Writer : Otto F. Kernberg, M.D.
Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement.
Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a teasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.
THE PRINCIPAL THESES OF THIS PAPER
Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations. It is an essential part of the very nature of sexual excitement. Sexual excitement is a basic affect: it is a fundamental constituent of libido, which I see as a hierarchically supraordinate drive. This idea is in consonance with proposals in my earlier work that consider affects as the "building blocks" of drives (1976, pp. 85?07);
Associate Chairman and Medical Director, The New York Hospital-Cornell Medical Center, Westchester Division; Professor of Psychiatry, Cornell University Medical College; Training and Supervising Analyst, Columbia University Center for Psychoanalytic Training and Research.
Presented at the panel on "Sadomasochism in the Perversions," Fall Meeting of the American Psychoanalytic Association, New York, December 17, 1988. Accepted for publication April 27, 1989. (1982; in press). Sadomasochism may present as a specific perversion. This perversion is characterized by deriving pleasure from inflicting or receiving pain as an obligatory precondition for achieving sexual gratification and orgasm. This obligatory precondition implies a restriction in the variety, scope, and flexibility of sexual life. The degree of severity of this perversion depends on the degree of ego and superego pathology.
My basic theoretical frame stems from Freud's (1905) description of infantile sexuality. However, I consider the source of the libidinal drive to lie not in the excitation of erogenous zones per se, but in the affect of sexual excitement, which incorporates zonal excitation together with the cognitive aspects of early object relations and other communicative, neurovegetative, and psychomotor substructures of this affect. My view of sexual excitement as a basic affect also incorporates Erikson's elaboration of the theory of infantile sexuality in terms of modes and modalities of object relations implied in the activation of zonal excitation (Erikson, 1963, pp. 72?08).
In earlier work (1986), (1988a), (1989) I stressed the crucial importance of the levels of personality organization梚n other words, of psychic structure梬hen assessing perversions. The difference between perverse fantasies and their symbolic enactment in sexual relations and love, on the one hand, and a consolidated perverse structure, on the other, depends on the nature of ego and superego organization.
The psychodynamic meanings of perverse fantasies and actions lie on a continuum, from normality to psychopathic perversion. The structural characteristics of the different clinical types and degrees of perversion vary greatly, according to whether they are associated with an integrated tripartite structure of normality and neurosis, at the one extreme, a borderline and narcissistic personality structure in the intermediate realm, or with the syndromes of malignant narcissism, antisocial personality structure, and perverse organization in psychosis, at the other extreme. The degree to which the perverse tendencies are transformed into action depends on the predominance of aggressive over libidinal components in the individual's instinctual equilibrium and the regressive nature of his personality structure, including the regression and/or disintegration of the superego, the predominance of splitting processes in the ego, the consolidation of a pathological grandiose self, and the weakening and loss of ego boundaries.
Some Illustrative Cases
The following five cases illustrate sadomasochism at various levels of psychopathology, short of actual psychosis. Listed in the order of the severity of the pathology, they should serve to put my discussion in context.
The patient, a man in his early twenties, masturbated on the roofs of buildings and threw bricks on women walking on the street below; he reached orgasm at the moment when he either hit a victim or observed the extreme fright of a potential victim. This patient, temporarily hospitalized at the time of his evaluation under court order, presented a sadistic perversion unmitigated by any sense of guilt or any capacity of concern for his victims or for himself. He also evinced a combination of grandiosity, arrogance, and contempt as dominant characterological features. He illustrates the combination of a sexual perversion and a total deterioration or absence of superego functions in the context of a narcissistic personality structure. He was clinically not psychotic, and I formulated the diagnosis of a sadistic perversion in an antisocial personality. Sadistic perversion can also be present as part of psychosis, a further degree of this extreme psychopathology.
A man, in his late thirties, was in psychoanalytic treatment because of a long-standing incapacity to commit himself to any loving relationship with a woman, sexual promiscuity, and growing dissatisfaction with his sexual life. He was white and had a black mistress, a colleague at work with whom he collaborated in creative projects. She loved him, accepting the limitations of their relationship, which had a sporadic, discontinuous quality stemming from him. Although he had had homosexual experiences in the past, and considered himself "potentially bisexual" as an expression of his sexual freedom and superiority, his current sexual experiences were almost exclusively heterosexual.
What he enjoyed most with his current mistress was a triangular situation: Having persuaded her to participate in a m閚age ?trois, he would offer her as a sexual partner to a close male friend. His sexual excitement peaked when, while she was having intercourse with his friend in the patient's presence, she would look at him with a loving expression indicating that she was submitting herself to this sexual relationship only because he had asked her to, and with him in mind as her sexual object. Analytic exploration revealed that the meanings of this scene included his unconscious wish to humiliate her as revenge against a hated maternal figure, and the reenactment and magical reversal of his fantasy of being the "excluded third party" of the primal scene: in his fantasy, it was now his friend (= father) who was really the excluded third party. While this was not an exclusive, obligatory, and constant aspect of his sexual behavior, it constituted his most intense and enjoyable way of achieving sexual gratification. This patient presented a narcissistic personality, and, in the transference, a typical "perverse" development (Kernberg, 1985) in the sense of a transformation of everything "good" received into something "bad." He showed a consistent though unconscious effort to utilize the understanding gained from me to demonstrate his independence from me, the futility of psychoanalysis, and the superiority of sadistic enjoyment to any other type of human interaction. At the same time, however, this patient presented good superego functions in all nonsexualized aspects of his daily life, and responded positively to psychoanalytic treatment over an extended period of time.
This case, reported in another context in an earlier publication (1976, pp. 181?82), is of a woman with severe sexual inhibition, a lifelong incapacity to masturbate because, immediately following any sexual excitement, the face of her mother would flash up in her mind stopping her from further masturbatory activity. Her only erotically exciting behavior was represented by cutting herself in various parts of her body; the excitement was produced by observing blood flowing from these wounds (unconsciously representing an infinite number of tiny vaginas). She developed, in the course of her treatment, the fantasy in the transference that, if I were willing to shoot and kill her, she would feel fully gratified sexually. My killing her would mean that she mattered to me more than anything else in my life, and it would unite us forever in a way in which no other human interaction could. This patient, with a severe personality disorder involving schizoid, masochistic, and obsessive features, functioned on a borderline level of personality organization. She responded very well to psychoanalytic psychotherapy over several years (with an early resolution of her self-mutilating tendency), but her sexual inhibition diminished only very slowly and gradually over the years. This patient illustrates a masochistic sexual organization at a very primitive level, in the context of both lack of activation of ordinary pleasurable features of sexual excitement and an inordinate development of the aggressive components of it. Here, the aggression dominant within sexual excitement was matched with a well-integrated yet extremely sadistic and self-punitive superego.
The patient, a man in his middle forties, was impotent with his current girlfriend, a woman he loved deeply but with whom he was shy, at times even submissive, although he could be sexually free and fully potent in sadistic involvements with other women if they followed a carefully designed and ritualized protocol. The woman with whom he could be sexually potent had to receive him at the door of the apartment on her knees, suck his penis, then guide him to the bedroom where she undressed, was tied up, and whipped with a careful limitation of the degree of pain or lesions that he inflicted on her. When she appeared to experience only pain and no longer sexual excitement, whipping her lost its attraction for him. He ended his sexual encounter with satisfactory genital intercourse and no potency problems. He had this arrangement with several women over the years, and, apart from this specific scenario, he was concerned and helpful to, though not in love with, these women. This patient presented a sadistic perversion at a neurotic level of personality organization and a personality structure with hysterical and obsessive features. Psychoanalytic exploration revealed that his perverse ritual protected him against underlying castration anxiety, frightening competition with a powerful and dominant father, and an unconscious sense of himself as a little boy who would not be able to gratify the idealized oedipal mother.
This is the case of a woman in her early forties with a depressive-masochistic personality structure, in a late stage of her psychoanalytic treatment, during the course of which she was able to resolve an incapacity to achieve orgasm in intercourse with her husband, after many years of marriage. In one session, she developed the fantasy in the transference that she would come to a session, undress totally, and I would be so impressed by her breasts and her genitals that I would become a complete slave to her desire, respond by getting sexually excited and having intercourse with her, and she, in turn, would then be willing to become my slave and leave everything to follow me.
The only daughter of a dominant, prohibitive mother who was intolerant of any sexual manifestations in her daughter, and of a warm yet distant father who spent time away during extended periods of her childhood, she became immediately aware of the connections between her wish for a sexual relation with me and the rebellion against mother implied in the wish to seduce father away from her. To make me her slave combined the wishes for my full acceptance of her genitals and her sexuality, while punishing me for having preferred other women (her mother), and offering herself in turn for slavery to expiate her guilt. But she also experienced the enactment of the slavery fantasy as an exciting expression of aggression without having to fear its inhibiting effects on her sexual pleasure. To the contrary, she felt that this aggression would heighten the gratification of total intimacy and fusion in the reciprocity of slave and master involvement. Following that session, she was able to ask her husband, for the first time, in the middle of sexual intercourse, to pinch her nipples forcefully, which he did with intense sexual excitement, permitting her, in turn, to scratch his back deeply, so that he bled, and both, for the first time, reached an intense orgasm together.
In analyzing this experience, she expressed the fantasy that her husband was like a hungry, frustrated infant biting mother's breasts, and she, as mother, could gratify his needs while tolerating his aggression, that is, a powerful, understanding, and giving mother. At the same time, she felt, she was also a sexual woman relating to her husband-infant who thus was not a threatening father, and yet taking revenge against father who had abandoned her as well as against her husband himself, who had caused her pain, by causing him in turn to bleed. And she felt that to scratch him while embracing him tightly intensified their fusion and her sense that she could participate in his orgasm while he could participate in hers. The case of this patient, approaching completion of her analysis, illustrates important normal facets of sexual excitement, to be specified further on.
The Spectrum of Sadomasochism
In summarizing my view of the dynamic and genetic aspects of sadomasochism as a perversion (1989), I pointed out that, in contrast to the traditional relegation of polymorphous perverse features as appropriate merely to sexual foreplay, I consider them a crucial aspect of normal sexuality. These polymorphous perverse features emerge in many unconscious and conscious fantasies regarding sexual intercourse, and in the general erotic and emotional interactions of the sexual couple. Organized perversions at a neurotic level of personality organization do present, in both sexes, the psychodynamics originally proposed by Freud (1905), psychodynamics centering on the fixation at a partial, component drive in defense against full genital sexuality with its oedipal implications, the threat of incest, and castration anxiety.
What is striking about sadism and masochism and, in practice, the various combinations of these complementary sexual orientations, is that sadomasochistic elements can be found not only along the entire spectrum from normality to severe psychopathology, but as an essential component of all other perverse elements of sexuality. Thus, in voyeurism, exhibitionism, fetishism, bestiality, homosexuality, transvestism, we clinically always find sadomasochistic elements, and a careful study of the entire literature points to the indissoluble connection between sadomasochism and sexuality in general. Stoller (1985) has pointed to the universal nature of aggression as an aspect of sexual excitement, but has also stated that "when present, it is often a whisper, not a roar, and only a part, not the whole" (p. 42).
Cases of stable perversion and borderline personality organization, in contrast to perversions at a neurotic level of personality organization, typically present the dynamics described by British and French authors (Chasseguet-Smirgel, 1985a), (1986); (McDougall, 1978); (Meltzer, 1973), and they show the same condensation of oedipal and preoedipal conflicts under the dominance of preoedipal aggression characteristic of borderline personality organization itself. This condensation includes a regressive primitivization of the oedipal conflict, characterized by extremely primitive and threatening images of both parents, threatening combined father-mother images, and regressive distortions of unconscious perceptions of the functions of the genitals and the primal scene. It is clinically very different from the defensive regression to preoedipal stages of development found in patients with neurotic personality organization. Patients whose polymorphous perverse features are totally inhibited not because of repression, but from lack of activation of early eroticism (that is, some extremely inhibited borderline but not hysterical patients) present the same borderline dynamics. Their sexual inhibitions are the most severe that we encounter in clinical practice.
Sexual perversions in the narcissistic personality structure, particularly in malignant narcissism, show the psychodynamic constellations outlined by Chasseguet-Smirgel (1985a), (1985b), (1986). The full deployment of a regressive "anal universe" described by her overlaps the syndrome of malignant narcissism plus an organized perversion. The primitive destruction in unconscious fantasy of the contents of mother's belly as part of a general intolerance of reality, of the differentiation of sex and ages, and of the acknowledgment of the oedipal father, with a consequent severe disturbance in cognitive processes as well, are typical for the most severe of these cases of perversion in narcissistic personalities.
The cases I have described illustrate an additional aspect of my clinical experience, namely, that, while sadomasochism as an organized perversion (like all organized perversions) is probably more frequent in men (Money, 1988), I have found that sadomasochistic fantasies are probalbly more frequent in women, particularly in their masturbation fantasies.
The most prevalent psychoanalytic view about this apparent predominance of organized perversion in men links it with a greater intensity of castration anxiety in men. This seems a reasonable hypothesis, and I would suggest the possibility that, in addition, the differences in the sexual development of men and women play a role.
It seems reasonable to assume that the psychosexual disturbances related to early oedipal and preoedipal conflicts are played out more directly in boys' genital sexual life, and more diffusely in vicissitudes of the little girl's emotional involvements, particularly with father. Braunschweig and Fain's (1971) formulations regarding the differential early development of boys and girls, which I shall spell out later on, may be relevant to this issue.
Sadomasochism, I believe, starts out as the potential for erotic masochism梖or sexual excitement with pain梚n both sexes, and constitutes a very early capability to link aggression with the libidinal elements of sexual excitement in an essential way, thus paving the road toward the entire spectrum of sadomasochism at all levels of development and pathology. In light of clinical experience, it seems reasonable to assume that the experience of severe pain may intensify the attachment to the representation of the inflicter of pain, and bring about both a transformation of pain experienced into very early forms of aggression, and varying degrees of erotization of that painful experience and its aggressive elements. It is as if sexuality had, as one of its functions, the neutralization of aggression by incorporating it into the very fabric of sexual excitement. The unconscious identification with the aggressor linked with the erotization of pain facilitates a sexualization of primitive omnipotence, a primitive condensation of love and hatred that may proceed in several directions.
The profound sexual excitement and gratification derived from the expression of sadomasochistic impulses in the context of a sexually gratifying relationship points to the fundamental need to integrate love and hatred while assuring the dominance of love. Sexual excitement, in this regard, may be considered a basic affect that permits overcoming primitive splitting of love and hatred, and tolerating ambivalence. Hatred, we might say, is "coopted" by love. As the counterpart of this progressive development, under extremely pathological circumstances, the loving, affectionate aspects of sexual excitement may be recruited by the aggressive elements, leading to perversity, the malignant recruitment of love at the service of aggression, illustrated in Case 2, above.
Clinical Characteristics of Sexual Excitement and Erotic Desire
Let us now examine the characteristics of sexual excitement as we encounter them through psychoanalytic exploration. First, sexual excitement is an affect. It would seem trivial to state this, were it not that sexual excitement is so regularly left out of the studies of affect in the psychoanalytic, neuropsychological, developmental, and physiological literature. It has only been in recent years that psychoanalytic studies of sexual excitement in early development have been carried out, particularly by Stoller (1979), (1985) in this country, and Braunschweig and Fain (1971), (1975) in France. Not surprisingly, we find phenomenological descriptions of sexual excitement in literary essays, poetry, and philosophy; Bataille (1957), Singer (1973), and Scruton (1985) provide detailed descriptions of its psychological, subjective aspects.
Affect can be defined as a subjective experience of a pleasurable or painful nature, with physiological concomitants of that experience (both in characteristic psychomotor manifestations and neurovegetative phenomena), cognitive aspects of that subjective state consistently involving a relationship between self and other under the impact of that experience, and a communicative function conveyed by expressive, particularly facial, movements. Sexual excitement fulfills all these requirements.
It is customary to differentiate sexual excitement he diffuse activation of the sexual affect rom erotic desire concrete direction of that affect toward a particular object nd from love he integration of erotic desire with the complex affects implied in a tender, loving relationship. Insofar as erotic desire expresses a highly individualized wish for a sexual relationship with a particular object, it may indeed be differentiated from sexual excitement per se, but not because sexual excitement is objectless. In sexual excitement, similarly to other affects, an object is present, but it is not yet the fully crystallized object of the specific unconscious wish that characterizes erotic desire; it is, rather, a primitive part-object unconsciously reflecting the fusional experiences of symbiosis and merger wishes of early separation-individuation. In its origins, in the first few years of life, sexual excitement is diffuse, and dominantly linked to the object-related implications of the functions of erogenous zones. In contrast, in erotic desire the affect is more elaborated and the specific nature of the object relation is cognitively more differentiated. Erotic desire, in short, is a more mature form of sexual excitement. This may be a minor point, but I wish to stress that, in clinical practice, similarly to what characterizes other affects, we never find sexual excitement without an implied, conscious or unconscious object relation activated in the context of that affect.
This discussion relates to Freud's (1905) description of libido as a drive, originating in the stimulation of the erogenous zones, characterized by a particular aim and an object. In my view, libido originates in primitive affect states, including the peak affect state of elation characterizing the early infant-mother relation and characteristic of symbiotic experience and fantasy. Affectionate, and generally pleasurable, experiences with mother under ordinary, quiescent states are also integrated into libidinal strivings. Sexual excitement is a later and more differentiated affect; it enters as a crucial component of libido as a drive, but the origin of sexual excitement as an affect resides in the integration of multizonal erogenous excitement. Insofar as sexual excitement as an affect involves the total field of psychic experience, it is not limited to the stimulation of any particular erogenous zones, but generalizes pleasurable sensations to the entire body.
Sexual excitement also includes the erotic experience of painful stimulation and, at an unconscious level, the activation of unconscious fusion experiences under the sign of peak negative affect states. I believe that the affect of sexual excitement is the core element of libido, and that, while libido originates in pleasurable peak-affect experiences he affect of elation in the relation with mother (Kernberg, in press), this elation gradually takes on the characteristics of sexual excitement as a later, more complex affect state.
To highlight that we never find sexual excitement that does not have the implication of a conscious or unconscious object choice, I shall talk about erotic desire as the higher-level affect of which sexual excitement may be considered the precursor. What are the clinical characteristics of erotic desire as uncovered by psychoanalytic exploration?
A first characteristic of erotic desire is a search for pleasure always oriented to another person, an object to be penetrated or invaded or to be penetrated or invaded by. It is a longing for closeness, fusion, and for intermingling that has a quality both of a forceful crossing of a barrier and becoming one with the other person. The concrete sexual fantasies refer to invasion, penetration, or appropriation, and include, at the level of conscious or unconscious fantasy, the relations between bodily protrusions and bodily openings: penis, nipple, tongue, finger, feces on the penetrating or invasive site, and vagina, mouth, anus, on the receptive or encompassing site. The rhythmic stimulation of these bodily zones promises erotic pleasure, but that pleasure loses its gratifying quality when it does not serve the broader function of intermingling with an object. "Container" and "contained" are not to be confused with masculine and feminine, active and passive; we find fantasies of active incorporation and being penetrated passively together with fantasies of active penetration and being incorporated passively. Psychological bisexuality in the sense of the identification with both self and object in the specific sexual interaction is universal for men and women. One might say that bisexuality is first of all a function of identification with both participants of a sexual relation, or with all three in the triangulation of sexual experience.
A second characteristic of erotic desire is gratification from identification with the other sex, more precisely, with the sexual excitement and orgasm of the sexual partner, with a condensation of two complementary experiences of fusion. The first element here is the pleasure derived from the desire of the other, the love expressed in the other's response to the sexual desire of the self, and the associated experience of fusion in ecstasy. Together with this is the sense of becoming both sexes at the same time, of overcoming temporarily that ordinarily unbreachable barrier separating the sexes, with a sense of completion and enjoyment of the penetrating and encompassing, penetrated and enclosed aspect of sexual invasion. In this connection, a symbolic displacement of all "penetrating" parts of the anatomy among each other, and of all "encompassing" or "penetrable" openings on the other signal the condensation of eroticism from all zones, a normal regression in sexual excitement to "zonal confusion" (Meltzer, 1973), and the consequent confluence, in each concrete sexual activity or contact, of fantasies and experiences reflecting the entire body surface of both participants. In this identification with the other there is a gratification of the wish for fusion, of homosexual longings, and also of oedipal rivalry in that, by implication, all other relationships disappear in contrast to the unique and fused one of the sexual pair. By the same token, unconsciously identifying with both sexes eliminates the need to envy the other sex. In remaining oneself while becoming the other as well, there is a sense of achievement of intersubjective transcendence.
A third characteristic of erotic desire is a sense of transgression, of overcoming the prohibitions implied in all sexual encounters, a prohibition derived from the oedipal structuring of sexual life. This sense of transgression takes many forms. The simplest and most universal is the transgression against conventional morality, the ordinary social constraints that protect the intimacy of body surfaces as well as the intimacy of sexual excitement from public display. Stendhal (1822) pointed out that the very act of undressing repeals social notions of shame and permits lovers to face each other in a shameless way; getting dressed after the sexual encounter is a return to conventional shamefulness. Within the frame of conventional morality (Kernberg, 1987), there is a consistent tendency to suppress or regulate those aspects of sexual encounter most directly related to infantile polymorphous sexual aims; it is these aims, prototypically framed in the sexual perversions, that express most directly sexual excitement and erotic intimacy and the transgression of social conventions.
In a deeper sense, transgression includes transgressing oedipal prohibitions against sexual intimacy with the oedipal parent of the other sex, thus constituting a defiance of as well as a triumph over the oedipal rival. But transgression also includes transgression against the sexual object itself experienced as seductively teasing and withholding. Sexual excitement involves a sense that the object is both offering and withholding itself, and sexual penetration or engulfing of the object is a violation of the latter's boundaries. In this sense, transgression involves aggression against the object, aggression that is exciting in its pleasurable gratification, reverberating with the capacity to experience pleasure in pain and the projection of that capacity onto the object. The aggression is also pleasurable because it is being contained by a loving relationship. And so we have the incorporation of aggression into love and the assurance of safety in the face of unavoidable ambivalence.
The ecstatic and aggressive aspect of the search for loss of boundaries of the self represents a related deep and complex aspect of erotic desire. Bataille (1957) proposed that the most intense experiences of transcendence occur under the sign of love and under the sign of aggression. It is one of the most dramatic aspects of human functioning that the breakdown of boundaries between self and other occurs at points of deepest regression into ecstatic love and under conditions of extreme pain. The intimacy that develops between torturer and tortured, and its dramatic effects on the psychic experience of both participants, may well originate in the most primitive, ordinarily dissociated or repressed, awareness of fused, "all-bad" relations between self and object, which constitute the counterpart of the split-off "all-good" object in the symbiotic stage of development.
Setting aside the question of whether the symbiotic stage (Mahler and Furer, 1968) is the first stage of development of internalized object relations, or whether, as Stern (1985) proposes, it is a later and perhaps only limited or pathological development, sexual excitement and orgasm facilitate an experience of fusion with the other that provides an ultimate sense of fulfillment, of transcending the limits of the self. They also facilitate, in one stroke, a sense of oneness with the biological aspects of personal experience. By the same token, however, to be the object of pain induced by another, and to identify with the aggressive object as well as experiencing oneself as its victim creates a sense of union in pain that reinforces the fusion in love. To induce pain in the other, and to identify with the erotic pleasure in pain of the other, is the counterpart of erotic masochism. Sexual excitement, in this regard, also includes an element of surrender, of accepting a state of enslavement to the other as well as being master of the other's fate. The last of the cases I briefly mentioned illustrates this aspect of sexual excitement. The extent to which this aggressive fusion will be contained by love is importantly mediated by the superego, the guardian of the frame of love containing aggression. In short, both in pleasure and in pain there is a search for a peak affect experience that, temporarily, erases the boundaries of the self, a peak affect experience that gives a fundamental meaning to life, a transcendence that links sexual engagement with religious ecstasy and the experience of freedom beyond the boundary control of daily existence.
The idealization of the body of the other or the objects that symbolically represent that body are an essential aspect of sexual excitement. Lussier (1982) and Chasseguet-Smirgel (1985b) have pointed to the central function of idealization in, respectively, fetishism and perversion in general. This idealization represents the denial of anal regression in perversion, and the denial of castration anxiety by idealizing a partial, safer, limited aspect of sexual behavior. While I agree with the important function of idealization as a mechanism in pathology, I also believe (1989) that the idealization of the sexual partner's anatomy, the surface of his or her body, is a crucial aspect of the normal integration of tender and erotic strivings in both heterosexual and homosexual love relations. This erotic idealization parallels the normal idealization processes in romantic love described by Chasseguet-Smirgel (1985a), namely, the projection of the ego ideal onto the loved object with a simultaneous increase in self-esteem.
The replication of the ego ideal in the form of the idealized love object creates a sense of harmony in the world, the actualization of one's value system and aesthetic ideals: morality and beauty are actualized in the love relation. Meltzer and Williams (1988) have proposed the existence of an early "esthetic conflict" linked to the infant's attitude to mother's body. The infant's love for mother, in this view, is expressed in the idealization of the surface of her body and, by introjection of the mother's love expressed in the idealization of the infant's body, an identification with her in this self-idealization. This idealization would give rise to the earliest sense of esthetic value, of beauty.
Following Meltzer and Williams, the split-off aggression toward mother would, in contrast, be directed mainly toward the inside of her body, and, by projection, in experiencing the inside of mother's body as dangerous. From this viewpoint, the desire and fantasy of violent invasion of mother's body is an expression of aggression, of envy of her outside beauty as well as of her capacity to give life and love, and the idealization of mother's bodily surfaces, a defense against the dangerous aggression lurking under that surface. The origin of the idealization of woman's body on the part of men is consistently traceable to the idealization of and excitement with the surface of mother's body, similarly to the origins of the unconscious fears linked to the vagina and the interior of women's bodies.
Chasseguet-Smirgel's (1986) contribution to the archaic aspects of the Oedipus complex (the fantasied destruction of the differentiated organs of mother's body, of father's penis, and father's babies; and the transformation of mother's inside into an infinite, limitless cavity) is an important clarification of the nature of primitive aggression and fears directed to the interior of mother's body. Also, in men, the idealization of the body parts of homosexual partners can regularly be traced back to the idealization of mother's body. The idealization of male body parts is originally much less prominent in women, but this capacity develops in the context of a gratifying sexual relation with a man, who unconsciously represents the oedipal father in reaffirming a woman's body's beauty and value and thus liberates her genital sexuality from its early infantile inhibition. In both sexes, the integration of the tender and erotic elements of object relations provides more depth and complexity to the idealization of body surfaces as well.
The body of the beloved becomes a geography of personal meanings, so that the fantasied early polymorphous perverse relations to the parental objects are condensed with the admiring and invasive relation to the lover's body parts. Erotic desire is rooted in the pleasure of unconscious enacting polymorphous perverse fantasies and activities, including the symbolic activation of the earliest object relations of the infant with mother, and of the small child with both parents. All of this is expressed in the perverse components of sexual play and intercourse fellatio, cunnilingus, anal penetration, and in exhibitionistic, voyeuristic, and sadistic sexual play. Here the deep links between the early relation with mother in both sexes and the enjoyment of the interpenetration of bodily surfaces, protuberances, and cavities are central. Mother's physical ministrations of the infant activate the erotic awareness of his or her own body surfaces, and, by projection, the erotic awareness of the body surfaces of mother. Love received in the form of erotic stimulation of body surfaces becomes the stimulus for erotic desire as a vehicle for the expression of love and gratitude.
A woman who loves a man will become erotically aroused with intimate aspects of his anatomy, and, characteristically, if that love ends, her interest in and the idealization of that body will become extinguished. Correspondingly, in narcissistic men who give the appearance of rapidly losing their interest in previously idealized aspects of a woman's body will be able to maintain that interest if and when, as a consequence of psychoanalytic treatment, the unconscious deterioration of internalized object relations (typically related to profound envy of women) can be resolved. I am suggesting that, in both sexes, and despite differences related to the different history of their sexual development, idealization of body surfaces, the central aspect of erotic desire, is a function of the availability of primitive internalized object relations. And the personal history of a love relation becomes symbolically inscribed in aspects of the beloved object's anatomy.
The lack of activation or the extinction of body-surface eroticism, when intense aggression and a parallel lack of pleasurable body-surface stimulation combine in such a way as to interfere with the development of early idealization processes as part of erotic stimulation, determine a primary sexual inhibition. Such an inhibition is illustrated in the case of the woman whose intense transference love was connected with the wish that I kill her (Case 3). The secondary repression of sexual excitement linked to later superego functioning and later oedipal prohibitions is much less severe and has a much better prognosis in treatment.
The wish for teasing and for being teased is another central aspect of erotic desire. This wish cannot be completely separated from the excitement stemming from overcoming the barrier of something forbidden, and hence experienced as "sinful" or "amoral." The sexual object is always, in a profound sense, a forbidden oedipal object, and the sexual act a symbolic repetition and overcoming of the primal scene. But here I am stressing the object's self-withholding, teasing as a combination of promise and withholding, of seductiveness and frustration. A naked body may be sexually stimulating, but a body partially hidden becomes much more so. There are good reasons why complete nudity at the end of strip-tease shows is followed by a rapid exit.
Sexual teasing is typically though not exclusively linked to exhibitionistic teasing, and illustrates the intimate connection between exhibitionism and sadism. By the same token, voyeurism is the simplest response to exhibitionistic teasing, and implies a sadistic penetration of an object that withholds itself. As with the other perversions, it is characteristic that exhibitionistic perversion is a typical sexual deviation of men whereas exhibitionistic behavior is much more frequently interwoven with the character style of women. Psychoanalytic interpretations of female exhibitionism as a reaction formation to penis envy need be amended to incorporate our more recent awareness of the complex step the little girl undertakes in shifting her object choice from mother to father: exhibitionism is a plea for sexual affirmation at a distance. Father's love and acceptance of his little girl and her vaginal genitality reconfirms her feminine identity and self-acceptance (Paulina Kernberg, personal communication).
The experience of women's sexuality as both exhibitionistic and withholding, that is, as teasing, is a most powerful stimulus to erotic desire in men. And it is also a source of aggression, a motive for the aggressive implication of the invasion of a woman's body, a source of the voyeuristic aspects of the sexual relation that contain the wish to dominate, expose, and to encounter and overcome barriers of true and false shamefulness in the woman who is loved. Overcoming shamefulness is not the same as humiliation; the desire to humiliate usually includes a third party, a witness to the humiliation, and implies a greater degree of aggression, which threatens the capacity for an exclusive sexual object relation, as in Case 2.
The voyeuristic impulse to observe a couple in sexual intercourset a symbolic level, to violently penetrate the primal scenes a condensation of the wish to penetrate the privacy and the secrecy of the oedipal couple and to take revenge against the teasing mother. Voyeurism is an important component of sexual excitement in the sense that every sexual intimacy implies an element of privacy and secrecy and, as such, an identification with the parents and a potential triumph over them. The frequent symptom of many couples who cannot have enjoyable sex in their own home, in the relative proximity of their children, and can only permit themselves a free sexual life in a secluded area elsewhere, illustrates their inhibition of this normal aspect of sexual intimacy.
Which leads us to one more aspect of erotic desire, namely, the oscillation between the search for secrecy, intimacy, exclusiveness in the relation, on the one hand, and for a radical discontinuity, for shifting away from sexual intimacy, on the other. The conventional cliche of our society at this time is that it is women who want to maintain intimacy and continuity in love relationships beyond their sexual implication and that men dissociate themselves from intimacy following sexual gratification and orgasm. This assumption does not take into consideration the differences in development in male and female sexuality, and confuses the early stages of male development with mature development in both sexes. In clinical practice, we see as many husbands whose dependent longings are frustrated by their perception of their wives' affectionate dedication to their infants and small children, as we see women complaining about their husbands' failure to maintain sexual interest in them.
While it is true that there are different types of sexual discontinuity in men and women, the very fact of discontinuity in sexual involvement and repeated disengagements even within a continuous loving relationship is an important counterpart to secrecy, intimacy, and fusional aspects of erotic desire and behavior. In fact, the loss of this discontinuity, a sexual relation that merges with ordinary life and replaces it, may well create an accumulation of aggressive elements of fusional experiences that ends up threatening the entire relationship. The Japanese film "In the Realm of the Senses" by Nagisa Oshima illustrates the gradual deterioration into unbridled aggression of the relationship of two lovers whose sexual encounter becomes all-consuming, eliminating in the process their relation with the external world.
That erotic desire and sexual love should absorb and express all aspects of ordinary ambivalence of intimate object relations is quite obvious. The intensity of affectionate, tender, polymorphous pervers nd particularly sadomasochistic梖eatures of the sexual relation reflect the elaboration of this ambivalence, and constitute a basic cement of love relations. But in a more specific way, that ambivalence is illustrated by what, in earlier work (1988b), I have described as the direct and reverse triangulation of sexual relations, in essence, the unconscious and conscious fantasies accompanying erotic desire and sexual intercourse. These fantasies typically include for each of the sexual partners (a) an excluded but threatening third party (the oedipal rival) and (b) an idealized though unavailable third party, the original object of the positive oedipal conflict. The wish to be the unique, preferred, triumphant, exclusive love object of one's sexual partner, with actualized triumphs over the oedipal rival in each sexual encounter (direct triangulation) is the counterpart of that other desire (of reverse triangulation) in which one is involved with two sexual partners of the opposite sex, in revenge against the frustrating, teasing, denied oedipal parent.
These advanced oedipal dynamics are the counterpart to their primitive precursors, in which deep ambivalence toward mother and elimination of the primitive father bring about the threat of a fusion in aggression with destruction of the loved object, the counterpart to the idyllic world of ecstatic fusion with the idealized primitive mother. Bataille (1957), in a different context, has described the dynamic of sexual ecstasy and religious exaltation, on the one hand, and their aggressive counterparts of sacrilege and sacrifice, on the other.
Genetic Aspects of Sexual Excitement and Erotic Desire
Throughout the discussion of all these components of sexual excitement and erotic desire I have referred to some of their genetic roots. Braunschweig and Fain (1971), (1975) have developed an appealing theory of the characteristics of erotic desire in terms of the early development of the infant's and small child's relation to mother. To briefly summarize their viewpoint: the early relationship of the infant of both sexes with mother determines the child's later capacity for sexual excitement and erotic desire. Mother's ministrations and her expression of enjoyment in the physical stimulation of the male infant's body surface, while emotionally communicating her love for him, foster the infant's erotic desire, but also the infant's identification with mother both under such stimulation and under conditions of discontinuity established by mother's leaving the infant to return as a sexual woman to father. In relating to mother in father's presence, infants realize that mother's attitude is not quite the same as in his absence (Paulina Kernberg, personal communication).
Braunschweig and Fain attribute a crucial role to the mother's psychological turning away from the infant; they contrast mother's erotic stimulation of her male infant with the discontinuity established by her withdrawing her erotic interest from him and returning it to her husband. It is at this moment that the infant identifies himself with the frustrating yet stimulating mother, with her erotic stimulation and with the erotic stimulation of the sexual couple, that is, father as mother's object. This identification of the infant with the two members of the oedipal couple would provide the basic frame for a psychic bisexuality, and consolidate the triangular situation in the child's unconscious fantasy.
The male infant's acknowledgment of this frustration and of the implicit censorship of his erotic desire for mother would then shift his erotic stimulation into masturbatory fantasy and activity, including the desire to replace father and, in primitive symbolic fantasy, to become the father's penis and the object of mother's desire.
In the case of the little girl, mother's subtle and unconscious rejection of the sexual excitement which she would freely experience in relation to the little boy gradually inhibits the little girl's direct awareness of the original vaginal genitality; she would therefore gradually become less aware of her own genital impulses while being less directly frustrated by the discontinuity in the relation with mother. The identification with mother's eroticism would take more subtle forms, derived from mother's tolerance and fostering of the little girl's identification with her in other areas. With a tacit understanding of the "underground" nature of her own genitality, the little girl's deepening identification with mother would also strengthen her longing for father, and her identification with both members of the oedipal couple.
The little girl's change of object from mother to father determines her capability for developing an object relation in depth with the loved and admired and yet distant father, and the secret hope of eventually being accepted by him and of becoming free once more in the expression of her genital sexuality. This development fosters the little girl's capacity to commit herself emotionally to an object relationship that determines the woman's greater capacity for such a commitment in her sexual life, from early on, than is the case with men.
The explanation resides in the early exercise of trust, in the little girl's turning from mother to father, in his love and affirmation of her femininity "from a distance," also, in her capacity to transfer her dependency needs to an object physically less available than mother, and also, by the same change of object, the escape from preoedipal conflicts and ambivalence toward mother. Men, whose continuity of the relationship from mother to later female objects signifies potential perpetuation of both preoedipal and oedipal conflicts with mother, have greater difficulties in dealing with ambivalence toward women, and evince a slower development than women in their capacity to integrate their genital with their tender needs. Women, in contrast, tend to develop their later capacity for a full genital relation in the context of their earlier capacity for a love relationship in depth with a man. In short, men and women develop in opposite order their capacity for full sexual enjoyment and an object relation in depth.
Braunschweig and Fain's theory, it seems to me, provides a new psychoanalytic approach to the observations of early genital masturbation in both sexes (Galenson and Roiphe, 1977), and to the clinical observations about the erotic aspects of mothers' reactions to their infants. The implications of their theory for our understanding of erotic desire are quite apparent: the relation between erotic desire and the wish for fusion as an expression of the symbiotic longings for mother (Bergmann, 1971); the search for the teasing object, and the revengeful quality of the aggressive implications of sexual excitement; the polymorphous perverse quality of erotic desire as an expression of its origin in the earliest developmental stages; the different developments in male and female attitudes regarding genital and tender aspects of eroticism; the connection between sexualization of pain and the search for fusion in pain and the aggressive aspects of erotic desire; psychic bisexuality; the unconscious conflicts over an "excluded third party"; and the differential discontinuity regarding sexual relations.
Sadomasochism and Perversion
In the light of everything said so far, it seems reasonable to conclude that sadomasochism is an essential aspect of sexual excitement and erotic desire. It is crucially and intimately connected with the original libidinal aspects of body-surface stimulation in the context of the affectionate relation with mother, the idealization of body surfaces and openings representing the ideal object. Sadomasochism incorporates the aggressive impulses triggered in the context of frustration by that ideal object.
Sadism and masochism, I believe, enter into all aspects of libidinal, and its specialized sexual development; they are part of all other "partial drives," and reflect the integration of love and hatred at the basic level of sexual love.
I would now reformulate the concept of sexual excitement as a primitive affect in which objects are still partial and unrealistic, dependent largely on the unconscious fantasy activated in fusional states; erotic desire represents the organization of these primitive objects into the archaic oedipal constellation. Sexual love represents a further integration of erotic desire with an object relation in depth that contains the ambivalence of specific past relationships with parental objects. Sexual love also implies a mutuality in the reciprocal reinforcement of the ego ideal of the couple and the mutual neutralization of the remnants of the sexually prohibitive infantile superego.
Insofar as sexual excitement, its sadomasochistic elements, and its early object relations are indissolubly linked, it is this affect itself that may be considered a basic building block of libido as a drive. Erotic desire is expressed by the "embodied self" (Scruton, 1985) in which the physiology of sexual arousal and the psychology of desire for another person become condensed. Erotic desire aspires to recreate, in an intense pleasurable relation, the peak affect state that reproduces symbiosis, synthesizes love and hatred under the dominance of love, and permits the expression of sadomasochism as an unconventional, asocial, private, secret, intimate reconstitution of triumph over the oedipal couple in the primal scene.
To be willing to suffer for the sake of the loved object, and to demand that the loved object suffer in response to one's own desire is an expression of trust and an acknowledgment of the sadistic, aggressive aspect of love. We often find patients with perversion insisting that there is an honesty in perversion not contained in ordinary sexual relations; this defensive idealization contains a grain of truth (McDougall, 1978). The sadistic and masochistic aspects of erotic desire and of sexual relations provide the impetus for overcoming the barriers of social convention, moralistic prohibitions, disgust, and particularly shame, and thus express the couple's freedom from the restrictive nature of conventional morality. That freedom opens the road to a full gamut of sexual pleasure but also the danger of aggression unbound as part of the sexual relationship. The search for symbiosis in ecstatic love has deep connections with the search for symbiosis in pain: a temptation to sacrifice and destroy.
Normal sexual excitement and erotic desire present all the elements characteristic of perversion, such as idealization, regressive analization and regressive cannibalism in the form of the fantasied destruction of the interior of mother's body. What becomes specific of the perversions is the restriction of erotic desire because of oedipal prohibition and threat of castration in higher-level functioning patients, and its primitive counterpart, the threat of diffuse destructiveness and loss of capacity for differentiated relations with a sexual object in the more severe spectrum of psychopathology.
To conclude, I would like to point to the peculiar transference implications of the sadomasochistic aspects of sexual conflicts. In the case of true sadomasochistic perversion, as in all perversions, the danger exists of "as-if" developments in the transference, an imitative way of learning in the treatment that reflects the illusion of the "fecal penis" as a false representation of the true oedipal world (Chasseguet-Smirgel, 1985b). In patients with severe sadomasochistic acting out, the analyst's concern and the limits to the analyst's position of technical neutrality may become a signficant issue. It is in the mildest or less severe cases where, paradoxically, limitations to analytic work often evolve by the enactment of sadomasochistic implications of the analytic situation itself.
Insofar as powerful erotic currents are activated in the analytic relationship, the analyst cannot but "tease" the patient with an implicit seductiveness derived from the nonrepressive nature of the psychoanalytic situation. There is no other relation in which the free communication with the symbolic oedipal object spells out in such richness the essential nature of erotic desire and sexual excitement. To share with the analyst the most intimate sexual fantasies, experiences, and fears may tempt to exhibitionistic acting out, but also to masochistic "shameful" submission. Efforts to free the patient's sexual life from these defensive and inhibitory forces generates, under optimal circumstances, powerful erotic currents that need to be contained in an atmosphere of technical neutrality.
It would be trivial to state these well-known facts if, in clinical practice, we did not find so often the temptation to maintain the most intimate and secret aspects of erotic desire, typically those that contain sadomasochistic elements, at least partially hidden from analytic exploration. To help the patient achieve sexual freedom without fostering a seductive analytic atmosphere, to help the patient become aware of our respect for him while analyzing his distortions of the meaning of our lack of sexual response to him, is an important daily task in analytic work which is highlighted with patients presenting significant conflicts in the area of sadomasochism. Severe sexual inhibition, indifference, and boredom typically reveal deep conflicts around the sadomasochistic aspects of sexual excitement: the enormous frequency of these symptoms in analytic practice points to the importance of the analyst's internal freedom in dealing with these basic aspects of human sexuality.
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