The word on the street is that psychiatry has lost the mind in its quest for the brain. Is discussing this paper going to change that? My task is simply overwhelming. First, I will review the essay. Then, I will find my teaching points.
According to Freud, this essay was his second most important work (the first being The Interpretation of Dreams). In this essay he states that sexual tension promotes development from infancy through adulthood. For turn of the century Vienna, this was a revolutionary concept. He describes that the sexual experiences from 0-5 create the underpinnings of personality, yet are also sequestered from narrative memory. At 5, the child enters a period called latency in which dams in the form of disgust, shame and morals, allow the child to enter into a period of learning at school. Freud, ahead of his time, said that these dams are "organically determined". In essence, our DNA (yet to be discovered) creates a latency period so that a child can learn in school and not be preoccupied by sexual urges. This sexual energy gets buried and then resurfaces in the form of productive activities. Freud calls this reaction formation and sublimation.
His evidence that sexual forces occur throughout life is based on the child's way of self-soothing. He points to thumb-sucking as an example of a rhythmic repetition of a sucking contact by the mouth. The baby has transformed the location for nourishment into the location for sensual pleasure. This constitutes the oral phase of development. Likewise, the anal zone is transformed from an area responsible for somatic functions into an area where control can be exerted and the child can feel a sense of power.
Children can find sexual pleasure in a variety of ways. Freud said that children have a "polymorphously perverse disposition". Instincts can center around an erotogenic zone such as the mouth or the anus, or it can be a component instinct where the child is sexually excited by looking at other people (voyeur) or by having other people look at them (exhibitionism). Children are also extremely curious about sexual activities. Freud called this "the sexual researches of childhood". In this "sexual research" boys try to find out why they are different than girls. In so doing, boys realize they have a penis and that this is so precious that they then develop castration anxiety. Girls, on the other hand, realize they don't have a penis and so, according to Freud, they develop penis envy. These feelings quiet down as the child enters school-age, but then resurface in puberty. Freud calls this trajectory "diphasic".
Freud was the first one to describe how children experience sexual pleasure. This sexual pleasure comes in the form of mechanical excitations. For example, children love being thrown up in the air and they love to rock. The thrill of a child's rocking horse would be another good example. The familiar play of "rough housing' would be another example of a child's sexuality. Further, Freud goes on to say that feeling states are innately sexual. The child's fear is a source of sexual excitement in that jumping from high up creates fear followed by a sense of mastery in a parallel way to sexual activity. Finally, he says that passion about intellectual work is also a form of sexual satisfaction.
An interruption....a drug representative for Abilify comes to my office....I happily take some samples...I am invited to a dinner program chaired by my highly esteemed colleague.....I return to thinking about Freud and sexuality.....the mind and the brain converge.
The ever-present force of sexuality is described in this 1905 paper. Our skin and our sense organs are stimulated and we are excited. Certain areas are particularly excitable and these are termed our erotogenic zones. Pleasure can end and pain can begin when the intensity exceeds our tolerance. Freud then does self-promotion. He touts the "novelty" of his approach to this sensitive subject of child sexuality. Although lacking in humility, Freud importantly reminds us that there are varieties of sexual constitution. That is, each person is different (thanks to our DNA-which again, the discovery came after his time). Second, that sexuality and bodily functions are forever linked and that disorders of the body (such as Irritable Bowel Disorder) could result from sexual excitation which cannot find a suitable outlet and so the energy gets turned towards an organ.
So, I conclude by asking myself what I want these residents to learn from this "classic" article. First, I want them to read Freud like great literature. In fact, Freud won the Goethe prize. Second, I want them to see motivation as a complicated force, which in no small measure is determined by sexual energy and our pre-programmed need to reproduce. Finally, I want them to think developmentally, both that childhood history is always important to adult assessment, but in particular, I want them to think about the adult patient in terms of how his sexual needs were dealt with as a small child. This way of thinking might help them understand the underpinnings of their patient's symptoms.
Abilify helps a lot of patients be "more able". Psychoanalytic thinking does likewise.
|Original title||Drei Abhandlungen zur Sexualtheorie|
Three Essays on the Theory of Sexuality (German: Drei Abhandlungen zur Sexualtheorie), sometimes titled Three Contributions to the Theory of Sex, is a 1905 work by Sigmund Freud which advanced his theory of sexuality, in particular its relation to childhood.
Freud's book covered three main areas: sexual perversions; childhood sexuality; and puberty.
The Sexual Aberrations
Freud began his first essay, on "The Sexual Aberrations", by distinguishing between the sexual object and the sexual aim — noting that deviations from the norm could occur with respect to both. The sexual object is therein defined as a desired object, and the sexual aim as what acts are desired with said object.
Discussing the choice of children and animals as sex objects — pedophilia and bestiality — he notes that most people would prefer to limit these perversions to the insane "on aesthetic grounds" but that they exist in normal people also. He also explores deviations of sexual aims, as in the tendency to linger over preparatory sexual aspects such as looking and touching.
Turning to neurotics, Freud emphasised that "in them tendencies to every kind of perversion can be shown to exist as unconscious forces...neurosis is, as it were, the negative of perversion". Freud also makes the point that people who are behaviorally abnormal are always sexually abnormal in his experience but that many people who are normal behaviorally otherwise are sexually abnormal also.
Freud concluded that "a disposition to perversions is an original and universal disposition of the human sexual instinct and that...this postulated constitution, containing the germs of all the perversions, will only be demonstrable in children“.
His second essay, on "Infantile Sexuality", argues that children have sexual urges, from which adult sexuality only gradually emerges via psychosexual development.
Looking at children, Freud identified many forms of infantile sexual emotions, including thumb sucking, autoeroticism, and sibling rivalry.
The Transformations of Puberty
In his third essay, "The Transformations of Puberty" Freud formalised the distinction between the 'fore-pleasures' of infantile sexuality and the 'end-pleasure' of sexual intercourse.
He also demonstrated how the adolescent years consolidate sexual identity under the dominance of the genitals.
Freud sought to link to his theory of the unconscious put forward in The Interpretation of Dreams (1899) and his work on hysteria by positing sexuality as the driving force of both neuroses (through repression) and perversion.
In its final version, the "Three Essays" also included the concepts of penis envy, castration anxiety, and the Oedipus complex.
The Three Essays underwent a series of rewritings and additions over a twenty-year succession of editions — changes which expanded its size by one half, from 80 to 120 pages. The sections on the sexual theories of children and on pregenitality only appeared in 1915, for example, while such central terms as castration complex or penis envy were also later additions.
As Freud himself conceded in 1923, the result was that "it may often have happened that what was old and what was more recent did not admit of being merged into an entirely uncontradictory whole", so that, whereas at first "the accent was on a portrayal of the fundamental difference between the sexual life of children and of adults", subsequently "we were able to recognize the far-reaching approximation of the final outcome of sexuality in children (in about the fifth year) to the definitive form taken by it in adults".
Jacques Lacan considered such a process of change as evidence of the way that "Freud's thought is the most perennially open to revision...a thought in motion".
There are three English translations, one by A.A. Brill in 1910, another by James Strachey in 1949 published by Imago Publishing. Strachey's translation is generally considered superior, including by Freud himself. The third translation, by Ulrike Kistner, was published by Verso Books in 2017. Kistner's translation is at the time of its publishing the only English translation available of the earlier 1905 edition of the Essays. The 1905 edition theorizes an autoerotic theory of sexual development, without recourse to the Oedipal complex.
- ^J-M Quinodoz, Reading Freud (2005) p. 58.
- ^Sigmund Freud, On Sexuality (PFL 7) p. 45–46.
- ^Quinodoz, p. 59.
- ^Freud, On Sexuality p. 155
- ^The Basic Writings of Sigmund Freud, pp. 562–563. Random House 1938.
- ^Freud, On Sexuality p. 155 and p. 87.
- ^Ernest Jones: The Life and Work of Sigmund Freud (Penguin 1961) p. 315.
- ^Gay, p. 147.
- ^Freud, On Sexuality p. 131.
- ^Gay, p. 148.
- ^Angela Richards, "Editor's Introduction", Sigmund Freud, On Sexuality (PFL 7) p. 34
- ^Peter Gay, Freud: A life For Our Time (London 1989) p. 148.
- ^Richards, p. 35.
- ^Richards, p. 186 and p. 238n.
- ^Freud, On Sexuality p. 307
- ^Freud, On Sexuality p. 307.
- ^Jacques-Alain Miller ed., The Seminar of Jacques Lacan: Book I (Cambridge 1988) p. 1.
- ^Freud, Sigmund: Three Essays on the Theory of Sexuality. Basic Books 1962, pp. ix–xi.
- ^Gay, p. 572–575.
- ^Van Haute, P. & Geyskens, T. A Non-Oedipal Psychoanalysis? Leuven University Press 2012
- Freud, Sigmund (1962). Three Essays on the Theory of Sexuality, trans. James Strachey. New York: Basic Books.
- (1996). Drei Abhandlungen zur Sexualtheorie. Fischer: Frankfurt am Main. [Reprint of the 1905 edition.]