Part I
Erotics embodied
Transferences and countertransferences
Introduction to Part I
Thus the significance of psychoanalysis
is less to make psychology biological
than to discover a dialectical process
in functions thought of as âpurely bodilyâ,
and to reintegrate sexuality into the human being.
M. Merleau-Ponty, 1962
There is an amusing story of two friends in a nudist colony. They are walking together, naked, around the grounds. One has a band-aid on his upper arm. The other asks, âCan I see whatâs under that band-aid?â We are drawn to the hidden and mysterious; we are tempted to push boundaries, even in the most permissive contexts. Erotic experience exemplifies this urge (Stein, 1998). What is the nature of this push, this urge to get beyond the immediate and concrete? What are we looking for, what does it feel like? These are some of the questions that pertain to the present exploration into erotic life in the psychoanalytic and psychotherapeutic situation.
Given sexualityâs ubiquity in our culture and private fantasy life, it is remarkable to note the pervasive desexualization of psychoanalysis, a once sex-infused theory of human development. Indeed, Mann (1997) claims the erotic is the heart of oneâs unconscious fantasy life. We, as psychoanalysts, seemed to have known this at one time, but have forgotten it now. There was a time when psychoanalysis was viewed as âall about sex.â In recent decades, however, it seems not to be about sex at all.1 This ironic desexualization of psychoanalytic theory is thought to be an unintended consequence of the emergence of the interpersonal and object relations theories,2 along with the two-person paradigm shift in psychoanalytic theorizing. Fonagy (2008) quantified the apparent decline in interest in sexuality by examining word usage in electronically searchable journals of psychoanalysis. He found that the decline in sexual word usage is inversely related to the rise in relational word usage. So it appears that the decline in interest in sexuality has come about through, at least in part, the emphasis on object relational and especially preoedipal strains in human development and the therapeutic setting.
Similarly, sexuality has virtually disappeared from much of the writings on sadomasochistic relating, with an emphasis instead on pregenital, non-erotic needs. As Green (1995) stated, it is as if the etiologic determinants of psychopathology are thought to be located âbeforeâ or âbeyondâ sexuality. Dimen (1999) attributed much of the desexualization of psychoanalysis to the paradigm shift in contemporary theory from drive to object relations, noting that âwhere libido was, there shall objects beâ (p. 417).
Despite the de-emphasis, underestimation, or outright neglect, I doubt that sex has ever budged from the forefront of anyoneâs mind. In only the last few decades, sexualization, both in its defensive function and as an intrinsic aspect of human relating, has begun to be refound. In particular, the maternal erotic transference has been reconceptualized as another version of erotic desire, leading to explorations of the erotic nature of preoedipal sexuality (e.g., Chassaguet-Smirgel, 1970, 1993; McDougall, 1992; Benjamin, 1994a; Wrye and Welles, 1994; Dimen, 2003; Harris, 2005a). Space has also been cleared for the possibility of genuine, non-neurotic loving aspects of attachment. Bolognini (1994) describes erotic transferences along a developmental continuum (from erotized, to erotic, to loving, and finally affectionate), comprising a broader range of meanings for erotic transferences (see also Bonasia, 2001; De Masi, 2012). Subsequently, Bolognini (2011) has delineated the multiple roles of the analyst in relation to the patient as well. All of these, from both the analystâs and the patientâs perspectives, should make their appearance in the evolving phases of a thorough-going therapeutic treatment.3
Intimacy embodied
With the assumption of the individual as embedded in culture, embodied and emergent in relation, I conceive of healthy sexuality as a capacity for intimacy embodied, rendering any discussion of sexuality as referencing a body/being in relation to another body/being. I do not mean to imply that every healthy sexual act should involve an intimate union with another person, but that healthy sexual functioning must include the capacity for intimate sexual union. Simon (2013) traces the defining characteristics of healthy sexuality throughout the history of psychoanalytic theorizing and notes a tension between two registers of sexual functioning: mutual, reciprocal and whole object relationality along with the capacity for intense bodily pleasure. Note that these registers do not prescribe particular attitudes or behaviors per se, with the exception of privileging freedom, excitement, and pleasure within bodily and relational domains (Kernberg, 1991a). Sexuality, then, is not about anatomy or the genitals; the body is not separate or distant from oneâs experience of it. Healthy sexuality is a capacity for body-based erotic union with another. Psychoanalytic theorizing, however, has gradually lost its emphasis on sexuality in recent decades. My intent is to re-engage theorizing of sexuality within this holistic paradigm.
Itâs been said that in psychoanalysis, everything is about sex ⊠except for sex; thatâs about aggression. It is true to the point of clichĂ© that psychoanalysis, as a hermeneutic discipline, has revolved around the discovery or construction of meaning behind or underneath, an infinite project which changes and evolves with new perspectives, different lenses, and personal transformations. There is an everpresent temptation to use visuo-spatial metaphors, analogizing to the concrete world, where different locations shift oneâs perspective, where the construction of meaning can be categorized as surface to depth. There has been a sense in which psychoanalysis has had the feel of depth as elusive meanings were constructed from the previously unthought. The idea of a hidden, as in âthere but not visible,â proved heuristic and became bedrock, easier to imagine as concretized levels. Thus Freudâs unconscious was almost a place ⊠if not found, at least imagined as under, buried inside the depths of oneâs being, waiting to be discovered.
Layers became part of the leveled, hierarchical structure, with the more primitive envisioned as further away, earlier in time, and deeper in inward space. Psychoanalytic explorations searched for meaning beyond the surface; an ulterior and interiorized motive, as it were. Everything became about something else and sex, already complex, forbidden, and fascinating, was a particular source of mystery. But is there a place for erotic longing in our minds and bodies that does not point elsewhere?4 And what about that surface? The surface reveals the depth itself, more as a quality of beyond in a transcendent, meaning-making effort whose limit is infinite. It is through the exploration of erotics in clinical process that I address my first purpose: sex can be viewed holistically as intimacy embodied. It is at once a two-person embedded and embodied relational experience. It is concrete in the sense that it is a body-based experience, and in that sense, it is surface yet at the same time expresses the full intensity and depth of feeling for the individual.
Eros embodied
Second, my focus on the erotic nature of the therapeutic situation is an effort to reclaim sexuality as one of the many nexes that are of central concern to our patients. As mentioned, I am asserting that erotic transferences, of whatever shape, should make their way into every thorough-going analysis or therapy at some point. For over a century now, the prospect of placing erotic life front and center has been akin to holding down a scared rabbit in the woods. It has eluded even the psychoanalysts for which the tendency to search for meaning behind or beyond the manifest5 is almost routine. Deconstructing sexuality by searching beyond it has virtually, and I believe unintentionally (at least on a conscious level), made it disappear from our writings and thinking. Psychoanalysis developed through Freudâs shocking discoveries of the erotic nature of his patientsâ symptomatology, all within the context of a repressive cultural time. Freudâs main intent throughout his writings has been to legitimize psychoanalysis as a âhardâ science despite its scandalous content. In the past few decades, emphasis on object relational theories, the maternal/preoedipal, and otherwise unintentionally desexualized relational theories have once again relegated sexuality to the background as the maternal figure and her containing function became the primary focus (Green, 1995; Celenza, 2000; Dimen, 2003; Fonagy, 2008). So, whatâs sex got to do with it?
Desire structures perception and, given this, it is easy to understand how the therapeutic structure can provide an igniting spark to erotic excitement. Our patients come to the therapeutic setting with unfulfilled longing on conscious and unconscious levels. Analysts and therapists also have wishes and levels of comfort that influence what is seen, heard, and said. Many behaviors and statements made by the therapist are accompanied by rationalizations that serve to justify (in the moment) their expression. It is only after the fact that the analyst may become aware of a self-serving or defensive aspect to his/her expression that prevented the therapist from seeing its inadvisability. Many self-disclosures fall into this category (see Chapter 5 for an elaboration of this issue). The context that is likely to provide the fodder for a defensive, erotic reaction on the therapistâs part may be the patientâs emerging disappointment, sometimes stated directly but often just subliminally sensed by the therapist.6 If the therapist is unable to explore and tolerate the patientâs frustration, he/she may react with a conscious rationale to become more revealing, perhaps by disclosing some personal information with the idea that the patient will benefit from learning of some similarity between them.
Consider the following: An analyst had a dream in which the last patient from his workday (who happens to look like his daughter) appears. The dream involves a pertinent theme for the patient that, coincidentally, is also a timely conflict for the analyst. He decides to disclose the dream in the next session with the conscious rationale that the patient may see her conflict from a new perspective. What does she hear? Only, âYou are in my dreams,â when, in fact, it is not at all clear that the patient was the relevant person for this analyst, on this particular night and in this particular circumstance.
Yet, our theories have become desexualized to an extent that fails to prepare clinicians with the necessary armamentarium to cope with the level of desire and erotic material likely to emerge. This is even more ironic when we consider how easily the treatment situation (perhaps any intimate relationship) lends itself to sexual metaphor. The dialectic between holding and penetration fosters a mutual deepening and this dialectic is itself a sexual metaphor. For both therapist and patient, the psychotherapeutic work is penetrating and enveloping, incisive and holding, a firm receptivity that retains, envelops, and holds the other in mind.7
From the patientâs point of view, resistance to the erotic transference can take many forms: the inability to process or hold the analystâs insights; warding off the invasive, penetrating mother; or being unable to feel the analystâs receptivity to the patientâs prowess or insight. Criticisms of the analyst as uncaring, unsupportive, not listening, not recognizing, or wielding her authority to dominate, or remain superior are all phenomenal experiences that may reflect such dynamics. Alternatively, being unable to perceive the analystâs ability to hold him, retain what has been said, or contain the patientâs aggression (without retaliation) can become allusions to an underlying aggressivized erotic transference.
Erotic transferences and countertransferences
Throughout this book, I will be referring to erotic transferences and countertransferences and their therapeutic usage in contrast to sexual or sexualized transferences. The latter are more simple and straightforward, emerging as the expressed desire to have sexual intercourse with the analyst or therapist. These do not necessarily reflect an erotic relation, but an urgent need and demand to have sex with the analyst that is unelaborated and unrepresented. Erotic transferences are more complex and involve the patientâs incorporation of the therapist or analyst into their private erotic fantasies (Bollas, 1994; Mann, 1997), i.e., the imaginative use of the analyst as an object of desire. These reflect erotic transferences and can then become grist for the analytic mill. Therefore, the first step in the treatment setting is to elaborate the sexual transference into an erotic transference, i.e., to explore the patientâs fantasies as they are associated with the wish to have sexual relations with the therapist or analyst.
No matter what variety or form, erotic transferences are intensely challenging. There quickly arises a pressing need to manage the blossoming transference, as clinicians urgently want to prevent the patient from engaging in some threatening behaviorâeither to the analyst/therapist or to him/herselfâlosing the capacity to think or, in the extreme, having a psychotic breakdown. But before any of these questions can be addressed, there must be an adequate understanding of what a particular erotic transference means, i.e., what is your patient desiring, and what is being expressed when the patient makes a plea for (sexualized) love?
Along these lines, it is incumbent upon the analyst or therapist to remember that in many (if not most) instances, erotic longing is a demand for love in the absence of a capacity for loving (Frayn and Silberfeld, 1986). As in all transferences that are particularly intense, the strength of the demand signifies a host of unresolved, conflicted feelings or developmental deficits that drive and motivate manifest longings. Though the patient demands (and thinks he or she needs) a sexual relationship, sexualization may be a masquerade, a way of expressing as yet intolerable or otherwise unexpressable longings or vulnerabilities.
Sexuality has many guises and is commonly used in a wide range of defensive efforts. It is remarkably easy to transform a variety of tensions (abhorrences or excitements) to sexual longing. Yet the question to be posed is not simple. If sexualization is apparent and functioning as a defense, it must be asked, âDefense against what?â Here, there is virtually no limit to the variety of needs that may underlie sexualization. Self-object needs, hatred, separation, loss, a desire to destroy, envy, and so on, may all be eroticized as the patient (unconsciously) looks to divert her/his own and the analystâs attention.
To this list must also be added a pure and healthy desire (Bolognini, 2011) for erotic union with the analyst, experienced as an ideal potential lover. As I have written elsewhere (Celenza, 2007), these moments raise a fundamental question, asked most often in unconscious ways: âWhy canât we be lovers?â This fundamental question can be posed even between the most unlikely pairs.8 A useful exercise for the analyst is to wonder why there might be an absence of sexual desire with a particular patient. Why does this patient fail to erotically arouse, and might this be related to the issues of the treatment?
Every thoroughgoing analysis explores the full range of affects, and each in their full intensity. Indeed, this constitutes the definition of health, and its counterpart, the absence of neurotic (unnecessary, irrational, or vitality-constraining) inhibitions. As analysts, we welcome whatever our patients bring through an essentially affirmative attitude toward their symptomatology and problems in living. This is the basis of a nonjudgmental stance. In this spirit, we have to be able to bear intense hatred, contempt, devaluing, and rage, to name a few of the more problematic relational engagements. These affects are brought to the fore so that our patients can deepen their self-understanding and self-acceptance. In this way, we help our patients reckon with dissociated self-states so they can gain access to these parts of themselves and take responsibility for them. In essence, this is what is meant by the striving toward integration.
When sexualization functions as a defense, it is a signification of unresolved affects or modes of relating seeking to hide or evade (Coen, 1992; Kernberg, 1994) and this can be evident in the countertransference as well (Mann, 1997). These often include a repetitive, defensive attempt to magically transform destructive feelings into excitement. Depending on the developmental press, sexualization can function to transform vital urges, preoedipal issues, grief, loss, competitiveness, envy, hatred, and so on. In self-psychological language, Stolorow (1975) and Kohut (1977) speak of sexually expressed neediness. In short, âsexual feelings seem so effectively to transform oneâs perceptions and feelings from bad to goodâ (Coen, 1992).
I have found it helpful to conceptualize sexualization as either being subtracted from, or added to, a mode of experiencing. For example, erotic longing can be displaced onto alternative mental processes (and, thereby, subtracted from intimate contexts) in order to find expression wit...