Tag: Freud

Reich’s economic model of psychosomatics (2 – the biological core)

Following his discovery of the link between sexual repression and character, Reich inquired into the nature of the mechanism underlying this link. His starting point was the observation that there existed, even if they were hard to codify, characteristic postures and facial expressions which allowed the most unlearned observer to decipher the character disposition of his interlocutor. Reich hypothesized that these resulted from, in the main, hypertonicity of certain functional muscle groups. Almost all muscles display in equilibrium or at rest a natural level of contraction called tonus. When this equilibrium is disturbed by a constant perception of threat, muscles become pathologically hypertonic. The attitude habitually assumed, be it of aggression, mistrust, helplessness etc, then becomes anchored in the muscular economy with attendent effects (though Reich does not discuss this) on skeletal development as well. Reich contends that the somatic and psychic expression of neurosis are functionally identical and mutually reinforcing. The somatic expression he calls the “biological core” of the neurosis. It is similarly this pattern of muscular spasticity which disrupts the orgastic response.

Reich goes on to make his central conjecture, laid out in Function of the Orgasm, that the natural orgasm serves a purpose of discharging vital energy and thereby regulating the energy economy of the body; this is thus a direct somatic parallel to Freud’s libido theory. Disturbances of the orgastic function compel the organism to regulate its energy economy otherwise, whether by reduced energy production (lethargy) or by other, imperfect mechanisms such as compulsive behaviors which only kick in when the tension has reached an unbearable level and then only partly resolve it.

The hypothesis of the “functional identity” of the neurosis and its somatic expression allows Reich to complement then-existing psychoanalytic techniques with a body-oriented approach and, he claims, achieve more consistent results, more rapidly, as well as penetrate some types of neurosis which were less amenable to traditional methods. His espoused technique advocates alternating opportunistically between addressing psychic and somatic blockages. This he called “vegetotherapy” in an allusion to its effects on the vegetative, or what we would now call the autonomic (i.e. involuntary) nervous system. How he did this in practice seems to be less well documented, perhaps because his discovery of the biological core of psychic neuroses leads him into more speculative areas of inquiry and the period of his interest in psychosomatic therapy is as a result relatively condensed, leaving methodology to be developed by others.

This new period in Reich’s life is underscored by a realization that sexual repression has not only somatic effects with psychic correlates – neuroses – but also that these primary somatic effects have in the long term direct secondary chronic effects at the somatic level in the form of illnesses such as cancer, dementia and rheumatic arthritis. This takes the hygienic challenge a long way from treated self-reported actual neuroses with anecdotal curiosities in turn-of-the-century Vienna to treating major plagues of contemporary civilization, both psychic and somatic.

Part 3: Reich’s legacy

Reich’s economic model of psychosomatics (1 – from Freud’s libido theory to character analysis)

Although the work of Wilhelm Reich in relation to what he called sex-economy lies at the root of many contemporary approaches to psychotherapy and personal development, it is widely misrepresented, caricaturized and misunderstood and a summary of it for the educated layman is, to my knowledge at least, difficult to come by. I am often asked to explain Reich’s thought which has very much influenced my own, and so I thought fit to attempt such a summary. In this and the next article, I propose to set out how he arrived at, and the basis for, the character-analytic approach to psychotherapy and his later vegetotherapy which aimed at directly working on what he called the “biological core” of neurosis. In a subsequent article, I would like to offer a review of his theories in the light of current knowledge, and particularly in what one would hope could be described as a somewhat more accommodating social environment than prevailed at the time of his work. (UPDATE: since I wrote this article, a very good overview of Reich’s life and work has been written by Jason Louv, see here. My own treatment is a bit more technical.)

Reich’s developments of psychotherapy all draw root in Freud’s early work. Subsequent developments of Freud’s psychoanalysis, which Reich viewed as a capitulation to social conservatism, took their work in different directions. They share, nonetheless, a substantial common bedrock, and Reich remained deeply admirative of Freud’s labors even when he disagreed with him on fundamental matters.

As is well-known, the various phases of Freud’s thought never resulted in a single synthesis and different strands within it remained in tension with each other. Freud thus never arrived at an integrated theory of psychic functioning. Reich took his lead from Freud’s libido theory of neurosis; neurosis was thus the result of a binding of sexual energy as a result of developmental factors in childhood. Freud never elucidated how this binding took place or how psychoanalysis was precisely supposed to work in order to dissolve the binding and thus resolve neurosis, but he developed different models of psychodynamics, in each case essentially of a mental nature. The blocking factors in neurosis were thus mental representations and the prescribed route to their dissolution ultimately also mental, although it proceeded from the unconscious, which for Freud could not be directly observed.

Reich’s own approach is quite at ease with Freud’s model of the three stages of consciousness, being the system unconscious, the system preconscious and the system conscious. According to this model, drives which arise in the unconscious undergo a sort of filtering process in order to arrive at the level of consciousness, during which their associations and objects change more or less radically. Thus, for example, the infantile desire to suck, if insufficiently satisfied in infancy, persists in the unconscious and is satiated, though never ultimately satisfied, through ersatz means which could involve actual sucking (thumb, lollipop), other oral actions (obesity and bulimia), fixation with oral sexuality, or other forms of clinging behavior not immediately oral in their manifestation. In order to achieve satisfaction of these ersatz or secondary drives, individuals would develop typical strategems which are in a direct line of descent from those they employed successfully in childhood – all essentially manipulative, solliciting one or other emotion on the part of the caregiver which would then elicit the desired response. Some would focus on solliciting pity, others fear, still others admiration, or benevolence through humor, or distraction, etc. Whilst Freud did not feel he had a social mission and confined himself to the therapy of those cases who presented themselves for treatment, it is easy enough to see how the learning process in early childhood coupled with certain not immediately definable characteristics of the child would lead to characteristic dispositions in adulthood, a starting-point for Reich’s work.

Reich’s interest in character was at first prompted, however, by considerations of methodology. Freud and many of his close collaborators had never taken a systematic interest in determining and assessing what worked in the therapeutic context. It was supposed that individuals needed to “cooperate” in the therapy. If they failed to do so, there was no alternative approach available. Reich realized, however, that the fact of cooperation or of failure to cooperate was endogenous to the therapeutic setting. It itself needed to be interpreted and worked through. The manifestation of resistance was evidence that one was reaching carefully repressed material. To dismiss a patient for refusal to cooperate was to admit defeat, perhaps at the moment when one was closest to achieving a breakthrough.

Reich started with a layman’s concept of personality, but soon progressed it to a developmental model in which typical frustrations of infantile libido led to a freezing of certain character responses, which were then overlaid on each other. In the therapeutic setting, the therapist would work backwards through these layers, to arrive at, and liberate, the earliest material.

Reich also noted that all patients presented with actual disturbances of “natural” genital sexuality. These disturbances were of various sorts but fundamentally there were only a limited number of variables. Decreased or absent pleasure in the genital act could be due to (i) diminished sensitivity of the genital apparatus itself, (ii) its failure to respond to conventional stimuli or at all or (iii) a failure of genital response to (sufficiently) engage adjacent muscles involved in the natural orgastic response. Persons with diminished sensitivity were often, in the male, erectively potent or, in the female, highly flirtatious, but derived little pleasure from the sexual act. Reich saw this as an instrumentalisation of sexuality in the service of a secondary drive. Persons with erectile dysfunction or vaginismus were disinterested in sexuality or conventional sexuality because it conflicted with defense mechanisms they had developed. Persons, finally, with a flat orgastic response curve (premature ejaculation in the male, muted or no orgasm in the female) encountered during the process of sexual arousal psychological obstacles which made full sexual expression impossible. This typology of genital response, Reich was able to correlate, albeit loosely, with the stages in the development of the libido posited by Freud as well as with contemporary character. Frustration prior to the oral stage led to a withdrawal of sexual interest and to schizoid character. Frustration at the oral stage led to oral fixation and a lack of autonomy, expressed as sexual passivity and a capacity for surrender but a diminished response. Frustration at the anal stage led to rigidity and inability to surrender, whilst frustration at the genital stage expressed itself as individuals with strong seductive powers and sexually active, but reporting a lack of pleasure in the sexual act and as seeking it for secondary, narcissistic purposes. In Reich’s view, the vast majority of people presented with some form of neurosis and it had both character and genital expression.

Reich’s approach felt little need for Freud’s later ego theory, but remained compatible with it. In addition to his methodological work, Reich’s greatest breakthrough was his solution of the problem of masochism, discussed at length in Character Analysis. Freud had posited a primary masochism, fruit of a biological drive he termed the death instinct (Todestrieb). For Reich this had no parallel in the animal kingdom and was unacceptable. He derived masochism as a secondary drive when the pleasure principle was frustrated by overwhelming violence to which the individual as a small child was powerless to respond. The frustrated drive first sought an outlet in sadism, turning this sadism against itself when it was further repressed. Constant juxtaposition of pleasure and punishment led to a state where they became psychically interlinked. Reich pointed out that no-one took pleasure in actual pain, only in the expectation of it. Pent-up energy which could not be channeled into pleasurable activity led to tension and anesthesia and the need for more extreme stimuli to break through to the core of the sexual drive.

Whilst Freud brokered a peace with society and seems to have viewed sublimation of sexual drives as in some degree necessary to civilization, Reich presents an uncompromising faith in the natural order reminiscent of Rousseau and Nietzsche; for him it is axiomatic that to recover the natural functioning of the human organism is the one and only path to happiness. Natural man is capable, for Reich, of the highest moral qualities and it is his sexual repression that brings evil and suffering into the world.

Part 2: The Biological Core

The psychopathology of sexual response

18 Jul 2007

I have climbed another mountain.

Reich’s critique of Freud, though apparently unknown in mainstream discussion of the Freudian legacy to Western thought, is poignant. Freud made a pact with the devil: although he knew, he did not say; and as a result his theories are distorted ones, they are half-truths, packaged to take account of the world into which they were born. Although aware of the origins of neuroses in childhood sexual development, and how social conditioning removed spontaneous behavior, he nonetheless accepted that sexuality was dangerous and needed to be channeled into more socially “acceptable” forms of behavior. He called this “sublimation”, and for him, this was a natural stage of adult development. It was not a pathology.

Reich called his bluff. He stated that a fully satisfying genital sexual life and the absence of neuroses were two sides of the same coin. And although Reich has been rebuffed and ridiculed – and quite rightly when it came to his later attempts to create a theory of everything – his position has also deeply affected modern attitudes to sexuality in the West, whereby a woman is not quite normal unless she has three orgasms before breakfast.

But – with all respect to Reich – this focus on genitality is insane. It is just another artefact of the warped world into which both Freud’s and Reich’s theories were born.

Experiencing deep and full orgasmic pleasure does indeed characterize the natural state of man and woman. But it is a consequence of psychic health, a manifestation, it is not a recipe for achieving it or a cosmic status symbol.

In The Function of the Orgasm, Reich argued that orgasm serves to regulate bodily energies, essentially to release energies which otherwise would become stocked in the body and generate neuroses and psychosomatic phenomena.

Now, this is partly true, but it is not the end of the story.

Reich’s account of the orgasm appears to exclude that it may, itself, be used as a mechanism, perhaps even the most powerful mechanism, to rigidify the body and freeze neuroses into place. But a moment’s reflection suffices to see that this is how sexuality functions for many people. Such sexuality is labeled morbid and dismissed, it is not “real” and “healthy” sexuality and hence it is not what Reich is talking about. But this misses the point.

Now, I fully admit to being an amateur with only a limited background on these things, but I still think I’m on to something here. So here is my conjecture on the psychopathology of sexual response. Of course we now know much more than Reich or Freud ever could about the reality of human sexual behavior and it is time to retheorize psychotherapy based on this knowledge. Reich’s theories are based on a very crude metaphysics of bodily energy.

I believe that when our sense of self is under stress, the primary channel of psychosomatic repression is genital. Such repression may manifest itself in the sexual response – whether it is impotence or (exclusively in men of course) “premature” ejaculation. But it also manifests itself in sexual behavior, both direct behavior (what we are accustomed to calling “perversions”, though it is an obviously unsatisfactory term) and in sublimated behavior patterns such as violence, anger and so on, as well as in bodily phenomena playing a role in the ontogenesis of illness. The omnipresence of degraded genital sensitivity, in both sexes, which I have been able to observe in my own experience is ample indication that the primary locus of psychosomatic repression is the pelvic floor. I also believe that most therapists working in the Reichian tradition would agree with this and operate accordingly, but at an intellectual level, as a system, I am unconvinced that the Reichian account itself is complete or coherent.

A satisfying genital sexual life (as, presumably, self-reported) may even have nothing to do with the maintenance of mental health, it may, once again, simply be a manifestation of a satisfying emotional life, which is the primary cause of partial neurotic resolution, and indeed this seems rather more likely.

So the genitals are a battleground. On the one hand, the wounded sense of self directs energy against them and seeks release through them; on the other, reality intrudes by this channel too in the erotic response.

It is important to realize that what we are talking about here is “normal” sexuality, not (only) morbidity. In other words, it is the sexuality which Reich viewed as homomorphic to mental and physical health. Freud argued for sublimation, and Reich for dissipation of sexual drives. But the reality is that the sexual drive which Reich wished to dissipate through the orgasm, is itself stubbornly neurotic and the remedy Reich prescribed merely anchors this neurosis. If it does anything else, then that is merely by chance. It is entirely possible that it is better to dissipate certain energies in this way than to channel and manifest them in available alternative ways, although I am not sure about this because the genitals are at the origin of many psychopathologies and the apparent release may therefore be only temporary – moreover, sex typically involves two people and this release may therefore be, and probably often is, at the expense of the other. In any case, this does not by itself determine that Reich has described healthy sexual behavior. Of course, Reich’s findings are indelibly influenced by the clinical context of his and Freud’s work, even if he went on to well understand, in his most important work on child psychology, the social generation of psychopathology which determined the passing on of neuroses from one generation to the next.

When we observe sexual neurosis, we have not merely to prescribe genital release as a means of managing it; we have to look, in full Reichian logic, at what is generating this neurosis. And what is generating it is the wounded sense of self. In order to heal this, we need to step out of this subjectivity and observe objectively.

Here, sexuality can help, but only if we let it. Instrumentalizing sexuality closes all possibility that it will awaken us. It is merely another manifestation of the defense mechanisms that the wounded self has mastered. Rather, we must seek to deinstrumentalize it, just to experience it, to allow it to surprise us, to ensure it is placed firmly outside of our control so that it may be a gateway to challenge our self-construction and make us confront the fact that reality is other. And this is not only true of sex; it is true of all sensory phenomena. They are either a way out or a way in; and we must make them a way in. When our constructed self, our psychophysical armor, is permanently exposed to contradiction and cannot escape, only then are we free of it and living authentically.

I recognize that some may find this account of sexuality too remote from their own experience. Given that real sexuality has a dual character as both affirmation and effacement of the self, how to enjoy it fully in the present moment and not at some irrealistic future date? Indeed, may not the self-affirmatory aspects of sexuality, and not only the self-effacing ones, have a true therapeutic or energy-management function and value, in addition to being fun? Yes. Certainly. I also reject an ascetic view according to which only sex according to the purest (imagined) tantric canon has any value. Sex is fun, and I revel in all its variety and the humanity of it (though I certainly do not condone actions which are unilateral and predatory). But this is a subject for another blog entry.