Page    1   2   of this article. Journal of Orgonomy Volume 11 no. 2 A Case of Homosexuality Charles Konia, M.D.*   As in the case of all biopathies, homosexuality is based on orgastic impotence. Specifically, the homosexual is afraid of heterosexuality, and it is a primary task of therapy to enable the patient to face this fear. Although homosexuality can occur in any character type, from a therapeutic standpoint, one encounters two types of homosexual patients. In certain cases, the homosexual behavior clears relatively quickly in the course of therapy. In others, removal of the behavior is particularly difficult because it is intimately associated with underlying characterological defenses. This is true in the case of the passive-feminine homosexual. The passive-feminine character is essentially an anal character who has given up the phallic level and wards off genital impulses with anal and passive surrender. He may resort to homosexuality as an expression of his anal surrender. These cases are difficult to treat not only because of their inordinate fear of heterosexuality but also because their homo-sexual indulgence provides a certain degree of sexual release and substitute gratification, albeit at a great sacrifice to their emotional well-being. Their defense against genitality is very strong, and therapy is quite prolonged, requiring not only a clear understanding of the patient's structure, but also a great deal of persistence.   Anamnesis The patient was a 36-year-old, single, white, male bank teller who came to therapy because of his homosexuality. He had had homosexual fantasies from early adolescence, accompanied by severe guilt feelings. He had been a practicing homosexual for seventeen years, averaging two to three different sexual contacts per week. For the most part, these were one-time affairs. He masturbated frequently, fantasizing men forcibly penetrating him anally. In both his homosexual practice and his fantasies he picked strong men whom he assumed had a larger penis and therefore more virility than he. With these sexual contacts, he played the passive-feminine role. His own penis felt dead, and masturbation was accompanied by sensations in his rectum like those during defecation. When he was a child, his parents would warn him that he would get palsy, or become feeble-minded if be masturbated. He habitually wore underclothes that were soiled with semen and feces. He had a great deal of "belly anxiety" and was generally very frightened, especially when facing strong males. He felt a great inhibition in his work ability and had a poor mechanical aptitude. He knew that he could function much better if he were healthy. During his adult life, he had never had any conscious heterosexual desire. Medical history revealed that he was chronically constipated. He took suppositories daily, sat on the toilet for long periods of time, and was very preoccupied with his bowel movements. The mother was the dominant parent. As a child, the patient had an intense interest in girls and vivid heterosexual fantasies. His mother found out about his sexual play and told his father, who did nothing about it. The patient was ten when his heterosexual feelings disappeared on the death of his father, about which he was ambivalent. On the one hand, he was glad because the father was a weakling and because he had preferred the patient's older sister to him; on the other hand, he felt responsible for his death, renounced his aggressive drive, and became the kind of boy his mother wanted him to be gentle, compliant, and studious. This, however, was at the expense of his aggression and interfered with his being accepted by male peers. He defended himself strongly against having male interests, especially where competition was involved, for fear of being exposed as inferior. He hated the summer-time, for his peers were then involved with sports and he remained aloof from them. Despite his athletic habitus, his athletic abilities were surprisingly poor. Biophysically, he was attractive, well-developed and muscular. He did calisthenics and body-building exercises compulsively. His eyes appeared passive and showed anxiety. He was in touch with this and was able to express it when his eyes were opened wide. His eyes crossed when he attempted to roll them. He was able to make angry faces briefly, although this quickly turned into a soft, passive expression. His voice sounded anxious and whiny, and had an effeminate quality. His throat was constricted, but he was able to shout. The thorax was rigid and held in the inspiratory position. The intercostal muscles were tense and very sensitive to touch. The abdominal musculature was hard. His back was arched, the paraspinal muscles were hypertrophied, especially on the right side, his buttocks was tense and pressed into the couch. The lower extremities were we11 developed and also tense. He was able to hit the couch forcibly, and he kicked in a squashing manner. His general appearance was one of a highly energetic and apprehensive individual. He was heavily armored throughout, but gave a superficial appearance of looseness. 1 On the surface, he was overly friendly and submissive, accepting whatever I said, but there was a great deal of distrust, sneakiness, and spite underneath. Therapy Focusing on his most immediate character resistance, his cunning and submissiveness, gradually led to some critical remarks regarding me. He said I was not as physically well developed as he originally thought. He then became frightened of me and stated that coming to therapy was like a dreaded homosexual encounter. This was said with a disparaging smile and was followed by more criticism: He didn't feel anything. He felt sorry for me. I was working too hard, but, despite this, nothing was happening. I also mobilized his anal rage by having him kick. Briefly, he made snarling faces, but soon stopped, feeling that he had to stay in control. He stated that I might not like what he was doing, and then he directed another jibe at me: I am not really as strong as he thought. He quickly added that he wants me to be strong so he can get excited by me. I related this to his passivity and told him that he must be frightened of me. Working on his eyes brought out superficial misery and crying sounds, but he immediately protested, stating that it was all fake, and then retreated by going to sleep. I continued to mobilize his eyes, which began to improve slightly. He was able to feel some fear, but he soon became spiteful and resorted to his typical "nothing is happening" complaints. I pointed out his obstinacy and told him that he resisted therapy so that he could put something over on me, that undermining therapy was the only way he could be victorious. This seemed to make sense to him, but he was still too frightened to give up the negative attitude, so I continued to mobilize his fear biophysically. Further work on his eyes and his chest produced strong currents in the upper segments. He became afraid of these involuntary sensations, broke out in a cold sweat, and felt dizzy. He was obviously not prepared for this degree of sensation. He had thoughts of dying and felt very apprehensive. He was on the verge of crying but didn't. Instead, he resorted to his typical "nothing is happening" attitude. I worked on his spite by having him kick, which discharged a great deal of energy. He looked frightened, but, when I pointed this out, he again denied feeling anything. He became passive, smiled in a cunning way, and began talking ingratiatingly in a seductive, effeminate voice. I focused not on what he was saying but on the form of his expressions, mimicking all of his effeminate behavior. This led to a violent outburst of rage for a brief moment and was followed by an intensification of all his passive-feminine characteristics. He smiled in a foxy way, complaining that we were not getting anywhere, and expressed distrust: "How can I believe you when you say everything is a defense?" At this point, one aspect of his transference towards me became crystallized. He stated that he wanted me to like him, but that I should stay at a safe distance. I should support his illusion of our relationship which was one in which he obtained support from me. I should not get so close as to take away his protective defenses. This illustrates the typical transference situation that develops in these cases. The passive-feminine character defends himself against his own aggressive drives, as well as those of others, by means of anal surrender (passivity). He achieves this by becoming close to those he fears, developing an exaggerated and artificially friendly attitude towards them. At the same time, this attitude provides a degree of substitute gratification for his anal unsatisfied impulses. On a superficial level, his "nothing is happening" complaints meant that I was not giving him the love and affection that he expected. He stated that he lived like a hedonist, for the pleasure of the moment. I told him that he was contenting himself with crumbs, both in therapy and in his daily life, that all his substitute gratifications (his homosexual contacts and his relationship with me) were retained at a terrible price to his emotional integrity, that this not only drained his aggressive energy, but also made him feel guilty and worthless. I told him to eliminate all homosexual activity for at least two days prior to each session. 2   He admitted being distrustful of me: Why should I really be interested in him? I'm really seeing him for the money, etc. I kept after his fear by focusing on his sneaky facial expression. His entire face was tight, the eyes squinted. I had him exaggerate this expression by squeezing his face. This was followed with more work on his character. On the surface, he was his character. On the surface, he was compliant and submissive, wanting my approval. Beneath this, he was defiant, spiteful, and wanting to undermine therapy since this was the only way he could get revenge on me. This interpretation was confirmed by the following childhood memory that had made a profound impression on him. As a child, the patient and his father used to urinate together to see who could last longer, who had the bigger stream, etc. He was always aware of his father's larger penis. At a certain point, he decided that he was not going to compete with his father any more and made the conscious choice of retreating to his mother. He thus began to relinquish overt competition. From then on, he began to secretly find fault with males who were stronger than he, since this was the only way that he could get back at them. I interjected that, since he must render me impotent, he felt he could not rely on me to help him and that he compensated by developing a superior, "healthy" attitude, convincing himself that he really does not need anyone to help him since nothing is wrong with him. As will become clear later, these defensive attitudes were triggered by the surfacing of his deep misery and his castration anxiety. He kept defending himself tenaciously with his "I don't feel any-thing" attitude. I kept working on his spite, as well as his defensive passivity. This produced a challenging look, followed by a general feeling of well-being. I continued to vigorously mobilize his eyes which gradually brought out a fear of losing things, as well as a fear of looking. He said he was always afraid of losing things, and, if he did not scrutinize things too carefully, he could avoid becoming aware of his loss. Although this was an indication that his castration anxiety was surfacing, I nevertheless continued to work on his anal rage. Vigorous mobilization of the paraspinal muscles produced powerful kicking to the point that he felt as if his back were going to break. He looked more aggressive and expressed more verbal criticism of me. Then, reluctantly, he admitted to being afraid of comparing genitals and said that he hated any male whose penis was larger than his. Yet, he longed to be aggressive and secure the respect of his peers. However, he felt that he could never compete with other men: His penis was too small, they were far ahead of him, etc. As his anal aggression became further mobilized, he was able to look defiantly at me and regularly feel pleasurable sensations after kicking. He began to feel on top of the situation and laughed at the thought that he had somehow exceeded me. At this time, he first became interested in women and had fleeting, pleasurable heterosexual sensations. He began dating, but an attempt at intercourse showed that he was erectively impotent. This first glimmer of genital functioning and his subsequent disappointment produced a retreat into anality. He became impatient, complaining that I was not giving him his potency and had self-deprecating thoughts regarding his budding sexuality: "Who do I think I’m kidding?" Expressing disappointment at the size of his own penis, he again sought out homosexual partners who had larger penises. I intensified the mobilization of the paraspinal muscles, which at this time felt somewhat softer, working also on the muscles of the thighs and legs. This produced a strong expansion with intense warm perspiration and a feeling of openness in his head. He felt cocky and confident for a short time. Following this, he had intercourse with ejaculation for the first time, but with very little pleasure. He was still very tentative regarding his newly found potency, and felt on the brink of disaster. He said: "I'm afraid the wrath of God will fall on me!" With further mobilization of his rage, he gave into the strongest aggressive hitting that he had expressed thus far. He felt this aggression in his eyes, as well, and he expressed vigorous biting movements. Even he was amazed at the tremendous strength he displayed. He became very excited at the prospect of meeting different women, but his anticipation of becoming impotent again made him retreat into the relative security of his homosexuality. Although he behaved outwardly confident and aggressive with women, he refrained from putting his budding sexuality to the test. As his fear of disappointment became intensified, he again began having thoughts of being omnipotent. He stated that he could get better on his own, that he did not need me anymore. He then became impatient, exclaiming: "I want potency now!" He was angry at me for not giving it to him. Working on the buttocks and legs produced a strong sensation of pressure traveling from the back of the pelvis into the penis, accompanied by intense pleasurable feeling in the buttocks. The sensation of pressure in the penis developed into a sensation of itching and prickliness. Intensification of genital sensations increased his fear of disappointment and also his castration anxiety. He had thoughts of his penis being cut off. On the couch, he could not tolerate lying still. This brought out feelings of misery and utter helplessness. I therefore encouraged him to do absolutely nothing. He became very restless and terror-stricken and was on the verge of crying. But he could not express it because of the armor in his throat. He literally jumped off the couch when I gently began to mobilize his throat. He was very shaken and felt as if he were going to his execution. This was followed by a strong phase of resistance. Biophysically, he kept going off in his eyes. He had trouble focusing and felt as if a harsh chemical were being poured into them. He looked horrified. Characterologically, his sneakiness reappeared in full force. He also became distrustful and expressed more negative criticism: I don't really care about him, this is only a business for me, etc. I told him he himself had to decide whether or not he wanted to change, that the only way he could was by giving up his substitute life and fantasies and to stop using therapy as a prop to be superior to other men. I told him he could have homosexual feelings, but that he was only hurting himself by acting on them. I stated that he maintained a neurotic dependence on me by expecting a substitute penis. At the same time, he felt secretly superior to me by not facing the fact that he needed help. This struck home. He was able to recognize how he secretly subverted therapy, and he became more genuinely cooperative and independent. He began working on his own in therapy for the first time. He resorted to masturbation with homosexual fantasies instead of homosexual behavior and felt the necessity of taking hold of his life so that he could maintain his own aggression. His misery began surfacing again, but this made him feel terrified and helpless. In the session, he became very resistive, reverting to cheating me out of success by turning therapy into a battle of wills. I therefore proceeded to mobilize his paraspinal muscles. This time, he had the urge to hit with his pelvis as well as to kick. Following this, he recalled his vivid heterosexual interest and sex-play as a little boy. These feelings disappeared at age 10 when his father died. He recalled the ambivalence that he felt regarding his father's death and how this event ushered in his passive-feminine attitude. In the following session, he again became critical of my therapeutic abilities and accused me of not helping him. I repeated that he constantly put me in a position of failing, that this was the only way that he could get revenge on me. He finally admitted that he hated to see me be successful and said angrily: "It's all a game. You don't care anyway." I told him that it was he who made therapy a game. He became very shaken and was on the verge of tears. He again became more serious about getting well and began admitting his desire for a woman.     next page   Page    1   2   of this article. * Medical Orgonomist, Easton, Pa. Diplomate in Psychiatry, American Board of Psychiatry and Neurology.   Footnotes 1.  The passive-feminine character typically seems soft and yielding, but, in therapy, this proves to be a kind of armoring that is very difficult to dissolve.   back to text 2.  The orgonomist generally treats homosexuality in the same way he treats alcoholic be-havior, that is, he explains to the patient that his homosexuality is a defense, that as long as he persists in it, he is sabotaging his therapy and for this reason he needs to abstain entirely during the course of therapy. In practice, this is very difficult for patients to follow, particularly in the initial stages, but it is always present as a goal. - EFB   back to text