is a denial of the deeper-lying feminine identification. The male exhibitionist is identified with the female child and maintains awe and aggressive ambivalence toward the paternal phallus. Due to the greater ego-syntonicity of aggression in men, the passive-feminine self will be externalized to the object.
The fetishist escapes castration fear by the denial of his perception that women lack a penis. The denial is also necessitated by his alternating between identification with the phallic and aphallic mother. (pp. 236-7)

Homosexuals show a failure in all four factors that are necessary for the resolution of the Oedipus complex. In turning away from heterosexual objects by identification, the destructive impulses against the mother are resolved and, at the same time, they pave the way for the libidinization of aggression against the rival. The homosexual thus succeeds in defending himself against retaliation from both sexes. There are manifold variations in the compromise between aggression and libido (Nunberg) and whether, through narcissistic split, aggressive or libidinal attitudes are delegated to the object (also Anna Freud). In addition, elements which we mentioned in connection with other perversions are present to a greater or lesser extent, just as all other perversions show a degree of homosexuality due to their ubiquitous narcissistic elements and bisexual identification. (p. 239)

    2. Perversions are considered as symptoms in which the dominant defense - common to all perversions - is the dramatized denial of castration and in which the gratification of libido consists of a genetically-determined variety of pregentital fixations.
    3. The increased need to deny castration is based, on the one hand, upon the projection of a heightened aggression, on the other, on a marked bisexual identification, which was established as a defense against the destruction of the object, in whole or in part.
    4. [......]
    5. The frequent coexistence of schizophrenic symptoms with perversions indicates a common fixation point in the undifferentiated phase and in defenses against unneutralized aggression; the perverse symptoms represent an attempt at restitution of the narcissistic object relationship.
    6. Common to all perversions is the narcissistic object relationship established by the splitting of the self. The distance from schizophrenia depends on the grade of structural development and the grade of object relationship. (pp. 239-40)

Aggression and Perversion by Robert C. Bak, M.D.*, in Perversions - Psychodynamics and Therapy, Edited by Sandor Lorand, M.D. and Michael Balint, M.D., Gramercy books, New York, 1956, pp. 231-239.

* Robert C. Bak, M.D., Member, New York Psychoanalytic Society; American Psychoanalytic Association; International Psychoanalytical Association - Secretary, New York Psychoanalytic Institute.

The consensus reached by Dr. Bak and his fellow investigators, as outlined in the above quotations, clearly points to the fact that all perversions have at their etiological root the same toxic factor of bisexual conflict and gender confusion which forms the basic etiological core of schizophrenia, the "bearded lady" disease. Perversions, therefore, must be considered as indirect manifestations of this illness, part of the myriad symptomatology of the disease. Perversions and schizophrenia are invariably and inextricably entwined. As Dr. Bak states: "Whereas in fetishism, the uncertainty of body image and especially the confused sexual identity may be most striking, the vagueness of body periphery, of the boundaries of the body-self, may well be a sub-stratum of all perversions. It certainly plays a much greater role in sado-masochism than has hitherto been emphasized." If the word "schizophrenia" had been substituted for the word "perversions" in the above sentence, it would constitute the perfect description of the basic psychological profile of the schizophrenic person, male or female - that is, of one who is burdened with "uncertainty of body image," "confused sexual identity" and "vagueness of body periphery, of the boundaries of the body-self." No more accurate and intuitive portrayal of the underlying schizophrenic psyche could be elucidated.

737

The exhibitionist's shyness is at a minimum in the presence of young girls though he knows that indecency with children involves extra-heavy penalties from the law. But if certain women, mistaking the sollicitus for the sollicitans aspect of MGE, take the act of the male genital exhibitionist as an invitation to closer contact, he is immediately put off. He wants no partnership but needs female spectators to increase his narcissism at their expense. Thus by a retreat from object libido, the male exhibitionist arrives in his act at a feeling of hermaphroditic self-fulfillment, a sense of "intoxication with his own power," as Mr. Bleuler says. L. Eidelberg5 quotes an exhibitionist text which no doubt has its variations. It says: "It is not true that I want to have breasts. The truth is that I am proud of having a penis. It is not true that I am interested in watching women who undress. The truth is that I want to show them my penis." But, as already mentioned, it is not just the penis but the whole sexual region which is engaged in the exhibitionist's attitude to femininity and women. Its meaning in a nutshell is: "I am you, all of you, and - whether you swallow it or not - still more."

Male Genital Exhibitionism, by Hans Christoffel, M.D.*, in Perversions - Psychodynamics and Therapy, Edited by Sandor Lorand, M.D. and Michael Balint, M.D., Gramercy Books, New York, 1956, pp. 262-263.

* Hans Christoffel, M.D., Member, Swiss Psychoanalytic Society; International Psychoanalytical Association - Member (late Chairman), Swiss Psychological Society - Chairman, Basle Psychological Working Community

The man who indulges in male genital exhibitionism is clearly suffering from schizophrenia, the "bearded lady" disease, since this is clearly an "insane" act he is carrying out and one to which he has been driven to perform, regardless of its potential criminal consequences to himself, through the urgent pressure exerted upon his beleaguered psyche by his unconscious bisexual conflict and gender confusion.

As the above investigators have made clear, MGE is never an act executed by a man who is secure in his heterosexuality and masculine identity, but is always one which is transacted by a man who has a critical need to prove, both to himself and to the female(s) he accosts, that he is not a female like they, with breasts and other feminine attributes, but is undeniably a person who possesses a penis. No, his act proclaims, he has not been castrated and turned into a woman - here is the glaring evidence of the fact he is still a physically intact, powerful man. By shocking his female victims in this manner, he is desperately trying to reassure himself of the certainty of this supposition. In reality, however, he is an emotionally very disturbed individual, torn by his severe bisexual conflict and gender confusion, and much more to be pitied rather than feared.

MGE is one of the more startling of the myriad symptoms which can arise as the direct result of the schizophrenic "bearded lady" conflict underlying all functional mental illness.

736

The homosexual deviation in cocaine addicts was first described by Hartmann in extensive clinical studies.18

In certain cases, addiction is but the manifestation of a latent or circumscribed psychosis. In an observation of Benedek, the patient wanted to destroy her feminine body which she hated. This wish had emerged in her adolescence. She drank heavily and stuffed herself with large quantities of food. The drive toward bodily self-destruction served as a defense against repressed homosexuality. In her wish to destroy her feminine ego, she was also trying to destroy her mother with whom she identified herself on the oral level. The defensive struggle against this identification led to paranoid hatred of women. 19

In this context, I would like to mention briefly my own observation of compulsive bulimia in a schizophrenic girl. Here analysis demonstrated clearly that the compulsive eating served the purpose of establishing the original identification with her mother; at the same time it meant the destruction of her feminine loveliness, since it transformed her into a shapeless mass of flesh and fat. In this way, the patient was defending herself desperately not only against any heterosexual potentialities but, on a deeper level, against the narcissistic homosexual love for the mother and her substitutes. The voice of her fantasy love, that is, of her father, threatened to kill her unless she continued to stuff herself with food. Compulsive hair-pulling was another means of destroying her femininity and forcing her continued dependence on her parents. Her psychotic imagery expressed the split in her homosexual attitude. She was being threatened by her "beautiful" mother holding a sword while, at the same time, she was yearning for the lovely female figures of her own fantasy.

In my observations of neurotic obesity, I became aware of the role played by repressed homosexuality in my predominantly female patients. One of them, in addition to compulsive overeating, developed during analysis addiction to benzedrine which led her to take, in complete secrecy, immense quantities of the drug. She then displayed a transient paranoid psychosis in which the analyst became her chief persecutor with evil sexual intentions. The homosexual element could easily be detected in this heterosexually oriented delusional formation.

Among my women patients who were addicts, denial of femininity was a prominent feature; it manifested itself by amenorrhea and avoidance of feminine grace and apparel. In homosexual episodes, patients played the aggressive masculine role. In their heterosexual relations they showed complete vaginal anesthesia and, as one of my patients put it: they did not "discover" their vagina until a fairly advanced stage of analysis. It is in keeping with this attitude that, to their unconscious, food had also the symbolic meaning of the paternal phallus which they wanted to incorporate and thus to keep forever.20

Finally, we have to consider the role of homosexuality in that most popular and best-known form of addiction, alcoholism. Both superficial and clinical observation concur in stressing the predominance of certain homosexual trends in alcoholics. Here belong such trends as the importance of drinking in common in certain male group activities, the particular kind of conviviality and fraternization displayed by the drinker and, on the defensive side, the manifestation of paranoid tendencies with their further psychotic elaboration.

However, psychoanalytic authors, by and large, have agreed on the importance of latent homosexuality in the dynamics of alcoholism. Theoretically, this could be expected in view of such trends as morality and narcissism - trends which certainly are shared in common by the alcoholic and the homosexual. Clinically, we are impressed by the fact that alcoholism appears as one of the significant patterns of behavior in individuals with a weak ego structure. A similar ego structure is found in most homosexuals, latent and well as manifest. Clinical observations of non-psychotic and psychotic alcoholics point to trends which may be considered as characteristic - though certainly not specific - of latent homosexuality, such trends as impotence, suspiciousness and jealousy.

Abraham was the first to recognize the significance of latent homosexuality in the etiology of alcohol addiction. He spoke of men turning to alcohol as a means of gaining an increased feeling of manliness and of flattering their complex of masculinity. He drew attention to characteristic mannerisms of alcoholics and to special drinking customs among such groups as university students - all of them bearing latent homosexual characteristics. He also drew an interesting comparison between the structure of alcoholics and perverts.22 Juliusburger discussed the relation of homosexuality to inebriety and pointed out that periodic stages of anxiety may result from strong homosexual impulses. According to his observations, dipsomania is a manifestation of such unconscious homosexual drives, periodically breaking through the barrier of repression. Anxiety which manifests itself at the beginning of a dipsomanic attack arises under the impact of an unconscious homosexual wish; in our modern terminology, we would describe it as a reaction of the ego to the breaking through of the id impulses.28 In some of my own observations, I have found a similar pattern - with the emphasis put on seeking rapprochement with other men as a substitute for a deficiency in the early relationship to the father.

Knight observed, in his alcoholic patients, a conscious or almost conscious fear of being regarded as feminine. They showed impotence and ejaculation praecox and a typical dichotomy in their love and sex life.25 I can also confirm his observation that women with a strong homosexual component resort to drinking as a means of identifying and competing with men.

The rich variety of clinical developments which arise from the common background of insidious schizophrenia, alcoholism and perversions is well known to descriptive psychiatry. From the analytic point of view, the main distinction consists, perhaps, in the attitude of the ego towards the perversion. We observe patients whose ego accepts homosexuality as a drive as well as a gratification. Here perversion may become more or less integrated into the general pattern of living, without causing any other reaction than, possibly, anxiety based on a good appraisal of reality. Obviously, it is only natural that a passive young man who gets intoxicated and then seeks out tough, aggressive men in order to submit to their anal aggression, should fear the consequences of these encounters. A patient of this type admitted that he had been beaten up and robbed - but "only" twice in the course of four years of intense homosexual activity. The patient accepted both his masochism and his homosexuality.

The most complete, to my knowledge, analysis of a case of delirium tremens was published in 1926 by Kielholz. The analysis confirmed his former findings concerning the importance of the homosexual component in alcoholics. Clear homosexual and sadomasochistic tendencies in the patient were instrumental in shaping frightening hallucinations in individuals who were, for the most part, objects of his emotional and libidinal attitudes. Some of these fancied attacks on the patient had the characteristics of direct homosexual aggression. Kielholz pointed out the connection between the mass character of animal hallucinations and the deep libidinal links binding the drinker to his male drinking friends.27

The threatening and castrating character of the hallucinations in alcoholic delirium was the object of special study by Bromberg and Schilder. They described the dismembering tendency of these experiences which they found in the foreground of the clinical picture. The persecutors were chiefly other men - soldiers, drinking companions and the like. The choice of these persons was motivated by latent homosexual tendencies.28

Paranoid elements may already appear in the acute stages of so-called alcoholic hallucinosis. Voices accuse the patient of various misdeeds, among them not infrequently homosexual activities, and threaten him with a punishment which often amounts to symbolic or undisguised rape or castration.

In further clinical development, both the delirium and the hallucinosis may evolve into a chronic paranoid psychosis. It is generally believed that, in such cases, alcoholism was the manifestation of a latent or otherwise not recognized schizophrenia. It is easy to recognize typical defense mechanisms, used by the ego in its struggle against the breaking through of homosexuality, in the ideas of jealousy. They are a classic feature in many a chronic alcoholic and reach their peak in a paranoid psychosis.

The struggle against homosexuality may be covered up by the ego in various ways so that, in certain cases, we may see in succession a whole gamut of defense mechanisms. Obsessive-compulsive symptomatology may be followed by paranoid episodes until, finally, aggressive homosexuality may break through under the impact of alcoholic intoxication. In such patients, inebriety assumes the characteristics of so-called pathological intoxication, with outbursts of violent aggression and homosexual acts, or, at least, overt impulses and fantasies.

In a patient under my observation, these episodes clearly amounted to what may be described as a self-induced psychosis. In his early childhood, he was exposed to an unusual amount of aggression from both parents. His mother, full of hostility and possessed of a violent temper, used to tell the children that their father would kill them if he ever found out about their various transgressions. These included going to church, since the mother was a devout Catholic while the father belonged to a different creed. After absorbing this great dose of aggression, the patient naturally identified masculinity with savage brutality and isolated both from the rest of his ego. Oral identification with the mother and an inverted Oedipal constellation, with emphasis on femininity and passivity, were a natural result of this development. There was a great fear of the father, that is, of his incorporated and isolated aggression. Since the father was described by the mother as likely to become insane with rage and then capable of homicide, the patient had developed an intense fear of his father, of other men and of insanity. His passive and mostly latent homosexuality served the purpose of placating the dangerous father and his substitutes and of neutralizing his own aggressive virility.

Homosexuality and Psychosis, by Gustav Bychowski, M.D.*, in Perversions - Psychodynamics and Therapy, edited by Sandor Lorand, M.D. and Michael Balint, M.D., Gramercy Books, New York, 1956, pp. 114-123.

* Gustav Bychowski, M.D., Member, New York Psychoanalytic Society; American Psychoanalytic Association; International Psychoanalytical Association; Associate Clinical Professor of Psychiatry, New York University College of Medicine; Associate Visiting Neuro-Psychiatrist, Bellevue Hospital

The clinical information contained in the above quotations demonstrates unequivocally the core etiological role of bisexual conflict and gender confusion in a multitude of conditions not normally associated with schizophrenia, the "bearded lady" disease, yet which in reality form an integral part of the general symptomatology of this insidious illness.

The unfortunate victims of alcohol and drug addiction are basically self-medicating themselves in order to keep at bay the intense anxiety which is inevitably the product of the hysteric/physiologic conversion into this painful condition of their repressed homosexual excitations. Malignant anxiety is invariably the toxic outcome when the urgent homosexual libido is denied its normal orgasmic genital discharge due to its complete repression by the disapproving super-ego of the individual so afflicted. When these repressed homosexual excitations are blocked from their natural path of orgasmic genital discharge, their powerful affect, or energy charge, converts itself into anxiety and attempts to discharge itself in this abnormal manner in order to rid the organsism of the tremendous burden of tension caused by the dammed-up affect of the repressed homosexual cravings. Furthermore, since this anxiety is always experienced by the bodily organism as a painful, toxic condition, the person experiencing it frequently attempts to alleviate it through the narcotizing medium of alcohol and drugs. And since this is always a very short-term solution to a long-term problem, the use of these narcotizing drugs has to be repeated interminably, thereby leading to a fixed state of addiction by the individual. These drugs basically serve as chemical tranquillizers, or sedatives, in the same manner as do the clinical psychotropic drugs, the main difference being that in the case of drug and alcohol addiction, the sufferer becomes his or her own prescribing "physician."

Sigmund Freud once made the profoundly intuitive and significant statement that "Masturbation is the primal addiction." By this he meant that all other addictions stem from this original one and that the cure, then, for the later ones is to return once more to the original one by abreacting (through orgasmic physical release) all the phantasized sexual excitations which the now "addicted" individual had formerly discharged primarily by means of frequent masturbatory activity, but had later repressed as being ego-dystonic due to their "perverse" nature. Since schizophrenia is so closely interwoven within the addictive process, the abreaction by orgasmic release of these long-repressed homosexual phantasies has an enormously beneficial effect upon the individual's overall mental state, and is in fact the only "cure" for functional mental illness. [See especially Quotation 528 in "Schizophrenia - The Bearded Lady Disease", in its own link on this website.]

As for bulimia, anorexia, and obesity, all three conditions are obviously the product of a basic dissatisfaction within the individual regarding his or her natural gender consignment and its consequent bodily representation. Bisexual conflict and gender confusion invariably form the basic etiological core of these conditions, as they likewise do in all other closely-related schizophrenic symtomatology. The schizophrenic girl who hates her female body will destroy its natural feminine curves either through anorexic starvation or bulimic gluttony and obesity, or a varying combination of all three conditions, sometimes ending tragically in total self-destruction, or suicide. The obese, bulimic and/or anorexic male likewise suffers from the same gender-dysphoria as does the similarly afflicted female.

In the final paragraph of Quotation G., stark proof is provided that the genesis of homosexuality per se in any individual case does not have to rely on any reputed "genetic" basis to be operative but can appear solely as the consequence of a warped and unnatural parental upbringing, as has been so vividly illustrated in this particular case by Dr. Bychowski. With parents as mentally unstable (as the direct result of their own bisexul conflicts and gender confusion) as the ones described here, it is a wonder the son did not evolve into a raving, psychopathic maniac rather than just another "harmless" schizophrenic alcoholic bedeviled by his passive homosexual urges. In every case of homosexuality - and, if repressed, its twin, schizophrenia - in both men and women, if one delves deeply enough into the psychological history of the parents, it readily becomes apparent that bisexual conflict and gender confusion, in one or both parents, is the instigating factor in the child's own homosexual development.

In the telling words of Dr. Lewis B. Hill, in his classic book "Psychotherapeutic Intervention in Schizophrenia," (pp. 134-135), he closely examines and explains the structure of this toxic parental configuration:

"It would seem that the schizophrenic patient is often of the third generation of abnormal persons of whom we can gain some information. The preceding two generations of mothers appear to have been obsessive, schizoid women who did not adjust well to men. There is some evidence that they were, in a sense, immature and that within the obsessive structure could be found hysterical difficulties. It is to be noted, also, that there are two preceding generations of men who are not masters, or equals, in their own marriages and homes, or psychosexually very successful, and who are often described as immature, alcoholic, and passive, or hard-working, self-centered, and detached from the family. We do not know what sort of mothers and fathers these fathers of schizophrenics may have had, but it could be presumed that the fact that they let themselves be married to mothers of schizophrenics implies something concerning their own mothers.

"Loosely, the pattern which emerges is that of two generations of female ancestors who were aggressive, even if in a weak-mannered and tearful way, and two generations of male ancestors who were effeminate, even if the effeminancy was disguised by psychopathic tendencies. It might be expected, or at least we would not be surprised to find, that a child of such ancestry would have difficulties centering around the problems of active aggressiveness and passive submissiveness. If the child is unstable in its balance of activity and passivity, the likelihood is that, under the guidance of the sort of mother who gets herself called 'schizophrenogenic,' the passive behavior will emerge as the overt character of the child, whereas the active behavior will be noted only in the form of negativism, of stubborness, or retentiveness, and so forth."

As a final note, this commentator was once told by two men, long-time homosexual partners, that in their childhood their respective mothers had threatened to cut off their penises if they persisted in "playing with themselves." One mother said she would use sharp scissors, the other a carving knife, and both mothers prominently displayed said weapons as they made their terrifying threats. Here sharp scissors and carving knives definitely trump "genetics" in explaining the development of these mens' homosexuality. And undoubtedly, on closer examination, both sets of these parents would fit perfectly into Dr. Hill's above description of the schizophrenia and/or homosexuality-producing parental configuration.

735

    There is hardly any need to multiply these examples. This and similar observations led me to the conclusion that the latent homosexual constellation is a constant and most significant element of latent schizophrenia. This constellation centers around a primitive maternal identification [in males] which, by virtue of splitting, remains isolated from the rest of the ego field. Various defense mechanisms are put in action in order to build up the counter-cathexis necessary for maintaining the dissociation of the passive, maternal, feminine sector of the ego field. Among these defensive measures of the ego, we may detect narcissistic withdrawal, secondary hostility and bouts of active homosexuality. Owing to the dissociation of the passive segment of the ego field, the rest of the ego is able to develop a deceptively "normal," seemingly realistic and even pseudo-masculine behavior while passivity, masochism and the megalomania of primary narcissism remain confined to the dissociated segment of the ego. This facade may be maintained until the moment when, due to some precipitating event, a breakdown of ego defenses reveals a crack in the total ego structure and results in a manifest psychosis.
    Psychoanalytic observations of schizophrenics subjected to insulin shock therapy provide another opportunity for an understanding of the role of latent homosexuality in the origin of paranoid schizophrenia. In particular, these observations illustrate the important role played by the homosexual disappointment and the homosexual panic. The cathartic discharge provoked by the insulin coma creates a release of repressed libidinal impulses. The ambivalent homosexual attitude becomes split into its two components, with the positive one ideally invested in the transference reaction and thus accessible to analytic interpretations and working through.*
    Psychoanalytic investigations have demonstrated the affinity between homosexuality and the schizophrenic break. In certain complex cases of latent homosexuality, the counter-cathexis built by the ego in order to maintain the dissociation of the psychotic core from the rest of the ego, is so precarious that the psychotic invasion occurs, as it were, spontaneously and periodically. In such cases, the weakness of ego boundaries allows the intermittent release of internalized images which become projected onto various persons. The rapid shifting from passivity to activity and vice versa enables the individual to act out both attitudes, successively as well as simultaneously, and to play varied roles according to multiple identifications. Since his ego remains fixated in the stage of early narcissism, he is compelled to substitute homosexual acts for consistent and successful dealing with reality; in addition to libidinal gratification, the former offers the advantage of being invested heavily with magic omnipotence.

The kinship between schizophrenia and homosexuality is based on certain characteristics of ego formation. In my study of the ego of homosexuals, I have shown that the ego weakness characteristic of them is related to the ego weakness characteristic of schizophrenics. I came to the following conclusion: "The homosexual does not pursue the union with the woman, since, in its deep core, his ego has never separated from her. For the same reason, his ego has never really abandoned his prenatal narcissism and he has never acquired the feeling of virility. As a final consequence, he has never really been born into the society of men. Like the future paranoid, his ego has acquired a deep split. It has split off its primitive stage, what I have called the primitive superego, which has never come to grasp reality. Neither has it ever been able to accept any frustration. It has dealt with the latter by introjecting the maternal imago and trying to perpetuate possession through identification. It eternally pursues the phantom of its own and the father's masculinity by carrying within it the maternal image. In reality, it is bound to protect its deep narcissism. Its functioning is, in very truth, based on archaic constitution and primitive mental mechanisms,"12 a formulation expressed by Freud as early as his Three Contributions to the Theory of Sex. Exaggerated narcissistic cathexis is a common characteristic of the ego of the homosexual and the ego of schizophrenics. Fluidity of ego boundaries accounts for phenomena which are common to both groups of individuals.

Elements of homosexuality may be included in the structure of various forms of depression. They are evident in some cases of paranoid depressive reaction in the period of involution. Here the paranoid ideas not infrequently represent a projection of long-repressed homosexual fantasies; the patient either feels directly accused of homosexual acts or threatened by persecutors who want to assault him, make him into a male (or female, as the case may be) prostitute, etc.
According to psychoanalytic insight, the characteristic essential mechanism of the melancholic depression lies in introjection. Occasionally, however, projective mechanisms come into action; in that case, paranoid trends may be added to the picture of a so-called pure depression. Prevalence of such symptomatology may be indicative of the importance of schizophrenic elements in the structure of psychosis. To be sure, some germ of paranoid delusion can be observed in almost every depression of long duration. This was recorded by that great expert on melancholia, Robert Burton. "The melancholy are always aggressive. They cannot speak but they must bite. But they are unaware of their own aggression and feel attacked instead. As they that drink wine think all runs around when it is in their own brain."15

Homosexuality and Psychosis, by Gustav Bychowski, M.D.*, in Perversions, Psychodynamics and Therapy, Edited by Sandor Lorand, M.D. and Michael Balint, M.D., Gramercy Books, New York, 1956, pp. 105-109.

* Member, New York Psychoanalytic Society; American Psychoanalytic Association; International Psychoanalytical Association; Associate Clinical Professor of Psychiatry, New York University College of Medicine; Associate Visitng Neuro-Psychiatrist, Bellevue Hospital

In the early days of psycho-analytic research, a great deal more attention was paid by investigators into the psychic mechanisms involved in the development of mental illness in men rather than to those involved in the development of mental illness in women. We can see a clear example of this in the above quotation, where Dr. Bychowski is exclusively referring to bisexual conflict and gender confusion as the causative factor in schizophrenia in males. However, all the same psychic mechanisms he describes in this regard as applying to males also apply equally to females. For in both men and women, the key to their mental illness lies in their pathogenic, negative oedipal relationship with the mother.

In men, this "negative Oedipus complex" (Freud), in contrast to the normal, "positive" one, takes the form of the male child identifying closely with the mother in a passive, feminine manner rather than with the father in a forceful, masculine one, thereby making the father (and all men) the object of their libidinal strivings. And the female child, as the result of her own negative oedipal complex, identifies with the father in a masculine, competitive way and takes the mother (and all women) as the desired love object. "Emotional incest with the mother is indeed the very essence of lesbianism." (Charlotte Wolff, M.D., Love Between Women, p. 60) Unless strongly repressed and denied, these negative oedipal attitudes on the part of the both the male and female child would lead directly to an open homosexual orientation and lifestyle. Mental illness is the inevitable outcome, however, when these skewed, negative oedipal attitudes are repressed and the unfortunate child attempts to live a normal heterosexual life - witness the examples of schizophrenic illness as described by Dr. Bychowski in the above quotation. Basically, homosexuality and schizophrenia are opposite sides of the same coin. Homosexuality repressed is transformed into schizophrenia.

For these reasons, the mother becomes the key to the mental health of all mankind. If the mother is a sexually mature, heterosexual person who can relate lovingly and nurturingly to both her husband and children, all functional mental illness would be eradicated from the earth. And in every case, to the extent she does not possess these "normal" feminine, maternal attributes, mental illness will inevitably rear its ugly head, too often with devastating consequences not only to the individual so afflicted but even to the world at large. The saying that "the hand the rocks the cradle rules the world" is probably the most astute and concise example of psychological insight ever put to words. And with regard to the husband of this "model" mother, she would never allow herself to be married to a man who was not as sexually mature and heterosexual (one and the same thing) as she is, and therefore as good a male role model for his children as the mother is a female role model. With this ideal couple, then, it would be impossible for the malignant factor of bisexual conflict and gender confusion ever to gain a foothold in the psyches of their children, consequently "inoculating" them from the possibility of ever developing schizophrenia, the "bearded lady" disease, or any of its closely-related pathologies.

In summary, the more sexually mature and heterosexual - and consequently the more emotionally mature - is the mother, the more mentally healthy will be her children. And the less she is such, the less mentally healthy will they be. This psychological equation qualifies as a fixed law of nature, always operative.

734

Observations on various forms of mental disturbance accompanied by homosexuality, or vice versa, on homosexuals manifesting symptoms of psychosis, have been known to classical, that is, pre-analytic psychiatry.1 Yet it was not until the tool of psychoanalysis could be applied to our investigations that the connection between psychosis and homosexuality could become the subject of more than a purely descriptive study.
     It seems that the first clinical description - suggesting a possible connection between psychosis and sexual inversion - appears is De Prestigiis Daemonum, the magnum opus by Weyer, the hero of what has been called the first psychiatric revolution (1563). "I knew another Sodomite who complained that he always heard passers-by come to cause noise in his ears; even his parents, he said, were doing it; he wrote to me on his own behalf, quite secretly asking me whether I could not give him some advice, since some people had told him that his trouble was in the organ of hearing."2
     With the advent of psychoanalysis and its impact on clinical psychiatry, the concept of psychotic symptoms developing as a defense of the ego against the awareness of homosexuality came into being. However in Bleuler's monograph we find this problem mentioned only briefly on two occasions.
     A brief review of psychoanalytic contributions to the problems of psychosis and homosexuality should start with the classic contributions by Freud. He followed his pioneering study of Schreber's case (1911) by a comparative study of jealousy, paranoia and homosexuality (1912) and the study of a case of paranoia running counter to the psychoanalytic theory of the disease (1915). In the latter he showed that even when the persecutor of a woman patient happened to be a man, he nevertheless was only a substitute for the maternal image.3
     According to them, MacAlpine and Hunter, two British psychoanalysts, think that the change into a woman, which was one of the turning points in the development of Schreber's psychosis, "was not punishment by castration for forbidden homosexual wishes nor was it meant a means of achieving such wishes; rather its purpose was to permit procreation as a woman.
     "Schreber's basic bisexuality had developed into a true manifest ambisexuality, male and female potentials being equally matched. Thus he developed fantasies of self-impregnation while he was acting the part of a woman having intercourse with himself."6
     This penetrating reanalysis of Schreber's material reminds us of elements described in some former detailed clinical observations of schizophrenia, in particular the classic publications of Nunberg.7
     The role of ambisexuality, with its far-reaching consequences in the clinical picture of advanced schizophrenia, has been evident for a long time. From a clinical point of view, one should bear in mind that Schreber not only went through periods of deep paranoid aggression and extensive elaboration but also long periods of catatonia. We know especially, from detailed observations of catatonic attacks and catatonic stupor, that fantasies of self-procreation frequently play an important part.
     It is also generally recognized that confusion about one's own sexual identity is a frequent and important part of schizophrenic symptomatology. It may occur at a relatively early stage of the illness and, at times, may be detected by psychological testing prior to becoming manifest clinically. In my opinion, this symptom reflects a significant change in the patient's ego and may be described as a struggle of the feminine and masculine identification, or, in other words, generally speaking, of the paternal versus the maternal introject.
     Detailed observations of this process can best be gathered during analytic therapy of patients in a stage of incipient or even latent schizophrenia. They are supplemented by whatever data we can gather from the observation of frank psychotics. An additional source of information is provided by the analytic observation of patients subjected to insulin shock therapy.

Passive homosexual feelings began to dominate the transference situation and were warded off by fleeting ideas of reference and persecution. I shall return to this observation at a later point in the discussion of the structure of latent psychosis. For future reference, I shall call this patient Michael.
Such changes in the body ego, when further advanced, may result in the sensation of transformation into a female. Incidentally, we observe with much less frequency the delusion of transformation into a male in a woman. It would be incorrect to assume that such changes occur only in advanced clinical stages of frank schizophrenia. We observe them in initial stages in ambulatory or even latent schizophrenics, where we have the opportunity to study their structure and various shadings.

Homosexuality and Psychosis, by Gustav Bychowski, M.D.*, in Perversions, Psychodynamics and Therapy, Edited by Sandor Lorand, M.D. and Associate Editor Michael Balint, M.D., Gramercy Books, New York, 1956, pp. 97-8, 100.

The insight that madness is invariably and inextricably interwoven within a framework of bisexual conflict and gender confusion can be traced as far back as 1563, as noted in Quotation A above, with the clinical description by Weyer of the symptoms of a man obviously suffering from paranoid schizophrenia while simultaneously afflicted with a bisexual conflict severe enough to have him labeled by Weyer as a "Sodomite."

But as Bennett Simon, M.D., clearly illustrates in his book, "Mind and Madness in Ancient Greece," Cornell University Press, Ithaca and London, 1978, the role of bisexual conflict and gender confusion, with its inevitable etiological connection to madness, can be traced even further back than Weyer's 1563 example - to ancient Greece, as is documented here in three excerpts from Dr. Simon's book.

1. Dionysus is the god who induces madness, and in some mythic versions was himself driven mad by Hera in revenge against Zeus. Hera is also said to have caused his effeminacy, which is closely related to the theme of madness.57 - p. 115

2. ...In the Bacchae[ITSALICS] Pentheus starts out at one extreme - he will brook no illusions or convenient fictions. By the end of the play, this insistence on brute reality has turned out to be quite brittle, and he gradually goes mad. The boundary between reality and madness is marked by the scene in which he dresses as a woman, deluding himself that he in not deluded. - p.147

3. There is a hint here, but only a hint, that Orestes has to combat a feminine side of himself. But what is clearly in focus is the sense that Orestes' madness is inevitable.
In an important sense the conflict is an external one, though he may suffer internally because of it. Orestes is caught up in a conflict he did not create. Aeschylus' portrayal of Orestes is different from Euripides' version, where we find that the external conflict between Apollo and the Furies mirrors the inner conflicts between the male and female parts of his character."
- p. 103-4

Dr. Bychowski gives many theoretical and clinical examples of how this factor of bisexual conflict and gender confusion invariably lies at the very core of all mental illness, up to and including the severest manifestations of catatonic and paranoid schizophrenic symptomatology.

In Quotation B, Dr. Bychowski states that "the delusion of transformation into a male in a woman" is much less frequent than the other way around - a male into a female. One reason for this may be due to the very lenient manner in which society treats "tomboyish" women as opposed to "tomgirlish" men. Male-like attributes in women are often praised and encouraged by society whereas female-like behavior in men has historically always been universally scorned, at least until very recent times. There is definitely a strong double-standard operating here. Girls and women can act and dress like men without much societal disapproval and consequently in most cases they have no great emotional or physical need to "transform" themselves into men. They have already been acting like men to a great extent anyway. This is not so for men, however, as any urge to act out their feminine feelings has been made much more imperative due to their long-time suppression, and therefore men have become incomparably more prone to psychotic acting-out in order to relieve the unremitting pressure of any consciously disavowed opposite-sex emotional, physical and sexual tendencies which they may unconsciously harbor.

Nevertheless, there are still many documented accounts of women experiencing delusions of being transformed into men. One of the most notable cases was reported on by Dr. R. J. Stoller in his book "Splitting (A Case of Female Masculinity)." [reference also quotations 99-105 (inclusive) in the book "Schizophrenia - The Bearded Lady Disease"]

G: Why worry about this one little thing? It's not hurting anybody. I'm not hurting anybody with it. And it's not hurting me. It's not a delusion. It's inside of me. This is something I've always known, and I've always felt; and it's there, and it's real, and its mine; and you can't take it away from me, and neither can anybody else, so you might as well kiss my ass.
      S: Does this penis ever show up in your daydreams?
      G: How can it show up when it's really there? What are you talking about? You make it sound like it's a dream.
      S: Have you ever had sexual daydreams in which you had a penis like a man?
      G. No.
      S: What's the matter?
      G: Nothing.
      S: Don't say 'nothing' to me.
      G: You're just bugging me, that's all. I've told you all there is to know.
[Shouting] I have this. I have it and I use it and I love it and I want it and I intend to keep it, and there's nothing you can do about it. Its mine. It makes me what I am."
---"Splitting (A case of female Masculinity)," Robert J. Stoller, M.D., Dell Publishing Co., Inc, New York, 1973, p. 15.

Here we see a woman, Mrs. G., who in her schizophrenic delusion firmly believes she has a male penis, despite Dr. Stoller's best efforts to disabuse her of this insane idea. But she is as firmly convinced of the truth of her delusion as was Freud's Judge Daniel Paul Schreber convinced of his, which was that that he was turning into a woman, with newly formed breasts, for the sole purpose of procreating a new race of humans on the earth, as God had willed him to do. And both Mrs. G's delusion that she had a penis and Dr. Schreber's delusion that he was turning into a woman were clung to so tenaciously and ferociously because they served to defend their respective egos against conscious awareness of their powerful, underlying and repressed homosexual cravings and drives. In their deluded minds, it is almost as if they preferred to be crazy rather than be labeled "queer," or homosexual.

This terrible fear in the individual of facing the reality of powerful homosexual drives is, tragically, the common denominator in all functional mental illness, from - as previously stated - slight neurosis up to and including the most debilitating forms of schizophrenia. The severity of the ensuing mental illness is always determined by the quantitative degree of the bisexual conflict.

The mind-set that "I would rather die than admit it" too often holds sway in mankind's psyche, leading frequently to dreadful consequences both to the individual so afflicted and to his or her surrounding society - witness the schizophrenia-blasted lives of Adolph Hitler, Joseph Stalin, Timothy McVeigh, Lee Harvey Oswald and the countless other madmen (and some madwomen) throughout the ages who have inhabited the extremities of the spectrum of mental illness - the "bearded lady" disease.

733

     About this time, my girl, Joan, decided she didn't want to marry me.
We'd had this beautiful affair, and I wanted to marry her, but she decided she wanted to go home to California. So I followed her there. I thought I'd get some construction work, or some movie work, a change of scene. I rented a place in Venice, decided to write my second novel there by the sea, but when I looked out the window, I saw the surf breaking backward - literally, the surf was breaking backward. What really triggered it though, the actual beginning of the psychosis, was when I was talking to my girl on the phone, trying to find out why she'd left me, why she wouldn't marry me. Somehow that had deballed me, and I said, "Well, maybe I'm gay." And then suddenly a voice in my head cut in on the conversation and said, "Your life has ended. You will never write again."
     Now I'm telling you the facts instead of the psychological interpretation. I became impotent. I tried to jerk off and I couldn't come.
I began hearing these voices. I wanted to kill every woman I saw. I had seizures. You know, they were actual seizures. And it's the single most terrifying - It always is sexual, or was sexual. You get a hot feeling in your cock. Your heart almost stops. Your inner voice says, "Uh-oh." And this rage comes, and you want to get a knife. And it's always in the cunt, too, you know. Or slash the breasts off. Or in the eyes. Any orifice. [......]
     But then other things happened. See, everything was happening at once - my girl leaving me, my brother disappearing, my novel coming out. And I can't sleep. I'm having conversations. The inner voices are going like mad. It just gets worse and worse. I begin to see things. Every upright object becomes, not exactly a visual cock, but I imagine sperm coming out of it. I feel like a zombie. I would walk around like this. I stand on street corners, immobilized, for five hours, just standing there.
     Then I ran out of money. So Diane said, "Come and stay with me." And I couldn't say, "Diane, you're taking care of me but I'm also a homicidal maniac right now and I may kill you." So I moved in there, and then I had another seizure, in the bedroom. The voice started again: "You're going to kill." I tore up the whole bed and actually broke the bed slats to stop myself from going down to the kitchen to get a knife.
     In April, my parents called up to say that my brother's body had been found. He'd jumped off a bridge into the Connecticut river - that was Thanksgiving weekend - and the river had finally thawed. [......] So I have to go back. And I'm nuts. But I can't tell anybody because I've got to be the strong son coming home for the funeral. I'm saying to myself, What am I going to do? I'm having these spells. I'm hearing voices. All upright objects are spewing out sperm. But I can't tell anybody. So I go to the funeral....
     I was crying all the time, not just about Peter but about the girl who wouldn't marry me. I cried from April until - every day - reading old letters from her, over and over again, looking at her picture, and, you know, just crying. I'd get up in the morning, cry, go have breakfast, come back and cry. I couldn't do anything. I couldn't even order from a menu. You cannot make a decision. [......]
     Now I'm living at my folk's house on East 85th Street. And I went to visit a girl named Charlotte, and I had another attack. She was lovely. She had written me a lot of letters from New York, saying, "Come back, I love you." And now I'm just about to fuck her, and suddenly it switches around, and I have to say, "Charlotte, I'm about to kill you." And she was very cool. She said, "You're not going to kill me." And I said, "I'm having these terrible attacks." And she said, "Just calm down. Nothing's going to happen." And remember, I was impotent. I couldn't get it up. So nothing happened. I just said, "Hey, thanks." You know. And left. [......] We were there together alone, and I suddenly got the - you know - got the hot flashes, the heavy breathing, and you know, the voice saying, "Kill, kill, kill!" I was in a state of absolute rage, but I didn't know it. I had to excuse myself - "Mom. Mom. Excuse me. I gotta go now. I'll see you." Well, inside - I'm about to kill my mother, you know. And I still couldn't tell anybody about it.
     I was always terrified of shrinks - because, one, shrinks never helped my father, and two, they didn't seem to help my brother, and, three, I said, "If I go to a shrink, maybe he'll claim that I'm a homosexual. [......] Knock on the door. A sixteen-year-old-girl comes to the door. I whisper: "I'm Anthony Tuttle, and I think I'm having a heart attack. Get me to the hospital." We walk shakily over to Doctor's Hospital, and they give me - what is it called? - an electrocardiogram. And I say, "I'm under psychiatric care. This may be a fake. I'm - you know, a very troubled person." I finally see my physical doctor, who's a wonderful guy, and he says, "Tony, you're in big trouble, and I think you should go to a mental hospital." [......]
     But I finally went, to St. Luke's. It was the same day my agent sold my novel to Universal for thirty grand. I'm put on Thorazine immediately. I'm still homicidal in that I have the attacks. I have two guards watching me - aides - but at least I get sedated. Then that night a doctor started talking to me - Mel was his name - and he just said, "What's the problem?" And it was love at first sight, you know. I mean trust. As soon as I began to talk, and began to understand how outraged I was, and hurt, I began to get better. [......] And that fall I met a girl called Monique. My heart was still in California, but I had a wonderful affair with Monique. She nursed me back to sexual health - you know, gave me my cock and balls back, and I am forever thankful to her. She took care of me. But I had a couple of terrible attacks with her. You know - "Knife! Kill!." Once I left that bedroom right back there, and I telephoned Mel, and I said, "Mel, I'm here in bed with Monique, and I'm having an attack." And Mel, who lived right around the corner, said, "Meet me at Carl Schurz Park." So I met him there, and he walked me up and down, you know, saying, "Look, you're going to be okay. Tell Monique to leave the apartment.
     Mel got to me somehow. There was no posing. I just sensed that he really cared. I never lay down on a couch, you know. He gave me five years of what's called supportive therapy. His job was to get me, you know, functioning again. I can still go back to Mel whenever I need to, although I haven't seen him in more than a year now. I still have rages, occasionally feel an echo of an attack, but - I've been going with a very young girl, and she called me up the other day and said, "I can't see you any more." And I said, "Okay." [......] - Five years ago, six years ago, I would have said, "What's wrong with me? Maybe it's because I'm forty and she's eighteen." [......] But there's nothing wrong with me. That sounds arrogant, but I don't feel it, you know. [......] I'm trying to think if I'm dramatizing to you the severity - but the attacks I had, and the despondency, and the sitting here --I tried to hang myself, but I didn't know what to hang myself with. But all I can say is that this was the profoundest experience of my life, and I feel absolutely blessed. Whenever I feel depressed, like when I was driving the taxi, I say, "Man, you've been to hell and back." I feel you have to have the shit kicked out of you to appreciate the blessedness of the clean breath or the lovely kiss.

GOING CRAZY, An Inquiry Into Madness In Our Time, by Otto Friedrich, Simon and Schuster / New York, 1975, 1976, pp. 150-155.

Anthony Tuttle has been driven insane by the repressed state of his severe bisexual conflict and gender confusion - the "bearded lady" disease. Several times he mentions his deep fear of being labeled "gay" or "homosexual," which fear arises, of course, from the fact that in a deeply repressed and compartmentalized part of his unconscious mind he is a homosexual. And this homosexuality has made him impotent with women, thus inciting in him an enormous rage - also consisting of an equally large component of intense envy for the female role - that he feels for all women, thereby causing him to come perilously close to carrying out his homicidal feelings towards them.

Mr. Tuttle, fortunately, was able to keep just enough of a grip on his fragmented sanity to stop himself from taking that final, irrevocable step leading to murder. He succeeded where hundreds, if not thousands, of other men, and occasionally women, afflicted with the same illness - paranoid schizophrenia - in times past have failed, and often with horrific consequences to many more than just the one intended victim.

In this case it can be observed that every element of mental illness is included in Mr. Tuttle's case of paranoid schizophrenia, triggered as it invariably is by the patient's severe bisexual conflict and gender confusion. Visual hallucinations were first represented by his observing that " - literally, the surf was breaking backward." His first audio hallucinations began with the sudden voice in his head which told him, "Your life has ended. You will never write again." Notably, this voice came to him just after he had told himself, as the result of his failed romance with his girlfriend, that "Well, maybe I'm gay."

Following these early schizophrenic hallucinations, others began to come fast and furiously as his psychologial breakdown became more intense. "And I can't sleep. I'm having conversations. The inner voices are going like mad. It just gets worse and worse." Then a return to his visual hallucinations: "I begin to see things. Every upright object becomes, not exactly a visual cock, but I imagine sperm coming out of it." This particular visual hallucination has a very strong element of homosexuality in it. That is, every object he sees reminds him of an erect penis in a state of orgasm.

Next he experiences catatonic symptomatology: "I feel like a zombie. I stand on street corners, immobilized, for five hours, just standing there." Then comes a very vivid descripton of what debilitating clinical depression feels like: "I was crying all the time, not just about Peter [his suicided brother] but about the girl who wouldn't marry me. I cried from April until - every day - reading old letters from her, over and over again, looking at her picture, and, you now, just crying. I'd get up in the morning, cry, go have breakfast, come back and cry. I couldn't do anything. I couldn't even order from a menu. You cannot make a decision." And then his confession that: "I'm trying to think if I'm dramatizing to you the severity - but the attacks I had, and the despondency, and the sitting here --I tried to hang myself, but didn't know what to hang myself with."

What we see scattered throughout Mr. Tuttle's description of his schizophrenic breakdown are subtle hints of its cause - the repressed homosexuality which even he, unknowingly, in several places noted previously, alludes to as perhaps being the instigating factor in his insanity. And he is very definite about the fact his mental breakdown is based somehow on sexuality. "And it's the single most terrifying - It always is sexual, or was sexual."

He also makes two "Freudian slips" in his account of his madness which point directly to his repressed bisexual conflict and gender confusion. First, he refers to the "hot flashes" he experiences in describing the feeling that overcomes him preceeding his terrifying, impotence-fueled rages. "Hot flashes", of course, describe a quintessential female phenomenon. Secondly, when reporting his reaction to his initial meeting with his future therapist, Mel, in the hospital, he says: "And it was love at first sight, you know." Then he quickly changes this to: "I mean trust." Perhaps he had a moment of insight here about his true feelings for Mel and needed to cover them up, even to himself, changing "love" to "trust."

His following five years of "supportive therapy" with Mel were obviously of great benefit to Mr. Tuttle. Hopefully a full review of his repressed bisexual conflict and gender confusion formed a large part of the work that took place during this "supportive therapy". The only note of alarm in this respect is the fact that even after these five years of psychotherapy, "I still have rages, occasionally feel and echo of an attack..." If true, this means that Mr. Tuttle was never able to face the full import of his repressed homosexuality and that consequently he would always remain in peril of another schizophrenic relapse.

732

Cultural expectations for men and women with schizophrenia may differ, and it has been reported that men with schizophrenia may be less able to carry out normal gender role activities than their female counterparts (4). A limited body of literature on gender identity and schizophrenia suggests that men and women with schizophrenia may experience disturbed sex role identification (5). Perhaps in relation to deep and pervasive stigmatization of mental illness, men and women with schizophrenia often appear "genderless" insofar as mental illness itself is perceived to eclipse other factors in identity.
In the study reported here we evaluated gender identity among men and women with schizophrenia by characterizing level of self-identification with traditionally masculine and traditionally feminine role concepts. We hypothesized that gender identity among persons with schizophrenia is likely to differ from normative gendered orientations among men and women. Specifically, we hypothesized that men with schizophrenia would have less identification with characteristics associated with male gender than would men who did not have schizophrenia.

Gender Identity and Implications For Recovery Among Men and Women With Schizophrenia - Martha Sajatovic, M.D., Janis H. Jenkins, Ph.D., Milton E. Strauss, Ph.D., Zeeshan A. Butt, M.A., Elizabeth Carpenter, M.A., PSYCHIATRIC SERVICES, January 2005, Vol. 56, No. 1, p. 96.

Thus we meet the problem of bisexuality. Of course, this problem is also present in the common neurosis. Yet in the neurosis the problem of bisexuality is dealt with on an oedipal level and does not endanger the ties with reality.
In schizophrenia, on the other hand, attempts to solve the bisexual problem and still remain in contact with reality fail. Therefore, in its deepest nature, schizophrenia arises from a bisexual conflict, and this bisexual conflict eventually leads to a state where the heterosexual factor is relinquished.

The Importance of the Non-Psychotic Part of the Personality in Schizophrenia, Maurits Katan, M.D., International Journal of Psycho-Analysis, No. 35, 1954, p. 121.

Indeed, these sex-linked differences in schizophrenics would seem to be an unstated but not unfamiliar psychiatric observation. In discussing this finding with psychiatrists who have handled male and female wards we find an immediate recognition in typical comments that female wards are always nosier and more disturbed, require more attendants, etc. This would appear to be one of those glaring facts which must have a clear, cold eye, such as interaction categories, cast upon them before they can be truly seen. [......]
It is of considerable interest to speculate as to the significance of these findings for our understanding of the nature and etiology of schizophrenia. Does schizophrenia make females more active and males more passive? This would fit the notion of Letailleur and his associates (1958) of the reversal of sex roles as a function of the disease process. However, probably this is not the case as our developmental data suggest that the females have been more active and the males more passive from early childhood.

A Serendipitous Finding: Sex Roles and Schizophrenia, Frances E. Cheek, Journal of Abnormal and Social Psychology, Vol. 69, No. 4, pp. 398-99.

Sex-typed reactions are contrasted in male and female normals and chronic schizophrenics. In general, the schizophrenic shows sex-role alienation on tests which contain a self-image reference (a Role Playing Test, a Body Parts Acceptance Test, and a Figure Preference Test.) Female schizophrenics tend to react in a more assertive manner like normal males, and male schizophrenics like normal females. In a direct test of assertive vs. yielding story sequences on the TAT, the sex-difference reversal is significant only if housewives are used as normal female controls. The inclination of female schizophrenics toward assertive story sequences is matched by a similar inclination in career women, suggesting this role reversal is not as critical to the schizophrenic condition as the self-image disturbance. In conscious sex-typed interests and attitudes, schizophrenics do not differ from normals. A theory is proposed relating schizophrenia to sex-identity alienation in the early years of life.

Sex-Role Alienation in Schizophrenia, David C. McClelland and Norman F. Watt, Journal of Abnormal Psychology, Vol. 73, No. 3, 1968, p. 226.

    Kagan and Moss (1962) report findings that suggest the etiology of this shift. They found that male children (age 0 - 3) to whom mothers were hostile tended to grow up to be withdrawn, non-achievement-oriented, and socially anxious (showing the schizoid, non-assertive type of adjustment in males.) In contrast, female children to whom mothers were hostile tended to grow up into active, competitive, assertive women (showing an atypical pattern with some components of a schizoid type of adjustment in females.) It is conceivable that maternal hostility created sex-identity problems in the children which were solved by opting in part for the opposite sex approach to life. (Ibid, p. 227)

    Table 4 reports some very different results. Both male and female schizophrenics say more often than normals that they would choose to play opposite-sex roles. Nearly half of the schizophrenics made three of more opposite-sex choices whereas only 10% of the normals made as many. (Ibid, p. 232)

    Among the males, cross-sex choices arise particularly with respect to the alternatives: "secretary vs. policeman" and "cow vs. bull." In both cases the male schizophrenics chose the female roles ("secretary" 7/20 times and "cow" 8/20 times) significantly more often than the normals (0/20 and 1/19 times, respectively). This fits the general hypothesis that male schizophrenics are avoiding assertive male identities. (Ibid, p. 233)

In Quotation A. above, the statement is made that "....men and women with schizophrenia often appear "genderless" insofar as mental illness itself is perceived to eclipse other factors in identity." This is a very keen observation, the accuracy of which is best reinforced by examining the seminal theoretical construct briefly outlined by Dr. Maurits Katan in Quotation B. "Therefore, in its deepest nature, schizophrenia arises from a bisexual conflict, and this bisexual conflict eventually leads to a state where the heterosexual factor is relinquished." Thus if the heterosexual factor has been "relinquished", and the homosexual factor has been repressed, that leaves the schizophrenic person with no discernible "factor" at all - and therefore basically "genderless."

The sum of all the information contained in Quotations A, B, C, and D point inexorably to the unshakable truth of the assertion that bisexual conflict and gender confusion lie at the very core of all functional mental illness, from slight neurosis up to and including the most severe forms of schizophrenia, and that the severity of the mental illness ensuing from this conflict is always determined by the degree of the conflict itself.

Furthermore, the vital role of the mother in ensuring the mental well-being of her child is highlighted once again by the researchers Kagan and Moss in Quotation D, where they show that maternal hostility in the very early years of life can have a profoundly deleterious effect upon that unfortunate child by engendering in it a state of incipient bisexual conflict and gender confusion, leading inevitably to a future for the child which will be marked by a continuous struggle with mental illness. Accordingly, Once more the label which has frequently been assigned by various researchers to this type of toxic, maternally-hostile mother bears repeating here - the "schizophrenogenic" mother.

[Note: For those readers wishing further information on the subjects covered in Quotations A, B, C and D above, please refer to Quotation 250, Quotations 267 through 280, and Quotations 498 through 504, in the book "Schizophrenia - The Bearded Lady Disease," to be found in its link on this website, or else ordered from a bookseller.]

731

In this section I shall sketch something of the knot one young man of twenty-three was in when I first saw him. I present this as a paradigm of the internalization of a multi-generational family situation, such as I have seen in a number of people, and still leads to a diagnosis of schizophrenia. I shall simplify enormously.

        He experiences himself as follows:

     Right side: masculine
     Left side: feminine
     Left side younger than right side.
     The two sides do not meet.
     Both sides are rotten, and he is rotting away with them to an early
     death.
     His mother's father (MF) died shortly after Paul was born.

From psychoanalysis and other information:

     His mother and father separated when he was five.
     His mother told him he 'took after' his father.
     His father told him he 'took after' his mother.
     His mother said his father was not a real man.
     His father said his mother was not a real woman.
     To Paul, they were both right.
     Consequently, on the one hand (or, as he would say, on the right
     side), he was a female male homosexual, and on the other hand (his
     left side), he was a male lesbian.
     His mother's father (MF) died shortly after Paul was born.
     Paul's mother said he took after her father.
     But the issue of real or not-real had been reverberating in this
     family for several generations.
     His mother's mother (MM) did not regard her husband (MF) as a real      man.
     Nor did his mother's father (MF) regard his wife (MM) as a real
     woman.

The Politics of the Family, and Other Essays, by R.D. Laing, M.D., Pantheon Books, 1969, 1971, pp. 563-564.

To return to Paul. His mother thought she could be a better husband and father than his father. And his father thought he could be a better wife and mother than his mother.
In his view of his mother's view of her father, and his mother's view of her mother's view of her husband; and his father's view of his mother, and his father's view of his father's view of his wife, THERE HAD NEVER BEEN A REAL MAN OR WOMAN IN THE FAMILY FOR FOUR GENERATIONS. [Caps added for emphasis] - (Ibid. p. 56)

His body was a sort of mausoleum, a haunted graveyard in which the ghosts of several generations still walked, while their physical remains rotted away. This family had buried their dead in each other. The foregoing is a very simplified sketch of a complex process of the increasingly tortured and tortuous sexual confusion that had developed within the family structure, which we cannot go into here.
This young man was tied in a knot; it had taken at least four, perhaps five or more, generations to tie it. (Ibid. p. 57)

It is glaringly obvious from Dr. Laing's above account that Paul's schizophrenia, as is invariably the case in every instance of this illness, springs directly from a pathological condition of massive bisexual conflict and gender confusion, present not only in Paul himself, but in all the immediate members of his family, stretching back, in R.D. Laing's words, "four, perhaps five or more, generations..."

This situation is best summed up by the starkly honest proclamation by the father of another schizophrenic patient, gender not specified, who simply stated: "When I married I was only half a man and could only marry half a woman." (Schizophrenia and the Family, Lidz, Fleck & Cornelison) The fact that the gender of this particular schizophrenic patient was not specified in this account is immaterial, since the parents of all schizophrenics, both male and female, are invariably afflicted with the same marked bisexual conflict and gender confusion as that which has been so insightfully delineated by the above-quoted father, and further by Dr. Laing. Thus in one incisive and memorable sentence this father has described the basic reason children grow up to develop not only schizophrenia, the "bearded lady" disease, but any other closely-related functional mental illness as well.

Because this core pathogenic element of familial bisexual conflict and gender confusion can stretch back as far as four or five generations, as noted by Dr. Laing in quotation C. above, many investigators are falsely led to believe that schizophrenia is genetically-based. This is also the average layperson's understanding of the disease. Of course in the above "gender-confusion" sense, schizophrenia is of "genetic" origin in that it can always be traced back to previous "tainted" generations of sexually confused families.

Finally, this nature-dystonic state of familial bisexual conflict and gender confusion eventually reaches a generational dead-end, due to the fact that many people suffering from schizophrenia never marry, or if they do marry, do not have children. Thus nature provides its own finish to an unproductive and pathological offshoot of mankind.

Sitemap