Gender and perversion – what constitutes a “Bad Mother”

Summary Background: There is a need for reconsidering the conceptualisations of female perverse behavior, especially in connection with motherhood. Methods and findings: Based on case material obtained through psychoanalytic psychotherapy with female patients from a psychosomatic gynecological outpatient clinic, the characteristics of the psychic structure of these patients who presented symptoms of deliberate self harm and of misusing and mistreating their children, are outlined. Another common trait is the embeddedness of their perverse behavior in a generational chain of transmission. Female patients who mistreat their children had been victims of traumatising experiences in their own biography, inflicted by their mothers and directed towards their bodies. Discussion: Female perverse behavior, therefore, is fundamentally different from male perversion: the perverse act in women is aimed against themselves and/or their children. Currently used diagnostic statistical manuals lack categories to describe this symptomatology adequately. Further research is requested to understand a mother's perverse actions and thus develop treatment strategies, without marginalizing these patients. Accepted October 6, 2002; Published online December 9, 2002 Correspondence: o. Univ. Prof. Dr. Marianne Springer-Kremser Departement of Psychoanalysis and Psychotherapy, University of Vienna Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria; e-mail: marianne.springer-kremser@akh-wien.ac.at     

GOVERNMENT AND THE PERVERSE SOCIAL DEFENCE

Part of Isabel Menzies Lyth's legacy is the concept of social defence. This article examines the perverse social defence, recently hypothesized by Susan Long, and deploys the concept in a critical exploration of aspects of the modernization of the public services in the UK. It is argued that the ‘targets and indicators’ culture constitutes a perverse defence which fosters the development of an as if relationship between government and reality. The article explores the damaging impact of this defence upon the capacity of government and society to stay in touch with the suffering generated by increasing social inequalities.     

‘AND WHAT ROUGH BEAST …?’: PSYCHOANALYTIC THOUGHTS ON EVIL STATES OF MIND

ABSTRACT Evil is a concept traditionally alien to psychoanalytic discourse. Using a Kleinian framework it is argued that the term 'evil states of mind' usefully describes the experience of possession by a destructive personality suborganization founded on identification with a bad internal object. These states may be temporary and give rise to guilt and concern. In some cases, however, benevolent parts of the self are attacked and obliterated. The resulting loss is not experienced and mourned; instead perverse logic transforms it into a triumph. In this way the pain of loss and envy of the good possessed by others is denied, and psychic truth is replaced by perverse thinking in which good and bad are reversed. Satanic cults represent the pure organizational embodiment of the destructive subpersonality. Variants of evil states of mind are described with reference to psychotherapy patients and interviews with satanic cult members.     

Working with Problems of Perversion

Psychoanalytic psychotherapists increasingly find themselves treating patients who present with problems of compulsive sexual behaviour or sexual perversions. Drawing from clinical examples and theoretical perspectives, the author delineates six key themes which encapsulate her own learning when commencing work with perverse patients. The first is the heterogeneity of this group of patients, both in terms of symptoms and presentation, but also in terms of the depth and developmental implications of the pathology. Further themes are the patient's fear of the object and the inability to bear separation. The author explores the significance of negative countertransference which may be experienced in relation to perverse patients, as well as the risks of being drawn into exhibitionistic or voyeuristic dynamics. Finally, the nature of the superego in perverse patients and the impact of this on the transference are discussed drawing on O'Shaughnessy's notion of the abnormal superego.     

SARS流行期医科大学学生EPQ调查

目的　探讨面对突发医学事件 ,医科大学学生的个性变化 ,为医学生的思想教育、管理及教学提供心理学的依据。方法　在 SARS流行期间 ,我们采用艾森克个性问卷 EPQ对某医科大学 5个年级 5 0 0名学生进行了问卷调查 ,应用 SPSS软件进行分析。结果　 1医科大学学生 SARS期间情绪稳定、性格外向、倔强 ,讲求实际 ,同时纯朴、诚实。 2男同学比女同学倔强、讲求实际、固执 ,女同学比男同学更易于掩饰自己。 3来源于城市的同学和来源于农村的同学比较 ,来源于城市的同学更倔强、更讲求实际、更固执 ,来源于农村的同学相对更易于掩饰自己。结论　应针对医科大学学生的个性特征及其特定的文化背景 ,加强心理卫生健康教育。     

THE INHERENT SHAME OF SEXUALITY

ABSTRACT Despite a seemingly sexually liberated culture, sexuality is still disturbing. Freud's original emphasis on the importance of sexuality has largely been lost in much contemporary psychoanalysis, displaced by a focus on attachment. His intuition that sexuality and civilization are in some sense in conflict may have profound implications, throwing light on the nature and function of our linguistic culture and the fetishistic nature of human sexuality. Sexuality is the paradigmatic object of shame and repression, tending to incorporate all else that is repressed. Human beings may tend to long for experience that is unmediated by the linguistic - and this is the promise and the terror of sexuality.     

Sexuality and attachment from a clinical point of view

The clinical experience of five attachment-based psychoanalytic psychotherapists is pooled in an exploration of how issues in relation to sexuality and attachment emerge in the consulting room. Our clinical experience shows that sexuality, far from being a powerful instinctual drive that invariably needs to be explored clinically, is far more a reflection of early attachment histories. Instead of the standard pressure cooker of sexuality, which if not expressed leads to pathological emotional conflict we identify a melancholy sexuality, a cold arctic-like desert unwarmed by human relationship that barely achieves expression. We find that a broader and more fluid conception of sexuality as not just genitally focused but as erotic helps us relate to difficulties around sexuality as having to do with conflicts in relation to or associated with desire for contact and connection linked to past histories of loss, abandonment and sexual abuse. We argue theoretically that the psychological dimension of the biological system of human reproductive capacities, that is to say, the actually lived experience of human sexuality cannot be separated from the psychological dynamics of attachment within a social and cultural context. We discuss clinical issues including the sequelae of primary erotic attachments and working with sexual fantasies and working with erotic transference/countertransference re-enactments. A clinical example illustrates in some detail how we work with an adult survivor of sexual abuse troubled by intrusive sexual fantasies.     

Sexuality and attachment from a clinical point of view

The clinical experience of five attachment-based psychoanalytic psychotherapists is pooled in an exploration of how issues in relation to sexuality and attachment emerge in the consulting room. Our clinical experience shows that sexuality, far from being a powerful instinctual drive that invariably needs to be explored clinically, is far more a reflection of early attachment histories. Instead of the standard pressure cooker of sexuality, which if not expressed leads to pathological emotional conflict we identify a melancholy sexuality, a cold arctic-like desert unwarmed by human relationship that barely achieves expression. We find that a broader and more fluid conception of sexuality as not just genitally focused but as erotic helps us relate to difficulties around sexuality as having to do with conflicts in relation to or associated with desire for contact and connection linked to past histories of loss, abandonment and sexual abuse. We argue theoretically that the psychological dimension of the biological system of human reproductive capacities, that is to say, the actually lived experience of human sexuality cannot be separated from the psychological dynamics of attachment within a social and cultural context. We discuss clinical issues including the sequelae of primary erotic attachments and working with sexual fantasies and working with erotic transference/countertransference re-enactments. A clinical example illustrates in some detail how we work with an adult survivor of sexual abuse troubled by intrusive sexual fantasies.     

Mental health of Moroccan women, a sexual perspective

Sexuality is a complex process coordinated with neurological, vascular, and endocrine systems. It incorporates family, societal, and religious beliefs and interpersonal relationships. Sexuality in the Muslim world is further complexed by tradition and discrimination of women. Studies conducted in Ibn Rushd University Psychiatric Center, Casablanca, Morocco, explored various aspects of sexuality in a traditional Muslim society: sexual behaviour (representative sample of Casablanca population n=728), sexual dysfunction (n=644), prevalence of abuse during childhood, effect of breast removal on sexuality (prospective study on 100 patients), effect of menopause on sexuality (comparative study between Moroccan and Tunisian samples, n=200), pregnancy and sexuality (follow up study in primary health care, n=100), and Ramadan and sexuality among healthy fasting people.     

THE PERVERSE CORE AND ITS ROLE IN THE CROSSROADS BETWEEN SELF-REPRESENTATION AND CONFUSION

abstract    In our practice as psychoanalysts we frequently meet the perverse, and this may incorporate a range of pathologies. For example, borderline or psychotic structures are often associated with a sexualized and perverse use of the body. We discuss in the following clinical case study how sadistic sexual fantasies mingled with primal scene representation gave rise to persecutory anxieties, and how this blocked progress towards a resolution of the oedipal stage. It was at the point of intense psychic pain with a consequent fear of psychotic breakdown that the patient sought psychoanalytic help. We conclude that psychoanalytic treatment in such cases is likely to involve a deep regression, and that communication between the patient and the psychoanalyst will rely primarily upon a sharing of feelings and emotions.     

Sexuality after gynaecological cancer: A review of the material, intrapsychic, and discursive aspects of treatment on women's sexual-wellbeing

Research in the area of gynaecological cancer has increasingly examined changes to women's sexuality, with the impact of treatment on sexual wellbeing considered particularly important. The objective of this paper is to review research on gynaecological cancer and sexuality from the years 1990 to 2011. Research has documented a range of post-treatment anatomical and physical changes to women's sexual wellbeing, including changes to sexual desire, pleasure, orgasm, vaginal lubrication, genital sensitivity, arousal, and frequency of sex. Women's intrapsychic experiences of changes to sexuality include anxiety, depression, distress, and negative perceptions of sexual identity and body image. Socially constructed discourses surrounding gender and sexuality also shape women's experiences of their sexual wellbeing post-gynaecological cancer and treatment, with many women feeling a loss of womanhood and femininity with the removal of, or changes to, their reproductive organs. Finally, women's relationship context, pattern of couple communication, and partner support are associated with women's ability to cope with changes to sexuality post-gynaecological cancer. Given that sexuality is an important part of quality of life, it is important that health professionals actively communicate information to women and their partner about the effects of treatment on sexual wellbeing, in order to legitimate and normalise sexuality in this context. It is concluded that research in the area of gynaecological cancer and sexuality needs to acknowledge not only the physical/anatomical/material effects of cancer treatments, but also women's intrapsychic experiences of changes to sexuality, her relationship context, and the role of gendered discourses in shaping women's experiences of sexuality post-gynaecological cancer and treatment.     

"We have our own special language." Language, sexuality and HIV/AIDS: a case study of youth in an urban township in South Africa

Background

Despite the fact that most South African youth know about HIV / AIDS and how it can be prevented, there is a high prevalence of HIV / AIDS amongst youth in South Africa. Generally youth do not practice safe sex, and youth sexuality is characterised by multiple sexual partners, not using condoms and transactional sex.

Objectives

To minimize the risk of HIV infection, it is necessary to understand youth sexuality. In this paper I explore youth sexuality with a specific focus on how language influences sexuality.

Methods

I use discourse analysis and qualitative research techniques. Purposive sampling, a form of non-probability sampling was used. I interviewed seventy youth individually or in groups and used in-depth semi-structured interviews.

Results

The use of language influences youth sexuality. Youth have developed a specialised language to talk about sex and sexuality and this language has become part of the daily discourse, so that unsafe sexual practices become norms and are justified.

Conclusions

The realm of language can be a creative way for peer and HIV / AIDS educators to work with youth towards creating a healthier sexuality. However, as language always occurs in a material context, it is also necessary to work towards changing the material environment, such as poverty. This environment not only facilitates the development of a particular language but it also encourages unsafe sexual practices such as transactional sex.     

Ethics and social policy in research on the neuroscience of human sexuality

The potential benefits of neuroscientific research into sexuality are great, but neuroscientists must participate in debates over the social, forensic and therapeutic implications of their findings. If serious research in sexuality is to be supported by the public, researchers must continue to earn society's trust with responsible and thoughtful presentation of their work.     

A KLEINIAN THEORY OF SEXUALITY

abstract    The author examines claims made some years ago by Green (1995 ), but still referenced today by others, that the theoretical and clinical emphasis given by British Object Relations theorists – Balint, Fairbairn, Winnicott and especially Klein – to the pregenital dimension of the mother–infant relationship has reduced the importance of sexuality in psychoanalysis resulting in a desexualization of classical theory and practice. The author notes that, except for Parsons (2000 ) and Litowitz (2002 ), these charges have gone unchallenged and he wishes to contribute to this 'debate' by presenting a Kleinian theory of sexuality. Meltzer's (1973 ) book Sexual States of Mind will be used as a primer for such a theory since the explicit goal of this text is a structural revision of psychoanalytic sexual theory from an Object Relations perspective. Through Meltzer's concept of 'sexual states of mind', and his sub-theory of 'aesthetic reciprocity' as a theory of primal seduction, the author will demonstrate how the diverse features of infantile and adult sexuality are given a very detailed, comprehensive understanding within an Object Relations paradigm. In fact, if there has been a turning away from sexuality in psychoanalysis, as Green and others contend, it is not because of Object Relations theory but because of the great complexity brought to our understanding of sexuality by Object Relations paradigms. The author presents this paper as a tribute to Donald Meltzer who died in August 2004.     

Sexuality among infertile couples

A monographic type, bibliographic and hemerographic study on the sexuality in couples with fertility problems is presented. The study is based on the Rubio Aurioles' model of human sexuality, and the four holones (reproductivity, eroticism, affective bonds, gender) in couples with fertility problems are described. A review of clinical studies on the prevailing sexuality in this kind of couples and some theoretical reflections are also presented.     

Sexuality after breast cancer: A review

It is widely recognised that women's sexuality can be particularly complex after breast cancer, with sexual changes often becoming the most problematic aspect of a woman's life. The impact of such changes can last for many years after successful treatment, and can be associated with serious physical and emotional side-effects. The objective of this paper is to review research on breast cancer and sexuality from the years 1998 to 2010. Research has documented a range of physical changes to a woman's sexuality following breast cancer, including disturbances to sexual functioning, as well as disruptions to sexual arousal, lubrication, orgasm, sexual desire, and sexual pleasure, resulting from chemotherapy, chemically induced menopause, tamoxifen, and breast cancer surgery. Women's intrapsychic experience of changes to sexuality includes a fear of loss of fertility, negative body image, feelings of sexual unattractiveness, loss of femininity, depression and anxiety, as well as alterations to a sense of sexual self. The discursive construction of femininity and sexuality shapes the way women construct and experience their illness and their body – leading many women to try to appear ‘normal’ to others post-breast surgery. Finally, the quality of a woman's partnered relationship consistently predicts sexual health post-breast cancer – reinforcing the importance of recognising the intersubjective nature of issues surrounding breast cancer and sexuality. It is concluded that analyses of sexuality in the context of breast cancer cannot conceptualise the physical body separately from women's intrapsychic negotiation, her social and relational context, and the discursive constructions of sexuality and femininity: a material–discursive–intrapsychic interaction.     

Sexuality and intimacy after gynecological cancer

Matters of sexuality and intimacy greatly impact quality of life of patients with gynecologic cancers. Vast amount of evidence exists showing that cancer dramatically impacts woman's sexuality, sexual functioning, intimate relationships and sense of self. Sexual functioning can be affected by illness, pain, anxiety, anger, stressful circumstances and medications. There is a growing acknowledgement that these needs are not being appropriately addressed by providers.     

Reading Perversion

ABSTRACT. This paper argues that disavowal , the mechanism underlying perversion, is by its very nature self-contradictory and cannot be fully accounted for by either of Freud's psychical topographies. It is suggested that successive theorists have failed to solve this problem adequately, but have tended to discuss perversion in terms more appropriate to either neurosis or psychosis. This paper proposes that perversion displays a radically unique style of defence; it is described how this differs from repression in particular. Finally it is shown how analysis of the rhetoric of perverse fantasy can clarify the nature of this unique defensive strategy.     

Sexuality in the later years — the impact of health and body-image in a sample of older women

Research on sexuality in the elderly is still rather scarce. Quite often, there is an underlying assumption that health problems function as main constraints against sexuality in the later years. This article tries to challenge this view and proposes that health aspects tend to be — at least among women — quite overestimated. The data presented here are from a study on sexuality and ageing. Sixty West German women, born between 1907 and 1936 had been interviewed on their psychosexual development in the context of their life-histories. The results show that health variables are of rather little significance in explaining the development and/or maintenance of sexual interest and activity in old age. More general aspects of the so-called body-image seem to be more valid in shedding some more light on the determinants of psychological well-being and of keeping sexuality alive in old age.