Subject: review of new Isay book
From: [email-masked]
Date: Mon, 14 Oct 1996 19:27:03 -0400

Book Review
Becoming Gay: The Journey to Self-Acceptance
By Richard A. Isay, MD
Pantheon Press
(210 pages hardcover, $23.00)
Reviewed by Michael Shernoff, MSW

A more accurate subtitle for this book might have been My Journey to
Self-Acceptance as a Psychoanalyst since it is most interesting in the
sections where the author shares his personal journey. Thus this reviewer
felt that only the introduction, the first chapter "Becoming Gay: A Personal
Odyssey" and the last chapter "Opposing institutional Bias: Anti-Gay
Discrimination in Psychoanalysis" to be strong and compelling.  These
chapters are where Isay describes his own evolution personally,
professionally and ultimately into an activist within the professional
psychoanalytic societies.
 Having relished almost all of  Becoming Homosexual, Richard Isay's first
book, and having found it interesting, innovative and useful to my clinical
practice I was looking forward to reading Becoming Gay, his latest work.
 Unfortunately I was largely disappointed by the absence of any new
theoretical material and by the limitations imposed by Isay's anachronistic
and myopic clinical view as a psychoanalyst. He seems almost completely
oblivious of the strides made in gay affirmative psychotherapy outside the
narrow realm of analysis long before the professional analytical associations
were brought kicking and screaming (in no small measure due to Isay's own
heroic efforts) into officially adopting less bigoted policies on
homosexuality and homosexuals as analysts.  Whether or not he is aware of the
history of gay affirmative psychotherapy, he writes as if he is inventing
many of the concepts that he discusses.  His absence of citing authors and
theoreticians who have previously written extensively about gay affirmative
therapy undermines his credibility, and what he most wants...for both his
colleagues and readers to take him seriously.
Becoming Gay is genuinely moving when Isay is telling his personal story.
 His homosexual inclination surfaced during his first year in analysis. At
that time, and during the years that followed, Isay was not at all resistant
to having his feelings for other men excised through therapy.  "I thought it
was a sign of the severity of my emotional problems that I was not attracted
to women," he recalls, " and my lack of passion made me more eager than ever
to begin treatment."  Like many gay men at that time and since, he longed to
be straight. At his analyst's urging, he met a woman he fell in love with,
 married and had two sons.  Isay's honesty in recounting his growing
realization that he was able to suppress his homosexual desires only with
constant reassurance from his analyst is one of the strengths of this book.
 Once he completed his analysis he was tortured by a desire for sex with men,
and began to act out these desires in seedy settings for anonymous sex.  When
his sons were grown, Isay came out of the closet as a middle aged man, and
ended his marriage.  As far as he reveals his personal struggles it is a
riveting, but not unique or unfamiliar story.  In addition, as it is told it
is too seamless, for me not to wonder at details omitted. Thus as a memoir,
Becoming Gay stands in stark contrast to Martin Duberman's two biographical
works, Cures and Midlife Queer, about his coming out and surviving the
pitfalls of homophobic psychoanalysis.   Isay's descriptions of taking on and
struggling with the psychoanalytic profession in order to get them to ever so
slowly and reluctantly confront their own bigotry is where he shines, and
demonstrates remarkable courage and fortitude that is to be admired and
commended.
One of the problems with this book is that frankly it is dated and does not
contain anything new or innovative in terms of treating gay men
psychotherapeutically.  None of the case studies that Isay presents is of a
well adjusted, self accepting gay man who seeks therapy for life enhancement
or treatment of one of the myriad of  reasons men seek me out that are
completely unrelated to their acceptance of their own homosexuality.
 Obviously internalized and unexamined homophobia needs to be addressed in
therapy with any gay or lesbian person. Has Isay never treated a happy, out
gay man, in a satisfying relationship who just seeks therapy to increase the
quality of his life?  It would not seem so from the case vignettes he
presents.  Repeatedly, Isay presents portraits of tortured homosexuals,
struggling to accept who they are and to create a self-actualized life.
 Using the cases in this book, it would seem that the residents of
Manhattan's Upper East who consult Isay have been living in a time warp
untouched by post-Stonewall evolution. Where has more than twenty seven years
of the impact of the contemporary gay liberation movement disappeared to for
these individuals?  In addition, Isay never acknowledges the fact that gay
men are not all white and middle or upper middle class.  This absence of any
discussions of how cultural differences contribute to individual gay men's
psychic constructions contributes to the dated and obsolete nature of the
book.  	
Through out Becoming Gay Isay seems to extrapolate from his own personal life
history, generalizing to the lives of the men he sees as patients,
universalizing his own dynamics.  Thus most of the cases reported sem to
mirror Isay's own developmental experiences. Clinically he seems to be on the
firmest footing when he describes his work with heterosexually married
homosexually inclined or active men.  His discussions of and portrayals of
both gay youth and older gay men once again seem taken from an era that had
not benefited from more than a quarter of a century of gay community building
and activism. Thus I had to resist my urge to just skim these chapters.
I was outraged that Isay would have the hubris to include a chapter on AIDS
when he admits he has only consulted with twenty men who were HIV infected
and treated nine of them in insight oriented therapy.  This hardly makes him
an expert in this area.  Though to his credit, he does describe abandoning
traditional psychoanalysis to be an emotional available support for patients
of his with AIDS.  Shockingly his discussion of treating people with HIV/AIDS
is superficial, and full of cliches about the love that AIDS has brought into
the lives of the PWAs he has treated. While acknowledging that at times this
has indeed been the case, both as a person living with HIV and as a therapist
working in Manhattan's Chelsea neighborhood, one of the ground zeros of the
epidemic,  I wanted to scream that there are not any silver linings to this
plague.  Isay's need to search for meaning in the midst of the AIDS plague is
an understandable rite of passage for all of us working with PWAs.  But once
again, his not citing other clinicians who have written about this process,
makes him seem self-aggrandizing if not dishonest.  His observations about
spirituality and illness will be familiar to readers of Thomas Mann's Magic
Mountain or Susan Sontag's Illness as Metaphor and AIDS and its Metaphors.
  I was often made uncomfortable by Isay's all too frequent use of the term
masochist to describe various patients, especially those infected with HIV.
 This had a moralistic and judgmental tone that was too reminiscent of how
psychoanalysts have traditionally referred to all gay people.  Isay has made
significant contributions to the emotional, psychological, social and
political well being of gay people through his pioneering work in being at
the vanguard of attempting to bring psychoanalysis into the modern era.
  What might have greatly contributed to making Becoming Gay an inherently
more interesting work would have been a critical discussion about the
relevance and meaningfulness of traditional psychoanalysis as a viable
therapeutic modality for gay people.  

Michael Shernoff, MSW is a psychotherapist in private practice in Manhattan
and is adjunct faculty at Hunter College Graduate School of Social Work.  He
is also a contributing editor to In The Family magazine, and is a senior
consulting editor of The Journal of Gay & Lesbian Social Services.  He can be
reached via email at [email-masked] or at his home page
http://members.aol.com/therapysvc