People in a World Between: Psychodynamic Themes in the Treatment of Bisexual Patients

Normal sexual behavior is on a continuum—with homosexuality at one end, heterosexuality at the other, and bisexuality at the midpoint. Most people have some bisexual potential. A bisexual person is capable of having intimacy with either a man or women but may be made uncomfortable by the ambiguity of their libidinal longings, feel different, isolated, and long to make a clearer gender choice—homosexuality or heterosexuality. The sacrifice to the self and the psychic conflicts that block such a lifestyle resolution brings these bisexuals into treatment and clinicians are confronted with a need to apply psychodynamic theory in new and more flexible ways. Using two case studies this paper discusses forms of androgynous transference, pregnancy fantasy, and dream interpretation that can unfold in the psychotherapy of bisexual patients.