6 April 2009PSYCHOANALYSIS AND SEXUAL DISORDERS
Psychoanalysis has, from its inception, been inexorably linked with problems of and ideas about human sexuality. From the very beginning of Freud’s thinking about the neuroses, particularly at first the hysterias, the problem of sexuality assumed a significant and central role. It was Charcot, with whom Freud had studied in Paris, after all, who had said that hysteria was une chose genitale. When Freud returned to Vienna after his Parisian experience, his collaboration with Joseph Breuer deepened his knowledge of hysteria and led him, with Breuer, in the direction of fashioning an effective means of treating hysterical symptoms. The collaboration with Breuer is interesting, insofar as Breuer himself seemed anxious to avoid, minimize, and even deny the role of sexuality in the causation of hysteria. Breuer, following the lead of certain French thinkers including Janet, preferred to explain hysterical expressions on the basis of hypnoid states, in which the patients were thought to be particularly vulnerable to traumatic experiences that resulted in the characteristic hysterical dissociation within the mind. Breuer’s attitude toward sexuality was well displayed in his account of the famous case of Anna Î in which his capacity to ignore and deny obvious sexual elements in the patient’s history was strained to the utmost. As the patient’s intensely erotic transference intensified, Breuer found increasing difficulty in maintaining his treatment of her and finally was forced by his wife’s increasing jealousy to break it off. The result was a precipitation of a hysterical pseudocyesis, which Jones notes was the logical outcome of Anna’s highly erotic involvement with Breuer.
If Breuer could shut his eyes to the evidence of sexuality, for interesting transference reasons of his own (Pollock, 1968), fortunately for the development of psychoanalysis Freud did not. In the cases he presented in the Studies on Hysteria (1893-1895), Freud was explicit in relating issues of sexuality and sexual conflict to the etiology of hysteria. Freud’s thinking led him in the direction of a reactive or defensive theory of neurosis which had at its basis sexual conflicts. More specifically, his clinical experience led him to hypothesize that the roots of hysteria, and presumably other neuroses, lay in an infantile sexual trauma which had been defensively repressed and which was re-expressed in the neurotic symptomatology. As Freud explored the reminiscences of his patients, following Breuer’s cathartic principle, he discovered more apparent evidence of such infantile sexual trauma in the recollections of his patients.
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