The first technique for survival and for need gratification is dependency. This is an adaptation that is rooted in the biological helplessness of the infant at birth. Clinical studies demonstrate that the adult unconsciously thinks of the infantile period as one of magical control. This must be the way the infant sees himself. He is magically omnipotent and his parents are magical agencies for the satisfaction of his needs.

An Adaptational Approach In recent years Freud's concept of homosexuality has been challenged by those workers who discarded the libido theory in favor of a more adaptational approach. This made possible the reclassification of homosexuality as a neurosis and opened pathways to psychotherapy.

Freud's constitutional orientation led him to adopt the concept of bisexuality. This concept held that each individual was constitutionally endowed with both male and female psychosexual attributes that eventually sought instinctual gratification in terms of object choice.

The concept of homosexuality proposed by Sigmund Freud remains relatively unchanged in most of the psychoanalytic literature of today. The theoretical approach used by Freud in the development of this concept makes it difficult to explain certain phenomena that are a part of the homosexual conflict.

In my experience, excessive sexual desire is so rare as to constitute a clinical curiosity when it is a primary symptom. An abnormally intense sexual appetite in females has been termed "nymphomania" and the corresponding condition in the male is "Don Juanism."

Of course, sexual desire is frequently inhibited on the basis of irrational and false dangers; sexual situations which are in reality safe may be perceived consciously or unconsciously as dangerous on the basis of remnants of past experience. These must be differentiated from those situations where a sexual encounter or relationship really is destructive to the person.

Hypoactive sexual desire is probably the most prevalent of all the sexual dysfunctions. Harold Lief has reported that 40 percent of patients applying to the Marriage Counsel of Philadelphia for help with sexual problems were suffering primarily from what he terms inhibited sexual desire, or ISD. This is consistent with our own experience. Since we have begun to take cognizance of disturbances in libido we have also found that desire problems are extremely common in our population.

A new understanding of why some people get sick when exposed to germs while others remain healthy is radically revising the popular concept of what causes illness. How resistant we are to. the microbes in our lives is a function of how well we are coping, which in turn depends largely on how we look at problems our "cognitive appraisal" and the chemical changes that our thoughts produce in our brains and bodies.

Cancer is an example. Although claims are made yearly that the cure rate is steadily improving, people with the leading kinds of cancer are no more likely to survive than they were a generation ago. Deaths from cancer continue to rise yearly in the United States, even though we have spent about $18.5 billion on research since the national Cancer Act of 1971 was passed and "the war on cancer" declared. By comparison, it cost about $10 billion to develop and launch the first space shuttle.

Although much of the evidence on disease mechanisms is new, studies linking psychological factors to physiological effects have been accumulating for several decades. Yet the heady revolution has made little difference in the practice of medicine and the treatment of patients.