MASOCHISTIC : REACTIONS IN A
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BERNSTEIN, M.D.
LATENCY-AGE GIRL :
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about latency in girls without attempting a comprehensive discussion of the complex changes that occur. Latency in girls is generally accepted to have occurred when there is apparent relinquishment of the oedipal wishes, with the abandonment of the wish for a child from the father. The motive force is fear of the loss of the mother’s love (Freud, 1924a). Additionally, there is the realistic disappointment of the wish for the child. Other authors (Horney, 1926; H. Deutsch, 1930; Lampl-de Groot, 1928) have added the fear of penetration and destruction by the father’s penis. A concomitant diminution of sexual drive is postulated as usual but not inevitable. There is a shift from the primary objects to peer relations. Ambivalence with girl friends reflects an earlier pattern in the relation to the mother. Triangular relationships among girls are frequent and more or less mirror the oedipal constellation, Boys are treated with contempt, and their aggressiveness and dirtiness are reacted to with disgust. These attitudes serve also to repudiate the girl’s earlier envy and masculine wishes. WISH FIRST TO COMMENT
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Sexuality Typically, a struggle against masturbatory practices ensues, with occasional or frequent breakthroughs. Separation of fantasy from the act can lead to differing patterns of defense, gratifications, and guilts (A. Freud, 1949). One commonly used defense against masturbation is regression to pregenital-e.g., oral-gratification. A nine-year-old girl told me she used to put her fingers inside, but now this disgusted her. I asked her what she did instead, and she answered that she sucked her thumb. Transfer of interest from the genitals to the entire body and to clothes enhance the girl’s narcissism, when she devotes greater attention to her appearance. Freud (1925) stated that the narcissistic disappointment in her genitals causes the girl to relinquish masturbation-to avoid the feeling of genital inferiority. It may well be, however, that the repression of the oedipal wishes, which arises at the same time as the girl experiences pleasurable genital feelings, can cause the repression of genital sensation. Lampl-de Groot (1950) has noted that one of the most important determinants of the degree of masturbatory activity is the mother’s attitude, which becomes a factor in the child’s superego attitude in identification with the frustrating or prohibiting mother. It is my experience and that of others who have reported cases (Bornstein, 1953; Harley, 1961; Kestenberg, 1968; Fraiberg, 1972) that it is difficult to gain access to detailed verbal material regarding masturbation in latency girls. As Bornstein (1953) has said, “Unfortunately little is known about the course and rhythm of excitation and complete or incomplete gratification by masturbation in children between eight to ten years.. .” (p. 69). She did, however, report material from analyses of a six-year-old girl, a nine-year-old girl, and a ten-year-old girl, all of whom interrupted masturbatory activity to avoid overwhelming orgastic sensations, Earlier analytic data led to the assumption that the little
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girl was aware only of the external genitalia-clitoris and labia-that the clitoris was the homologue of the penis, and that the girl’s feelings of inferiority led to penis envy, the masculinity complex (tomboyishness), and suppression of masturbation. Helene Deutsch (1930) gave examples of two cases of vaginal masturbation, but declared that these were exceptions caused by early seduction and defloration, and were atypical for latency girls. Fliegel (1973), in discussing the history of the changes in analytic theory regarding feminine psychosexual development, saw the entire subject as controversial with Helene Deutsch and Lampl-de Groot supporting Freud’s original view that the girl is led to the Oedipus complex by the castration complex and Horney (1926), Jones (1927), and Fenichel (1 930) expressing points of disagreement. Recently, there has been considerable interest in obtaining a clearer and more complete picture of sexual function and responses in the female, and this has been evidenced in studies of young girls. Kestenberg (1968) reported the analysis of a four-year-old girl who masturbated externally and vaginally but also anally. At the age of sixteen months, the girl had suffered from a fungus infection which had involved the genital and perianal areas. Baths and ointments were used to relieve the irritation. Her condition had caused a preoccupation with genital sensations, According to Kestenberg, this prevented an externalization of the sensations and denial of the vaginal introitus, which, Kestenberg believes, is reinforced by the repression of oedipal fantasies at the beginning of latency (p. 474). As latency girls progress toward prepuberty, they “discover the secret” of the vaginal opening, a secret they share with girl friends and from which boys are excluded. Barnett (1966) reported fantasies, play sessions, and dreams of a nine-year-old girl and a twelve-year-old girl, which she interpreted as proving that these girls had vaginal sensations and awareness. According to Barnett, this awareness creates anxiety which causes repression, decathexis of the vagina, and
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hypercathexis of the clitoris. Kestenberg (1968) described a nine-year-old girl who masturbated clitorally to achieve orgasm. The gir!’s masturbation fantasies were masochistic; they involved men who enslaved and tortured her. In a highly illuminating study, Fraiberg (1972) d’iscusses genital arousal in girls. Her attention to the subject was drawn by her observation that an adult patient suffering from sexual frigidity had had a childhood experience similar to those of two of Fraiberg’s latency girl patients, namely, a “turning away from the genital coinciding with total loss of erotic sensation” (p. 439). The crucial event had been an overwhelming excitement of orgastic proportions. These girls had discovered and explored the vagina and had then repressed sensation. Using an age-appropriate language, Fraiberg was able to obtain a remarkably vivid and precise description of the localization of the different genital feelings resulting from masturbatory activity. It thus appears that masturbatory activity in the latency girl can involve the clitoris, labia, vagina, and anus. The range of feeling and awareness may extend from complete anesthesia and denial to full orgastic-like response. I should like to suggest that the repression of genital sensation may also be owing to masochistic fantasies that accompanied the masturbation and are perceived as too dangerous. In both of the cases reported by Fraiberg “a sadistic fantasy was required” (her italics) to reach the high point of excitement (p. 453). The underlying masochistic fantasy is implied in the case of Nancy, who identifies herself with children enslaved by animals and treated like horses, who were forced to pull a heavy load with the bits cutting into their mouths. The second girl, Suzanne, was excited by the fantasy of a girl being kidnapped, stripped of her clothes, and then looked at by the men.
Aggression If our knowledge and understanding of the sexual drive in latency girls is incomplete, our comprehension of the fate of Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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the aggressive drive is much more rudimentary. I am compelled to emphasize certain aspects of the vicissitudes of the aggressive drive in latency girls. To begin with, there is a general impression that, from birth, i.e., constitutionally, girls show a lesser degree of aggression than boys. This opinion is based on observations of behavior and is therefore subject to question: is the manifest activity equivalent to the strength of the innate drive? Observation does not take into full account defensive modification and adaptation to social expectation. Putting this aside for the moment, let us turn to the fate of the aggressive drive in latency. The shift of the cathexis from the primary objects in the process of resolution of the oedipal conflict liberates part of that energy, which becomes available in neutralized form (Hartmann et al., 1949) for such tasks as mastery of the environment, learning, and sports and games. Some portion of the aggressive drive is probably utilized for countercathexis of oedipal wishes and fantasies. Depending also on the degree of regression, some aggression will be directed along pregenital channels and find sadomasochistic expression. Symptomatically, one sees this in more frequent nailbiting, hair-pulling, teasing behavior, and occasional cruelty to insects, animals, and siblings. It may also be reflected in masturbatory patterns, which can include sadomasochistic fantasies and the inflicting of pain on parts of the body, including the genitals. Internalized aggression also enters into the formation and functioning of the superego. Here, also, depending on the degree of neutralization or reinstinctualization, masochistic tendencies may find expression in moral masochism. With the growth and development of the ego in latency, there is an expansion of the synthetic function. Hartmann et al. (1949) have stated, “Through a simultaneous cathexis with libido the aims of aggression are modified. This modification may be brought about in two different ways: by the mere coexistence of two investments, leading to the prevalence of libido over aggression; and by the fusion of both instinctual drives’’ (p. 19). Failure of such modification through arrest in Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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development or regression can result in divergence of libidinal and aggressive aims, persistence of primitive fantasies, attitudes, and behavior, with serious impairment of object relations. One possible outcome is the development of masochistic patterns or character.
Masochzim Although many clinical studies and case reports include material relating to masochism in latency girls, published contributions by child analysts specifically devoted to this topic are few in number. The subject has received attention by analysts of adults, and many of them refer to the importance of childhood experiences and development in the genesis of the adult varieties of masochism (see Panel, 1956). Loewenstein (1957) points out that a common clinical fact tends to be overlooked, namely, that the patients themselves describe the origin of their perversion as being linked to a particular specific scene in childhood. He notes that Greenacre (1953) called attention to the importance of traumatic overstimulation in certain cases of fetishism and severe neuroses. Loewenstein describes as universal a behavior he terms “seduction of the aggressor,” wherein the child induces a threat which is followed by its removal and loving response of the parent. Expanding on Freud’s (1924b) formulation, Loewenstein discusses the various forms of masochism as: erotogenic, part of the sexual life of women, a perversion, and as a pattern of behavior, including the masochistic character, the mentality of the slave, and moral masochism. It is particularly in relation to the second form-i.e., as part of the sexual life of women- that there has been considerable disagreement. Freud (1933) stated: It is perhaps the case that in a woman, on the basis of her share in the sexual function, a preference for passive behaviour and passive aims is carried over into her life to a greater or lesser extent, in proportion to the limits, Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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restricted or far-reaching, within which her sexual life thus serves as a model. But we must beware in this of underestimating the influence of social customs, which similarly force women into passive situations. All this is far from being cleared up. There is one particularly constant relation betw...en femininity and instinctual life which we do not want to overlook. The suppression of women’s aggressiveness which is prescribed for them constitutionally and imposed on them socially favours the development of powerful masochistic impulses, which succeed, as we know, in binding erotically the destructive trends which have been diverted inwards. Thus masochism, as people say, is truly feminine [pp. 115-1161. Helene Deutsch (1930) emphasized masochistic psychosexual development in girls as follows: “In place of the active urge of the phallic tendencies, there arises the masochistic phantasy: ‘I want to be castrated’, and this forms the erotogenic masochistic basis of the feminine libido. Analytic experience leaves no room for doubt that the little girl’s first libidinal relation to her father is masochistic, and the masochistic wish in its earliest distinctive feminine phase is: ‘I want to be castrated by myfather’ (p. 52). She expressed the idea that in neurotic development, the superimposition of guilt in the form of moral masochism may obscure the underlying original erotogenic masochism. In the same paper, she declared that, “The first, infantile identification with the mother is always, independently of the complicated processes and reactions belonging to the sense of guilt, masochistic, and all the active birth-phantasies, whose roots lie in this identification, are of a bloody, painful character, which they retain throughout the subject’s life” (p. 54). Deutsch saw the earliest relationship to father and mother as masochistic; these developmental formulations are controversial. Gero (Panel, 1957) considers sadism and masochism to be rooted in the bisexual organization of human instincts, with the sadistic position as essentially masculine and the masochistic position essentially feminine (p. 560). Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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Waelder (Panel, 1956) declares that the normal woman is not masochistic, a point that Bak put in reverse form: the masochistic woman is not truly feminine. In a previously published paper (Bernstein, 1957), I drew attention to the importance of narcissistic attitudes on the part of parents in the development of masochistic patterns in children, patterns designed to prevent recurrences of passively experienced disappointments and object loss. The result was a compulsive repetition of self-induced disappointments, rejection, and humiliation. Brenman (1952), citing the case of a self-destructive adolescent girl, examines masochism as a complex configuration embodying drive, defense, and adaptive functions. This point of view is further developed by Brenner (1959), who describes several male patients and a woman with masochistic tendencies. Among other conclusions, Brenner finds that “Masochism is a normal component or characteristic of the human personality, as witness the part it plays in superego formation and functioning. The difference between the normal and masochistic character is one of degree rather than of kind. . . . Masochistic character traits and fantasies are alegacy of infantile sexual conflicts, principally of oedipal conflicts in most cases. As such they are related to the principal danger situations of early childhood, which are typically the dangers of object loss, of loss of love, and of castration, but the importance of each of these danger as a motive for defense will vary from one masochistic patient to another” (pp. 224-225). In Brenner’s view, therefore, masochism is not identified as feminine, although his clinical examples point to the unconscious wish for the men to be castrated and loved by the father, i.e., to be women in their childhood fantasy. Case Report
Kathy, an eight-year-old girl, was referred for treatment because she feared insect bites and was afraid to walk to school
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alone. Also, she had been having so many bodily complaints that she was taken to a consulting pediatrician who said she was “hypertonic” and had a greater sensitivity to pain than most children. In addition, the mother reported that the little girl reacted very strongly to criticism and felt she was treated unfairly. The parents became concerned over the persistence of the fears and consulted a child analyst who recommended analysis.
History Birth was normal. Breast feeding was begun but on the seventh day the baby developed a temperature of 102 and the pediatrician ordered breast feeding discontinued. The temperature subsided, but Kathy reacted with diarrhea to the formula; this continued for two weeks until a more dilute formula was substituted. Allergic reactions to various foods disappeared after several months, and diet became unrestricted. Development was normal, although Kathy was clumsy in body movement, and this was reflected in avoidance of play involving gross motor activities. She ate and slept well; toilet training was uneventful. Kathy shared the parental bedroom until six months of age. Up until the age of five years, she would touch her genitals and occasionally exhibit herself to other members of the family. The parents told her that touching herself in public was unacceptable; this effectively stopped the overt masturbation. At the age of five, Kathy was subject to a series of injections necessitated by an ear infection which threatened to spread. The mother was a hysterical personality; she had developed fears of airplane crashes. She also had intestinal cramps. The father was an educator whose interest in psychology stemmed from his reading. At the time Kathy was seen, he tended to accuse his wife of not being sufficiently attentive to the children, and this led .to arguments between
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the parents. There had been deaths in the families of both parents during their own childhoods, and there was a resultant atmosphere of concern in the home about accidents, illness, and death. Kathy had an older brother and a younger sister. The older brother teased her mercilessly; she was chased and hit, often as a result of her own provocation. There were repeated episodes of excitement around bathroom activities. Psychological testing revealed a girl apparently overwhelmed with anxiety, especially separation anxiety. This was considered to be largely a function of her inability to deal with her impulses. Projectives indicated a constant struggle with parental figures to get what she wanted. She saw them as depriving and frustrating, with resultant hostility and death wishes toward them. Defenses included compulsive ordering, projection, and reaction formation. These did not operate too well, and she was consequently obsessed with vague fears and morbid thoughts, particularly thoughts of death. Kathy reacted to being told that she would be seeing me for help by saying that she expected me to help her in two ways: with her problems, and just by talking-by being nice. She foreshadowed a later part of the analysis when she complained that one of her problems was that her friends always made her take the part of the boy whenever she played at being grown-up and married.
The Analysis At her first visit, Kathy impressed me as an attractive, friendly little girl, quite feminine in manner. The first hours expressed her conflicts about sexuality and aggression by stories about twins. One involved a policeman who had a twin brother who was a robber. She made a drawing of fraternal twins and was undecided as to which should be the boy. Regular treatment began in the fall, at which time she declared that her problems were that she wanted to grow up, and she was so excited about it that it made her unable to Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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think about other things. She could not elaborate on this wish. Her other problem was that she sometimes felt bad if she fought with her mother and father and thought they didn’t like her. Later she added that she was afraid of shots and bees, even though she had never been stung by a bee. After expressing feelings that her mother loved her less than her siblings and recounting various deprivations, she attempted to deal with fears of separation from or abandonment by an angry mother by stories involving reversal of roles: Kathy would be angry and leave. In the transference situation, she had a disturbing fantasy that the taxi driver who was supposed to pick her up after her hour would not wait for her and hence she would be left at my office. The anxiety also resulted in a nightmare: “I am with a friend. The moon became a man. The moon was angry because a man had been shooting rockets up to it. The moon started to chase the man. Then it chased us. I got very frightened and woke up. I stayed with my mother until six o’clock in the morning.” Associations led to discussions of her fears of anything happening to her mother. She was then able to report that sometimes she got angry at her mother and wished she would get killed. Then she would have another mother. However, she then reminded herself of the good things her mother did, and started to cry. In a later hour, she reported ways in which she punished herself for these angry wishes: she would pull her hair, or deprive herself of TV, or give a sibling part of her allowance. Another reaction to the expression of her hostility to her mother was a temporary regression to a wish to be the baby of the family as an imagined way of being mother’s favorite. The fantasy of being the baby inside mother resulted in a fear of being unable to unlock the bathroom door-i.e., of being trapped. She then alternated between the wish to be the protected and loved baby and the wish to be the powerful, punishing mother. She tried to deal with fears of being punished by making an exciting game of it and by frightening her younger sister. At home, she began to defy her mother, refusing to make Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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her own bed. She was also more aggressive to her father, jokingly slapping him and touching his penis through his clothes. In a counterphobic act, she put a needle through her own skin and showed it to the family. Concurrently, she was able to go to school alone. In the analysis, a period of silence resulted in a fantasy that I would shout at her or send her home or call the mother to punish her. She related this to her own anger at herself. At this point, the mother had some intermenstrual bleeding and was advised to enter the hospital. The children were told that the mother had a “bellyache.” Kathy reacted by having nightmares. In one, she was told she would die; in another, a lady said that she was going.to kill the whole family. In the dream, Kathy made a dummy and poured ketchup over it, and the lady said, “Ah ha. I got one of them.” The allusion to the mother’s bleeding was clear. Some days later, it became apparent that the children knew the reason for the mother’s hospitalization; one of them had overheard a telephone conversation concerning the mother’s illness. The father then explained the need for the operation. Kathy took the whole thing matter-of-factly. Subsequent material dealt with the birth of the younger sister and Kathy’s fantasy that the baby had come out of the belly. She drew pictures of the hospital, and I indicated her wish to visit the mother. Hospital rules made that not possible. Kathy reported to me that she had heard that they would cut a hole in her mother’s middle, take something out, and then stitch. While the mother was hospitalized, Kathy and her father had a fight. Although she defended herself against her positive oedipal wishes at home, Kathy expressed them in the transference by bringing me a cake and a very good school report card. She expressed her wish to get presents and to have her meals in bed, as the mother was being served in her convalesence. Dreams expressed the same wish to get presents from her father, but were accompanied by others that reflected the fear of-beingpunished (scalped) by a drunken Indian woman. The
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last was a reference to the mother’s unstable gait due to weakness and was also a reference to Kathy’s perception of her own instability and undependable controls. Kathy’s hostile feelings were displaced onto her siblings with the wish that her father would give her brother a beating and that a genii would take her sister away. Following this, there was a resurgence of anxiety about being lost or abandoned. She then talked about her fear of injections. This led to recollections of Kathy’s running around when the doctor was about to give her an injection and the mother holding Kathy’s arm so that he could. Actually, it had been the father who had held her down. Later in the analysis, discussion of the sibling rivalry led to memories of herself lying in bed when she was four years old: she was in her own room at night, not asleep, and it felt as if everything was spinning around. The feeling was scary but fun. The reference to masturbation in connection with rivalry suggested that beating fantasies accompanied the masturbation. The positive oedipal wishes continued to develop in the transference and were expressed in desires for me to take her to lunch, to give her presents, and, finally, to exchange visits to our respective homes. She had the fantasy that I would punish her by not letting her go to her own home. This was interpreted as her wish to have me adopt her. The hostility to the frustrating mother was revealed in a slip when she said, “I was so angry with my father because I thought he was going to kill my mother-I mean, make her go to the hospital.” The defensive anger at her father was displaced to me in her remark that she wasn’t going to talk. She would waste my time and not want my presents because I was like her father and he sent her mother to the hospital. This was explained to her as a means of shifting the blame for her own wish. She quickly abandoned her denial of her wish for presents from me. What emerged was her jealousy and her wish for a child from me. The struggle against her death wishes toward the mother resulted in a nightmare about a substitute teacher who
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was going to kill the girls and put them in a closet. In this dream, Kathy cut the woman’s ears off and then cut off other parts of her body. She then found that the other girls were not killed, only hurt. The reversal from passive to active was a characteristic defense and can be understood as her reaction to the traumatic situation of enforced passivity in receiving the series of injections. Regression to messing and an episode of wetting herself were accompanied by expressions of penis envy reflected in jealousy of her brother and fantasies about robbers. She debated whether she should dress up as a lady bank robber for Halloween. She then returned to her wish for a child as proof of love from her father. In the transference, she imagined being pursued by a one-eyed monster on her way to my office. Further, the monster would jump on her back or bite her leg; finally, I would murder her. These fears became more intense when her parents left for a weekend and she had to resort to sleeping in the same room as her grandparents, who were taking care of the children during the parents’ absence. The fears also caused her to express reluctance to come to my office. She said this might be because she was afraid I might do something to her. A connection between these fantasies and masturbatory activity could be established associatively in her accompanying reports of fun and excitement involved in tickling and wrestling at the same time that she related slight genital bleeding and discomfort. Guilt about her hostility to her parents, more especially to her mother, aroused need for and fears of punishment. These were expressed through fantasies of beatings, deprivations, and of being killed. She related this to earlier ideas that her ear trouble and the “shots” were forms of punishment. Analysis of these fears was followed by a brief recurrence of ear pains and fears of deafness. The material then shifted to her desires to be a boy, to compete with her brother. She expressed her conflict about exhibiting and resisted an attempt on her brother’s part to
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engage her in mutual exhibiting. She recalled earlier looking at her brother’s and men’s penises; this was in direct association to her fears of getting shots by a needle described as “a long thing.” There were fantasies of incorporating the penis orally, and the following dream: “I was riding a horse. My brother was cooking some food. I ate it all up. He was angry.” Her associations led to playing tricks on others. This was related to her fantasies of having a penis. This concludes the abstract of analytic material from the analysis of this girl during latency. She had shown so much improvement in overcoming her fears, increasing her participation in school games and sports, with diminished physical complaints and a widening circle of friends that it was decided to terminate the analysis. She did well until late adolescence when she experienced severe anxiety with feelings of unreality and persecutory ideas. She went to another analyst for further analysis; this centered around her need to establish masochistic relationships with both men and women, a later version of the earlier fears of being attacked.
Discussion Ideally, latency in girls would be characterized by apparent diminution of the sexual drive (whether due to inherent biologic, psychophysiologic, or psychosocial factors) , with repression of the oedipal wishes and a shift away from the primary objects. In addition, the increasing capacity and expansion of ego functions enable them to tolerate greater degrees of unsatisfied tension and provide them with a greater range of defenses and more adaptive means of gratifying instinctual needs. The regressive shift to anal-sadistic organization in the first part of latency may lead temporarily to sadomasochistic fantasies and behavior. With further ego development, permitting neutralization and sublimation , there is a progression to more aim-inhibited goals and increased involvement with peer relationships. Primitive pre-
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oedipal fantasies and wishes are repressed or decathected; as a result of their diminished intensity, they are seen as less threatening. Factors that may interfere with this progression include excessive deprivation, illness, traumatization, overstimulation and overgratification, inconstant or inconsistent mothering, and pathogenic identifications. With my patient, a number of these factors did impinge on her development. The mother was a hysterical personality with neurotic fears of bodily injury and death. This heightened her daughter’s concern for her own and her mother’s safety and increased her guilt over hostile wishes toward her mother. The seductive relation with t h e brother, involving mutual exhibitionism, which stimulated intense penis envy and aggression, teasing, and provocative behavior, increased the sadistic and masochistic tendencies and encouraged her acting out of masochistic fantasies with him and her peers. The fortuitous advent of the ear infection which required a series of injections served as an organizing experience around which her masochistically colored oedipal wishes could be crystallized into a phobic symptom, the fear of being stung by bees. The symbolic equation of needle equals stinger equals penis is obvious. The outward calm that this girl developed during the series of injections was a result of suppression of the anxiety. An unconscious erotization of the experience led to a wish to repeat it. Against that, she developed the fear of being stung by bees, a classic example of displacement. To progress to latency, the child must repress, or at least diminish in intensity, the wishes and fantasies toward the oedipal objects. Whatever interferes with such renunciation impedes the psychological maturation with its shift toward peers and external reality. With Kathy, the experience of the series of injections had the effect of making a masochistic oedipal fantasy seem more real, with the pediatrician serving as a father figure.
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This case demonstrates a number of factors contributing to masochistic patterns in a latency girl: 1. Early primal scene exposure, as suggested by the history and dream of the man and the moon. 2. A tendency to inhibit outward expression of aggression, manifested by body clumsiness and stiffness, and to direct it against her own body, demonstrated by hair-pulling. 3. Identification with a suffering mother. 4. A masochistic oedipal fantasy of penetration and impregnation viewed as destructive to her body. 5 . A prolonged traumatizing illness with the experience of having to submit to a painful procedure, namely, a series of injections. 6. Libidinization of the pain and anxiety. 7. Seductive stimulation and teasing with members of her own family and peers.
Conclusion Psychoanalytic theory postulates that all children pass through a preoedipal phase characterized in part by sadomasochistic strivings and fantasies. These urges and fantasies color to a greater or lesser degree the oedipal wishes. In the case of the girl, the oedipal wish for a child typically includes penetration and impregnation by the father’s phallus. The girl may perceive this as a dangerous threat to bodily integrity; resultant anxiety contributes to repression of the oedipal wishes and, to varying degrees, genital sensation and masturbatory activity. With the increasing strength of the ego, and stability and moderation of the superego, the girl is better able to cope with her drives and unrelieved tension. She also can deflect the drives away from the primary objects and aims, and acquires a greater tolerance for the drives and wishes. However, this process will be interfered with by such factors as primal-scene exposure, traumatizing illnesses and operations, continued se-
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ductive stimulation, and erotization of the pain and anxiety of fear-producing situations. To the extent that earlier fantasies and wishes remain unmodified by diminution of intensity, deaggressivization, and sublimation, there may be a corresponding persistence of masochistic orientation or other infantile personality problems. REFERENCE5 Ba-rnett, M. C. (1966), Vaginal awareness in girls. Thtj Journal, 14:129.141. Bernstein, I. (1957), The role of narcissism in moral masochism. Psjchoanal. Quart.. 20:358-377. Bornstein, B. (1953). Masturbation in the latency period. The Psjchoanalq.tic Study o f t h e .Child, 8:65-78. New York: International Universities Press. Brenman, hl. (1952), On teasing and being teased: And the problem of “moral masochism.” The Psychoanal~ticStudy of the Child, 7264-286. New York: International Universities Press. Brenner, C. (1959), The masochistic character: Genesis and treatment. T h h JoUmal, 7:197-226. Deutsch, H.(1930), The significance of masochism in the mental life of women. Zntemat. J. Psycho-Anal. 11:48-60. Fenichel, 0. (1930), T h e pregenital antecedents of the Oedipus complex. In: Collected Papers, First Series. New York: Norton, 1953, pp. 181-203. Fliegel, Z. 0.(1973), Feminine psychosexual development in Freudian theory: A historical reconstruction. Psychoanal. Quart., 52385.409. Fraiberg, S. (1972). Some characteristics of genital arousal and discharge in latency girls. The PsychoanalJ.tic Study of the Child, 27:439-479. New York: International Universities Press. Freud, A. (1949), Certain types and stages of social maladjustment. In: Searchlights on Delinquency, ed. K. R. Eissler. New York: International Universities Press, pp. 193-205. Freud, S. (1924a). T h e dissolution of the Oedipus complex. Standard Edition, 19:173-179. London: Hogarth Press, 1961. -(1924b). The economic problem of masochism. Standard Edition, 19:157170. London: Hogarth Press, 1961. -(1925), Some psychical consequences of the anatomical distinction between the sexes. Standard Edition, ,19:243-248. London: Hogarth Press, 1961. (1933), New introductory lectures on psycho-analysis. Standard Edition, 22:112-136. London: Hogarth Press, 1964. Greenacre, P. (1953). Certain relationships between fetishism and a faulty development of the body image. In: Emotional Growth. New York: International Universities Press, pp. 9-30. Harley, hl. (1961), Masturbation conflicts. In: Adolescents: Psychoanaljtic APproach to P r o b l e m and Therapy, ed. S. Lorand & H. Schneer. New York: Paul B. Hoeber. Hartmami. H., Kris, E. & Loewenstein, R. hl. (1949), Notes on the theory of
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aggression. The Psychoanalytic Study of the Child, 3/4:9-36. New York: International Universities Press. Homey, K. (1926). The flight from womanhood: the masculinity complex in women, as viewed by men and women. Internat..]. Psycho-Anal., 7:324-339. Jones, E. (1927). The early development of female seiualGy. Internat. J. PsychoAnal., 8:459-472. Kestenberg, J. (1956), Vicissitudes of female sexuality. T h eJournal, 4:452-476. -. (1968), Outside and inside, male and female. ThisJournal, 16:457-520. Lampl-de Groot, J. (1928), T h e evolution of the Oedipus complex in women. Internat. J. Psycho-Anal., 9:332-345. (1950). On masturbation and its influence on general development. The Psychoanalytic Study of the Child, 5:153-174. New York: International Universities Press. Loewenstein, R. (1957). A contribution to the psychoanalytic theory of masochism. ThisJournal, 5:197-234. P a d (1956). The problem of masochism in the theory and technique of psychoanalysis, M. H. Stein, reporter. ThisJournal, 4:526-538. Panel (1957), Theory of aggression, bl. Ostow, reporter. ThisJournal, 5:556-563.
Submitted January 8, 1975 12 Welwyn Road Great Neck, New York 11021
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LATENCY-AGE GIRL :
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about latency in girls without attempting a comprehensive discussion of the complex changes that occur. Latency in girls is generally accepted to have occurred when there is apparent relinquishment of the oedipal wishes, with the abandonment of the wish for a child from the father. The motive force is fear of the loss of the mother’s love (Freud, 1924a). Additionally, there is the realistic disappointment of the wish for the child. Other authors (Horney, 1926; H. Deutsch, 1930; Lampl-de Groot, 1928) have added the fear of penetration and destruction by the father’s penis. A concomitant diminution of sexual drive is postulated as usual but not inevitable. There is a shift from the primary objects to peer relations. Ambivalence with girl friends reflects an earlier pattern in the relation to the mother. Triangular relationships among girls are frequent and more or less mirror the oedipal constellation, Boys are treated with contempt, and their aggressiveness and dirtiness are reacted to with disgust. These attitudes serve also to repudiate the girl’s earlier envy and masculine wishes. WISH FIRST TO COMMENT
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Sexuality Typically, a struggle against masturbatory practices ensues, with occasional or frequent breakthroughs. Separation of fantasy from the act can lead to differing patterns of defense, gratifications, and guilts (A. Freud, 1949). One commonly used defense against masturbation is regression to pregenital-e.g., oral-gratification. A nine-year-old girl told me she used to put her fingers inside, but now this disgusted her. I asked her what she did instead, and she answered that she sucked her thumb. Transfer of interest from the genitals to the entire body and to clothes enhance the girl’s narcissism, when she devotes greater attention to her appearance. Freud (1925) stated that the narcissistic disappointment in her genitals causes the girl to relinquish masturbation-to avoid the feeling of genital inferiority. It may well be, however, that the repression of the oedipal wishes, which arises at the same time as the girl experiences pleasurable genital feelings, can cause the repression of genital sensation. Lampl-de Groot (1950) has noted that one of the most important determinants of the degree of masturbatory activity is the mother’s attitude, which becomes a factor in the child’s superego attitude in identification with the frustrating or prohibiting mother. It is my experience and that of others who have reported cases (Bornstein, 1953; Harley, 1961; Kestenberg, 1968; Fraiberg, 1972) that it is difficult to gain access to detailed verbal material regarding masturbation in latency girls. As Bornstein (1953) has said, “Unfortunately little is known about the course and rhythm of excitation and complete or incomplete gratification by masturbation in children between eight to ten years.. .” (p. 69). She did, however, report material from analyses of a six-year-old girl, a nine-year-old girl, and a ten-year-old girl, all of whom interrupted masturbatory activity to avoid overwhelming orgastic sensations, Earlier analytic data led to the assumption that the little
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girl was aware only of the external genitalia-clitoris and labia-that the clitoris was the homologue of the penis, and that the girl’s feelings of inferiority led to penis envy, the masculinity complex (tomboyishness), and suppression of masturbation. Helene Deutsch (1930) gave examples of two cases of vaginal masturbation, but declared that these were exceptions caused by early seduction and defloration, and were atypical for latency girls. Fliegel (1973), in discussing the history of the changes in analytic theory regarding feminine psychosexual development, saw the entire subject as controversial with Helene Deutsch and Lampl-de Groot supporting Freud’s original view that the girl is led to the Oedipus complex by the castration complex and Horney (1926), Jones (1927), and Fenichel (1 930) expressing points of disagreement. Recently, there has been considerable interest in obtaining a clearer and more complete picture of sexual function and responses in the female, and this has been evidenced in studies of young girls. Kestenberg (1968) reported the analysis of a four-year-old girl who masturbated externally and vaginally but also anally. At the age of sixteen months, the girl had suffered from a fungus infection which had involved the genital and perianal areas. Baths and ointments were used to relieve the irritation. Her condition had caused a preoccupation with genital sensations, According to Kestenberg, this prevented an externalization of the sensations and denial of the vaginal introitus, which, Kestenberg believes, is reinforced by the repression of oedipal fantasies at the beginning of latency (p. 474). As latency girls progress toward prepuberty, they “discover the secret” of the vaginal opening, a secret they share with girl friends and from which boys are excluded. Barnett (1966) reported fantasies, play sessions, and dreams of a nine-year-old girl and a twelve-year-old girl, which she interpreted as proving that these girls had vaginal sensations and awareness. According to Barnett, this awareness creates anxiety which causes repression, decathexis of the vagina, and
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hypercathexis of the clitoris. Kestenberg (1968) described a nine-year-old girl who masturbated clitorally to achieve orgasm. The gir!’s masturbation fantasies were masochistic; they involved men who enslaved and tortured her. In a highly illuminating study, Fraiberg (1972) d’iscusses genital arousal in girls. Her attention to the subject was drawn by her observation that an adult patient suffering from sexual frigidity had had a childhood experience similar to those of two of Fraiberg’s latency girl patients, namely, a “turning away from the genital coinciding with total loss of erotic sensation” (p. 439). The crucial event had been an overwhelming excitement of orgastic proportions. These girls had discovered and explored the vagina and had then repressed sensation. Using an age-appropriate language, Fraiberg was able to obtain a remarkably vivid and precise description of the localization of the different genital feelings resulting from masturbatory activity. It thus appears that masturbatory activity in the latency girl can involve the clitoris, labia, vagina, and anus. The range of feeling and awareness may extend from complete anesthesia and denial to full orgastic-like response. I should like to suggest that the repression of genital sensation may also be owing to masochistic fantasies that accompanied the masturbation and are perceived as too dangerous. In both of the cases reported by Fraiberg “a sadistic fantasy was required” (her italics) to reach the high point of excitement (p. 453). The underlying masochistic fantasy is implied in the case of Nancy, who identifies herself with children enslaved by animals and treated like horses, who were forced to pull a heavy load with the bits cutting into their mouths. The second girl, Suzanne, was excited by the fantasy of a girl being kidnapped, stripped of her clothes, and then looked at by the men.
Aggression If our knowledge and understanding of the sexual drive in latency girls is incomplete, our comprehension of the fate of Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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the aggressive drive is much more rudimentary. I am compelled to emphasize certain aspects of the vicissitudes of the aggressive drive in latency girls. To begin with, there is a general impression that, from birth, i.e., constitutionally, girls show a lesser degree of aggression than boys. This opinion is based on observations of behavior and is therefore subject to question: is the manifest activity equivalent to the strength of the innate drive? Observation does not take into full account defensive modification and adaptation to social expectation. Putting this aside for the moment, let us turn to the fate of the aggressive drive in latency. The shift of the cathexis from the primary objects in the process of resolution of the oedipal conflict liberates part of that energy, which becomes available in neutralized form (Hartmann et al., 1949) for such tasks as mastery of the environment, learning, and sports and games. Some portion of the aggressive drive is probably utilized for countercathexis of oedipal wishes and fantasies. Depending also on the degree of regression, some aggression will be directed along pregenital channels and find sadomasochistic expression. Symptomatically, one sees this in more frequent nailbiting, hair-pulling, teasing behavior, and occasional cruelty to insects, animals, and siblings. It may also be reflected in masturbatory patterns, which can include sadomasochistic fantasies and the inflicting of pain on parts of the body, including the genitals. Internalized aggression also enters into the formation and functioning of the superego. Here, also, depending on the degree of neutralization or reinstinctualization, masochistic tendencies may find expression in moral masochism. With the growth and development of the ego in latency, there is an expansion of the synthetic function. Hartmann et al. (1949) have stated, “Through a simultaneous cathexis with libido the aims of aggression are modified. This modification may be brought about in two different ways: by the mere coexistence of two investments, leading to the prevalence of libido over aggression; and by the fusion of both instinctual drives’’ (p. 19). Failure of such modification through arrest in Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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development or regression can result in divergence of libidinal and aggressive aims, persistence of primitive fantasies, attitudes, and behavior, with serious impairment of object relations. One possible outcome is the development of masochistic patterns or character.
Masochzim Although many clinical studies and case reports include material relating to masochism in latency girls, published contributions by child analysts specifically devoted to this topic are few in number. The subject has received attention by analysts of adults, and many of them refer to the importance of childhood experiences and development in the genesis of the adult varieties of masochism (see Panel, 1956). Loewenstein (1957) points out that a common clinical fact tends to be overlooked, namely, that the patients themselves describe the origin of their perversion as being linked to a particular specific scene in childhood. He notes that Greenacre (1953) called attention to the importance of traumatic overstimulation in certain cases of fetishism and severe neuroses. Loewenstein describes as universal a behavior he terms “seduction of the aggressor,” wherein the child induces a threat which is followed by its removal and loving response of the parent. Expanding on Freud’s (1924b) formulation, Loewenstein discusses the various forms of masochism as: erotogenic, part of the sexual life of women, a perversion, and as a pattern of behavior, including the masochistic character, the mentality of the slave, and moral masochism. It is particularly in relation to the second form-i.e., as part of the sexual life of women- that there has been considerable disagreement. Freud (1933) stated: It is perhaps the case that in a woman, on the basis of her share in the sexual function, a preference for passive behaviour and passive aims is carried over into her life to a greater or lesser extent, in proportion to the limits, Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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restricted or far-reaching, within which her sexual life thus serves as a model. But we must beware in this of underestimating the influence of social customs, which similarly force women into passive situations. All this is far from being cleared up. There is one particularly constant relation betw...en femininity and instinctual life which we do not want to overlook. The suppression of women’s aggressiveness which is prescribed for them constitutionally and imposed on them socially favours the development of powerful masochistic impulses, which succeed, as we know, in binding erotically the destructive trends which have been diverted inwards. Thus masochism, as people say, is truly feminine [pp. 115-1161. Helene Deutsch (1930) emphasized masochistic psychosexual development in girls as follows: “In place of the active urge of the phallic tendencies, there arises the masochistic phantasy: ‘I want to be castrated’, and this forms the erotogenic masochistic basis of the feminine libido. Analytic experience leaves no room for doubt that the little girl’s first libidinal relation to her father is masochistic, and the masochistic wish in its earliest distinctive feminine phase is: ‘I want to be castrated by myfather’ (p. 52). She expressed the idea that in neurotic development, the superimposition of guilt in the form of moral masochism may obscure the underlying original erotogenic masochism. In the same paper, she declared that, “The first, infantile identification with the mother is always, independently of the complicated processes and reactions belonging to the sense of guilt, masochistic, and all the active birth-phantasies, whose roots lie in this identification, are of a bloody, painful character, which they retain throughout the subject’s life” (p. 54). Deutsch saw the earliest relationship to father and mother as masochistic; these developmental formulations are controversial. Gero (Panel, 1957) considers sadism and masochism to be rooted in the bisexual organization of human instincts, with the sadistic position as essentially masculine and the masochistic position essentially feminine (p. 560). Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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Waelder (Panel, 1956) declares that the normal woman is not masochistic, a point that Bak put in reverse form: the masochistic woman is not truly feminine. In a previously published paper (Bernstein, 1957), I drew attention to the importance of narcissistic attitudes on the part of parents in the development of masochistic patterns in children, patterns designed to prevent recurrences of passively experienced disappointments and object loss. The result was a compulsive repetition of self-induced disappointments, rejection, and humiliation. Brenman (1952), citing the case of a self-destructive adolescent girl, examines masochism as a complex configuration embodying drive, defense, and adaptive functions. This point of view is further developed by Brenner (1959), who describes several male patients and a woman with masochistic tendencies. Among other conclusions, Brenner finds that “Masochism is a normal component or characteristic of the human personality, as witness the part it plays in superego formation and functioning. The difference between the normal and masochistic character is one of degree rather than of kind. . . . Masochistic character traits and fantasies are alegacy of infantile sexual conflicts, principally of oedipal conflicts in most cases. As such they are related to the principal danger situations of early childhood, which are typically the dangers of object loss, of loss of love, and of castration, but the importance of each of these danger as a motive for defense will vary from one masochistic patient to another” (pp. 224-225). In Brenner’s view, therefore, masochism is not identified as feminine, although his clinical examples point to the unconscious wish for the men to be castrated and loved by the father, i.e., to be women in their childhood fantasy. Case Report
Kathy, an eight-year-old girl, was referred for treatment because she feared insect bites and was afraid to walk to school
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alone. Also, she had been having so many bodily complaints that she was taken to a consulting pediatrician who said she was “hypertonic” and had a greater sensitivity to pain than most children. In addition, the mother reported that the little girl reacted very strongly to criticism and felt she was treated unfairly. The parents became concerned over the persistence of the fears and consulted a child analyst who recommended analysis.
History Birth was normal. Breast feeding was begun but on the seventh day the baby developed a temperature of 102 and the pediatrician ordered breast feeding discontinued. The temperature subsided, but Kathy reacted with diarrhea to the formula; this continued for two weeks until a more dilute formula was substituted. Allergic reactions to various foods disappeared after several months, and diet became unrestricted. Development was normal, although Kathy was clumsy in body movement, and this was reflected in avoidance of play involving gross motor activities. She ate and slept well; toilet training was uneventful. Kathy shared the parental bedroom until six months of age. Up until the age of five years, she would touch her genitals and occasionally exhibit herself to other members of the family. The parents told her that touching herself in public was unacceptable; this effectively stopped the overt masturbation. At the age of five, Kathy was subject to a series of injections necessitated by an ear infection which threatened to spread. The mother was a hysterical personality; she had developed fears of airplane crashes. She also had intestinal cramps. The father was an educator whose interest in psychology stemmed from his reading. At the time Kathy was seen, he tended to accuse his wife of not being sufficiently attentive to the children, and this led .to arguments between
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the parents. There had been deaths in the families of both parents during their own childhoods, and there was a resultant atmosphere of concern in the home about accidents, illness, and death. Kathy had an older brother and a younger sister. The older brother teased her mercilessly; she was chased and hit, often as a result of her own provocation. There were repeated episodes of excitement around bathroom activities. Psychological testing revealed a girl apparently overwhelmed with anxiety, especially separation anxiety. This was considered to be largely a function of her inability to deal with her impulses. Projectives indicated a constant struggle with parental figures to get what she wanted. She saw them as depriving and frustrating, with resultant hostility and death wishes toward them. Defenses included compulsive ordering, projection, and reaction formation. These did not operate too well, and she was consequently obsessed with vague fears and morbid thoughts, particularly thoughts of death. Kathy reacted to being told that she would be seeing me for help by saying that she expected me to help her in two ways: with her problems, and just by talking-by being nice. She foreshadowed a later part of the analysis when she complained that one of her problems was that her friends always made her take the part of the boy whenever she played at being grown-up and married.
The Analysis At her first visit, Kathy impressed me as an attractive, friendly little girl, quite feminine in manner. The first hours expressed her conflicts about sexuality and aggression by stories about twins. One involved a policeman who had a twin brother who was a robber. She made a drawing of fraternal twins and was undecided as to which should be the boy. Regular treatment began in the fall, at which time she declared that her problems were that she wanted to grow up, and she was so excited about it that it made her unable to Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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think about other things. She could not elaborate on this wish. Her other problem was that she sometimes felt bad if she fought with her mother and father and thought they didn’t like her. Later she added that she was afraid of shots and bees, even though she had never been stung by a bee. After expressing feelings that her mother loved her less than her siblings and recounting various deprivations, she attempted to deal with fears of separation from or abandonment by an angry mother by stories involving reversal of roles: Kathy would be angry and leave. In the transference situation, she had a disturbing fantasy that the taxi driver who was supposed to pick her up after her hour would not wait for her and hence she would be left at my office. The anxiety also resulted in a nightmare: “I am with a friend. The moon became a man. The moon was angry because a man had been shooting rockets up to it. The moon started to chase the man. Then it chased us. I got very frightened and woke up. I stayed with my mother until six o’clock in the morning.” Associations led to discussions of her fears of anything happening to her mother. She was then able to report that sometimes she got angry at her mother and wished she would get killed. Then she would have another mother. However, she then reminded herself of the good things her mother did, and started to cry. In a later hour, she reported ways in which she punished herself for these angry wishes: she would pull her hair, or deprive herself of TV, or give a sibling part of her allowance. Another reaction to the expression of her hostility to her mother was a temporary regression to a wish to be the baby of the family as an imagined way of being mother’s favorite. The fantasy of being the baby inside mother resulted in a fear of being unable to unlock the bathroom door-i.e., of being trapped. She then alternated between the wish to be the protected and loved baby and the wish to be the powerful, punishing mother. She tried to deal with fears of being punished by making an exciting game of it and by frightening her younger sister. At home, she began to defy her mother, refusing to make Downloaded from apa.sagepub.com at Bobst Library, New York University on May 24, 2015
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her own bed. She was also more aggressive to her father, jokingly slapping him and touching his penis through his clothes. In a counterphobic act, she put a needle through her own skin and showed it to the family. Concurrently, she was able to go to school alone. In the analysis, a period of silence resulted in a fantasy that I would shout at her or send her home or call the mother to punish her. She related this to her own anger at herself. At this point, the mother had some intermenstrual bleeding and was advised to enter the hospital. The children were told that the mother had a “bellyache.” Kathy reacted by having nightmares. In one, she was told she would die; in another, a lady said that she was going.to kill the whole family. In the dream, Kathy made a dummy and poured ketchup over it, and the lady said, “Ah ha. I got one of them.” The allusion to the mother’s bleeding was clear. Some days later, it became apparent that the children knew the reason for the mother’s hospitalization; one of them had overheard a telephone conversation concerning the mother’s illness. The father then explained the need for the operation. Kathy took the whole thing matter-of-factly. Subsequent material dealt with the birth of the younger sister and Kathy’s fantasy that the baby had come out of the belly. She drew pictures of the hospital, and I indicated her wish to visit the mother. Hospital rules made that not possible. Kathy reported to me that she had heard that they would cut a hole in her mother’s middle, take something out, and then stitch. While the mother was hospitalized, Kathy and her father had a fight. Although she defended herself against her positive oedipal wishes at home, Kathy expressed them in the transference by bringing me a cake and a very good school report card. She expressed her wish to get presents and to have her meals in bed, as the mother was being served in her convalesence. Dreams expressed the same wish to get presents from her father, but were accompanied by others that reflected the fear of-beingpunished (scalped) by a drunken Indian woman. The
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last was a reference to the mother’s unstable gait due to weakness and was also a reference to Kathy’s perception of her own instability and undependable controls. Kathy’s hostile feelings were displaced onto her siblings with the wish that her father would give her brother a beating and that a genii would take her sister away. Following this, there was a resurgence of anxiety about being lost or abandoned. She then talked about her fear of injections. This led to recollections of Kathy’s running around when the doctor was about to give her an injection and the mother holding Kathy’s arm so that he could. Actually, it had been the father who had held her down. Later in the analysis, discussion of the sibling rivalry led to memories of herself lying in bed when she was four years old: she was in her own room at night, not asleep, and it felt as if everything was spinning around. The feeling was scary but fun. The reference to masturbation in connection with rivalry suggested that beating fantasies accompanied the masturbation. The positive oedipal wishes continued to develop in the transference and were expressed in desires for me to take her to lunch, to give her presents, and, finally, to exchange visits to our respective homes. She had the fantasy that I would punish her by not letting her go to her own home. This was interpreted as her wish to have me adopt her. The hostility to the frustrating mother was revealed in a slip when she said, “I was so angry with my father because I thought he was going to kill my mother-I mean, make her go to the hospital.” The defensive anger at her father was displaced to me in her remark that she wasn’t going to talk. She would waste my time and not want my presents because I was like her father and he sent her mother to the hospital. This was explained to her as a means of shifting the blame for her own wish. She quickly abandoned her denial of her wish for presents from me. What emerged was her jealousy and her wish for a child from me. The struggle against her death wishes toward the mother resulted in a nightmare about a substitute teacher who
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was going to kill the girls and put them in a closet. In this dream, Kathy cut the woman’s ears off and then cut off other parts of her body. She then found that the other girls were not killed, only hurt. The reversal from passive to active was a characteristic defense and can be understood as her reaction to the traumatic situation of enforced passivity in receiving the series of injections. Regression to messing and an episode of wetting herself were accompanied by expressions of penis envy reflected in jealousy of her brother and fantasies about robbers. She debated whether she should dress up as a lady bank robber for Halloween. She then returned to her wish for a child as proof of love from her father. In the transference, she imagined being pursued by a one-eyed monster on her way to my office. Further, the monster would jump on her back or bite her leg; finally, I would murder her. These fears became more intense when her parents left for a weekend and she had to resort to sleeping in the same room as her grandparents, who were taking care of the children during the parents’ absence. The fears also caused her to express reluctance to come to my office. She said this might be because she was afraid I might do something to her. A connection between these fantasies and masturbatory activity could be established associatively in her accompanying reports of fun and excitement involved in tickling and wrestling at the same time that she related slight genital bleeding and discomfort. Guilt about her hostility to her parents, more especially to her mother, aroused need for and fears of punishment. These were expressed through fantasies of beatings, deprivations, and of being killed. She related this to earlier ideas that her ear trouble and the “shots” were forms of punishment. Analysis of these fears was followed by a brief recurrence of ear pains and fears of deafness. The material then shifted to her desires to be a boy, to compete with her brother. She expressed her conflict about exhibiting and resisted an attempt on her brother’s part to
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engage her in mutual exhibiting. She recalled earlier looking at her brother’s and men’s penises; this was in direct association to her fears of getting shots by a needle described as “a long thing.” There were fantasies of incorporating the penis orally, and the following dream: “I was riding a horse. My brother was cooking some food. I ate it all up. He was angry.” Her associations led to playing tricks on others. This was related to her fantasies of having a penis. This concludes the abstract of analytic material from the analysis of this girl during latency. She had shown so much improvement in overcoming her fears, increasing her participation in school games and sports, with diminished physical complaints and a widening circle of friends that it was decided to terminate the analysis. She did well until late adolescence when she experienced severe anxiety with feelings of unreality and persecutory ideas. She went to another analyst for further analysis; this centered around her need to establish masochistic relationships with both men and women, a later version of the earlier fears of being attacked.
Discussion Ideally, latency in girls would be characterized by apparent diminution of the sexual drive (whether due to inherent biologic, psychophysiologic, or psychosocial factors) , with repression of the oedipal wishes and a shift away from the primary objects. In addition, the increasing capacity and expansion of ego functions enable them to tolerate greater degrees of unsatisfied tension and provide them with a greater range of defenses and more adaptive means of gratifying instinctual needs. The regressive shift to anal-sadistic organization in the first part of latency may lead temporarily to sadomasochistic fantasies and behavior. With further ego development, permitting neutralization and sublimation , there is a progression to more aim-inhibited goals and increased involvement with peer relationships. Primitive pre-
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oedipal fantasies and wishes are repressed or decathected; as a result of their diminished intensity, they are seen as less threatening. Factors that may interfere with this progression include excessive deprivation, illness, traumatization, overstimulation and overgratification, inconstant or inconsistent mothering, and pathogenic identifications. With my patient, a number of these factors did impinge on her development. The mother was a hysterical personality with neurotic fears of bodily injury and death. This heightened her daughter’s concern for her own and her mother’s safety and increased her guilt over hostile wishes toward her mother. The seductive relation with t h e brother, involving mutual exhibitionism, which stimulated intense penis envy and aggression, teasing, and provocative behavior, increased the sadistic and masochistic tendencies and encouraged her acting out of masochistic fantasies with him and her peers. The fortuitous advent of the ear infection which required a series of injections served as an organizing experience around which her masochistically colored oedipal wishes could be crystallized into a phobic symptom, the fear of being stung by bees. The symbolic equation of needle equals stinger equals penis is obvious. The outward calm that this girl developed during the series of injections was a result of suppression of the anxiety. An unconscious erotization of the experience led to a wish to repeat it. Against that, she developed the fear of being stung by bees, a classic example of displacement. To progress to latency, the child must repress, or at least diminish in intensity, the wishes and fantasies toward the oedipal objects. Whatever interferes with such renunciation impedes the psychological maturation with its shift toward peers and external reality. With Kathy, the experience of the series of injections had the effect of making a masochistic oedipal fantasy seem more real, with the pediatrician serving as a father figure.
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This case demonstrates a number of factors contributing to masochistic patterns in a latency girl: 1. Early primal scene exposure, as suggested by the history and dream of the man and the moon. 2. A tendency to inhibit outward expression of aggression, manifested by body clumsiness and stiffness, and to direct it against her own body, demonstrated by hair-pulling. 3. Identification with a suffering mother. 4. A masochistic oedipal fantasy of penetration and impregnation viewed as destructive to her body. 5 . A prolonged traumatizing illness with the experience of having to submit to a painful procedure, namely, a series of injections. 6. Libidinization of the pain and anxiety. 7. Seductive stimulation and teasing with members of her own family and peers.
Conclusion Psychoanalytic theory postulates that all children pass through a preoedipal phase characterized in part by sadomasochistic strivings and fantasies. These urges and fantasies color to a greater or lesser degree the oedipal wishes. In the case of the girl, the oedipal wish for a child typically includes penetration and impregnation by the father’s phallus. The girl may perceive this as a dangerous threat to bodily integrity; resultant anxiety contributes to repression of the oedipal wishes and, to varying degrees, genital sensation and masturbatory activity. With the increasing strength of the ego, and stability and moderation of the superego, the girl is better able to cope with her drives and unrelieved tension. She also can deflect the drives away from the primary objects and aims, and acquires a greater tolerance for the drives and wishes. However, this process will be interfered with by such factors as primal-scene exposure, traumatizing illnesses and operations, continued se-
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ductive stimulation, and erotization of the pain and anxiety of fear-producing situations. To the extent that earlier fantasies and wishes remain unmodified by diminution of intensity, deaggressivization, and sublimation, there may be a corresponding persistence of masochistic orientation or other infantile personality problems. REFERENCE5 Ba-rnett, M. C. (1966), Vaginal awareness in girls. Thtj Journal, 14:129.141. Bernstein, I. (1957), The role of narcissism in moral masochism. Psjchoanal. Quart.. 20:358-377. Bornstein, B. (1953). Masturbation in the latency period. The Psjchoanalq.tic Study o f t h e .Child, 8:65-78. New York: International Universities Press. Brenman, hl. (1952), On teasing and being teased: And the problem of “moral masochism.” The Psychoanal~ticStudy of the Child, 7264-286. New York: International Universities Press. Brenner, C. (1959), The masochistic character: Genesis and treatment. T h h JoUmal, 7:197-226. Deutsch, H.(1930), The significance of masochism in the mental life of women. Zntemat. J. Psycho-Anal. 11:48-60. Fenichel, 0. (1930), T h e pregenital antecedents of the Oedipus complex. In: Collected Papers, First Series. New York: Norton, 1953, pp. 181-203. Fliegel, Z. 0.(1973), Feminine psychosexual development in Freudian theory: A historical reconstruction. Psychoanal. Quart., 52385.409. Fraiberg, S. (1972). Some characteristics of genital arousal and discharge in latency girls. The PsychoanalJ.tic Study of the Child, 27:439-479. New York: International Universities Press. Freud, A. (1949), Certain types and stages of social maladjustment. In: Searchlights on Delinquency, ed. K. R. Eissler. New York: International Universities Press, pp. 193-205. Freud, S. (1924a). T h e dissolution of the Oedipus complex. Standard Edition, 19:173-179. London: Hogarth Press, 1961. -(1924b). The economic problem of masochism. Standard Edition, 19:157170. London: Hogarth Press, 1961. -(1925), Some psychical consequences of the anatomical distinction between the sexes. Standard Edition, ,19:243-248. London: Hogarth Press, 1961. (1933), New introductory lectures on psycho-analysis. Standard Edition, 22:112-136. London: Hogarth Press, 1964. Greenacre, P. (1953). Certain relationships between fetishism and a faulty development of the body image. In: Emotional Growth. New York: International Universities Press, pp. 9-30. Harley, hl. (1961), Masturbation conflicts. In: Adolescents: Psychoanaljtic APproach to P r o b l e m and Therapy, ed. S. Lorand & H. Schneer. New York: Paul B. Hoeber. Hartmami. H., Kris, E. & Loewenstein, R. hl. (1949), Notes on the theory of
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aggression. The Psychoanalytic Study of the Child, 3/4:9-36. New York: International Universities Press. Homey, K. (1926). The flight from womanhood: the masculinity complex in women, as viewed by men and women. Internat..]. Psycho-Anal., 7:324-339. Jones, E. (1927). The early development of female seiualGy. Internat. J. PsychoAnal., 8:459-472. Kestenberg, J. (1956), Vicissitudes of female sexuality. T h eJournal, 4:452-476. -. (1968), Outside and inside, male and female. ThisJournal, 16:457-520. Lampl-de Groot, J. (1928), T h e evolution of the Oedipus complex in women. Internat. J. Psycho-Anal., 9:332-345. (1950). On masturbation and its influence on general development. The Psychoanalytic Study of the Child, 5:153-174. New York: International Universities Press. Loewenstein, R. (1957). A contribution to the psychoanalytic theory of masochism. ThisJournal, 5:197-234. P a d (1956). The problem of masochism in the theory and technique of psychoanalysis, M. H. Stein, reporter. ThisJournal, 4:526-538. Panel (1957), Theory of aggression, bl. Ostow, reporter. ThisJournal, 5:556-563.
Submitted January 8, 1975 12 Welwyn Road Great Neck, New York 11021
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