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"Johnny, I Hardly Knew Ye:" toward revision of the theory of male psychosexual development.

"The psychology of women," as it now exists, is a shadowy negative of the psychology of men, and can be successfully formulated only if male psychology is reassessed and considerably revised. Male theorists and practitioners have made virtues of the harsh facts of male socialization. These conditions, which have unhappy repercussions in the male ego and in the culture as a whole, are modifiable only if they are identified and understood.

Anxiety, Castration

Psychosexual development: an examination of the role of prenatal hormones.

Naturally occurring endocrine syndromes and the offspring from steroid-treated pregnancies are the major sources of evidence for a role of prenatal hormones in psychosexual development in man. Effects of prenatal androgens have been established for the sex-dimorphic behaviour clusters of energy expenditure (increased), parenting rehearsal (decreased), peer associations (shifted to male), and grooming-related behaviour (decreased); most of the information was obtained on the syndrome of congenital adrenal hyperplasia and in progestin-induced female hermaphroditism. Studies of children and adults exposed prenatally to exogenous oestrogens and/or progestagens suggest slight demasculinizing effects but cannot yet be considered conclusive. Gender identity is largely dependent on the sex of rearing; a direct role of prenatal hormones in its formation has not been shown. The evidence for the role of prenatal hormones in the development of sexual orientation is inconclusive.

Female

Development of psychosexual concepts in relation to expressive language performance.

Cognitive-developmental theory suggests that the learning of gender identity concepts is a sequential process, beginning with the learning of one's own gender, and moving to recognition of the invariance of gender as a human characteristic. Neither clinical nor theoretical literature can fully explain the steps involved. In this study, retarded and nonretarded children were asked to respond to tasks requiring knowledge of core gender identity and gender constancy. When both the retarded and nonretarded children were pooled, a significant interaction was found across all ages between expressive language performance and the development of the psychosexual concepts of core gender identity and gender constancy.

Age Factors

Penis envy: from childhood wish to developmental metaphor.

Two phases of penis envy are considered. The first regularly occurs early in development and is registered as a narcissistic injury which can be resolved under optimal conditions and can contribute to female psychosexual development. If, however, it is not favorably resolved or, even more significantly, if the basic character disorder is of a narcissistic type, the awareness of the genital difference becomes one of many narcissistic traumas. A later phase of penis envy usually represents a regressive effort to resolve oedipal conflicts. In the past, these two phase-oriented forms of penis envy have not been adequately distinguished. Two clinical examples are presented in which the envy of men was only part of a tendency to envy in a narcissistic character disorder. In the analysis, the interpretation of the penis envy offered a metaphor around which all of the "free-floating" envy could coalesce. The cases illustrate the necessity to consider penis envy as the manifest content of a symptom that needs analysis, rather than as "bedrock" or ultimate conflict.

Adult

Separation-individuation and reconstruction in psychoanalysis.

The development constructs of Mahler and her coworkers are seen as clinically based theory which enrich practice. Freud discovered the importance of the infantile past and psychosexual development in particular, he related these findings to the psychodynamics of neurotic structures, and devised a successful therapeutic model based on his findings. Mahler has uncovered and detailed other aspects of infantile mental life, related genetically not to neurotic byt also to other mental structures, thereby broadening the range of applicability of Freud's therapeutic model. Clinical vignettes are offered depicting unresolved residua from the infantile developmental phases described by Mahler. The issue of the analyst's and the patient's conviction concerning reconstructions that attempt to reach across the "primal repression barrier" is discussed. Finally, it is suggested that working through involves, among other things, completion of developmental process that had been interrupted in the childhood of the patient.

Anxiety, Castration

Bamboo phobia in an eighteen-month-old boy.

We have presented a developmental history and an account of the treatment of an eighteen-month-old boy who had a bamboo phobia. Conceptual problems concerning drive organization, the expression of drive derivatives, and object relations have been explored. The correlation of these with Mahler's separation-individuation theory has been considered. Analysis of the bamboo phobia revealed two castration themes. One related to projections onto the father, and another onto the mother and sister. Our case illustration highlights the important role of object-relations development in determining the level of psychosexual organization. It also demonstrates the difficulty in correlating level of psychosexual development with capacity for symptom formation. The importance of sexual and aggressive impulses in separation-individuation is emphasized. The bamboo phobia is seen as a symptom formed to deal with psychosexual conflicts that played a part in the rapprochement crisis. Tth role of fantasies and internal representations of objects, as well as the parents' actual behavior, is stressed--again, in relation to the influence of the drives.

Child Behavior Disorders

Visual inhibitions of automobile driving.

Three patients in psychotherapy who were symptomatically unable to drive automobiles also gave histories of having been afflicted with oculomotor disorders in childhood. This calls attention to the previously undiscussed visual dimension of automobile driving, which is considered in general terms. The specific question of an inhibition of visual function resulting in avoidance of automobile driving is then raised, and a case illustration given in which the attachment of sexual and aggressive meanings to the act of looking was important in the formation of an automobile driving symptom. The particular impact of ocular deviation on early psychosexual development is explored, using the clinical material as a point of departure.

Aggression

Sex differences in psychoanalytic treatment.

Sex sterotypes, clinical observations, and psychoanalytic theory of sex differences are presented. Stereotypes show differences in areas of inhibition and clinical observations, differences related to the phallic and genital phases in psychosexual development. Divergent analytical views on the sexual development of boys and girls are discussed.

Female

Dependence and psychotherapy--developmental considerations.

This article illustrates how the assessment of the level and degree of dependency in psychotherapy can be used as a diagnostic and therapeutic tool. Dependency varies with the stage of psychosexual development, with the degree and state of illness, and with the stage of treatment. Appropriate monitoring of this factor promotes optimal growth potential in the patient.

Affective Symptoms