Sexuality Conflicts Depression and Anxiety in Female Patients: The Neglected Path

Mia W Biran

doi:10.4172/2167-1044.1000224

Abstract

This paper reviews the neglect of sexuality conflicts and confusions in adult female patients in the psychotherapy literature and some possible causes for it. This problem was already pointed at by Biran, Britton and Yarom. Biran described a case of 50-year old female presenting dream material, memories, and associations revolving around gender identity conflicts (see below). In another paper, Biran presented a case of a menopausal patient with depression related to the reemergence of old sexual identity conflicts. Yarom perceives hysteria as a problem resulting from thwarted sexual development. For both the boy and the girl, the development of sexual identity is halted due to pathological reactions from both parents. The resulting hysteria expresses itself through 1) Vacillations in gender identity (Am I a man or a woman? Am I weak or strong, passive or active?); 2) Over usage of repression, dissociation, splitting, denial and foreclosure; 3) The use of the body and mechanisms of conversion to represent and project the internal conflicts around sexual identity. All of these defenses are operating in the transference and countertransference between therapist and patient.

Highlights

Biran, Britton and Yarom [1,2,3,4] described the tendency of the girl to over-identify with her father as a compensation for an impoverished relationship with the mother of early childhood, resulting in what he referred to as the “masculine protest.”Menopause is an object of disavowal and even fright for many psychoanalytic writers [5]
Even the influential book “Psychoanalytic Theories of Development” by Tyson and Tyson [6] does not address menopause in its chapter on Gender Development. This scarcity is rather striking in light of the proliferation of articles and books dealing with femininity, female sexuality, and motherhood. Terms such as “sexuality” and ”desire” are seldom mentioned in relation to menopausal women despite the fact that there are, on the average, still some 25 years left to reach old age after menopause! It seems like nothing has changed since ancient cultures defined menopause in women as marking the beginning of old age
In 1912, Freud [7] wrote: “Because a certain period of life is reached, along with the biological processes ruled by law, the quantity of libido in their psychical economy has undergone an increase which in itself would be enough to upset the balance of health and create the condition for neurosis

Summary

Introduction

Britton and Yarom [1,2,3,4] described the tendency of the girl to over-identify with her father as a compensation for an impoverished relationship with the mother of early childhood, resulting in what he referred to as the “masculine protest.”. Even the influential book “Psychoanalytic Theories of Development” by Tyson and Tyson [6] does not address menopause in its chapter on Gender Development This scarcity is rather striking in light of the proliferation of articles and books dealing with femininity, female sexuality, and motherhood. In 1912, Freud [7] wrote: “Because a certain period of life is reached, along with the biological processes ruled by law, the quantity of libido in their psychical economy has undergone an increase which in itself would be enough to upset the balance of health and create the condition for neurosis As we know, such somewhat sudden increases in libido are regularly associated with puberty and menopause, at the times when women arrive at certain ages” Freud [9] believed that menopause is similar to puberty in the increase in libido it brings with it, but that frustration due to the loss of loveobjects in the external world might turn this increase into neurosis

Clinical Material Illustration

Discussion