Prof. Dr. Luiz Miller de Paiva
Psiquiatra, Psicanalista, Professor Adjunto da Escola Paulista
de Medicina e do Instituto de Psicoterapia Analítica
de Grupo
Dra. Alina M.A. de Paiva Nogueira da Silva
Psiquiatra, Mestre pela Escola Paulista de Medicina
1. INTRODUCTION
Observing Dorothea Tanning's pictures The Birthday or Wedding
Night, we reflect on why paint a beautiful woman covered
in branches of trees with a vampire-like monster at her
side?
Likewise, other paintings have a similar theme:
In 1854, Henry Fussli painted The Nightmare with a beautiful
woman in a lascivious position, dreaming of monsters (winged
horses, etc.), writhing and twisting in despair; seeming,
however, to experience a great deal of genital desire, accompanied
by sheer terror of the act, transforming pleasure into suffering.
Paul Delvaux in Venus Asleep shows us, in an atmosphere
of Greek classicism, a naked woman lying down and another
woman, dressed ceremonially, pointing to a skull at her
side. The analytical significance would be to show how sexual
pleasure is associated to death. In fact, Salvador Dali,
in his sculpture La Licorne shows a horse with a single
horn (phallic symbol of purity and neutralizer of poisons)
as male potency (horse-power) entering delicately in a wall
in the shape of a heart, in order to extract blood (to deflower)
from the timorous naked girl prostrate on the ground.
Salvador Dali's Canniballism in Autumn, in which a man and
a woman penetrate each other, one devouring the other. In
the picture, we can see knives, forks, etc. all of it "telescoped"
in a cannibal fashion. These fantasies may persist until
adult life, if there were quarrels,fighting, and separating
of the parents.
** Presented in XI INTERNATIONAL CONGRESS OF GROUP PSYCHOTHERAPY
- Montreal, August 22, 1992
2. CLINICAL MATERIAL
With these pictures and sculptures in mind, we had a group
session in which the following took place:
A woman (unhappy in marriage), with several children and
a chauvinistic husband, dominating, miserly, brutal and
aggressive, living in constant strife,and always frigid.
She felt the sexual act as it were between two men. She
had never masturbated; excessively religious. Since child-hood,
she felt neglected because she had not been born a man,
causing disillusionment to her father, and she was envious
of her brother, the "figlio maschi", owner of
all the rights. As group analysis progressed, she became
aware of the elaborations of her unconscious fantasies of
aggressivity towards her father, also a despot (superimposing
him on the image of her husband) and of the strong resentment
that she bore her mother, for being weak and very submissive).
Once, during a group session, she said: "Yesterday,
I had a very short dream that impressed me very much. I
was in the diningroom at home, sitting,dressed in a straightjacket.
I remember my children were near me. What most impressed
me was that all of them were smiling calmly, including myself.
At a given moment, I asked them, serenely, if they could
remove the straightjacket for a little while so that I could
scratch myself". The group interpreted that scene as
indicative that the patient was hindering harmony within
her home with so much controlled aggressivity and hostility,
however, without despair. The patient said: "Really,
I am not only afraid of going mad, but lately, I have felt
pursued by the fear of death". The patient then began
to recount a second fact that had occured the day before:
"I was persuaded by friends to go to the opera, so
I decided, then, to go to the dressmaker's and have a dress
made because on the first of next month, I will be 40 years
old and this coincides with the opening of the opera season.
I chose a purple dress,but it reminded me of death. The
color reminded me of a coffin: in fact, I had the impression
that I was buying a dress because I was going to die on
my birthday with my death at that moment".
Another patient from the group (who had lost her mother
when she was 3 years old and her father put her into a boarding
school at the age of 6, felt abandoned and rebellious and
became a person who was envious, pseudofrigid and dissatisfied
with everything and with everyone); she also said she had
had two dreams:
"I was having intercourse with my husband and did not
know whether it was anal or vaginal. On one side, a nun
(who used to spoil me a lot when I was in boarding school)
asked: "Does it hurt much?" I said yes, that it
did hurt a lot, but I was laughing as I said so.The nun
was confused and brought me a towel and some soap for me
to clean myself. At this moment, the nun, with a transparent
skirt, showed an enormous penis; when I looked at her again,
she had changed into the priest in the Buñuel film
who had killed the gardener. Terrified, at a glance, I saw
my husband's revolver, so I picked it up and shot him right
through the forehead".
Another dream:
"I was walking in the Luz Railway Station with my husband's
penis, putting it in my mouth as if it were a baby's pacifier.
I decided to suck it, and as sperm came out, I got angry
and bit it. At this point, my husband (who was by now in
possession of the penis) protested in pain. With hate, I
pulled the penis out again and threw it into the lavatory
(I was, by then, in my apartment)".
These dreams were interpreted as the patient's experiencing
coitus as aggressive and dirty, but that caused a certain
amount of pleasure, although it made them suffer. The nun
would be the analyst-mother who tries to help them; however,
he becomes persecutory when she realizes that he is the
mother combined with the father (combined figure) (8,a).
The group as a whole showed unconscious murderous fantasies
towards the analyst, or of eliminating him also. The mother
of patient A had died of a brain tumor, hence the terror
of suffering the same illness as her mother, if she had
had an orgasm - fear of lex talionis.
The second dream was also interpreted as penis envy. To
go out with it, to walk about, would be to have total possession,
thus becoming more sure of herself without so much censure:
the Luz Railway Station would represent incestuous pregnancy
(for her father lived in the interior of the state of São
Paulo) and, as she had matricidal feelings she aggresses
and, under threat of imminent aggression, she castrates
the man-analyst. who possesses something strong that causes
envy.
These fantasies explained the fact that, if they achieved
genital pleasure, they would be punished for two reasons:
first, for fear of being attacked by the mother, if she
attained orgasm (she did not feel she had the right to experience
genital pleasure) and, second, because she felt she possessed
a castrating vagina dentata of the penis that was so envied
(hate of the male figure) (8,b). On the other hand, the
patients also did not feel satisfaction in living (their
depressive crises were accompanied by suicidal ideas) and
one of them often had amenorrhea (interpreted as an unconscious
desire to not be a woman owing to her concept of the frail
sex) (8,c).
The association between death and life followed several
considerations made by the group. The analyst then showed
that the fear that was felt of death was not fear of physical
death, but rather fear of the death of a taboo, from which
resulted the birth of reality.
3. COMMENTS
3.1 Genital Level
At each level in the progression of pleasure, the process
(as in the levels of evolution of the libido), may be interrupted,
repressed, denied, substituted by a symptom. Excitation
of the clitoris is disappointing, unequal, ambiguous, contradictory
to the vulvar pleasure that was activated, but not completed.
Clitoral pleasure enters only as an accessory at the moment
of maximum vaginal pleasure. Orgasm restricted only to the
clitoris does not subsequently calm sexual tension.
The erogenous participation of the neck of the womb also
produces an authentically satisfactory orgasm.
Dolto (2) writes that: "Orgasm that is merely vaginal
is usually insufficient to eliminate sexual tension, and
may produce spasms in the vagina and around the vulva for
some minutes and more rarely, spasms in the anus, that are
at times painful, owing to the absence of participation
of the corpus uteri in the movements that are characteristic
of female orgasm".
However, in our analytical experience, we observed that
anal pain was owing to fantasies of orgasm-death. Anal pain
experienced as aggression (being "taken" in ano).
The antero-superior walls are what produce maximum pleasure.
The woman's partner is the only witness of this orgasm (8,c).
Intercourse is a symbol of the reciprocal capacity to give.
The assuaging of all tensions, the nirvanic well-being and,
each time, the conviction of a happiness that is more intense
than the previous one. She experiences the feeling of tenderness
and recognition by her partner and a sensation of renewal.
So that a woman can fulfill her desire in complete orgasm,
she must participate entirely in the emotional and sexual
encounter with her partner. However, the absence of carnal
harmony does not necessarily, at least for the woman, mean
that a creative relationship is impossible.
By submitting themselves to intercourse without disdain,
women can, after intercourse, experience a generalized well-being.
There was pleasure, but clitoral and vulvovaginal orgasms
did not manifest themselves on a conscious level (2). Nevertheless,
in our view, prolonged group analysis will show some very
resistant conflict of being felt, that sooner or later,
can cause vital anguish. This is a theoretical problem that
is still not resolved (8,c).
There are women who are completely satisfied with their
orgasms but that are completely crazy. They are completely
absorbed in bringing up their children and in their work
all of which shows us that it is not only a perfect orgasm
that is a panacea for all ills. Human life is entirely symbolic
and, what is most important is not the fecundity of the
body but rather the affective and spiritual fecundity.
3.2 Impulses of Life and Death
Subjective experiences of pleasure and pain are generally
differentiated between themselves; they may, however, without
any doubt, under certain conditions, appear mingled and
associated in complex ways.
The psychoanalytical exploration of intense affective explosions
in regressive patients, by its regularity, shows that there
is no such thing as "pure" affection without cognitive
content (5) and it also has, invariably, an aspect of object
relations.
Kernberg (5) observed that object relations in transference
also contain a certain affective state.
The masochistic suffering of a female hysterical patient
who experience the analyst as frustrating and punitive,
may serve as a defense against sexual excitation and the
positive oedipal impulses involved: the combination of sadness,
rage and self-pity reflects a complex affective state.
The defensive process disorganizes the affective state itself,
as usually occurs in frigidity and in impotence.
Hate can cause aggressive behavior that is highly pleasurable:
sadic pleasure in causing pain, humiliation and suffering;
pleasure in devaluing others as occurs with certain frigid
women, who in order to devalue the man do not have any orgasm
thereby deriding him. This behavior can be rationalized
as an expression of righteous indignation, the included
to be expressed in explosive nonmitigated violence, that
obscure its true origin - sadistic pleasure - in the act
of destroying the object of its hate.
It was necessary for an entire generation of psychoanalysis
devoted to the treatment of severe character pathologies
and borderline conditions, of regressive types of perversions
and of the psychoses to clarify the list of regressive forms
of agression.
A strange process occurs with a patient under the domination
of primitive hate: a common defense against the awareness
of this hate is the absolute destruction of the patient's
capacity to be conscious of it, in such a way that the patient's
mind can no longer "contain" the acknowledgement
of a dominant emotion such as feeling orgasm. In practice,
the intolerance to reality (capacity to love) converts the
physical reality into hate, directed against the self and
against the object (to have an orgasm with the penis).
Under the influence of intense hate, the patient may present
the combination of localized curiosity, arrogance and pseudo-stupidity
described by the Bionian School. Also, we may add the intolerance
of the male figure (the phallus) or the female figure (vagina
dentata) (8,b,c).
Intolerance toward the phallus as a good object is reflected
in the excessive avidity on the part of the female patient,
the voracity toward the genital act, arising from ontological
insecurity or through marital quarrels, forms of sadomasochism.
This intolerance is the expression of the deepest fears
of losing the loved object, basically, the good mother.
The patient is threatened by the fantasy of his own destruction
as a consequence of pathological projective mechanisms that
transform the frustrating hated object (the "bad"
mother) into a powerful, dangerous and threatening enemy
that might well annihilate the patient.
At its source, hate is the result of the incapacity to eliminate
frustration by means of orgasm (8,c).
However, primitive hate at a solid, intense level generates
a vicious circle that not only perpetuates it but also pathologically
develops it, which leads to the persistence of frigidity
and of impotence. This feeling of being attacked by an object
formerly needed and loved, is the most primitive experience
of betrayed love that augments hate even further with a
greater enlargement of hate by means of projective identification
and now the object is perceived as extremely cruel and sadistic
(the opposite sex).
Hate and the efforts to destroy an Oedipal rival, the pleasure
of triumph over this rival and the vindictive rejection
of an unfaithful loving object include differentiated levels
of hate.
3.3. Primitive Origins of the Correspondence of Impulses
of Life and Death
As to the origins of the correlation between orgasm and
the fear of death, they are found in infantile conflicts
in the molding periods (7,c). For this understanding, we
must base ourselves on the writer Yukio Mishima, narcissist,
homosexual, exhibitionist, fetishist, tormented by numerous
sadomasochistic fantasies and genius, described as the "Leonardo
da Vinci" or "St. Sebastian" of present-day
Japan. He had an insatiable need to prove himself superior
to everyone in multiple fields.
In Sun and Steel (10,a) he writes: "... as from childhood,
I feel in me a romantic impulse towards death; but a type
of death that requires, as its vehicle, a body of classical
perfection... a tragic and powerful figure of sculptural
muscles is an indispensable requirement for a noble, romantic
death, so long as it occur in the prime of youth.”
Twenty days before his death, Mishima organized a "Mishima
Exhibition". In fact, as J.A. Vallejo-Nágera
(15) was to write, he had allowed himself a "posthumous
homage while alive".
The exhibition was divided into four rooms, the "Rivers"
(the River of Literature, the River of Theater, the River
of the Body and the River of Action) along which flowed
his interests and activities and that were now to converge
into the Sea of Fertility - his final work.
For many years, I stated that I could remember things I
had seen at the moment of my birth". With this phrase,
Mishima begins his Confessions of a Mask (10,b).
Meltzer (7) calls this complex emotional situation in which
a newborn baby finds himself as "Aesthetic Conflict".
He is submersed by new sensations that stem, essentially
from his mother, sensations that upset him and the sense
of which eludes him.
As we have seen, patients A and B also show the conflicts
with their respective mothers, since infancy.
"Death gains roots at the moment of birth" (10,b).
Meltzer (7) says that: "... these secrets of nature
belong to the category of things from within the body of
the mother. Possession and control of her and, therefore,
of mortality, are the final objective of knowledge, because
death is felt as an obligatory return to her womb, just
as life was an exile from her womb. Through probable fear
of his mother, Mishima became homosexual. He says that:
"Excrement symbolizes the earth, and there is no doubt
that it was the malevolent love of Mother Earth that tempted
me" (10,b).
The sensitivity of true artists is capable of the action
of blended death impulses, though not so much as the impulses
of life. There, where the death impulse predominates, the
libido is at the service of the death impulse; and this
is particularly manifest in perversions (12). In a broad
sense, it might be stated that the self-destructive function,
as noted by Segal (13), acts, for the death impulse, a role
corresponding to that which sexuality acts for the life
impulses...
Mishima (10,a) says that: "One day, my teacher opened
that book precisely at that page that so fascinated me and
asked:
· "Do you know the story of this picture?"
· "No".
· "It looks like a man, but it is a woman. Her
name was Joan of Arc..."
· "That was a shock. The person I took to be
HIM was Her. If that handsome rider was a woman, was everything
not reduced to nought?"
J.C. Smirguel (1) and Joyce McDougall (6) characterize
as prototypes of identity of the perverse. The two pillars
upon which human identity is built are ABSENCE and DIFFERENCE.
In the perverse, this ceases to have any significance and
importance. Absence of a penis can be filled by a fetish,
differences do not exist, and in their place, arises an
all-poweful and complete being.
Greenacre (4) believes that the fetish results from innate
aggressivity and trauma in the first year of life; it is
not only defensive and brings with it the fear of castration,
it is Winnicott's transitional object. The transitional
object is used for comfort and the fetish for sexual use.
The former is created in response to the experience of separation
(baby pacifier, teddy bear, etc., substitute the mother's
breast), whereas the fetish incorporates the fear of castration
- that is, the hostile desire to destroy the penis in intercourse,
and at the same time, protect the body caused by penetration.
We had a patient who could only have intercourse if his
wife wore a new pair of shoes and walked in them. As a child,
he would go to the foot of his parents' bed and his mother
would carress him with her feet. He became fixed on the
foot as a sexual object. A woman can substitute a penis
for a boot; it is the famous case described by Hug-Hellmuth
in which the woman was in love with her military father
who wore boots and was much admired, which caused her a
sexual perversion (11). Likewise, there was the case of
an individual that used a coffin as a place for intercourse.
On the other hand, transvestism seems to be the catastrophic
result (in the Bionian sense) of an arrest in growth or
psychological distortion the primary trauma of which would
be at the root of a psychotic depression through emotional
absence of the father: part of the mother would be rewarded
in the body of the transvestite (14). Therefore, the transitional
object is normal and the fetish abnormal or else the adjunct
factor for performing of the genital act, as we have seen
in Patient B, the penis is a baby pacifier. Sometimes, premature
orgasm or the cut of orgasm should the penis penetrate,
are fantasies dominated by the death instinct.
With Freud (3) in "a beaten child" was the beginning
of the understanding of the intimate mechanism of perversion.
Freud (3,b) had already concluded that "a child that
is being beaten" is, at a certain stage of transformation
of this fantasy, the subject himself, leading him to perversion.
Freud (3,a) said that the death impulse operated silently
within the body, that we could never see its manifestations
in a pure state, but only those that fused with the libido.
Segal (13) in turn, commented that there is an intricate
fusion of impulses, but that there are also pure actions
of the death impulses, possible.
In some self destructive psychotics, only the self remains
relatively whole and preserved when it can prevent the return
of the enormous projected aggression, as usually happens
with a neurotic with the sensation of having an orgasm and
dying. Fear of the genital act would be through terror of
entering the field of death. By projective identification,
he wishes to kill and, as punishment, he can be killed;
hence, by the boomerang system, he feels the woman has a
"vagina dentata"(7,b,c).
Mishima (10,a) had already "prophesied" that "Man
gives his seed to woman. Then starts the long, long, indefinable
journey towards nihilism".
4. CONCLUSION
The group therapist must treat patients with disturbances
in orgasm (orgasm-death and fetishism) as a frustrated and
vulnerable child, whose desires have to be satisfied within
bounds of possibility with a gradual tactful clarifying
of what these bounds are. A patient treated in a group as
a "special" human being, symbolically as "his
offended majesty", the "baby" may, in the
hands of a patient, talented analyst transform the chaos
and violence of his unconscious fantasies into superficial
calm of a compensated narcissistic personality. Psychotherapy
becomes a secure refuge that protects the patient from the
rigors of the present life and protects the therapist from
the furious attacks of hate in the unconscious of the patient.
With the diminution of the perception of the analyst felt
as a bad object, the patient can now begin to become aware
that the object of his love and of his hate is the same.
By means of group sessions, we can show, clearly, how secondary
elaborations of unconscious fantasies, loaded with guilt,
increase the death instinct in such a way that it will prevent
orgasm (pseudofrigidity and impotence) and also, the joy
of living. If this unconscious guilt is less intensive,
it will not prevent clitoral orgasm or the introducing of
the penis (premature orgasm) or a certain joy in living;
however, if guilt is very marked, it will render orgasm
with the penis inside the vagina difficult for the woman
or will lead to impotence in the case of a man, owing to
his strong aggressivity towards his partner; in the woman,
this guilt is reinforced by phallocentric guilt,(woman-serf).
We conclude that: the individual will defend himself against
a greater ill (death) by choosing a lesser ill (pseudofrigidity
or impotence).
5. SUMMARY
The love-hate theme expansible to orgasm-death is first
broached with the citing of famous paintings: Wedding Night
by Dorothea Tanning; The Nightmare by Paul Delvaux; La Licorne
and Autumn Cannibalism by Salvador Dali.
Clinical material from a group session is commented upon
to clarify, in practice, the conflict between love-death
and orgasm-death.
The author discusses the difficulties in obtaining pleasure
and broaches the deeper causes for non-obtention of orgasm
or when orgasm is only clitoral and premature ejaculation.
The individual may be led by the life instinct (love) and
be contaminated by the death instinct (destructiveness)
during sexual intercourse. He broaches the impulse of life
and of death as an object relation, where the defensive
process disorganizes the affective state itself leading
to impotence, frigidity, perversity and the fetish (the
latter as a transitional object and adjunct factor).
Hate may give rise to aggressive behavior which is highly
pleasurable - sadism by humiliation or arrogance bring about
suffering. These processes are, at times, unconscious, stemming
from the molding periods - the bad-mother fantasy as a powerful
enemy.
Hate stemming from secondary elaborations of unconscious
fantasies and a subsequent feeling of guilt, would lead
to an inability to love and through orgasm to do away with
the subsequent frustrations.
In conclusion, the predominance of the death instinct prevents
love, orgasm, and the ability to love. If this unconscious
guilt is less intense, it will not prevent clitoral orgasm
or the introducing of the penis (premature orgasm) or a
certain pleasure in being alive; if, however, the guilt
is very marked, orgasm will be rendered difficult for a
woman with the penis inside the vagina or will lead to impotence
in the case of a man, owing to strong aggressivity towards
his partner; in the woman, this guilt is reinforced by phallocentric
guilt (the woman-self), so that the individual defends himself
in face of a greater evil (death) preferring the lesser
evil (pseudo-frigidity or impotence).
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