On the Origins of Lesbianism

by Linda Ames Nicolosi

This article first appeared in the National Association of Research and Therapy (NARTH) Bulletin.  It is based on an interview with Elaine Siegel, Ph.D., A.D.T.R., a supervising and training analyst at the New York Center for Psychoanalytic Training.

Dr. Siegel lectured extensively in the United States and Europe.  She wrote three books, including Female Homosexuality: Choice Without Volition (1988). She passed away in 2013, the same year we interviewed her for this article.

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Much has been written recently about lesbianism from a gay-advocacy viewpoint. Therefore Dr. Siegel’s psychodynamic insights— approached from a different perspective— are of special and unusual interest.

There are different types of lesbianism, as Dr. Siegel notes, whose origins will be different from the one described here. But the early-developmental trauma model that she describes was the most common pathway she found among her patients.  (The other common family pattern described by clinicians:  that of a mother who is the object of abuse, leading the daughter to reject the embrace of a feminine identity as representing weakness, and feeling “unsafe.”)

In Female Homosexuality, Dr. Siegel describes the families of her lesbian patients.  Many of these patients had evidently been raised by narcissistic mothers, whose controlling influence attempted to force the fragile, emerging selves of their daughters into an identity that was alien to them. As a result of this disturbed relationship, the daughters, who had been unable to identify with the feminine, developed a severe body-image distortion.

“[M]others,” she says, “seemed to use their children as sometimes desperately needed, sometimes desperately repudiated extensions of themselves…When these little girls tried to turn to their fathers, they did not fare much better. Preoccupied with their business deals, the men sporadically paid attention to their daughters, overstimulated them, and then appeared to forget that they were around…These fathers, when they took the time to react at all, responded to their daughters as persons who had to be made over in their own, masculine image.” (She described one father who tried to make his daughter “fearless” by taking her for a ride on her sled while it was tied to the back of his car.)

Dr. Siegel says, “I have given these accounts to underline that my patients grew up in atmospheres that substituted empty facades for reality, and that tried to force their emerging identities into rigid, idealized forms of behavior alien to them,” with a resulting “severe arrest in ego development” despite outwardly well-adjusted personalities.

“Unable to identify with either parent,” she says, “they literally did not know that they were female.”

The mothers are described as immature, emotionally fragile and aloof from the needs of their daughters. They did not treat their daughters as whole and separate persons, but as extensions of themselves who were expected to fulfill the mother’s needs, not their own. In adulthood, their daughters, having been unable to identify with femaleness, sought to repair their defective body images by seeking a sexual partner similar to themselves.

Because they were unable to integrate their sexual organ into their body image, these women typically developed an unconscious denial of gender differences.

“The little girl who turns to homosexuality never has a chance to create herself. She is a creation of her mother, whose self-love she was meant to enhance,” says Dr. Siegel, paraphrasing M.R. Khan in Alienation in Perversion (1979).

Interview 

Q. Dr. Siegel, how did you become involved with the National Association of Research and Therapy of Homosexuality (NARTH)?

A. Many years ago, I sought supervision from the psychoanalyst Charles Socarides. By a series of circumstances, I had a large group of homosexual women in treatment, but at that time, I was unfamiliar with lesbian dynamics and not sure how to proceed.

Q. Did this supervision help?

A. Absolutely.  I had been aware that females became homosexual for different reasons than males, but not much in the literature prepared me for actually treating female homosexuals.  As Dr. Socarides and I worked, I understood that lesbianism was due to a developmental lag.  In other words, I discovered that female homosexuals–at least the ones I was treating (I’m sure there are different kinds) had a specific type of distorted body image.  They did not appear to have appropriate feelings in the vaginal area; that was not an erotic zone for them.  Of course, they will hotly dispute this fact, and cite reasons why they really do enjoy foreplay and sexual play.    But I found, rather, a profound anesthesia of that whole region.

The interesting thing is that I had no preconceived notion about female homosexuality.   I was a “modern woman”; I had believed that homosexuality was just another “way of being in the world” until I started to work with these ladies.  They surely taught me differently.

Q. Can you tell me how you got started in the treatment of lesbianism?

A. I started to work with these women because I had belonged to a feminist consciousness-raising group, and one of these women opened a Women’s Center for treatment.  She asked me if I would be one of the treating therapists.  And, I said, of course; and very soon, I had a whole practice full of women who were really suffering.  They were not happy with their lives, and they came into treatment specifically because they wished for a longterm relationship, but were unable to have it.

Q. With a man?

A. No.  They just wished for a longterm relationship.  They did not specify male or female. I tried hard to keep my analytic neutrality toward my patients’ sexuality. I felt, and still feel, that the analysand herself has to decide whether she wishes to be hetero- or homosexual.

When one thinks about homosexuality, one has to realize that a woman’s first love-object is most often her mother. In my group of analysands, the wish toward objects was most often for a tender, empathic mother who was visible in the transference. These wishes are at first unconscious, but as treatment progresses, wishes toward significant others become conscious in the transference. These wishes belonged to a very early developmental phase.

Early “castration anxiety” [i.e., fear of the power of the avenging mother] distorts the female body image, resulting in panic states due to the unconscious fear of the annihilation of self and other. Essentially sensuous wishes and needs then become sexualized, sometimes resulting in female homosexuality.

I had to be careful not to let my own opinions about homosexuality interfere with their growth. If I had not stayed empathic toward these early needs, my analysands would have been unable to tolerate further analytic investigation.

And if this early phase, which is in essence homosexual, is not traversed, then love for the father–which will lead to heterosexuality–becomes difficult.

Q. So they didn’t really give you any indication of what type of longterm relationship they were interested in?

A. Correct.

Q. And they didn’t indicate whether they were homosexual or not?

A. Correct; but they seemed anxious about their sexual orientation, and if they saw themselves as homosexual, I thought, well, OK, you’re homosexual.  Now interestingly, there were a couple of women who did not start homosexual behavior until after they were in the treatment, where their transference–or the flight from it–made them feel safe enough act it out.

Later, upon analyzing their behavior, they gave it up.  It had been a regression in the service of building themselves up because when they were in therapy with me, I could work with them and talk about these options…how and why they had to stimulate themselves in an unusual manner.  I found it extraordinary how many of them had ugly names for their vagina.  They called them “stink holes,” and they were not pleased with this part of the body–as opposed to males, who are usually very pleased with their penises.

Q. How did this negative body image arise?

A. Invariably, it was a faulty mother-daughter relationship.  Often the mothers were very narcissistic and didn’t allow themselves to be role models for the daughter.

Q. And so, the daughters could not assume a female identity?

A. That’s right.  Because they felt the mothers were either too seductive or too intrusive, or didn’t pay any attention to them at all.  It was always a disturbed relationship of some sort.  Very often, the mothers appeared to be–at least in their daughter’s view–terribly narcissistic.

The tragedy was that when these children turned to their fathers, the fathers also used the children for their own aggrandizement.  When their daughters didn’t go along with this, then the fathers would be disappointed and drop the girls emotionally on their heads, just like their mothers had.  So, these were really tragic life histories.

These patients’ neediness was manifest in their demanding (among other things) of body contact from me. When I declined, they were very offended.  I had to explain to them that I was not there to gratify them, but to help them look at their lives so they could make healthy decisions.

Yet, I kept myself as available as I could, and put up with four o’clock in the morning telephone calls.  There was all sorts of acting out from them, but slowly we went forward. Now, the interesting thing is that even though some of the women  did not turn heterosexual through therapy, they still made large gains.  They no longer had to use these bizarre techniques to stimulate themselves such as using nipple clamps, tying each other up, and so on.  They became happier and more fulfilled people–although they panicked at the idea they might turn heterosexual.

Q. Really, it’s that threatening?

A. Oh, yes.  And the other thing that was very difficult for all of the women–they had a lot of trouble with their “lesbian sisters.”  They were told by them that they were betrayers, that they were evil, that they were letting the women down, and why did they go to this awful therapist, Dr. Siegel, who “kills homosexuals,” you know, this kind of nonsense.

Q. Kills homosexuals?  That was the expression that was used?

A. Yes.  When I gave a speech at the New York Institute for Psychoanalytic Training, there was a group of homosexual women who had placards that read, “Elaine Siegel kills homosexuals.”  And I tried to get into a dialogue with them, but it was impossible.  Their tactic was to disrupt the proceeding, and they did.

Q. Of all the homosexual women you’ve worked with, how successful were you in helping them to acquire a heterosexual identity?

A. More than half.  At least 70% decided to at least give heterosexuality a try.  Now, you see, if you look at this from an analytic angle, some of them started to live heterosexual lives, but still had homosexual fantasies.  So, to my mind, the analyses were not finished, but the women thought they were finished.

Q. And did they stay?

A. Interestingly enough, no–not all of them.  What they did do, was keep writing me letters and visiting me for Christmas or something.  It was almost as though they needed “Big Mama” to bolster their still-shaky identities.

Q. So, the transference remained positive to a certain degree.

A. Of course, but they needed more analytical work when they remained locked into their early trauma.

Q. That is a terrific success rate.

A. Oh, yes.  But I attribute the success to the fact that I really didn’t ever allow myself to think:  you must turn heterosexual.  When there was a flight from the transference into homosexual acting out, I would never, never, never condemn them, but try to understand it from the transferential point of view.  And they began to trust me.  They all went through phases where they said, “You can’t understand me because you are heterosexual.  I bet you’re even married or have a man in your life.”  And I had to swallow and think, “You’re right, I don’t know what a homosexual liaison feels like, I don’t.”

Q. So what were their reactions to their own changing feelings in the therapy?  How did they express those observations to you?

A. At first, they were terribly anxious.  Then they became depressed and sad.

Q. Why do you think the sadness?

A. The sadness was because they had to give up something that to a certain extent, had worked for a long time.  You know, people don’t turn to homosexuality because they want to; inner forces compel them to it.  This is true for males and females.

But when this kind of a defense and adaptation no longer works, of course a person is going to be upset.  And the relief and the joy of a more fully experienced life and body will come much later.

Q. How did the ones that reached that level express those experiences to you?

A. Oh, they would say to me that I was the greatest analyst in the world and they would thank me so much.  It was really touching.  You know, I’m not supposed to say this–analysts must stay neutral–but counter-transferentially, I was fond of the whole batch of them.

Q. Did they express surprise about what was happening to them?

A. No, no.  They were not surprised, because it is a gradual process, you see.  It is not an awakening and saying, “Ahha, I am heterosexual now.”  They had already gone through sadness, through experiencing a terrible hole in their body image, in which their genitals had been treated terribly…

Q. So they hadn’t been able to identify with their own femininity…

A. But by the time they got to the point of rebuilding themselves and their body image, they already knew that change was happening, so they were not surprised.  They were at first angry, then grateful.

Q. Did they ever comment to you on the experience of both worlds, and the difference between both worlds?

A. Yes.  You know, it’s very interesting.  The ones who had expressed the wish to have a child, were more willing to examine themselves analytically than the others. At the beginning, they had said, “Well, I can always be artificially inseminated.”  Or, “Well, I have a very good girlfriend who has a brother, and maybe he would be willing to give his sperm,” or something like that.  And I just said, “Uh-huh,” and would wait until we got to a less volatile place where we could discuss that.  When they were ready, we would discuss what it would be like to raise a child without a father.  Or what it would be like to raise a child with two mommies.  And, as I have said in my books and articles, these women were intelligent and creative.  They understood these things.

Q. In recent years, you’ve given seminars in Europe.  I’ve heard you had some interesting experiences.

A. Well, when I was speaking at a mental-health association meeting in Sweden, a good half of the audience were homosexual women.  They were surprisingly willing to enter into a dialogue.  In other words, they didn’t say, “Dr. Siegel wants to kill homosexuals.”  They asked questions like, “Why do you want to treat us?  Why do you think homosexuality is an illness?”  And I would always say to them, “I don’t think homosexuality is an illness.  I think it’s a developmental lag.  That’s something quite different.”  And, I don’t ask you to come into treatment.  You come into treatment voluntarily.  Nobody stands there with a gun forcing you.

And they would say, “Why do you want to examine homosexuality?  Do you do that with heterosexual people?”  And I would say–of course I do; the crux of the matter in any analysis is what a person does with his or her sexuality.

Q. The difference between that audience’s reaction and the American reaction was considerable.

A. When my book appeared in Germany, people were also willing to talk.  Interestingly, however, the publisher had a bad experience.  He had a large order for the book and then it was returned because the bookseller said, “I won’t have that in my store.”  I have not heard of such a situation in the United States.

However as you know, the political situation in the United States makes it almost impossible now to treat homosexuals. Even the American Psychological Association has a large contingent that feels you shouldn’t take homosexuals into treatment if you believe the condition represents a problem in any way.

But as we know, the homosexual who wishes to change–who has an unconscious wish to change–is one of the most misunderstood people in the world today.

Elaine Siegel’s related journal articles include “Severe body image distortions in some female homosexuals” (Dynamic Psychotherapy, vol. 2, no. 1, Spring/Summer 1984), and “The connection between playing and adult love: Reconstructions from the analyses of some homosexual women” (Dynamic Psychotherapy vol. 4, no. 1, Spring/Summer 1986).