Frontiers of Infant Psychiatry - Vol. 2

By Justin D. Call; Eleanor Galenson et al. | Go to book overview

47
Infantile Origins of Disturbances in
Sexual Identity

Herman Roiphe, M.D.

Eleanor Galenson, M.D.

Sexual perversions, which are often accompanied by a florid and frequently bizarre distortion of sexual identity, have attracted the attention of psychoanalytic and psychiatric investigators for the better part of this century. Many psychoanalysts agree with Freud and Bak that the dramatized or ritualized denial of castration is the central core of all perversions and that this denial is acted out through the regressive revival of the fantasy of the maternal phallus (Freud, 1905, 1923, 1927, 1938; Bak, 1968). The psychoanalytic study of the perversions, particularly that of fetishism, has increasingly implicated preoedipal factors as being responsible for the perversions. Abraham, as early as 1910, stressed the importance of the sadomasochistic elements. Gillespie (1940) pointed to important oral factors in his patients. Bak (1953) described disturbances in the early mother-child relationships and unusually strong separation anxiety in his cases.

In a series of papers on fetishism, Greenacre, (1953, 1955, 1960) pointed to disturbances in the first eighteen months of life which interfered with the child's ability to form a stable image of the body and, by bringing about complementary disturbances in the phallic phase, resulted in an exaggeration of the castration complex. According to Greenacre, the very young have more trouble in establishing an image of their genitals than of most other parts of the body. "Normally" she states,

the child's concept of the genital area becomes consolidated during the phallic phase, due to an increase in spontaneous endogenous sensations arising at that time. But when disturbances occur in the pregenital phase, such as a mother who is not good enough or an infant so impaired by injury, illness, or congenital defect that no mother can be good enough, the body-disintegration anxiety from these earlier phases combines with the overly strong castration anxiety of the phallic phase and depletes rather than reinforces the child's sense of sexual identity. (pp. 191-192)

The contributions we have mentioned have come almost exclusively from reconstructions of infantile development gained from the analysis of adult patients. Over the last several years there have been efforts to integrate clinical experience with the findings of psychoanalytically informed longitudinal studies of early development gained from direct child observations (Mahler et al, 1975; Roiphe and Galenson, 1981). In this paper we attempt to trace the possible effects of severe preoedipal castration reactions on the subsequent drive organization and on the development of self and object relatedness, ego organization, and

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