The Bieber study: A review revisited

A reader sent along a link to a review of the psychoanalytic study of homosexuality headed by Irving Bieber and reported in 1962. Titled Homosexuality: A Psychoanalytical Study of Male Homosexuals, the nine-year study of 106 gay men summarized the reports of psychoanalysts about their patients but did not interview the patients directly.
The pdf of the the review by George Carter, MD is here. Since it is brief, I am going to post it and then comment.

Homosexuality—A Psychoanalytic Study of Male Homosexuals
Irving Bieber et al.
New York, Basic Books, Inc., 1962,358 pp.
A statistical comparison from questionnaires submitted not to their patients, but to a group of
psychoanalytic psychotherapists, gives much interesting information about 106 overtly homosexual male patients, as compared with 100 not overtly homosexual male patients (controls). Most of the study patients were seen once (13%), twice (50%), or three times (31%) a week for periods varying from months to years. The group included patients with character disorders, neurotics, and schizophrenics The questionnaires intensively covered wide areas of development and functioning including relationships between parents,. patient and mother, patient and father, patient and siblings; sexual development and current, functioning; choice of homosexual partner; relation to women; latent homosexuality, etc. The emphasis is on conscious present and past attitudes, experiences, and behavior of the subjects, and does not explore the therapist’s dynamic understanding of the material. It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?” It is also difficult to evaluate the statistics at times. For example, the authors base some of their theoretical conclusions on the fact that they find ‘latent homosexuality” less frequently (in their controls) than is ordinarily reported in psychoanalytic literature. But the data collection method may not be psychoanalytic, since it is not clear that the reporting analysts asked their patients to free-associate! It is difficult to evaluate the results.
Nonetheless, the study does point up some interesting issues. It suggests most strongly that overt homosexuality is especially apt to occur among those exposed to certain constellations of early family relationships, including what the authors call a close-binding, intimate mother and a distant or detached father. There are many other interesting inferences, especially about prognosis and treatment. However, the authors’ stated basic theoretical conclusion that homosexuality is the result of hidden, but incapacitating fears of the opposite sex seems over-simplified and over-determined, since they started with this as a working assumption, but found direct evidence for it, as I understand it, in only about 70% of the studied group and in at least one-third of the nonhomosexual controls.
GEORGE H. CARTER, M.D.

One observation I had not noticed before relates to the evaluation of the survey by the analysts involved:

It is notable that 74% of the therapists either did reply (55%) to, or answered simply “no” (22%) to the question: “Did the analyst feel the questionnaire explored the fundamental dynamics of the patient?”

If most participants in the study did not believe the instrument captured the essence of the patient how can any conclusions be drawn from the results? There are numerous problems with this research as a study of causation, but this is another serious blow to the validity of the approach Bieber used.
The Bieber study is often cited as a foundation for reparative drive theory. Bieber, like modern day reparative therapists, believed that a “constructive, supportive, warmly related father precludes the possibility of a homosexual son; he acts as a neutralizing, protective agent should the mother make seductive or close-binding attempts.” As the reviewer above pointed out, Bieber went into the study believing that a fear of women as a reaction to a too close mother, was at the root of male homosexuality. He believed that the father could bring the boy out of this problematic attachment, if he was “warmly related.”
The reviewer hints at but does not elaborate on the confirmation bias at work here. Bieber believed homosexuality was the result of a certain set of family forces and found what he expected to find. As Carter points out, the patterns were not universal and existed in the heterosexual controls as well.
However, despite the problems with validity, no follow up, no direct questioning of patients, etc., Bieber made a conclusion which continues to have influence in the modern ex-gay movement. The concept of the father’s intervening role with the overinvolved mother can be seen in the masculinity enhancement approach to reparative therapy. If you make a man more trusting of men (as dad should have done), then you give a man the courage to distance himself from mother (women). Once distant from mother (women) and in the world of the father (men), he loses his fear of being engulfed by mother (women) and finds them appealing. I think the appeal of the New Warriors Training Adventure comes from this view of masculinity. The Mankind Project view is that women have prevented men from being initiated into manhood. Only a man can initiate a man. So since by (reparative) definition, SSA men are fearful of mother (women), the need is to initiate them in the world of men (father) by other men (pretend fathers). What I have never heard addressed by reparative advocates is why these family constellations mark both same-sex and opposite-sex attracted men. If this set of factors was determinative in some general way for all same-sex attracted men, then why do we see SSA men who do not have these backgrounds and OSA men with them?