I was sleeping in the fraternity house in college. I heard this cat in great pain. I looked out the window and here was this wretched black beast injured horribly in some way. He was screaming in terrible pain. There was a lot of blood pouring out of his rectum. It was more than that. The cat had a great hole in him through his crotch. He was all torn up. I jumped out of bed and shouted: "Why doesn't someone put that beast out of its misery?"

The tomcat that had prompted the dream had been slain presumably for seeking a sexual partner. The patient's unconscious identification with this cat revived the hidden infantile fantasies of punishment for sexual transgression. The stage had been set for this revival by the gradual emergence of competitive material in relation to .his father. He himself spontaneously arrived at the correct answer to the nightmare with a few quick associations. First, he thought of the fraternity house. It brought to mind the homosexual episode previously described. Then he identified the cat as himself. Next, he remarked that he had a pet cat, a black one. It was a spayed male. Here, he had the sudden flash of insight. A spayed male was a castrated male and that must be the way he thought of himself: a woman, a homosexual, a castrated male. It remained only to tie together for him the castration anxiety, the oedipus complex, and the inhibition of assertion. He was shown that developmentally the first situation of competition was with his father. This competition derived from the Oedipus complex, and the anticipated paternal retaliation consisted of death, castration, and anal rape. He conceived of the original competition as sexual in its nature, but he then extended the concept of punishment to encompass nonsexual competition as well. The end result was the inhibition of assertion with which he had become so familiar.

This last discussion brought the psychodynamics of the central conflict completely into the open. This ended the first year of therapy. The patient could now be encouraged in appropriate assertion. He embarked upon a sustained attempt to reestablish his sexual potency and to resolve his inhibition of aggression. Every effort was made by the therapist to support these attempts. He resumed intercourse with his wife and after a few initial failures gradually regained his potency.

The marriage, however, did not hold together. Too much damage had been done, and in the end the couple agreed amicably to separate. Each has since remarried. The problem with aggression proved more difficult than that with sex. Its resolution was equally successful, but took a good deal longer. The focal point for his reeducation became his relationship with the minor executive who was his boss. He refused to accept blame for the latter's mistakes and began to claim credit for any stolen ideas. He became more and more bold in his resistance and eventually carried the fight all the way to the higher authorities. Finally, one day, he came to therapy in great excitement. His boss had been fired, but not only that, the patient had been given the job and with a commensurate raise in salary. The boost in self esteem and self. confidence can well be imagined. He had jousted with his father, as it were, and had emerged the victor, alive, undamaged, and with his genital intact. It was not long thereafter that the therapy was brought to a successful close. A follow up interview three years later revealed a further consolidation of his therapeutic gains. There had been no return of symptoms, his new marriage was going well, and he had advanced still higher in his vocation.

This chapter has demonstrated the great importance of a correct motivational breakdown in the therapeutic management of an anxiety about homosexuality. In this particular case, the anxiety was strictly a pseudohomosexual anxiety; a true homosexual motivation was never observed. It is essential, however, to grasp that even if a homosexual motivation had been present it would not have excluded the coexistence of the pseudohomosexual conflict. True homosexuality has a dynamic of its own that stems from similar developmental sources, but it must be analyzed as an independent entity in its own right. In other words a homosexual motivation would simply have created still another problem; it would in no way have obviated the pseudohomosexual problem already present.

The motivational breakdown used in the understanding and treatment of this case was made within an adaptational frame of reference. The instinctual frame of reference does not easily permit such a breakdown because it makes mandatory an interpretation based on the concept of constitutional bisexuality. It is difficult to conceive how a purely instinctual approach could be therapeutically successful. The patient would have to be told of his innate feminine component and the latent homosexuality that went with it and urged to come to terms with both. He would be subjected to this exhortation in spite of the fact that no erotic homosexual intent could be attributed to him. Such an interpretation is completely unrelated to the reality in which the patient finds himself and serves only to intensify the very anxiety it is designed to alleviate. It fails completely to provide the patient with any therapeutically useful motivational insight into his behavior. Pseudohomosexuality is a disorder where the frame of reference, adaptational as opposed to instinctual, can mean the difference between therapeutic success and therapeutic failure.