'Are you asking for my help to be gay?': what 40 years as a psychoanalyst has taught me about sex and desire

Lessons from the Consulting Room: Unraveling Sex, Desire, and the Hidden Self. Step into a world where certainty about who you are and what you desire is more illusion than reality. Forty years in the psychoanalyst's chair have revealed that, beneath polished surfaces and well-ordered lives, people are often divided and unsure, especially when it comes to sex and desire. We live in a culture that pushes us to be whole, to declare ourselves and our preferences with confidence, but the truth is far messier. Within the quiet sanctum of analysis, people are invited to shed their masks, to be honest in ways that the outside world rarely permits. Here, desire is not a label or an identity, but a living, shifting force shaped by histories, fears, and the earliest bonds of childhood. The stories that unfold are never about simple sexual orientation or acts, but about the intricate ways people organize their lives to hold together the parts of themselves they both cherish and hide. Matt, a successful family man, crafted a careful balance—devoted husband and father on one hand, and secret lover of men on the other. He wasn't troubled by labels, nor was he searching for a new identity. What he longed for, perhaps without knowing it, was a space where he could unite the fragments of his personality, to feel real in his own skin rather than divided. His journey revealed how emotions, not identities, guide sexual choices, and how early lessons about anger and keeping the peace can shape the ways we love and desire as adults. Abigail, an accomplished academic, found herself spiraling after years of achievement and independence. Her story, too, was about more than her work or her time as a sex worker; it was about the desperate hunger to be chosen, to matter, to heal the wounds left by a distant, rejecting father. Sex work became an antidote to her feeling of invisibility, a way to claim specialness that had been denied in her earliest years. Yet, the ghosts of her past persisted, lurking beneath her choices until they could be named and understood in the therapy room. Then there's Mary, the nun whose life was haunted by the trauma of parental loss and a deep, almost primal terror of pregnancy. Her retreat into religious life was less about faith than about safety—a way to avoid the perils of intimacy and motherhood. Only after menopause and years of therapeutic exploration did she feel free enough to leave the convent, to risk love and physical connection, and to find healing where she had once expected only fear. These stories illuminate a profound truth: our sexual selves are not fixed, but are the sum of our journeys through love, pain, longing, and loss. The roots of desire run deep, often tangled with family histories, childhood wounds, and the push-pull of love and hate. It is only when people are driven to the brink—when they can no longer maintain their facades—that they become willing to look inward, to ask the uncomfortable questions, and to begin the hard work of self-discovery. Desire, then, is never simply about sex. It is about the search for wholeness, the struggle to accept every messy, contradictory part of ourselves, and the hope that, in understanding our own hearts, we might finally find a way to love and be loved, honestly and fully.