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O r r o I;. KERNBERG,h.1.D.
- r t i E s E s OF
HE I~RINCIPAL nm PAPER are: Sadomasochism,
T a n ingredient of infantile sexuality, is an essential part of
tiorinal sexual functioning and love relations. It is a n essential
part of the very nature of sexual excitement. Sexual excitement
is a basic affect: it is a fundamental constituent of libido, which
I see as a hierarchically supraordinate drive. This idea is in
consonance with proposals in my earlier work that consider
affects as the building blocks of drives (1976, pp. 85-107;
333
Case 1
Case 2
A man, in his late thirties, was in psychoanalytic treatment be-
cause of a long-standing incapacity to commit himself to any
Case 3
Case 4
Case 5
This is the case of a woman in her early forties with a de-
pressive-masochistic personality structure, in a late stage of her
psychoanalytic treatment, during the course of which she was
able to resolve an incapacity to achieve orgasm in intercourse
with her husband, after many years of marriage. In one session,
she developed the fantasy in the transference that she would
come to a session, undress totally, and I would be so impressed
by her breasts and her genitals that I would become a complete
slave to her desire, respond by getting sexually excited and
having intercourse with her, and she, in turn, would then be
willing to become my slave and leave everything to folloiv me.
McDougall, 1978; Meltzer, 1973), and they show the same con-
densation of oedipal and preoedipal conflicts under the domi-
nance of preoedipal aggression characteristic of borclerline per-
sonality organization itself. This condensation includes a
regressive primitivization of the oedipal conflict, characterized
by extremely primitive and threatening images of both parents,
threatening combined father-mother images, and regressive
distortions of unconscious perceptions of the functions of the
genitals and the primal scene. I t is clinically very different from
the defensive regression to preoedipal stages of development
found in patients with neurotic personality organization. Pa-
tients whose polymorphous perverse features are totally inhib-
ited not because of repression, but from lack of activation of
early eroticism (that is, some extremely inhibited borderline but
not hysterical patients) present the same borderline dynamics.
Their sexual inhibitions are the most severe that we encounter
in clinical practice.
Sexual perversions in the narcissistic personality structure,
particularly in malignant narcissism, show the psychodynamic
constellations outlined by Chasseguet-Smirgel (1985a, 1985b,
1986). T h e full deployment of a regressive anal universe de-
scribed by her overlaps the syndrome of malignant narcissism
plus a n organized perversion. T h e primitive destruction in un-
conscious fantasy of the contents of mothers belly as part of a
general intolerance of reality, of the differentiation of sex and
ages, and of the acknowledgment of the oedipal father, with a
consequent severe disturbance in cognitive processes as well,
are typical for the most severe of these cases of perversion in
narcissistic personalities.
T h e cases I have described illustrate an additional aspect
of my clinical experience, namely, that, while sadomasochism
as a n organized perversion (like all organized perversions) is
probably more frequent in men (Money, 1988), I have found
that sadomasochistic fantasies are probably more frequent in
women, particularly in their masturbation fantasies.
that the infant identifies himself with the frustrating yet stimu-
lating mother, with her erotic stimulation and with the erotic
stimulation of the sexual couple, that is, father as mothers
object. This identification of the infant with the two members of
the oedipal couple would provide the basic frame for a psychic
bisexuality, and consolidate the triangular situation in the
childs unconscious fantasy.
T h e male infants acknowledgment of this frustration and
of the itnplicit censorship of his erotic desire for mother would
then shift his erotic stimulation into masturbatory fantasy and
activity, including the desire to replace father and, in primitive
symbolic fantasy, to become the fathers penis and the object of
mothers desire.
In the case of the little girl, mothers subtle and uncon-
scious rejection of the sexual excitement which she would freely
experience in relation to the little boy gradually inhibits the
little girls direct awareness of the original vaginal genitality;
she would therefore gradually become less aware of her own
genital impulses while being less directly frustrated by the dis-
continuity in the relation with mother. T h e identification with
mothers eroticism would take more subtle forms, derived from
mothers tolerance and fostering of the little girls identification
with her in other areas. IVitli a tacit understanding of the un-
derground nature of her own genitality, the little girls deepen-
ing identification with mother would also strengthen her long-
ing for father, and her identification with both members of the
oedipal couple.
T h e little girls change of object from mother to father
determines her capability for developing an object relation in
depth with the loved and admired and yet distant father, and
the secret hope of eventually being accepted by him and of
becoming free once more in the expression of her genital sexu-
ality. This development fosters the little girls -capacity to com-
mit herself emotionally to an object relationship that deter-
mines the womans greater capacity for such a commitment in
her sexual life, from early on, than is the case with men.
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