The theme of this year’s spring conference of Division 39 of the American Psychological Association was “Sex.” Highlighting the term “sex” was likely a deliberate choice: emphasizing the body as well as the activity in comparison to “sexuality,” which has broader, more vague connotations. Nevertheless, a main accent throughout the conference was how inevitably social and political issues infiltrate what we mean by sex, as well as how sex might serve to further social and political causes. In one sense, the conjoining of different strands of liberation is not radically new, as Freudian-Marxists and some Critical Theorists have made similar arguments in the past. In another sense, there was something radically new in the effort to broaden our understanding and acceptance of diverse forms of sex and to make space for the voices of sexually minoritized people. What follows are some musings about the endlessly uncanny realms of sex and sexuality.
Let’s begin with a brief reflection on the history of psychoanalytic ideas about sex, particularly with reference to our present-day concerns. Freud was certainly audacious in refusing to retreat from engaging the topic and in postulating that sexual issues underlie psychopathology. While sexual issues might mark conflict and the presence of the unconscious in ways I will discuss, I doubt that we would still concur that sexual issues are lurking beneath most disorders. This does not in itself mean that sex ought to have diminished importance. On the contrary, I would argue that sexual issues deserve attention in psychoanalysis, as they can be regarded as an intrinsic part of patients’ identities. Or to put the point more strongly, understanding a person’s identity entails understanding their relation to sex and sexuality.
Sexual liberation did not hold appeal to Freud. In contemplating pleasure, he seems less concerned with affirming its value, as opposed to endorsing our capacity for transcendence through sublimation. In Civilization and its Discontents, Freud does reckon with how societies that coerce us to renounce instincts can make us sick, although he falls far short of Marcuse in advocating a rebalancing of the reality principle with the pleasure principle.[i]
At the risk of sounding anachronistic, it is tempting to worry that Freud might fail the litmus test of being “sex positive.” Still, it would be mistaken to ignore that in the early days, many people were attracted to psychoanalysis precisely because, if not sex-positive, it was not as sex-negative as society was at the time, and at least it welcomed exploration about sex as a legitimate object of study. As Danto has spotlighted, psychoanalysts inspired the creation of clinics in working class neighborhoods that provided healthcare, including birth control, and advocated passionately for public health about sex.[ii]
The rise to prominence of psychoanalysis in the US led to a shift in its self-image. As psychoanalysis spread throughout the mental health world and became known to the general public, it warmed to respectability, aiming to help patients adapt to the society in which they lived. A crucial factor was that in the US, psychoanalysis was under the control of the medical profession, which had a conservative gatekeeping influence by controlling who could join the field, excluding people who might be more inclined to think critically about social, cultural, and political issues. The story of how psychoanalysis, which began ahead of the social curve and then fell behind, bears retelling.[iii]
Various schools of psychoanalysis evolved by focusing less on sex. Ego psychology was interested in pursuing an understanding of aspects of the conscious mind that had been ignored, was comfortable with the language of adaptation, and was open to empirical investigation. Object relations emerged from work with children, and featured the early, dyadic (pre-Oedipal) relationship, a step forward beyond dwelling exclusively on the Oedipal complex in development. Despite the rivalry and differences between ego psychology and object relations, both theories share something in not engaging much with sex or sexuality.
Insofar as psychoanalysis has distanced itself from focusing on sex, a contributing factor has been attachment theory. Attachment theory emphasizes the affiliative bond between infant and caregiver and does not have much to offer concerning infantile sexuality.[iv] In highlighting the sense of safety, and in linking this to exploration, the attachment bond tends to characterize states of excitement as in need of regulation. As Adam Phillips has shrewdly discerned, psychoanalysts have gravitated to adopt the role of being a good mother in their work, thus constricting the space for both parties in new ways.[v]
A contrast can be found in French psychoanalysis. Lacan protested the drift of American psychoanalysis toward social adaptation, insisting that Freud’s great contribution was to reject the notion of an integrated identity, within and between self and others. As Lacan famously stated, “I am not whole. Neither are you.”[vi] Although Laplanche distanced himself from Lacan (who had been his analyst), we can observe a Lacanian commitment in his views on the decentered self and sexuality. For Laplanche, sexuality is enigmatic, and can never be fathomed because excitement derives from experiences of object loss. The object can exist only in the form of the idea of the lost object. There is something profound here: that sex is driven by fantasy, that the fantasy is unconscious, and that we have a dim sense of being propelled by our desires as they elude our understanding.
While it might seem improbable to be able to reconcile attachment theory with Laplanche’s view of sexuality, this is precisely what Fonagy attempts to do.[vii] He begins by acknowledging the “desexualization” that has occurred in psychoanalysis by documenting the decreasing references to “sex” (and related terms) in the psychoanalytic electronic system (PEP) from 1920-2002. Fonagy sees this as an unfortunate turn away from grappling with the immense importance of sexuality in early life development.
Citing Laplanche, Fonagy offers a challenging theory of why our experience of sexuality is mysterious: sexual excitement is one of the only infant behaviors that caregivers find it difficult to mirror. The evidence for this is found in self-reports from caregivers who say that they tend to look away or ignore such behavior as well as from the striking fact that in standard observational studies, used for training. sexual excitement is not reported. Of course, further evidence, based on direct observation of dyads for the response of the caregiver to an infant’s sexual excitement would be necessary to lend support to Fonagy’s hypothesis.
One implication of Fonagy’s view is that normal sexuality is not so normal. Indeed, Fonagy goes so far as to suggest that we are all borderlines in the realm of sexuality— prone to projection, merging, and confounding boundaries. For Fonagy, the intense emotions produced by sexual excitement are incompatible with mentalization. However, he does imagine the potential for reinternalization, where one takes back projected parts of the self, and he believes that secure attachment facilitates this process. Sexuality, defined in terms of “urgency and playfulness” can be owned, but never completely. Fonagy’s perspective emphasizes developmental history, and he ends up defending the distinction between “normal and inadequate psychosexuality,” the latter a softer version of perversions that derives from attachment strugggles.
The relation between mentalization and sex/sexuality is perhaps more complex than it might seem. It is an insight worth preserving that in valuing mentalization, there might be times when it is desirable not to mentalize. (Ironically, then, to mentalize well is to know when and when not to mentalize). But is it the case that amid sexual excitement that we do not mentalize? I am not so sure. In the most satisfying sex, doesn’t it rely upon a crescendo-like reading of each other’s excitement? Don’t we hold onto a curiosity about the response to the other, even if we feel driven by fantasies that the other might or might not share? At the very least, this ought to aid us in appreciating that mentalization is embodied and exists in multiple forms, and that some forms might be driven by emotions in the foreground with cognition in the background, the opposite of how mentalization is often portrayed.
Let us turn to consider the more radical perspective by Saketopoulou. Her body of work not only upends the distinction between normal and perverse sexuality but adds to a line of thinking about ecstatic sexual experience, following Bersani and (Ruth) Stein, which she terms states of “overwhelm.”[viii] Through “limit work,” states of overwhelm have the potential to “catalyze psychic transformation.” This happens, if and when the ego is bypassed, that is, by virtue of giving oneself over to another, a receptivity that is equated with “dispossession.” Saketopoulou challenges the discourse on consent to urge us to consider what might be gained by suspending it. Encountering the other by displacing consent can mean that what one likes what one imagined not liking (and her examples fall into this category), but it would have to include additional options— both that one dislikes what one imagines disliking and that one does not like what one imagines liking.
Trauma informs Saketopoulou’s account of states of overwhelm, arguing against the notion that that trauma can be resolved and in favor of reducing suffering through the pleasure that states of overwhelm can induce. In other words, she embraces “traumatophilia,” where the degrees of freedom are increased, but the false hope of moving beyond trauma is abandoned. It is unclear how to understand trauma here: does Saketopolou mean to point to developmental history, as Fonagy does? Does she intend to include all forms of trauma? Or is she suggesting something closer to the notion that trauma is a condition of (all) human lives? So that, overwhelm might be construed as a potentially beneficial state for all of us? Saketopoulou focuses especially on how trauma plays out with race and gender.
Like Fonagy, Saketopoulou follows Laplanche in construing sexuality as enigmatic. Howevr, unlike Fonagy, Saketopoulou takes seriously the notion that infantile sexuality is the core of the sexual drive. Infantile sexuality, which is polymorphic, is described as “rogue, deviant, and savage.” Here it would seem that Saketopoulou means to affirm that finding pleasure in infantile sexuality would be desirable for any of us, not just people who have been traumatized. Urging us to recognize the backdrop of infantile sexuality seems less pathologizing than suggesting we are all borderlines. Moreover, Saketopoulou’s recognition of the liberatory potential of so-called perversions (a term she questions but believes is still relevant), pushes us, not just to reinstitute sexuality in psychoanalysis, but to expand our understanding of the meaning and range of sexual practices.
Is psychoanalysis on the verge of becoming sex-positive? Well, that depends on how such lingo is understood. Is it simply a natural step forward in a trajectory that began with Freud’s awareness of how little we really know about normal vs. perverse sexuality? I am comfortable with welcoming the expansion of sexual practices, specifically for tolerance of activities that were formerly known as perversions, if they include an element of pleasure. Or, resorting to other psychoanalytic terms, there is nothing wrong with doer vs. done to, as long as there is an element of play.
In addition, I appreciate how the term “sex positive” encourages us to adopt a non-judgmental stance in relation to others. This is particularly important in envisioning the “re-sexualization” of psychoanalysis, where clinicians must not abide by the inhibitions about discussing sex and sexuality followed in social life.[ix] We still know so little—for example, do our most private fantasies have their source in infantile sexuality? Does a consensus exist that understanding patients on the deepest level includes knowing about them as sexual beings?
Insofar as being sex-positive is about one’s own experience, not just others, however, things become more complicated. I will leave this as an open question: however much we strive to be adopt a stance of being non-judgmental, how could we not have strong, unruly feelings, in coming up against our infantile sexuality and our fantasies?
[i] H. Marcuse (1974). Eros and Civilization. Beacon.
[ii] E. Danto (2007). Freud’s Free Clinics: Psychoanalysis and Social Justice, 1918-1938. Columbia.
[iii] Three books on the history of psychoanalysis that are worth reading are Russell Jacoby’s The Repression of Psychoanalysis (1983), Eli Zaretsky’s Secrets of the Soul (2005), and George Makari’s Revolution in Mind (2008).
[iv] K. Zamanian (2011). Psychoanalytic Psychology, Vol 28(1), 33-47.
[v] A. Phillips (1994). On Kissing, Tickling, and Being Bored: Psychoanalytic Essays on the Unexamined Life. Harvard.
[vi] J. Lacan (1992). The Seminar of Jacques Lacan, Book 7: The Ethics of Psychoabalysis. Norton.
[vii] P. Fonagy (2008). A Genuinely Developmental Theory of Sexual Enjoyment and Its Implications for Psychoanalytic Technique. Journal of the American Psychoanalytic Association, 56(1), 11-36.
[viii] A. Saketopoulou (2020). Risking sexuality beyond consent: overwhelm and traumatisms that incite. The Psychoanalytic Quarterly, 89(4), 771–811.
[ix] See the Introduction and essays in A. Lemma and P. Lynch., Eds (2015. Sexualities: A Contemporary Psychoanalytic Perspectives. Routledge.