Psychoanalytic and biological perspectives on lesbian patients: why developmental themes are more important in psychotherapy.

Abstract

During the feminist and gay rights movements of the 1970s, lesbians began to cohere as a sociopolitical group in previously unknown ways. Yet lesbian issues remained in the shadows within both movements. Feminists did not want to be regarded and potentially dismissed as predominantly lesbian by their largely heterosexual audience. Within the gay rights movement, the emergence of the acquired immune deficiency syndrome (AIDS) crisis necessarily focused the political dialogue on the health concerns of gay men. Today lesbian lives are becoming evident on Main Street as figures such as Ellen DeGeneres begin to appear in living rooms across America. These recent advances have not occurred without significant backlash by the religious Right, which has characterized the wishes of gay men and lesbians to love, work, and play free of discrimination as a demand for “special rights.” Amidst the polarized political debates and the growing societal presence of lesbians, many mental health practitioners wonder what they need to understand or know to work effectively with their lesbian patients. This paper describes two perspectives on lesbians—the psychoanalytic and the biological—and addresses how each perspective can affect clinical work. In addition, it offers a new perspective on common themes in lesbian development, designed to inform clinicians working with lesbian patients in psychotherapy.