The Psychogenesis of a Case of Homosexuality in a Woman

Freud’s (1920) case, the psychogenesis of a case of homosexuality in a woman, with reference to other relevant texts.

Freud’s 1920 case presents an examination of the psychogenesis of homosexuality in an 18 year old girl who pursued the adoration of a lady ten years her senior (p. 147). Early on, the young girl’s father meets the two of them together and casts an angry glance (p. 147). This instigated a suicide attempt by the young girl which had the secondary gain of making the parents ‘back off’, with the addition of an increased respect from the society lady (p. 147). In Freud’s case of hysteria (1905), Dora’s parents discover her suicide note but question her intent. Similarly, a secondary gain for Dora was not only making her father concerned and thus allowing her to grow closer to him, but it also may have been an attempt to keep her father away from Frau K. Both cases have the undertones of a suicide attempt being used to make the parents first take note of their daughter’s pain.

The girl’s libido, or manifestation of her ‘sexual instinct’ (Freud, 1916-1917, p. 313) was never directed towards young men (Freud, 1920, p. 147). Her father was outraged when he discovered her homosexual tendencies and if psychoanalysis failed, a speedy marriage would ensue (Freud, 1920, p. 148). Little Hans (Freud, 1909) was given threats of castration from his mother due to his fascination with his ‘widdler’. Not too dissimilar, the father of the young girl (1920) was threatening a castration between his daughter and the society-lady if her fascination did not cease. Freud remarks that during analysis the young girl didn’t hold back on what she said about the father (1920, p. 148). However, at this stage of development the father is only viewed as nothing more than a ‘troublesome rival’ (Freud, 1931, p. 2).

Freud (1920) adds that during her childhood the girl passed through the normal attitude of the feminine Oedipus complex (p. 150). The later comparison of her brother’s genitals did leave a strong impression on her (p. 150), in that she felt inferior or that she had ‘come off badly’ (Freud, 1924). The girl showed signs of a maternal instinct to a small boy when she was 13 years old (1920, p. 151). Later, during a revival of her infantile Oedipus complex, the girl began to desire an unconscious wish for a child with the father (p. 152). ‘Normal’ women and homosexuals may desire the phallus and rebel against the frustration of castration (Riviere, 1929, p. 310), thus the earlier genital comparisons with her brother had led her to want a child as a substitute for her inferior organ. Here Freud is making a reference to 'penis-envy' (1925). This ‘penis-child’ equation (1925) was denied when it was the mother, her unconscious rival, who bore the child – her third brother (Freud, 1920, p. 152).

Owing to this disappointment, the girl gave up her wish and discarded the father as love-object (p. 152). Instead, the mother became the love-object and Freud’s analysis of the girls dreams revealed the society lady to be a substitute (1920, p. 151). The recognition of the anatomical difference between the sexes can force girls away from masculinity to adopt the development of femininity (Freud, 1925). In contrast, this incident led the girl to become a homosexual ‘out of defiance against her father’ (Freud, 1920, p. 152), and to repudiate the feminine role in general (p. 152), in favour of what Freud later discussed as a ‘masculinity complex’ (1925).

Freud (1920) broke off the treatment with the girl when he recognized the transference of the girl’s hatred towards her father and men (p. 154). In a similar fashion, Freud’s treatment of Dora (1905) was cut short when she ended analysis abruptly, which Freud felt to be an act of betrayal or vengeance on Dora’s part (1905, p. 157). Advising for the treatment to be continued by a woman doctor, Freud adds, that the girl promised her father to give up seeing the society lady (1920, p. 154).

Perspective

I love this story from Irvin D. Yalom.

 

One of his patient's with breast cancer who throughout adolescence had been locked in a long, bitter struggle with her naysaying father. Looking forward to some form of reconciliation, she looked forward to her father driving her to college; a time she would be alone with him for several hours. The trip turned out to be a disaster. Her father behaved true to form by grousing at length about the ugly, garbage littered creek by the side of the road. She on the other hand saw no litter whatsoever in the beautiful, rustic, unspoiled stream. She found no way to respond and eventually, lapsing into silence, they spent the remainder of the trip looking away from each other.

 

Later, she made the same trip alone and was astounded to note that there were two streams - one each side of the road. ''This time I was the driver'', she said sadly, and the stream I saw was as ugly and polluted as her father had described it. But by the time she had learned to look out her father' window, it was too late - her father was dead and buried.

 

Yalom remarks that the story remained with him, and on many occasions he has reminded himself and his patients, 'Look out the other's window'. Try to see the world from another's perspective.

 

It's so relevant to many things in life such as empathy and honing our compassion for others. I think it's just awesome, and makes me want to delve into more of Yalom's writings.

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A Sunday Evening Musing on the Grip of Addiction.

For years addiction therapists and counsellors tended to be people who had been addicts themselves, these days, not so much. Drug and alcohol counsellors who have experienced addiction first-hand represent a dwindling slice of the addiction therapy community. Someone once told me that it isn't possible to become a drug addiction counsellor if you've never been addicted to drugs like heroin, cocaine and so forth. Or you wouldn't be a very good one at least. While they were no addict themselves it did get me thinking, and in a sense I could see the point through their naiveté.

 

I think that's probably like saying you can't help someone suffering from alcoholism because you aren't an alcoholic; or that you wouldn't be able to deal with suicide bereavement because you never tried taking your own life; or a paedophile needs to be reformed and rehabilitated by a former paedophile. I mean that may sound like a bit of a sledgehammer to crack a walnut, but their opinion is not too dissimilar.

 

I don't think that all addictions should have to be approached and individually tailored to the client presenting. William S. Burroughs remarked before, whether ''you sniff it, smoke it, eat it, or shove it up your ass, the result is the same - addiction''. Sure, a heroin addict is going to have a different set of circumstances when trying to avoid their substance, than say an alcoholic, who would be presented with far more opportunities to access and even come into contact with the substance they're trying to avoid. The 'availability hypothesis' states that the greater the availability of a drug in society, the more people are likely to use it and the more they're likely to run into problems with it (Thompson, 2012). The alcoholic's addiction is given extra traction by the innumerable ways society shoves it in their face. It's actively encouraged, under-priced, and sold aggressively. Sure what the hell are ye doing without a pint in yer hand?

''The essential process of addiction is the replacement of people with things. Addicts form primary relationships with objects and events, not with people. In a relationship with an object, the addict can always come first'' (Thompson, 2012).

 

But what's driving the addiction? It is at the end of the day a mixture between psychology and physiology. Psychologically, it's a cognitive battle. Respite only comes from changing your thinking and you won't be able to change anything if you don't change the thought patterns. But how does an addict attempt to change their biology? Physiologically, all addictions are going to have their roots in the major reward centres of the brain. The pleasure pathways. The networks that quash all the aversive psychological effort and scream far louder than most people can cope with.

Addicts go for pleasure even if it is detrimental to their lives. It is often the thoughts of withdrawal that poisons the outlook of an opiate addict. A psychological fear of an impending physiological nightmare. They can say they won't use anymore, but when the body starts to go into the initial phase of withdrawal, nothing will make sense to the person other than another hit to dampen the pain. It's cyclical. It's tragic. For some people, there really is no silver spoon but plastic spoons and dope; but heroin addicts should be treated like patients and not criminals foremost. You have to deal with person - not the crime of using heroin.

It's similar reward paths for tobacco. It has in fact been argued that giving up cigarettes is analogous to that of opiate withdrawal. But who gives a sh*t about the cigarette smokers, it's only a drug that kills over 5 million people annually worldwide. For heroin, a conservative estimate recorded 7,630 drug-induced deaths in EU member states and Norway in 2009, with the majority of these related to opiate use. It accounts for the greatest numbers of deaths related to drug use in Europe; Ireland having the highest rate of heroin use in Europe with just over 7 cases per 1000 population. There's no denying that these figures are a paltry sum in comparison to tobacco products. 

 

''None would argue that gambling is a vice, one in which most of us indulge from time to time without harm. But as with all vices, there is the problem of overindulgence, or addiction'' (O'Brien, 1995). Often in the mire of an addiction, people become detached from the things that had a lot of meaning for them. But there's always a choice point for people. I mean gamblers know over the long term that the house will always have the edge. But does that stop them from throwing down weekly wages on bets when the electricity's gonna be cut off at home? You can bet your arse it doesn't. Right there and then, reward circuitry, pleasure, the immediacy of positive feelings. The guilt hides out back and doesn't show up till later, if at all. Same physiology.

What about sex addiction? Is this just a fancy term for promiscuity? If I was arsed I'd have researched it more, but the closest I have for now is relating to a Freud remark in the early part of the 20th century, ''Masturbation is a shortcut between desire and satisfaction, allowing the subject to by-pass the external world''. Again, replacing people - the addict wins. And win they do! To be honest if you want a good representation of sex addiction then just watch Shame with Michael Fassbender.   

Then there's food addiction, I mean a lot of people nowadays have a private relationship with food, they'll hide their negative eating habits behind closed doors and comfort eat. This isn't anything new. It only takes a quick look up and down the high street to see who's wearing in public the unhealthy choices they're making in private. There's a modern plague of obesity happening in a world where 'cupcakes are the new cocaine' (Thompson, 2012). Again, it harks back to the same underlying physiological roots.

Drug use is human. It has been around since day one. It will never go away. We use addiction to resolve our problems. People are constantly chasing the semblance of happiness and we are pushed in the direction of addictive solutions (Loose, 2012). People are hooked on gadgets and technology. Billions are spent on trying to be beautiful. You're being force-fed the ''you're worth it'' type of attitude, and you god damn well better be hungry. It really is incessant. People are looking for an effect from their consumption; preferably something physical and immediate please.

Drug-use is an extremely effective way of dealing with suffering; it brings immediate relief. For some people, addiction is something that stabilises their structure, ''this is why I worked all day for old douchebag up in the insurance brokers shitbox, now I'm letting loose''. Back to reality. Sometimes however the hooks can go deep, and deeper yet again, before they know it, it's a full on marathon just to keep up. Addiction of any form is a struggle that shapes many peoples day to day lives and it's a difficult terrain to navigate. It's toxic. It's a sickness. But for a lot of people it's not about getting them to be extremely happy again or an attempt to cure. It's about getting them back to 'zero'.

I think in essence addiction is a very personal thing, not something that is the sole realm of ex-addicts. Indeed an ex heroin addict would be an excellent person to learn from in dealing with a heroin addiction. With addiction though, experts talk treatment, not cures. Edward de Bono remarked that an expert is ''someone who has succeeded in making decisions and judgements simpler through knowing what to pay attention to and what to ignore''. What can be learned from an addict is immeasurable; the patterns, the pitfalls; and the lies and excuses one will believe that stoke the furnace of addiction. So in that sense ex addicts are probably the real experts.

But there's just one little hair in the soup; the world isn't filled with ex-addicts.  So to say that addiction can't be dealt with from a qualified professional angle, is quite obtuse and frankly utter nonsense.

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"...addiction implies in most cases the avoidance of the social bond with other people. It is for this reason that the term a-diction is appropriate as it indicates that addiction is largely a matter of avoiding speech, language, communication, symbolisation and representation"
                                                                                                                       ~ Rik Loose (from 'Addiction in Modern Times')

LSD and Psychotherapy

Lysergic acid diethylamide (LSD) first acts on the brain's serotonin system; the part of the brain responsible for feelings of well-being, and subsequently on the prefrontal cortex; which processes some of our uniquely human abstract thoughts. It also seems to reduce communication between different brain areas, leading to loss of inhibitions.

 

Dr. Ronald Sandison (1916 - 2010) was one of the first people in the U.K to use LSD in psychotherapy over 50 years ago. He remarked that it had three effects:
 

1) a general enhancement of 'what's going on inside'

2) a specific effect in raising forgotten memories, particularly traumatic memories

3) it seems to allow people the facility to explore those memories

 

Dr. Ben Sessa (pictured), consultant Psychiatrist at Bristol University, wants to pick up where Sandison left off. Dr Sessa argues that ''the role of LSD can speed up the process of breaking down the client's defences''.


Today, despite a growing belief of it's benefits among some parts of the medical community, the laws have made further use in psychotherapy almost impossible.

 

Sessa adds, ''I believe it can be used safely in the context of the clinical environment. If there is a possibility that LSD or other hallucinogenic drugs can have therapeutic potential in psychiatry, then I do believe they should be researched to explore this, because to leave that stone unturned is potentially closing the door on that group of patients who may benefit.''

 

Many experts today believe the dangers of LSD are more fiction than fact. It's physiologically non-toxic and no one has ever died from an overdose. True, one or two people in the 60's may have jumped out of windows, but that seems to have become a myth ingrained in history.

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''LSD was an incredible experience. Not that I’m recommending it for anybody else; but for me it kind of – it hammered home to me that reality was not a fixed thing. That the reality that we saw about us every day was one reality, and a valid one – but that there were others, different perspectives where different things have meaning that were just as valid.'' 

                                                                                              ~ Alan Moore