Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families (Book Review)

Author:  D'Ercole, Ann and Jack Drescher
Publisher: Hillsdale, NJ: Analytic Press, 2004
Reviewed By: Richard Ruth, Spring 2005, pp. 44-45

It is no longer a “big deal” for analysts and analytically oriented therapists, of the full kaleidoscope of genders and sexualities—because that is what our community looks like now—to be working with same-sex couples. Or is it? This past fall, while deeply engaged in reading and mulling over this short, quirky, feisty book, I decided I might review it most creatively by “giving it a spin” —using one of its chapters (the late Adria Schwartz’s “Ozzie and Harriet are Dead: New Family Narratives in a Postmodern World”) as a text in a seminar I was leading for mostly beginning child therapists. The students, clinicians of the new millennium, had spoken of being eager to talk about issues of gender and sexuality, and I made the assumption that notions of gay/lesbian/bisexual-affirmative analytic thinking would not be completely remote to them.

In trying to make the postmodern language of the chapter less foreign to the students, I thought I might begin by tracing the development of analytic thinking about how Oedipal conflicts do and do not apply to gay and lesbian people. I spoke about the notion the gay analyst Richard Isay advanced in the 1980s (ancient history to the writers in this volume—nowhere is he cited) that gay and lesbian children tend to form primary libidinal bonds, during the early Oedipal period, with the parent of the same gender, and not the parent of the opposite gender, as heterosexual children do.

Oy vey, as Freud might have sighed on one of his bad days. A lesbian student was enraged, and spoke about how hurt she had been by any notion that analytic ideas might still be being imposed on gay and lesbian people. My sharing of my own experience that, as a gay man, I had found Isay’s ideas personally helpful did not assuage. The postmodern culture wars were on, alive and not necessarily well in our little seminar room.

Perhaps echoing my teaching experience, my observation and prediction would be that, if one begins reading this volume with the notion that treating same-sex couples is just the same as treating heterosexual couples—though, in some ways, it is—the sense of the intricate, subtle, complex differences will soon prove dizzying. The ten essays in this volume ask to be read with no preconceptions.

In the postmodern world into which these thoughtful clinical writers invite us, one is often encouraged to consider the structural elements of a text, so a few observations along those lines: Most of these writers are women (and one has to go deep into one chapter before it becomes clear that one of the writers is a man). Almost all are New York-based. Only one is a medical analyst. None cite affiliations with institutes of the American Psychoanalytic Association. Though there is a vaguely relational flavor to the writing, most of the authors seem to eschew declarations of theoretical orientation. Virtually no quantitative research is cited; all the writers are clinicians writing about their clinical experiences (except one, a sociologist, and her qualitative research findings are but a small step away from clinical writing), and all operate with the assumption that such writing need not defend its right to speak. The relevance of psychoanalytic thinking to the work is similarly taken for granted, though also viewed with an open weave; other kinds of clinical ideas are brought in when desired, with little apparent muss or fuss.

Are these background or foreground issues? Hold the thought, and consider this one: The book is replete with small typographical and copy-editing errors. At first, this put me off, but, over the course of my reading, it grew on me. By the end of the volume, my impression that the writers and editors were perhaps more concerned with thoughts than with formalities led to a sense that what I was reading was like a new-century version of a 1960s underground newspaper, reportage from the front.

And a lot, indeed, is going on on the front. Same-sex couples are forming families in all kinds of new ways—adoption; insemination with known and unknown sperm donors; within and often (not always by choice) outside of old and new legal structures; monogamous and not. Some of these families stay together and thrive, and thus end up in therapists’ (or sociologists’) offices not so much with a focal presenting complaint as with a request for developmental facilitation of various kinds; others break apart, with not only no template, but disturbingly often with no recognition, of their complex emotional agony. And yet, at least within certain communities, gay, lesbian, bisexual, and transgender people (this latter a group not addressed in the current volume) raising children are not new—the couples in this book are not “firsts,” although they may be representatives of a certain kind of first generation—nor is the notion that their own communities contain comfortable numbers of out analysts and therapists (at least, but not only, in New York) ready and willing to help them through. These writers, seemingly, see a lot of same-sex couples. And their clients/patients are not coming in because they question their sexuality, though, as several writers here elaborate, in their inner lives there are often difficult wellsprings of internalized homophobia, shame, and role conflict.

Everything is up for question and exploration here (and perhaps this is true of all honest and good psychoanalytic endeavors). Are gender and sexuality fixed, or perhaps more accurately seen as fluid and sometimes ambiguous? Is the body itself a “given” in analytically informed work, or is it more properly seen in its psychic representation as a construction, influenced by (an often anti-woman and anti-gay) culture but filtered through the structures and processes of psychic life? If marriage and monogamy are not the operative assumptions, then is the notion of a couple itself essentially more elusive than we would be accustomed to believe, as one writer here argues? How do we deal with issues of normality and difference in ways that do not embody biased assumptions? How do we help couples navigate the complex relational currents when object choice becomes delinked from parental role, an assumption generally not encountered in heterosexual families and in persons raised in them?

Of course, same-sex couples come to us not to feed our theoretical musings, but for concrete help, so the clinical narrative here moves quickly away from these kinds of knotty open questions. In a book that is intentionally non-prescriptive, the task of summarizing content in this area is quite challenging, and, for the most part, I will choose to punt—not out of laziness (this review has had a substantial pregnancy, and the labor has not been easy, either), but because this book insists that the point is the clinical stories themselves, each of them unique and to be encountered more in their uniqueness than in any assumption of automatic applicability to other situations.

If there is a loose common interventive theme, it might be that we have to meet same-sex families on their own terms, which are going to differ significantly from what evolves in the inner lives of people raised in heterosexual families and with heterosexual orientations. Beginning with the (not-so-) obvious, children of lesbian mothers have more than one “real mother,” yet, in a culture saturated with heterosexual assumptions, the lesbian parents may have very strong feelings about who is and is not the “real mother,” based on the vicissitudes of biological and non-biological parenting as well as complex psychodynamics, and children—always skillful at dividing and trying to conquer—may treat their two mothers, or two fathers, differentially as well.

Another common theme here is that therapists, gay/lesbian/bisexual therapists in no way excluded, will typically find ourselves bumping up against our own assumptions, preconceptions, and less-than-serviceable inner templates as well in working with these couples, rooted in our earliest experiences and processed through our active unconscious. The writers in this book model, often with impressive candor and grace, what it is like to do analytic work holding and not resisting notions of ambiguity, uncertainty, flattened patient/therapist hierarchy, and genuine mutuality at the center of the work.

It would be too easy, however, to end on this note of intellectual and clinical satisfaction—although I commend this book to the reader with no hesitance as a truly useful, satisfying, provocative and groundbreaking read. I made mention earlier that this volume has the feel of war reportage and, if there is an unconscious theme to this volume, it is the subliminal awareness that these writers are not just talking about, but dedicated to, helping couples some in the culture see as contagion to be eradicated and not as people with a right to live their lives.

This fall, early in my encounter with this book, my lesbian rabbi got married. At the point in the service where the presiding clergy typically beams and says, “And now, by the authority invested in me by the state of . . .” the presiding rabbi spoke of how the state did not give this loving, committed couple the right to marry, or with it the state’s protection. As an alternative, the members of the congregation were asked to rise and commit, individually, to stick by the couple no matter what. Therefore, I rise in gratitude to the authors who have shared their work with us in this important volume. Freedom is always dangerous, and to be cherished.

Reviewer Note

Richard Ruth is a psychologist/psychoanalyst in private practice in Wheaton, Maryland. He on the steering committee teaches and supervises in the Child and Adolescent Psychotherapy Program of the Washington School of Psychiatry and is a clinical faculty member at The George Washington University. He is the Section II to the Division Board.

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