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Psychoanalytic constructions of female development and women's conflicts about achievement--Part II.

Central to the dynamics that underlie women's conflicts about their own autonomous achievements are the reappraised psychoanalytic concepts of penis envy and masochism. These ideas need not be abandoned because of the phallocentric bias that is responsible for their initial formulation. When they are conceptualized as serving defensive ego-maintaining functions for the woman, their richness in expressing aspects of women's psychological experiences becomes evident. Both culturally ascribed meanings to physiological differences and the physical differences themselves have an impact on an individual's developing psychological sense of self, and of self in relation to others. Girls and boys have different anatomies, which give rise to different bodily sensations, different definitions of what is acceptable and what is taboo, and arouse different feelings and reactions in caretakers on whom the child is dependent. The girl's developmental task of separation and individuation is complicated in two major ways that are relevant to adult women's achievement-related conflicts. First, as a female child, she is both more closely identified with her mother and more closely identified with by her mother. Her sensitivity to relationship and loss--particularly in her bond to her mother--grows in part from the intensities of these reciprocal identifications and from the capacities for empathic, affective relating that cultural and maternal expectations impart to daughters. Because mothers are so identified with their same-sex children, and because, as women, they themselves have learned to sacrifice aspects of their autonomy for either nurturant or dependent functions, mothers communicate ambivalent wishes and expectations to their daughters. On the one hand, a daughter receives the injunction that she carry on for her mother by fulfilling her thwarted longings and by compensating, with her own achievements, for her mother's disappointments. On the other hand, the daughter receives the simultaneous message that her accomplishments arouse her mother's envy and potential retaliation, but, most destructively, threaten to leave her empty, without a dependent appendage through whom she can live and bolster her self-worth. The second, complicated, aspect of the girl's task of separation and individuation, which relates to her adult conflicts around achievement, lies in the relationship between the cultural devaluation of whatever women have to do, and the kinds of fantasies and experiences to which the more hidden, internal and mysterious female genitals lend themselves.

Achievement↗

Mockery through caricature: a variant of introjection utilized by a masochistic woman.

This case study of a woman with moral masochism focuses upon her characteristic defenses. Particular attention is paid to her utilization of a variant of identification. This patient's mother was a strict, harsh disciplinarian who insisted upon total compliance as a condition for her approval and love. This roused considerable anger and resentment in this patient but also intense anxiety, lest she lose her mother's love. To deal with this, she adopted an ingenious strategy. She established a veneer of pseudocompliance, following her mother's dictates to the letter. She incorporated many of her severe attitudes. She took these to an extreme, in effect caricaturing her. Through this process of exaggerating these bits of maternal behavior she made herself miserable, i.e., she became anhedonic, anorectic, and anorgasmic except via painful anal intercourse. This was a most useful compromise formation that enabled her to appear as her mother's ideal child and, therefore, retain her love. At the same time, by achieving a state of misery through following her mother's orders, she exposed her as ridiculous, and thus covertly discharged considerable aggression.

Adult↗

The role of just world belief and anger issues in self-defeating personality.

Persons who scored higher on a measure of self-defeating personality did not believe in a just world as implied in the writings of such theorists as Reik (1941); however, they had a greater awareness of anger and feelings of mistrust and suspiciousness of others, held anger in, and were self-critical. These latter findings are consistent with conclusions regarding masochism proposed in 1991 by Glickauf-Hughes and Wells.

Adult↗

[Psychopathological study of parents who abuse their children].

After recalling the studies of French authors, especially those of P. Parisot and L. Caussade at the Congress of Legal Medicine in Nancy (1929), and more recent, those of the Nancy school, and, in Paris, those of P. Straus and A. Wolf, of L. Kreisler and P. Straus, the author studies Anglo-Saxon research on subject, particularly that undertaken in the U.S.A. The study by Steele and Pollock on the psychology of parents of battered children has shown anomalies with an infantile characteristic in the psychology of some parents (apparently having no problems and living in easy circumstances, but demanding of their children a constant reassurance which the latter are unable to give, hence a permanent frustration leading to agressivity and actual tormenting. Eight observations are presented, covering the whole range of clinical forms observed with parents of battered children: psychopathic personality with perverse sado-masochism, affective immaturation with decompensation during pregnancy, lack of psycho-affective balance with aggression upon some of the children (target-children), a need for domination in the form of tyrannical matriarchate, nevropathy with aggressive perfectionism, and finally subnormal personality with nevropathy, the latter categories leaving a hop for a possibility of attaining transformation through analytical psychotherapy, such as practised by the author in one of his cases.

Adult↗

The addiction to negativity.

In this paper, we have described a type of resistance that has attracted increasing psychoanalytic attention in recent years. Patients exposed to intense negativity during early life may develop an addiction to negative experience as adolescents and adults, and this may constitute a central organizing feature of their personality. In almost all patients, however, some moments of negativity may be observed. We have traced the developmental origins of an attachment to negativity, drawing especially on psychoanalytic investigations of preoedipal pathology. Manifestations and derivatives of early negativity include anhedonia, attachment to physical pain, fear of success, masochism, deprivation of self and others, and negative voyeurism. In discussing the dynamic functions of negativity, we place particular emphasis on two motives: the patient's desires for revenge against early objects that have been a source of deprivation and frustration; and the defensive function of negativity in helping to express as well as ward off dangerous wishes to merge with the object. Deviant forms of autoerotism are likely to be used by these patients to deal with the reactivation of early experiences of neglect and rejection. When negativity is used as a defense or method of relating to others it can lead to a severe disruption of the psychotherapeutic relationship. We have reviewed suggestions for the management of extreme negativity in treatment. Resolution of the therapist's countertransference reactions, especially induced feelings of frustration, rage, and helplessness, is crucial. Emphasis also has been placed on the patient's desires for revenge against self and object, and the manner in which these may be understood and eventually resolved. Only when patient and therapist begin to investigate the adaptive functions of extreme negativity can this pathological symptom be resolved and the patient's awareness of self and sense of autonomy be enhanced.

Adolescent↗

[Repetition and its psychic function].

Thoughts on repetition as a psychic process and not as conduct or behavior. Placing the phenomenon in the framework of the relationship to objects and in its relation to defense mechanisms in general. Which leads to discussing its connections to a death-instinct and masochism, and to situate narcissism as an easy way to find a balance as opposed to an elaborate and thrifty but disordered imbalance, and in its constructive value for one's identity.

Adolescent↗

[Psychodynamic aspects of sports diving].

Individual and group discussions with divers and instructors were used to discover the psychodynamic bases of the diver's psychology. The clearly narcisistic compensation mechanisms, based essentially on so-called "cross-identification" appear to explain the apparently contradictory personality traits revealed by both psychodiagnostic techniques and phenomenological analysis. The recognition of cross identification as the basis of the narcisism-masochism collusion appears to be a useful addition to the field of accident prevention.

Adult↗

Multideterminism in asthmatic disease.

A discussion of "The Role of Primal Scene and Masochism in Asthma," by Cecilia Karol, M.D. Dr. Karol has described a relationship between primal scene experience, sadomasochism, and asthma. While her clinical material strongly supports the relationship that she is attempting to prove, other researchers have found different conflicts that appear equally convincing in relationship to asthma. The following discussion attempts to correlate these differing perspectives, along with data from the fields of allergy, immunology, and animal research, in an attempt to provide a more inclusive explanation for these divergent points of view.

Asthma↗

Parental overstimulation in asthma.

A discussion of "The Role of Primal Scene and Masochism in Asthma," by Cecilia Karol, M.D. The author presents case material corroborating Dr. Karol's hypotheses about the role of primal scene exposure and sadomasochistic fantasies in asthma and which documents the thesis that primal scene is a part of a global pattern of parental overstimulation which in the pregenital maturational phases establishes the predisposition to develop asthma. He further confirms Melitta Sperling's hypothesis that unconscious conflicts of the mother or father predispose a child to the development of psychosomatic disease and that specific parental habits and fantasies involving the lungs determine the choice of the respiratory system for symptom formation.

Adolescent↗

The unfinished manuscript in the drawer: observations on the analysis of a type of symptom.

The interminable project, such as an unfinished manuscript in the drawer, is a familiar affliction in populations of writers, artists and intellectuals. An unrelenting absorption in such a project consuming whole decades of one's life distinguishes this plight from more benign varieties of work inhibition. The interminable project lends itself to a real dilemma of a double life. A case of a female writer and lecturer is presented, in which a longstanding unfinished manuscript figures as a principal complaint. In addition to familiar developmental conflicts, which psychoanalysis finds in psychopathologies of ambition and achievement, the analysis of this patient called for particular attention to various gains of the symptom itself; for example, its lending feasibility to the patient's alternative career by making of it something less ideal and therefore less crucial than it otherwise would have been. Moreover, the harrowing consumption of time that characterises such symptoms was also maintaining a state of moral masochism that gratified the patient's subdued ambivalence towards the analyst and the analysis. A literary project that exists principally to serve such ends as these expires as something feasible when the analysis has subtracted from it its extra-literary aims and devices.

Adult↗

Role of genetic factors in human sexual behavior based on studies of Tourette syndrome and ADHD probands and their relatives.

Most significant variations in the expression of human sexuality are considered to be the result of learned behavior or psychological problems. Tourette syndrome (TS) is a common, hereditary tic and disinhibition disorder sometimes associated with compulsive use of obscene words (coprolalia) and previously reported to be occasionally associated with exhibitionism. To further explore the relationship between the Gts genes and sexual behavior, questions concerning a wide range of such behaviors were administered to 1,040 subjects, 14 years of age or older, consisting of 358 TS probands, 101 non-proband relatives with TS, 359 non-TS first degree relatives, 79 attention deficit hyperactivity disorder (ADHD) probands, 70 unaffected relatives of the ADHD probands, and 73 controls. The behaviors included magnitude of sex drive, sex orientation, exhibitionism, transvestitism, transsexualism, sadism, masochism, pedophilia, fetishism, aversion to being touched, and aversion to sex. While most of these behaviors occurred in a distinct minority of TS subjects, there was a significant positive correlation between each behavior examined and the degree of genetic loading for the Gts gene(s). The nature of these behaviors and their association with TS suggests many are variants of obsessive-compulsive disorder. Studies in animals indicate that changes in serotonin and dopamine play a significant role in the sexual behavior and many lines of evidence are consistent with the hypothesis that TS is due to genetic changes in serotonin and dopamine metabolism. These studies suggest that genetic factors play a much greater role in a wide range of forms of sexual expression than previously thought.

Adolescent↗

Sexuality in traditional China: its relationship to child abuse.

The sexual and marital history of China for 3000 year is reviewed, indicating a general open humanistic attitude about sex, with little perversion, sado-masochism, or denigration of sexuality. Foot fetishism (particularly foot binding) has been extensive in the past, but less so since World War I. Respect for women and their sexual rights and importance has been related to the low rate of child abuse. Currently, restrictions on sexual freedom and psychological injury to children is increasing in the urban areas (20% of the population) with resultant increase in infanticide particularly of little girls.

Adolescent↗

Factitious disorder and coexisting depression: a report of successful psychiatric consultation and case management.

The authors present a case illustrating factitious illness with a coexisting depressive disorder. The factitial presentation involved self-mutilation that served to procure and prolong patient status, while obscuring the recognition of a major depressive episode. The importance of accurate assessment and prompt recognition of factitious illness is discussed, with emphasis upon the identification of contributing psychodynamics, underlying psychopathology and ongoing psychosocial stressors. Psychiatric consultation efforts were successful, but in the context of considerable morbidity. Psychotherapeutic gains occurred only after vigorous antidepressant drug therapy and substantial psychotherapeutic efforts that empathically addressed the patient's masochism and dependency.

Adult↗

Balint after Lacan ... and after.

This paper examines Balint and Lacan's views about regression and symbolism, language, and transference. The author points out their similarities, their differences, and then proposes a synthesis through his approach of history, genealogy, trauma, and crisis. Freud's notions of masochism, of fixation (innate or phylogenetic) may thus be renewed, leading to the analyst's capacity to cope with deep regression and borderline (Balint) psychosis and perversion (Lacan) or to psychosomatics, including epilepsy.

Epilepsy↗

Preferential rape in the theory of courtship disorder.

The theory of courtship disorder suggests voyeurism, exhibitionism, frotteurism, and preferential rape (a paraphilic preference for coercive sex) are expressions of a common underlying disturbance. Previous research has demonstrated that voyeurism, exhibitionism, and frotteurism are relatively likely to co-occur; however, their associations with rape are weaker. One explanation is that rapists are more heterogeneous and may not always be motivated by a paraphilic interest in coercive sex. Paraphilic interests can be identified using phallometric testing, but the sensitivity of the test is attenuated by voluntary control over erectile responding. Another approach is to look for a behavioral marker associated with paraphilic rape-proneness. Freund (1990) has argued that exhibitionism may be the "hub" of courtship disorder because exposing one's genitals to a stranger is rare in control subjects. We predicted that rapists who also engaged in exhibitionistic activity would be more likely than other rapists to also engage in other expressions of courtship disorder, i.e., voyeurism and frotteurism. To rule out the possibility that rapists who report exhibitionistic activity only differ in their willingness to report anomalous sexual behavior, we also predicted no difference between the groups in their self-reported involvement in other paraphilic activities such as sadism or masochism, or paraphilic target preferences such as fetishism or transvestism. Finally, we predicted no difference between groups in their willingness to admit to attempting or committing rape. The results supported our predictions, and lend credence to the notion of preferential rape as an expression of courtship disorder. Moreover, these results suggest that the presence of another paraphilia, particularly exhibitionism, may be useful as a behavioral marker for paraphilic rape-proneness.

Adult↗

The frog and the scorpion: sado-masochistic injury.

Interpreting the lesions of victims of sexual violence is one of the most difficult and most controversial areas of forensic medicine. The case we report involves the care of a victim of sado-masochism. It identifies the difficulties of both the forensic and legal management of sexual violence in an unusual context.

Journal Article↗

Insights into the struggle of creativity. A rereading of Anna Freud's "Beating fantasies and daydreams".

The wish to create, the dilemmas regarding the value, source, and ownership of one's potential and ideas, and the threats that these involve, are explored as they emerge in a dialogue between Anna Freud and her father, embedded in Anna Freud's first paper "Beating Fantasies and Daydreams" (1922). Insight into these aspects of the struggle of creativity contributes to the understanding of their relationship to writing, masochism, sublimation, and other associated psychological processes. Through the analysis of the paper the identity of the patient described is revealed to be Anna Freud herself. This sheds light on her personal development and the way in which it influenced developments in psychoanalytic thinking.

Austria↗

Suicide by intrarectal gunshot wound.

In this report, a bizarre case of suicide is presented. The decedent, who had a history of various paraphilias, including sexual masochism and fetishism, died from a self-inflicted intrarectal gunshot wound.

Adult↗