Archives of Sexual Behavior, Vol. 29, No.

6, 2000

Psychoanalysis and Sexual Fantasies

Richard C. Friedman, M.D.,1,3 and Jennifer I. Downey, M.D.2

Psychoanalysis began as a depth psychology, heavily based on the sexual experiences and memories of patients. A long-term treatment, utilizing a free association method, psychoanalysis has provided a window onto the meanings and functions of fantasy, including sexual fantasy. Although psychoanalysis has produced some scientic research, the eld has tended to rely on observational data collected from individuals studied in depth. Sex research on the other hand, carried out by investigators from different disciplines is based on empirical investigation. Each eld has made contributions fundamentally important to the other. In this article, we review psychoanalytic ideas about human sexuality and distinguish those that have been invalidated by systematic research from those that remain useful. Perhaps, the single most important revision of psychoanalytic theory during the past century was concerned with the psychological development of girls and women. We separately discuss the development of the sexes, and stress the need for bridge building between psychoanalysis and sex research.
KEY WORDS: psychoanalysis; fantasy; sexual fantasy; ambivalence.

INTRODUCTION Psychoanalysis is a depth psychology that originated from the study of sexually tinged fantasy. A problem present in the eld from its inception, however, has been the lack of a denition of erotic fantasy or even a general sense of agreement about its specic attributes. One reason for this may be that Freud blurred the distinction between the sexual and that which nonpsychoanalytically oriented laypersons might consider nonsexual. He believed that stimulation of various zones
1 Department of Psychiatry, and Payne Whitney Clinic, Cornell University Medical College, New York,

New York.
2 New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons, New 3 To

York, New York. whom correspondence should be addressed at 225 Central Park West, #103, New York, New York 10024. 567
0004-0002/00/1200-0567$18.00/0
C

2000 Plenum Publishing Corporation

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of the body, oral, anal, and phallic, led to pleasureful sensations, which he considered sexual (Freud, 1940). The psychoanalytic literature, therefore, contains countless articles, nominally about sexuality, discussing bodily zones invested with the so-called libidinal energy. The libido theory, placed sexual energy at the center of all human motivation and all psychopathology, is outdated and only of historical interest. The topic of sexual fantasy is more complex in women than men, and we reserve consideration of its meaning(s) in women until later in this article. In men, by sexual fantasy we mean subjectively experienced narratives that are associated with psychophysiological changes that occur during sexual excitement; and which always include a consciously experienced emotion that is explicitly sexual or lustful. These fantasies are experienced during masturbation, and are mobilized by pornography and many other stimuli of daily life (Freund et al., 1974; Masters and Johnson, 1966; Paredes and Baum, 1997; Stoller, 1979). THE FUNCTION OF FANTASIES Freud suggested that daydreams were a continuation of childhood play and were the product of wishes that compensated for lifes frustrations. Person has pointed out that fantasies are a type of imaginative thought that serve many different functions (Person, 1995). As Freud observed, they may represent wishes evoked in response to frustration in order to convert negative feelings into pleasurable ones. They may soothe, enhance security, and bolster self-esteem, or repair a sense of having been abandoned or rejected. Fantasies may (temporarily) repair more profound damage to the sense of self that occurs as a result of severe trauma. They also frequently serve role rehearsal functions, as occurs, for example, in little girls who consider dolls to be their babies and who play house as preparation for becoming adult mothers. Organized as images, metaphors, and dramatic action, fantasies in the form of artistic productions and mythology have been part of the human heritage probably for the entire life of our species. Freud provided a new framework for understanding these universal forms of human expression by noting that they could be critically analyzed in a similar fashion as all other products of the mind. THE MEANINGS OF FANTASY: CONSCIOUS AND UNCONSCIOUS The story line of a fantasy, meaningful in itself, also symbolically expresses additional hidden meanings. Underneath one narrative is another, and under that yet another, arranged in layers as is the mind itself. A fundamental discovery of Freuds, and one that remains valid today (unlike many of his ideas about human sexuality), is that some aspects of mental functioning are not subject to conscious

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recall. Even when unconscious, they may inuence motivation. Connections between conscious and unconscious thoughts, feelings, and memories occur in the form of associations. Just as neural networks exist in the brain, so do psychic networks in the mind, although the precise correspondences between the two have not yet been claried (Olds, 1994). Freud termed his unique method of exploring the pathways of these connections as psychoanalysis. His initial explorations in his self-analysis, carried out at the end of the nineteenth century, led to the awareness that the closer one comes to mental processes that are out of awareness, the more the rules governing mental organization appear to change. Although the thinking processes of ordinary daily life are more or less logical, unconscious mentation seems to be organized more like dreams. In dreams, many ideas, memories, and feelings may be represented by a single image. The narrative line of a dream consists of strings of such symbols and emotions that may or may not be ordinarily connected with the images as usually experienced during waking life, all arranged without regard to ordinary time/space rules of the physical universe. In dreams everyone can be anyoneman, woman, or child, or even nonhumanand all is possible. Freud termed the organization of the unconscious part of the mind the primary process and contrasted it with the secondary processthe system of organization of ordinary, everyday thinking (Freud, 1940). A perspective about fantasy, unique to psychoanalytic psychology, is that beneath the immediately coherent narrative line of waking fantasy are disguised stories that carry hidden meanings. These latent narratives consist of memories of real and imagined events linked in the imagination of the present. Since single symbols can represent multiple meanings, the amount of information carried by sequences of symbols is vast. Another core psychoanalytic idea is that one reason why some story lines are unconscious is because they contain wishes that are unacceptable to the conscience. The mind has the capacity to erase from its awareness certain unpleasant ideas, but not the power to completely eliminate their motivational force. SEXUAL FANTASIES Sexual fantasies are stories told to ourselves that are embedded in sexual feelings. These depend in both sexes on adequate enough blood levels of androgen (Money and Ehrhardt, 1972). Pharmacological blockade of the effects of androgen eliminates sexual feelings and thus the motivation to participate in sexual activity. The reason this is important from a psychoanalytic perspective is that psychoanalysts specialize in illuminating unconscious motivation. A psychoanalyst would immediately ask whether elimination of sexual feelings from the conscious mind actually meant that they were totally absent; could they be unconscious? Of course, there is no denitive way of proving that they are not. Total loss of sexual interest, however, and of erotic activity without positive evidence that sexual motivation is present, suggests otherwise (Bradford, 1995). Thus, when sexual

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fantasy is eliminated by antiandrogens, it is best conceptualized as absent from the mind. Since personality functioning is preserved when this occurs, it is an empirical demonstration that Freuds ideas about the central importance of the role of sexuality in total personality functioning were incorrect.

MALE SEXUAL FANTASY In physiologically normal adults, the most important inuence on the contents of sexual fantasy is probably gender. Male sexual fantasies are best understood as part of the psychology of men; female sexual fantasies in the context of the psychology of women.

THE OEDIPUS COMPLEX Psychoanalytic ideas about the development of sexual fantasy have been greatly inuenced by Freuds speculations about the Oedipus complex. In keeping with scientic progress, these have required extensive revision since his death. Here we consider his thoughts about males, of which only some have withstood the test of time. Freud, a physician and neurologist, was fascinated with the Oedipal myth long before he ever made systematic observations about human psychology (Sulloway, 1979). His ideas about the role of the Oedipus complex were formulated in the late 1890s and remained unchanged throughout his life. According to Freud, the sexual development of children is biologically determined to occur in two waves of intensity; or, in Freuds terms, diphasically. As he put it:
. . . It is further found that these phenomena which emerge in early childhood form part of a regular process of development, that they undergo a steady increase and reach a climax toward the end of the fth year after which there follows a lull. During this lull, progress is at a standstill and much is unlearned and undone. After the end of this period of latency as it is called, sexual life is resumed with puberty, or, as we might say, it has a second eforescence. Here we come upon the fact that the onset of sexual life is diphasic; that it occurs in two waves, this is unknown except in man. . . . (Freud, 1905)

Freud believed that human beings are biologically determined to be erotically attracted to their opposite-sexed parents. He considered this incestuous wish to be a part of the biological heritage of all people and to increase in intensity during early childhood, reaching a peak between ages 4 and 5. As a result of his incestuous desire, the boy nds himself in a competitive relationship with his father. As part of a complex of linked feelings, associated with the erotic desire for his mother, is rage at his father. The child fears retaliation from his father for his incestuous and parricidal wishes. Freud termed the boys fear castration anxiety, although he actually meant fear of penectomy. Freud viewed castration fear as the third

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component of the Oedipus complex (after desire for the mother and competition with the father). The childs next developmental stage was characterized by two central psychological processesidentication with the father and repression of the Oedipus complex. These processes were associated with the formation of the superego, a name given by Freud for what is generally termed as the conscience. Repression of the Oedipus complex and identication by the son with his father leads to the capacity to experience guilt, to regulate impulses, and to develop normal morality. Freud also proposed that as a result of the repression of the Oedipus complex, children went through a period of latency, which gets terminated by the hormonal surge of puberty. We have criticized Freuds ideas about the Oedipus complex elsewhere and refer the interested reader to Friedman and Downey (1995) for a more extensive discussion of this issue. The major aspects of the theory that have become obsolete are as follows: 1. Freuds ideas about the timing of developmental processes affecting or inuencing psychosexuality were found to be invalid. Freud reviewed the sparse database available to him for possible effects of prenatal hormones on neuroembryology and behavior, and rejected the likelihood that they had an important effect. This has proved to be erroneous. Thus, his exclusive emphasis on postnatal biopsychological events was misguided (Gorski, 1991; Money, 1998; Money and Ehrhardt, 1972). 2. Also invalid was his belief about the chronology of sexual desire, e.g., his discussion of the biphasic nature of childhood sexuality. The concept of a universal norm consisting of an intense surge of sexual arousal at age 45 followed by latency has little empirical support. There is actually substantial variability in the way sexuality is experienced and expressed, depending on constitutional as well as sociocultural inuences. Early genital exploration, including masturbation, commonly occurs prior to age 45 (Galenson and Roiphe, 1981), although there is no reason to believe that such activity is normative. Throughout childhood, boys participate in sexual activity more frequently than girls, a sex difference that is preserved later in life. Childhood sexual activity is likely to consist of genital inspection and manual exploration, but not sexual intercourse unless there has been a history of sexual abuse. Among many diverse developmental pathways is one in which there is a linear increase in sexual interest and activity over time without evidence of a quiescent phase of latency (Yates, 1993). 3. The hypothesis (expressed by Freud as a discovery) that there is a universal childhood incestuous wish has not only failed to be validated, but there is considerable evidence indicating that it is erroneous (Erickson, 1993). 4. Although there is no evidence of universal parricidal wishes, it is possible to conceptualize boys aggressive/competitive feelings about their fathers (and vice versa) as falling on a developmental line separate from sexual

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development. This line reects the inuence of prenatal androgens on aggression, especially as expressed in childhood (Friedman and Downey, 1995). 5. The universality of castration fear during early childhood also requires additional empirical validation. Although fears of bodily injury, including genital injury, are common, their role in child development remains to be claried (Schrut, 1993). 6. The development of conscience does not follow the pathway outlined by Freud. Moral development has been shown to be the result of complex interactions between many genetic, cognitive, and psychosocial inuences that occur throughout childhood (Kohlberg, 1981). PSYCHOANALYTIC PERSPECTIVES ABOUT THE OEDIPUS COMPLEX AND SEXUAL FANTASY Freuds ideas about the role of the Oedipus complex were quite specic and rooted in his ideas about the role of biology in psychological development. Subsequent psychoanalytic scholars, however, have frequently discussed the Oedipus complex in a much less precise fashion (Greenberg, 1988). A tendency emerged to blur distinctions between erotic and nonerotic, parents and their symbolic representations, and castration anxiety and its symbolic representations. In addition, psychoanalysts frequently viewed the timing of childhood events, retrospectively reported during psychoanalysis, as being accurate. For example, consider a 40year-old man who was being treated with psychoanalysis because of work inhibitions. Such a patient might have a dream that he was to deliver a speech before a committee of older men. Following it, he stubbed his toe and it bled and then fell off. Psychoanalysts throughout the world, during Freuds life and even today, might interpret the patients bleeding toe as a symbolic representation of castration anxiety even though no history might ever have been uncovered of the man actually fearing damage to his genitals. It is also credible enough to assume that the older men represented father gures and that, having been frightened of his father as a child, he remained so unconsciously even though his actual father was long dead. Many psychoanalysts would assume that the anxiety symbolically expressed in his dream and causing his vocational inhibition was triggered by unconscious incestuous desire. This assumption might be made, regardless of the facts of the patients sexual history, in light of the Oedipus complex described by Freud as occurring during early childhood. Using this case as an example of more general phenomena, we speculate that this person may never have desired to possess (or even be stimulated by) his mother erotically. He may, however, have felt competitive towards his father for his mothers attention. The fear of competition with his rival may have been experienced in imagery with symbolic connotations of genital damage. As an adult psychoanalytic patient, the man may have in addition

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expressed sexual conicts that seemed to be connected in his mind to his fear of older men. It is likely that these sexual components of his wishes and fears were integrated into his life narrative, however, years after what classical psychoanalysts consider the Oedipal phase of development. We do not believe that it is valid to infer the existence of an Oedipus complex as a universal norm, as described by Freud, either from the narratives of adults or even children in the psychoanalytic situation. We do believe that subgroups of people experience such an Oedipus complex and that Oedipal fears inuence the form of sexual psychopathology in many patients. PSYCHOANALYSIS, THE OEDIPUS COMPLEX, AND THE PATHOLOGICAL MODEL OF HOMOSEXUALITY There are many ways of categorizing the stimuli that elicit sexual excitement in men, and any method selected must necessarily be somewhat arbitrary. We, therefore, nd it helpful to think of three large categorieshomosexual, heterosexual, and bisexualwithin which are many subgroups, depending on the specic characteristics of objects and situations that are sexually stimulating. Men of homosexual orientation are predominantly or exclusively sexually excited by males; those of heterosexual orientation by females; and those of bisexual orientation by both. Although Freud (1905) believed that the origins of heterosexual orientation were obscure, psychoanalysts in the next generation tended to regard heterosexuality in all of its manifestations as a biological norm and other forms of sexual orientation as derailments produced by psychosocial traumata (American Psychiatric Association, DSM-I, 1957; DSM-II, 1968; Socarides, 1978). Freud also believed in universal bisexuality. By this he meant that all people have members of both sex as sexual objects in fantasy. The attraction to one or the other sex may be more or less conscious. In Freuds view (Freud, 1905), a man who consciously was exclusively heterosexual nonetheless had unconsciously made a homosexual object selection. Similarly a man who was exclusively homosexual harbored in his unconscious mind a heterosexual object. Freuds theory of bisexuality has been extensively criticized (Friedman, 1988; Friedman and Downey, 1993a,b). There is virtually no evidence that this theory is valid, and we do not use the term bisexuality in the Freudian sense. Modern gender psychology indicates that all people make various types of bigender identications. These have conscious and unconscious components but do not inuence gender identity once it has differentiated. The psychoanalytic community viewed homosexual orientation to be pathological until quite recently, lagging behind the general psychiatric community. The reasons for this have been extensively discussed by Lewes (1988), Isay (1989), Friedman (1988), and Friedman and Downey (1998). Perhaps the most compelling reason that psychoanalysts adhered to the pathological model of homosexuality, however, was widespread conviction that Freuds

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ideas about the Oedipus complex were accurate. Believing that boys were destined to be erotically attracted to their mothers, psychoanalysts could see no pathway except a pathological one for the development of homosexual orientation. Thus, a (simplied) idea about homosexual orientation was widely accepted. It was believed that homosexual orientation was defensively motivated as a response to unconscious anxieties about heterosexuality. Thus, each time a man experienced a sexual desire for a man, he enacted in his mind a pathological scenario. It was also widely believed that men of homosexual orientation had defective superego functioning because of inadequate identication with their fathers. It was generally held that psychoanalysis could and should convert sexual orientation from homosexual to heterosexual (Socarides, 1978). These ideas are formally viewed as being outdated and invalid by the American Psychoanalytic Association. Psychoanalysis is an international enterprise, however, attitudes towards homosexuality in some European and Latin American countries tend to be those that were in vogue in North America in the 1950s. PSYCHOANALYTIC PERSPECTIVES CONCERNING EROTIC IMAGERY Freud (1905) considered young children to be innately polymorphously perverse and that the capacity to be excited by so called perverse stimuli remained during adulthood as part of the normal sexual response. Freud was probably more interested in disorders that he termed neuroses than those which would now be called paraphilias (American Psychiatric Association, DSM-IV, 1994). He was also interested in sexual experience as it occurred in day-to-day living among people without psychiatric disabilities. The interests of subsequent psychoanalysts have been similar. Much more attention has been devoted to the so called perverse sexual fantasy and activity among normal and neurotic people than among those with paraphilias, although some psychoanalysts have made important contributions to understanding the psychology of the latter (Stoller, 1975a,b). This is probably because patients with paraphilias tend to have limitations in social skill and capacity for insight, and respond poorly to insight-oriented psychotherapy including psychoanalysis (Abel et al., 1992). Psychoanalysts as well as nonpsychoanalysts have speculated on the reason that paraphilias and paraphiliac-like erotic imagery should occur so much more commonly among males than among females. An extremely abbreviated summary of their views is that the experiences with abusive and neglectful caretakers, generally women during early childhood, beginning well prior to the Oedipal developmental phase, are of great etiological importance. The specic paraphiliac image selected by a given individual is often a function of actual experiences he has had during childhood. For example, Stoller discussed a case of a fetishist cross-dresser who was forcibly cross-dressed during childhood (Stoller, 1975a,b). Sometimes, however, the determinants of specic fantasy remain obscure. In many of these

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instances, psychoanalysts assume that the image was generated in fantasy. The sex difference in frequency of paraphilias is compatible with the sex difference in frequency of nonsexual violence and with the theory that hostility and sexual arousal are fused in these disorders. Stoller (1975a,b) stressed that paraphiliacs need to experience the sexual object in a dehumanized way, as a so-called part-object or a fetish. Themes of revenge (usually directed at the symbolic representation of the mother) lead to fantasies of torture, control, and domination. The need to soil and devalue the object is in keeping with anal inuences persistent in unconscious mental life (Kernberg, 1995). Regardless of the particular fantasy, there is a general tendency to experience the sense of danger overcome by the powerful sense of self in the sexually arousing situation. A number of psychoanalytic writers have also conceptualized the diverse objects and situations that psychoanalysts have traditionally considered perverse as defensive efforts to master traumata (Stoller, 1975a,b). A generally accepted idea is that a range exists with regard to intensity and exclusivity with which paraphiliac-like imagery are experienced. Most men experience such imagery at least to some degree. The determinants of intensity, frequency, and exclusivity vary depending on constitutional and psychosocial developmental inuences. We return to the topic of so-called perverse sexual fantasies in nonparaphiliac people later in this article. MALE SEXUAL FANTASY: FURTHER DEVELOPMENTAL CONSIDERATIONS The contents of erotic fantasy in males appear to be usually formed prior to puberty, more or less at the age of adrenarche (see Herdt and McClintock, 2000). Once experienced with the full erotic intensity that occurs with complete androgenization, they tend to dene the limits of erotic arousal during the entire life span. Stimuli that fall outside a persons pattern are experienced with indifference. For that reason, some authors have referred to individually specic sexual pattern as sexprints (Person, 1995) or lovemaps (Money, 1988). We nd it helpful to think of male sexual fantasy in terms of two major dimensions. We call the rst, orienting sexual fantasy by which we mean whether the person responds erotically to stimuli that are same gender, opposite gender, or both. The developmental differences between individuals who are homosexual, heterosexual, and bisexual remain to be ascertained. From a psychoanalytic perspective, boys and men who have the capacity for bisexual arousal are of unusual interest. Theoretically, such people might repress or amplify either the homo- or the hetero-erotic component of their erotic imagery depending on life stress and psychodynamic inuences. Such men might, for example, experience themselves as changing sexual orientation during various life phases and attribute such change to life circumstances (such as falling in love), or psychotherapeutic interventions of one type or another. However, it is important that the experiences of men in this group not be taken as valid for all men.

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The second dimension of sexual fantasy that we just alluded to concerns the situations and objects that characterize erotic imagery. We hypothesize that both dimensions of sexual experience become more or less xed during later childhood, although the outer limits of such differentiation remain to be established by research. We qualify this, however, by leaving room for unusual men whose sexual fantasy life seems to follow idiosyncratic rules. FEMALE SEXUAL FANTASY Although male erotic fantasy functions as a limit dening the realm of that which is erotically possible, the situation with respect to sexual excitement in women is more variable. In men, sexual arousal is generally equated with an awareness of a specic affect (e.g., lust), erection, and intense desire to achieve orgasm. Although the female equivalent of this occurs in some women, it is not universal. There is far more variability in the multiple behavioral dimensions constituting sexual experience. In order to understand the signicance of developmental aspects of female sexuality, it is helpful to rst consider aspects of the sexual experience and activity of adult women. SOMATIC AND SUBJECTIVELY EXPERIENCED ASPECTS OF FEMALE SEXUAL RESPONSE In laboratory situations, there is a good correlation between a mans awareness of sexual excitement/arousal and objective measurements of erection. This is not so for women. A number of investigators have conrmed that the relationship between what has been termed genital arousal (more or less the equivalent of male erection), and the subjective sense of feeling sexually aroused, is inconstant at best. In fact, at least in experimental situations, women may report little or no sexual arousal even when objective signs of genital arousal were unmistakable (Laan and Everaerd, 1995). Moreover, unlike men, only a minority of women consider orgasm the most important source of sexual satisfaction with a partner. In addition, whereas erection is necessary for men to achieve intromission, women can participate in heterosexual intercourse without sexual arousal. Common sense, clinical experience, and research data indicate that they frequently do so. Although most men who engage in intercourse experience sexual orgasm, a substantial number of women do not. These data indicate that women tend to participate in sexual activity, including intercourse, for many reasons, only some of which would be considered erotic by standards applied by men to their own behavior (Everaerd and Laan, 1994; Hateld and Rapson, 1993). Thus, although men tend to experience sexual arousal in a simple unitary way, women experience it more contextually in terms of combinations of emotions.

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Nuances of feelings, meanings, and attitudes towards real and imagined experience are more characteristic of the consciously experienced female experience than the male experience. A woman presented with a stimulus that a man might nd immediately erotic (a picture of a nude member of the opposite sex) may or may not experience it as sexually arousing. After all, what is traditionally considered pornography is largely consumed by men. On the other hand, men do not consume romance novels in any great numbers. From a male perspective, endless attention is devoted in these novels to a certain type of context and setting in which sexual arousal may ultimately be mobilized. The stories which pique the interest of so many women bore men (Stoller, 1975a,b). It seems evident that the characteristics and meanings of erotic fantasy differ between the sexes (although, of course, some overlap does exist). At the beginning of this article, we put forth a denition of sexual fantasy for men. The question naturally arises: Is it possible to put forth a denition for women as well? Perhaps the most important sex difference that bears on the question of definition concerns the onset of the feeling of sexual arousal. Should the sexual situation for women be dened very broadly in a way that includes experiences that have a high probability of leading erotic desire to be kindled? How does one deal with the problem that genital arousal is often present without concurrent subjective arousal? The second question is easier to deal with. Although it is true that genital arousal might occur without subjective arousal, there is no evidence that the converse commonly occurs (although this area has been sparsely investigated). In any case, we take the position that sexual arousal in women should be dened subjectively, that is, in our view, subjective reports of arousal are necessary for sexual fantasy to be so labeled. With regard to the question of kindling, we take the narrow view that the term erotic fantasy should be restricted to fantasy that is associated with the sense of being aroused. When circumstances that kindle are discussedromantic fantasies, for examplethey should be so labeled. The notion that female sexual fantasy depends more on relational context than male sexual fantasy is also compatible with evolutionary psychology. It is adaptive for women to seek partners who can provide resources and protect them and their offspring. Men, on the other hand, should (according to an evolutionary model) seek sexual encounters with as many different partners as possible (Buss and Schmitt, 1993). FURTHER THOUGHTS ABOUT SEX DIFFERENCES IN PSYCHOLOGICAL DEVELOPMENT A major theme that we have emphasized so far is the fact that males and females are on different psychosexual developmental lines throughout their life cycles. Their experiences of sexual fantasy, of boys and girls, men and women,

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must be conceptualized within this context. Different prenatal neuroendocrine environments lead to temperamental differences during early childhood. It may well be that the androgenization of the brain that occurs prenatally in males and not females radically inhibits or extinguishes the interest of males in infants and doll play during early childhood. Thus, even boys who are biologically normal but suffer from childhood Gender Identity Disorder and who enjoy playing with Barbie Dolls as a way of expressing their fascination with the female body outline, and its adornments, show little interest in maternal aspects of doll play (Zucker and Bradley, 1995). As small children, girls who experience some degree of prenatal androgenization as a result of genetically determined adrenal steroid metabolic disorders show diminished interest in maternal aspects of doll play. Interestingly, this phenomenon occurs independently of maternal rearing style, and among girls who ultimately menstruate, and usually grow into heterosexual women and become mothers (Collaer and Hines, 1995). The sex difference observed in all cultures during early childhood in rough-and-tumble play is also a result of prenatal androgen differences between the sexes (Maccoby, 1998; Maccoby and Jacklin, 1974). The themes of childhood play, different between the sexes, reect the different organization of their self and object representations. From the perspective of cognitive and social development, the sexes create different narratives or myths within which sexual fantasy life develops. In virtually all cultures, very young children are cared for primarily by women. Similar exposure of boys and girls to mothers during early childhood has different consequences for each. As separationindividuation proceeds, boys must struggle against the tendency to identify with their mothers femaleness, whereas girls experience an increased sense of security by doing so. As Gilligan has pointed out, this may be one reason for men to be threatened by intimacy, i.e., to feel less masculine, whereas women are more likely to be threatened by separation (Gilligan, 1982). This may also inuence a need commonly experienced and expressed by certain men defensively to devalue women in sexual situations and to engage in exhibitionistic masculine display behaviors as a way of bolstering masculine selfesteem. Such behaviors begin during the latency-age phase when it is common for boys to experience feminine traits in themselves, and nd their same-sex peers as negatively valued (Fine, 1987). Sex-segregated play is characteristic of older latency-age children. Boys commonly organize themselves during free play into hierarchical groups, similar to nonhuman primates. They are more apt than girls to be territorial and xenophobic and less tolerant of nonstereotypical gender role behavior than girls are (Friedman and Downey, 1993a). Oedipal narrative themes enter the life cycle as early as children can describe them and remain present throughout life. As we have discussed earlier with regard to men, when contemporary psychoanalysts refer to Oedipal themes, they tend not to mean the concrete wish to participate in sexual relationships with the

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opposite-sex parent and the fear and retaliation because of incestuous desires from the same-sex parent. We have earlier discussed Oedipal narrative themes with regard to male development and turn now to females. It is certainly common during childhood for girls to idealize their fathers in a romantic way and to resent attentiveness to their mothers. It is also common for girls to fear retaliation because of their jealous impulses, usually in the form of disapproval and loss of love from their mothers, although themes of bodily damage are also commonly experienced. These wishes and fears are usually kept secret. It is easy to trace their elaboration and displacement into fantasies in which the father gure is symbolically represented by a powerful older man who seduces the woman, overcoming her protestations, forcing her to succumb to his will, even raping her. This type of fantasy certainly is the bedrock of womens romance novels, or so-called bodice rippers. It probably is experienced by many women under diverse conditions and provides one type of imagined setting in which erotic excitement can develop (Stoller, 1979). In almost all societies, the rules regulating male and female sexual experience differ, with male experience being valued much more positively. Abuse of women by men is common, and overt physical abusesystematic rape, bodily mutilation, sexual slaveryis still prevalent in many nations. This difference in power and status interacts with the biological inuences to lead to a nal common pathway with respect to many behavioral sex differences including sexual fantasy. For example, the theme of being overwhelmed by a powerful male who stimulates but also protects, need not refer exclusively to the father, but understandably probably emerges commonly in response to the differential treatment of the sexes throughout entire societies. This observation is more or less in keeping with a psychoanalytic perspective rst expressed by Horney (1924, 1926). She suggested that the Oedipus complex in boys and girls is strongly inuenced by sociocultural factors and varies in intensity between children. She criticized Freuds biological determinism and phallocentricism and pointed out that the Oedipal narratives of women are shaped by sociocultural prejudices that today would be termed heterosexist. In any case, the Oedipal fantasies of both sexes express themes of power and dependency. We note that in our abbreviated discussion of Oedipal themes, we did not review many of Freuds ideas about the role of Oedipus complex in female development (anatomy is destiny, etc.) (Freud, 1925, 1933). These are considered outdated and have been abandoned by the psychoanalytic mainstream, at least in the United States. Freud also believed that penis envy was biologically determined and part of the constitutional endowment of all women. This hypothesis is also outdated (Downey and Friedman, 1998). Limitations of space do not allow us to review how modern ideas about the development of gender identity led to alteration of Freuds developmental model for girls. This topic has been discussed extensively by others and interested readers are referred to the work of Zucker and Bradley (1995), Tyson (1982, 1994), and Downey and Friedman (1998).

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THE MENSTRUAL CYCLE AND SEXUAL FANTASY In the late 1930s, a psychoanalyst, Benedek, and a gynecologist, Rubenstein, began an astonishingly original research project on the relationship between the hormonal uctuations of the menstrual cycle and verbalized sexual fantasy during the psychoanalytic process (Benedek, 1973). The investigators began their work with the prospective investigation of a single woman in analysis with Benedek. The patient was instructed to take daily vaginal swabs and rectal temperatures. These data were analyzed blind by Rubenstein who used them to date the physiological events of the cycle. After 10 cycle phases had been completed, Benedek reviewed detailed notes that she made of each analytic session (the references to actual menstruation having been edited out) and accurately predicted, on the basis of the patients verbalized sexual fantasies and associations, the precise date of ovulation during every cycle. The investigators went on to study 15 patients, for variable lengths of time, in whom Benedek accurately and blindly predicted cycle phase. Benedek and Rubenstein (1942) described phasic alteration in the fantasies of their patients. Early in the rst part of the cycle, self-esteem was high and erotic interest was primarily motivated by the desire for sexual stimulation. As ovulation approached, the patients tended to experience increased sexual tension and conicts associated with this. Immediately following ovulation there was a sense of relaxation following which during the luteal phase there was a pronounced change in the quality of sexual fantasies. The women now tended to focus on procreational aspects of sexuality: needs to be nurtured and protected were more pronounced. Imagery of babies and mothers was more plentiful. This was followed by a brief phase prior to menstruation when ego defenses appeared to weaken. Negative affects increased, as did the patients level of regression. Benedek and Rubenstein were aware that the phenomenon of estrus characteristic of lower animals did not regulate human sexual activity. They speculated, however, that despite the freedom from regulation of sexual activity by the hormones of the cycle, woman might experience an equivalent of estrus in fantasy. The investigation carried out by Benedek and Rubenstein, although achieving instant acclaim, has been mostly ignored in subsequent psychoanalytic thought about sexual fantasy. No attempt to replicate it has ever been carried out at a psychoanalytic institute. Components of Benedeks observations and ndings have been validated in many nonpsychoanalytic studies (Hedricks, 1994; Severino and Moline, 1989). Others still remain to be investigated. A compressed way of summarizing a large interdisciplinary body of work in this area would be as follows: There is substantial variability between women, regarding the timing of physiological events of the cycle and the experience and meaning of psychological events. Diverse subgroups exist and more extreme and repetitive uctuations occur among some than among others. For example, premenstrual regression as described by Benedek may have been a function

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of the neuroticism of her patients, and not of women in general. The sequential progression of fantasies from stimulatory to procreational may characterize a subgroup of women rather than women as a whole. It is evident from extensive research that many subgroups exist with regard to virtually all psychobiological parameters of the menstrual cycle, and that substantial variability exists not only between women but also may exist within individual women (Hedricks, 1994). Across studies, and in many different societies, however, there is little question that the inner experience of women is cyclic in many ways and that this is true of the intensity and quality of sexual fantasies as well as other aspects of their mental life. The notion of cyclicity does not suggest that any dimension of experience or behavior is not inuenced by psychosocial events or that any dimension of experience or behavior is somehow intrinsically more problematical (e.g., negatively valued) than among men, nor does it suggest that women are under biological inuence to a greater degree than men are. The complexity of womens sexual fantasy as discussed by Benedek is compatible with the earlier discussion of the psychophysiological area. Particularly ignored in the psychoanalytic literature is the fact that the quality of sexual fantasies in women and their many meanings may change phasically. Psychoanalysis as a whole treats sexual fantasy as if it is either trait-related or a result of reactions to specic life events and traumata. The notion of innately inuenced cyclicity imposes a requirement on clinicians to utilize more complex behavioral paradigms. For example, cyclicity by no means implies the notion of biopsychological events occurring in a vacuum without social context. In fact, the meanings attributed to psychological events during the cycle, including sexual fantasies, may be greatly inuenced by interpersonal experience, including sexual experience, and may also inuence the way such experience is psychologically processed by the woman. It might well be that the transference relationship with the analyst, a crucial aspect of psychoanalytic treatment, is inuenced by the menstrual cycle. Whether this is the case, however, remains to be explored with empirical research. The onset of menstrual cyclicity during the life cycle creates a discontinuity in female development which has no parallel among males. Benedeks point that procreative fantasies are a crucial dimension of the sexual experience of women requires particular emphasis. We suspect that erotic fantasy is much more closely linked to procreative fantasies in women than in men. These may include the wish to become pregnant, to deliver, to raise children, or any component of this sequence. Although the experience of cyclicity, not only with regard to physiological events, but with feelings as well, is discontinuous with earlier female development as well as female experience after menopause, many psychological continuities are obviously retained. By this we mean that girls are not called upon to create an entirely different representation of the self as a result of puberty. Rather, their self-representations must adapt to new circumstances. One set of psychological traits that we believe to be continuous throughout the life cycle is the one involving maternal interest. Thus, the fantasies of girls and women, including their sexual

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fantasies, tend to be inuenced by broad narrative maternalistic themes whose origins are in early childhood. From a psychoanalytic perspective, very little is actually known about the relationship between self- representation and sexual fantasy during adolescence. Although the research design used by Benedek and Rubenstein is impractical to carry out with modern teenagers, other ways of studying their fantasy life may be more practical. Longitudinal study of girls prior to and through puberty, adolescence, and adulthood is needed to shed light on the multiple aspects of the development of female sexual fantasies that even today remain a subject of conjecture. Also requiring study are the ways in which girls and women create unied narrative fantasy themes, some of whose components involve romance, power, and Oedipal themes, whereas others seem to be basically procreational. FEMALE HOMOSEXUAL ORIENTATION Separate developmental lines for males and females are also indicated by sexspecic differences in homosexual orientation. Although some lesbians describe a developmental pathway similar to that typical for gay men, many do not. Political homosexuality, for example, is a phenomenon that is for all intents and purposes conned to women. Political lesbians tend to be feminists who feel that heterosexual activity expresses unacceptable power differentials between women and men, whether or not they have strong attractions to women (DeFries, 1979). A different group of women experience homosexual desire for the rst time during middle adulthood. These women, many of whom are heterosocialized or even homophobic, nonetheless experience the emergence of erotic desire for another women in the setting of an empathic, supportive relationship. The erotic component appears as if kindled by the other aspects of the relationship. If this phenomenon occurs among men, it is very rare and has never been seen by either of us. The psychoanalyst Kirkpatrick (1984, 1989) has pointed out that the need for intimacy seems to be greater among women than men in sexual relationships and that genital release may not be their primary organizing and motivating factor. She observed that even though woman might have more intense orgasms with a man, she might nonetheless prefer sexual activity with another woman because of the greater degree of intimacy in their relationship. In any case, the notion of sexual fantasy as a limit in place by late adolescence may be true of only some women. Others may well retain the capacity for plasticity at least with regard to sexual stimuli. We have speculated elsewhere that if this is true with regard to sexual fantasy it might also be true for other psychological characteristics (Friedman and Downey, 1998). REFLECTIONS ON SEXUAL FANTASY AND PASSIONATE DESIRE The data used by psychoanalytic theory have been provided by psychoanalytic treatment of patients predominately of Western European background. The

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majority of these individuals were uent, at least moderately well educated, and from the middle and upper socioeconomic classes. Psychoanalytic theory has also been applied to art and literature from diverse societies and historical periods. However, inferences made from such scholarship should not be equated with cross-cultural research. This qualication having been made, we now speculate about sexual fantasy and passionate desire. One of Freuds particularly important insights is that human relationships are inherently ambivalent. Crystals of antipathy are always contained within the pattern of our meaningful affections. Unambivalent friendliness, exuberance, expansive playfulness, and joy are certainly part of our repertoire, but these feelings are never unalloyed for long in ongoing meaningful interpersonal experience. Freud, as have virtually all major psychoanalytic theorists, recognized that feelings of fearanxiety and ragehostility are inevitably mobilized in ongoing relationships, although they may be experienced in ways that are repressed or denied. Thoughtful psychoanalytic scholars have realized that the concept of ambivalence is, in a condensed and often disguised way, an integral component of sexual passion. Thus, during sexual arousal human beings tend to experience more than a unitary sense of lust. Men as well as women experience feelings of anger and anxiety that are usually associated with a sense of danger. Mixtures of these feelings inuence the attributions given to erotic fantasy. In less formal language it means that when we become sexually aroused we feel lustful but also fearful and often angry, and we process mixtures of these feelings with our characteristic defenses. As part of our mental processing activities, we create dramatic narratives which we (later) return to in the form of memories. As we become more sexually excited, the fantasy, with its different components, is experienced more and more vividly. These fantasies provide the stimuli for masturbatory activities and also endow specic, actually occurring sexual situations with meaning. During intense interpersonal sexual activity, the fantasy constructs of people appear to come to life and are shared. Both aspects of the actual activitythe enactment in external reality of subjective wishes and narratives and the sharing of such experience with its evoked mutual identicationsare experienced as thrilling. Sexual fantasy is rooted in bodily experienceones own body and that of others. The rst relationship in which ones body is more or less completely explored by another is with the mother or mothering person. Hence, psychoanalysts have noted that representations of the motherchild relationship and of the mothers body are symbolically included in sexual fantasy experienced during adulthood by both sexes (Chasseguet-Smirgel, 1986). Kernberg put it as follows (Kernberg, 1995, p. 26):
The fantasied early polymorphous perverse relations to the parental objects are condensed with the admiring and invasive relation to the lovers body parts. Erotic desire is rooted in the pleasure of unconsciously enacting polymorphous perverse fantasies and activities, including symbolic activation of the earliest object relations of the infant with mother and of the small child with both parents. All this is expressed in the perverse components of

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Friedman and Downey intercourse and sexual playin fellatio, cunnilingus and anal penetration and in exhibitionistic, voyeuristic and sadistic sexual play. Here the links between the early relationship with mother of both genders and the enjoyment of the interpenetration of body surfaces, protuberances and cavities is central.

Sexual passion brings the self to the boundary in the experience of pleasure associated with emotional intensity. At the outer boundary of the self, there is always a feeling of danger of dissolution, and then a feeling of relief, relaxation, and of being soothed when the intensity passes, and the self inhabits its customary, familiar surroundings. When sexual passion is shared with another person, the loss of self-boundary is associated not only with what is usually termed communication in conventional usage, but rather with the sense that the inchoate matter of ones interior and the others interior are mixed. This type of experience, whether actually occurring and encoded in memory, or only wished for but nonetheless psychologically represented in some form, endows sexual fantasy with the power of mysterious enchantment. The complex layers of meaning represented by the adult sexual experience are an important reason that childhood and adult sexuality, although similar in certain ways, are quite different in others. Children, even older ones, although capable of sexual activity do not experience their inner worlds as adults do. Their ideas about sex and love, virtue and vice, and rage and fear become modied with life experience and cognitive and social growth. Artists have intuitively grasped this. For example, Romeo and Juliet, Shakespeares play about adolescent lovers tells quite a different story than that of Anthony and Cleopatra, his drama about full-grown adults. CONCLUSIONS: PSYCHOANALYSIS AND SEX RESEARCH It is difcult to capture the subjective qualities of sexual fantasy in laboratory research settings or via questionnaire studies. On the other hand, research using psychoanalytic techniques is time-consuming and extremely difcult to implement. Moreover, many aspects of sexual fantasy and sexual arousal were unnoticed by psychoanalytic psychology and could never have been discovered via psychoanalytic exploration. It was only because of the physiological investigations of Masters and Johnson that psychoanalysis revised its erroneous models of female development and psychosexual functioning (Masters and Johnson, 1966). The pioneering work of Money and collaborators on gender identity led to similarly far-reaching revisions of psychoanalytic models of the mind (Money and Ehrhardt, 1972; Stoller, 1968). Psychoanalytic exploration alone could never have described the crucial distinction in women between genital and subjective arousal. Many questions about the somatic, psychological, and social determinants and consequences of sexual fantasy during development remain to be illuminated. These provide fertile ground for collaborative efforts between behavioral scientists and psychoanalysts.

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REFERENCES
Abel, G. A. G., Osborn, C., Anthony, D., and Gardos, P. (1992). Current treatments of paraphiliacs. Annu. Rev. Sex Res. II: 255291. American Psychiatric Association (1957). Diagnostic and Statistical Manual of Mental Disorders, 1st ed., American Psychiatric Press, Washington, DC. American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders, 2nd ed., American Psychiatric Press, Washington, DC. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th ed., American Psychiatric Press, Washington, DC. Benedek, T. (1973). Psychoanalytic Investigations: Selected Papers. Quandrangel: The New York Times Book Co., New York, NY. Benedek, T., and Rubenstein, B. B. (1942). The Sexual Cycle in Women: Psychosomatic Medicine: Medicine Monographs III, Nos. 1 and 2. National Research Council, Washington, DC. Bradford, S. M. W. (1995). In Oldham, J. M., and Bams, R. (Eds.), Annual Review of Psychiatry, Vol. 14: Pharmacological Treatment of the Paraphilias, American Psychiatric Press, Washington, DC, pp. 755779. Buss, D. M., and Schmitt, D. R. (1993). Sexual strategies theory: An evolutionary perspective in human mating. Psychol. Rev. 100: 204232. Chasseguet-Smirgel, J. (1986). Sexuality and Mind: The Role of the Father and the Mother in the Psyche, New York University Press, New York, NY. Collaer, M. L., and Hines, M. (1995). Human behavioral sex differences: A role for gonadal hormones during early development? Psychol. Bull. 118: 55107. DeFries, Z. (1979). A comparison of political and apolitical lesbians. J. Am. Acad. Psychoanal. 17(1): 5766. Downey, J. I., and Friedman, R. C. (1998). Female homosexuality: Classical psychoanalytic theory reconsidered. J. Am. Psychoanal Assn. 46(2): 471506. Erickson, M. T. (1993). Rethinking Oedipus: An evolutionary perspective of incest avoidance. Am. J. Psychiat. 150: 411416. Everaerd, W., and Laan, E. (1994). Cognitive aspects of sexual functionoing and dysfunctioning. Sex. Marit. Ther. 9: 225230. Fine, G. A. (1987). With the Boys: Little League Baseball and Preadolescent Culture, University of Chicago Press, Chicago, IL. Freud, S. (1905/1953). Three Essays on the Theory of Sexuality. In Strachey, J. (Ed. and trans.), Standard Edition, (hereafter S.E.), Vol. 7, pp. 125243. Reprinted by Hogarth, London, England. Freud, S. (1989). Some psychical consequences of the anatomical distinction between the sexes. In Gay, P. (Ed.), The Freud Reader, 1925. W.W. Norton and Co., Inc., USA, pp. 670678. Freud, S. (1933/1964). Femininity. In Strachey, J. (Ed.), SE, Vol. 22, pp. 112135. Reprinted by Hogarth, London, England. Freud, S. (19401949). An Outline of Psychoanalysis, W.W. Norton and Co., Inc., USA. Freund, K., Langevin, R., Chamberlayne, R., Deosoran, A., and Zajac, Y. (1974). The phobic theory of male homosexuality. Arch. Gen. Psychiat. 31: 495499. Friedman, R. C. (1988). Male Homosexuality: A Contemporary Psychoanalytic Perspective, Yale University Press, New Haven, CT; London, England. Friedman, R. C., and Downey, J. (1993a). Neurobiology and sexual orientation: Current relationships. J. Neuropsychiat. & Clin. Neurosci. 5: 131153. Friedman, R. C., and Downey, J. (1993b). Psychoanalysis, psychobiology and homosexuality. J. Am. Psychoanal. Assn. 41(5): 11591198. Friedman, R. C., and Downey, J. I. (1995). Biology and the Oedipus complex. Psychoanal. Q. LXIV, 234264. Friedman, R. C., and Downey, J. I. (1998). Psychoanalysis and the model of homosexuality as psychopathology: An historical overview. Am. J. Psychoanal. 58(3): 249270. Galenson, E., and Roiphe, E. (1981). Infantile Origins of Sexual Activity, International Universities Press, New York, NY. Gilligan, C. (1982). In a Different Voice, Harvard University Press, Cambridge, MA. Gorski, R. A. (1991). Sexual differentiation of the endocrine brain and its control. In Brain Endocrinology, 2nd ed., Raven Press, New York, NY, pp. 71103.

586

Friedman and Downey

Greenberg, D. F. (1988). The Construction of Homosexuality, University of Chicago Press, Chicago, IL. Hateld, E., and Rapson, R. L. (1993). Historical and cross-cultural perspectives on passionate love and sexual desire. Annu. Rev. Sex Res. IV: 6799. Hedricks, C. A. (1994). Sexual behavior across the menstrual cycle: A biopsychosocial approach. Annu. Rev. Sex Res. V: 122173. Herdt, G., and McClintock, M. (2000). The Magical Age of 10. Arch. Sex. Behav. 29: 587606. Horney, K. (1924). On the genesis of the castration complex in women. Int. J. Psychoanal. 5: 5065. Horney, K. (1926). The ight from womanhood: The masculinity-complex in women as viewed by men and women. Int. J. Psychoanal. 7: 324339. Isay, R. (1989). Being Homosexual, Farrar Straus Giroux, New York, NY. Kernberg, O. (1995). Love Relations: Normality and Pathology, Yale University Press, New Haven, CT. Kirkpatrick, M. (1984). Female homosexuality. Panel Report, Annual Meeting of American Psychoanalytic Association, San Diego, CA, 4 May. Kirkpatrick, M. (1989). Women in love in the 1980s. J. Am. Acad. Psychoanal. 17(4): 535542. Kohlberg, L. (1981). The Philosophy of Moral Development: Moral States and the Idea of Justice. Essays on Moral Development, Harper & Row, New York, NY. Laan, E., and Everaerd, W. (1995). Determinants of female sexual arousal: Psychophysiological theory and data. Annu. Rev. Sex Res. VI: 3277.37. Lewes, K. (1988). The Psychoanalytic Theory of Male Homosexuality, Simon & Schuster, New York, NY. Maccoby, E. (1998). The Two Sexes: Growing Up Apart, Coming Together, Harvard University Press, Cambridge, MA. Maccoby, E. E., and Jacklin, C. N. (1974). The Psychology of Sex Differences, Stanford University Press, Palo Alto, CA. Masters, W. H., and Johnson, V. E. (1966). Human Sexual Response, Little, Brown, Boston, MA. Money, J. (1988). Gay, Straight and In-Between, Oxford University Press, Oxford, England. Money, J., and Ehrhardt, A. (1972). Man and Woman: Boy and Girl, John Hopkins University Press, Baltimore, MD. Olds, D. D. (1994). Connectionism and psychoanalysis. JAPA 42(2): 581613. Paredes, R. G., and Baum, M. J. (1997). Role of the medial preoptic area/anterior hypothalamus in the control of masculine sexual behavior. Annu. Rev. Sex Res. VIII: 68102. Person, E. (1995). By Force of Fantasy, Basic Books, New York, NY. Schrut, A. (1993). Is castration anxiety and the Oedipus complex a viable concept? Presented at the meeting of The American Academy of Psychoanlaysis, San Francisco, CA, 22 May. Severino, S. K., and Moline, M. L. (1989). Premenstrual Syndrome: A Clinicians Guide. The Guilford Press, New York, NY, London, England. Socarides, C. W. (1978). Homosexuality, J. Aronson, New York, NY. Stoller, R. (1975a). Perversion: The Erotic Form of Hatred, Karnac Books Ltd, London, England. Stoller, R. (1975b). Pornography and perversion. In Perversion: The Erotic Form of Hatred, Karnac Books Ltd., London, England. pp. 6392. Stoller, R. (1979). Sexual Excitement: Dynamics of Erotic Life, Pantheon Books, New York, NY. Stoller, R. J. (1968). Sex and Gender, Science House, New York, NY. Sulloway, F. J. (1979). Freud: Biologist of the Mind, Basic Books, New York, NY. Tyson, P. (1982). A developmental line of gender identity, gender role and choice of love object. J Am. Psychoanal Assn. 40: 5984. Tyson, P. (1994). Theories of female psychology. JAPA 42(2): 447469. Yates, A. (Ed.) (1993). Sexual and Gender Identity Disorders: Child Adolesc. Psychiatr. Clin. North Am. 2(3). Zucker, K., and Bradley, S. J. B. (1995). Gender Identity Disorder and Psychosexual Problems in Children and Adolescents, Guilford Publications Inc, New York, NY.