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.