Psychotherapy of patients with a genuine potential for violence is difficult and dangerous. This is particularly true of the frequently encountered heterosexual patient for whom violence represents an ego defense against intolerable psychic pain associated with a crisis of masculine self-esteem. This often results from dependency and power conflicts which are unconsciously symbolized as homosexual acts. Such pseudohomosexual panic states may follow any adaptive failure, be it social, sexual, or vocational. Violence is a restorative act, attempting to restore masculine self-esteem via aggressive demonstrations of power and strength while at the same time denying the passivity and dependency symbolically linked to femininity. Avoidance of violence requires the rapid identification of pseudohomosexual vs true homosexual anxiety, and active interpretive involvement with the associated pseudohomosexual conflicts.