Academic journal article The Psychoanalytical Study of the Child

Mum's the Word: Are We Becoming Silent on Masturbation?

Academic journal article The Psychoanalytical Study of the Child

Mum's the Word: Are We Becoming Silent on Masturbation?

Article excerpt

This paper explores the trend in contemporary child analytic technique away from addressing material related to masturbation. The author invites reconsideration of the value of timely, tactful exploration of a child's impulses, fantasies, and related conflicts. The analyst's resistances to open discussion of these are addressed, along with the limiting effect this may have on the patient feeling fully understood. Clinical examples are provided of analytic work with children from prelatency through preadolescence, whose symptoms range from neurotic conflict to more severe and early disturbances.

All great writers upon health and morals, both ancient and modern, have struggled with this stately subject; this shows its dignity and importance.

-Mark Twain (1879)

INTRODUCTION

THE YEAR 2009 MARKED THE CENTENARY OF THE PUBLICATION OF Freud's "Analysis of a Phobia in a Five-Year-Old Boy" (1909), and it is worth pausing to imagine what the impact must have been on those who first read his account of a father talking openly with his son about masturbation. In this paper my aim is to share some of my reflections about how we child analysts are, or are not, talking with our own patients about masturbation one hundred years on from Little Hans. In their 2000 Marianne Kris Lecture to the Association for Child Psychoanalysis, Kerry and Jack Novick urged us to "reclaim the land" of "lost theoretical and technical territories" (2002, p. 55) represented by all the points of view of metapsychology.1 I believe that open discussion of the body and its pleasures is one aspect of the technical landscape that has been gradually but insidiously eroding, one that my remarks are meant to reclaim.

My first analytic patient began his treatment when he was ten and a half years old, with a laundry list of bad habits that he "used to do, but didn't do anymore." Although it took time, he clearly wanted help with his masturbatory urges, along with the fantasies, conflicts, and anxieties associated with them. In his or her own way, each patient I have seen since has wanted the same thing at some point in treatment, regardless of the nature of the presenting difficulties. However, in our profession, we may increasingly treat talking about masturbation as a bad habit we used to do but don't do anymore. In the clinical presentations I hear in my local analytic community, as well as nationally and internationally, there are accounts of well-conducted analyses, full of great empathy, that illustrate the mutual process of analyst and analysand arriving at liberating insights, understanding, and growth. Yet fewer and fewer of these include illustrations or even mention of work on masturbation. A possible explanation is that this work is so much taken for granted as part of child analytic treatment that no particular emphasis is seen as necessary, but I am skeptical.

Out of curiosity I searched the index of each of the volumes of The Psychoanalytic Study of the Child for the last decade. I found five or fewer listings under the heading "masturbation and masturbation fantasies" in all but one, and these often related to work with adult patients. Even when masturbation is referred to in presentations of child analysis, none gives examples of what was said between the analyst and patient.2 There is no heading for masturbation at all in the volumes for 2004, 2005, or 2006. In 2007 there are eight entries under the heading, but lest you think this was the end of a dry spell, all of these appear in a special section of papers on Little Hans.

THEORETICAL INFLUENCES

My reading of this is that there has been a shift in our clinical topography, which is now reflected in our literature. The reasons can be sought in a number of directions, but always, at base, they may be reduced to the same repudiation of the influence of infantile sexuality with which Freud recognized his discoveries would always be met. By the end of the "century of Freud" (Rangell, 2002) his theory - based on the drives, epigenetic development, conflict, and anxiety - shared the stage with self-psychology, object relations theory, and modern Kleinian views. …

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