especially occupied himself with the psychoanalytic treatment of homosexuality and claims many successes.[253] Sadger admits that there are many limits to the success of this treatment, and that it cannot affect the inborn factors of homosexuality when present.  Other psychoanalysts are less sanguine as to the cure of inversion.  Stekel appears to have stated that he has never seen a complete cure by psychoanalysis, and Ferenezi is not able to give a good account of the results; especially as regards what he terms obsessional homosexuality, he states that he has never succeeded in effecting a complete cure, although obsessions in general are especially amenable to psychoanalysis.[254]

I have met with at least two homosexual persons who had undergone psychoanalytic treatment and found it beneficial.  One, however, was bisexual, so that the difficulties in the way of the success—­granting it to be real—­were not serious.  In the other case, the inversion persisted after treatment, exactly the same as before.  The benefit he received was due to the fact that he was enabled to understand himself better and to overcome some of his mental difficulties.  The treatment, therefore, in his case, was not a method of cure, but of psychic hygiene, of what Hirschfeld would call “adaptation-therapy.”  There can be no doubt that—­even if we put aside all effort at cure and regard an invert’s condition as inborn and permanent—­a large and important field of treatment here still remains.

As we have seen in the two previous chapters, sexual inversion cannot be regarded as essentially an insane or psychopathic state.[255] But it is frequently associated with nervous conditions which may be greatly benefited by hygiene and treatment, without any attempt at all to overcome a homosexual attitude which may be too deeply rooted to be changed.  The invert is specially liable to suffer from a high degree of neurasthenia, often involving much nervous weakness and irritability, loss of self-control, and genital hyperesthesia.[256] Hirschfeld finds that over 67 per cent. inverts suffer from nervous troubles, and among the cases dealt with in the present Study (as shown in chapter v) slight nervous functional disturbances are very common.  These are conditions which may be ameliorated, and they may be treated in much the same way as if no inversion existed, by physical and mental tonics; or, if necessary, sedatives; by regulated gymnastics and out-of-door exercises; and by occupations which employ, without overexerting, the mind.  Very great and permanent benefit may be obtained by a prolonged course of such mental and physical hygiene; the associated neurasthenic conditions may be largely removed, with the morbid fears, suspicions, and irritabilities that are usually part of neurasthenia, and the invert may be brought into a fairly wholesome and tonic condition of self-control.