Psychosexual Functions in Women

462 Pages·1952·14.132 MB·English

by  Therese Benedek

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Studies in
Psychosornatic Medicine
PSYCHOSEXUAL
FUNCTIONS IN WOMEN
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Volumes in the
STUDIES IN PSYCHOSOMATIC MEDICINE
of
THE INSTITUTE FOR PSYCHOANALYSIS
Chicago, Illinois
AN APPROACH TO THE CAUSE AND TREATMENT OF V.EGETATIVJ~
DISTURBANCES--Franz Alexander, M.D., Thomas Morton
French, M.O., el al. 1948
PSYCHOSEXUAL FUNCTIONS IN WOMEN-Therese Benedek, M.D.
1952
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PSYCHO:i~~~~~ :EDICINE
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, P sychosexual
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Functions in Women
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By
THERESE BENEDEK, M.D.
' THE INSTITUTE FOR PSYCHOANALYSIS, CHICAGO
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THE RONALD PRESS COMPANY ., NEW YORK
Copyright, 1952, by
Tm: RoNALt> Par.ss Co:.trASY
All Rigltts I<cscrvcd
The text of tbis pub\icntion or 1u~>· J•M~
thereof mav not be reproduced m 1np
manner wh11tsoever witbuul ~ermission Ill
writing from tl1c pu\i\isber.
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Library of Congress Catalog Card Number: S2-6200
PIUltTl!D IN TIIE UNITED STAl't:S OP AMERICA
FOREWORD
Psyc/,osexual F1111ctio11s i11 fVomt·n constitutes the second volume
of the psychosomatic studies presented in this form by The Institute
fur Psychoanalysis. Chicago. The first was published in 1948 under
the title of Studies i11 Psychosomatic JI cdici11c-A n A pproac/1 lo flit•
Cause a11d Trealm£'11f of V cgetatfr.•e Dist11rba11ces. The present volume
is a collection of the studies in female sexuality made by Therese
Benedek over the last fifteen years.
A Doctor of l\iJedicine since 1916, Dr. Benedek began her career
as a resident in pediatrics in a hospital for infants in Budapest. Al
though she left that specialty for psychiatry and psychoanalysis, her
interest remained in the "psychosomatic approach," especially in the
endocrinological aspects of the interaction of body and mind.
The Institute for Psychoanalysis, Chicago, gave Dr. Benedek
an opportunity for this specialization within the general field of
psychosomatic research. Soon after she joined the staff she began
work on an extensive project in collaboration with the endocrinolo
gist, Dr. Boris B. Rubenstein. The result .of this investigation was
published as a monograph by the National:Research Council in 1942.
It is presented in this volume as Chapters 1-11. Although this is a
truly psychosomatic study in which psychoanalytic interpretation is
consistently correlated to physiolo_gical material, it has a special
aspect. Drs. Benedek and Rubenstein studied normal physiological
processes rather than pathological conditions. Their subjects were
women who were in psychoanalytic treatment for a variety of reasons
and who were being analyzed by several psychoanalysts connected
with the Institute.
In her analysis of the case records, Dr. Benedek was able to de
termine from the psychological material the current phase of the
sexual cycle. It was a methodological achievement of the first rank
to discover that interpretation of psychoanalytic material could be
correlated, with a high percentage of exactness, with an estimation of
the ovarian hormone production (based on evaluation of vaginal
smears and basal body temperature). This demonstrated psycho
analysis as a tool of biological research.
This study established the influence of the two ovarian hormones
upon the emotional orientation of women : of estrogen in the pre
ovulative phase and of progesterone during the postovulative phase
of the cycle. In contrast to other psychosomatic studies which demon-
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strate that emotions may motivate specific physiologic responses,
this study shows the specific psychic responses to physiological
stimuli. As is well known, the behavior of women is also determined
to a great degree by cultural influences which modify not only the
emotional reactions to the hormones, but un<ler certain conditions,
the ovarian function itself.
The later studies republished in this volume draw freely upon the
theoretical conclusions made from the detailed study of the hormonal
and emotional rhythm of the sexual cycle. They demonstrate the
subtle interaction between the psychodynamic forces and the cultural
factors which together motivate human behavior.
This volume holds more than usual interest for the medical pro
fession. Psychiatrists, gynecologists, and general practitioners may
gain from it a greater insight into the problems of their patients.
Anthropologists and other social scientists will find basic information
about women which is of value in their own fields of study. ~1Iany
laymen will be interested in this scientific effort to unravel some of
the complexities of women's behavior.
FRANZ ALE.XANDER
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PREFACE
This volume is a collection of studies in female sexuality based
on psychoanalytic investigation and carried out in conjunction with
physiologic obserrntion. \V ritten from the point of view of a par
ticular investigation, this work does not purport to be a compre
hensive presentation of the psychology of women. The methodology
as well as the conclusions, however, offer evidence, beyond that of
the usual psychoanalytic case studies, of the validity of the basic con
cepts of psychoanalysis. According to these concepts, the maturation
of the propagative function is the axis around which the psychosexual
per~onality develops.
Although psychoanalytic theory is in general well documented,
it has an obstacle to overcome in regard to the psychology of women.
This obstacle originates in Freud's concept that anatomical sex dif
ference represents to the woman a biological inadequacy in com
pnriROll ln men; that wnnutn'!il p:;ychology therefore centers nronnrl
a sense of inferiority, that her wish for childbearing and motherliness
is but an effort towards substitution £or physiologic lack. During
lhe Inst three ctecncks many psychoanalysts have attacked this con
cept. Karen Horney was the first to point out that this is not a
biological concept but is based on observations which can be e.."tplained
by cultural influences. vVhiJe this concept has not been discarded,
psychoanalysis has made great strides in understanding the function
of the mother in the psychose..··mal development of her children.
Freud himself initiated investigation in this field when he pointed
out the significance of the early relation between mother and daughter
and emphasized the influence of this long period of emotional inter
dependence on the psychose..xual maturation of the girl.
Although many studies yielded information regarding the psycho
sexual development of woman, the psychology of motherhood and
motherliness, except for the extensive study of Helene Deutsch, has
been little investigated. Since there were no psychosomatic investiga
tions to support the emotional dynamics related to the two phases of
the propagative function of woman ( the heterosexual relation and
childbearing), the psychoanalytic theory of female sexuality seemed
almost unfathomable.
Our. investigation was no~ begun w!th the goal of clarifying basic
theoretical concepts. Our aim was simply to find out whether
physiological function, such as ovulation, which in animals determine:
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their "social behavior," could be recognized in the emotion~ and hc
havior of women in our culture. This question was an:-werccl in
the affirmative. Further investigation of the sexual cycle n·,·eah:d
that woman's sexual hehavior. on superficial examination, only seems
to be independent of the propagative, biologic meaning of sexuality:
on closer scrutiny, we find that the difference hetween other mam
mals and the human female is that the woman's behavior is the result
of a complex, delicate interaction between personality and physiol1 ,~ic
regulation. After ten more years of psychoanalytic stucly of probkms
of motherhood and motherliness. it can he stated that the assumption
of a biological substratum for the emotional manifc stations of hoth
phases of the propagative function has significant heuristic value.
It opens new avenues for im·estigation and it explains many nf the
concepts derived from psychoanalytic observations. Jt is almnst :-ur
prising how "natural" many of the earlier psydrnanalytir cmtrept:
hecome when investigated in the light of hormonal regulation.
A comprehensive psychology of women, however, can he written
only with a detailed consideration of the psychology of men. l n thi:
w1lume the psychohiologic interaction hctwccn the sexes can only
he inferred from the material on the woman. \Vith these papers.
which deal with special aspects of the psychology of women, we !tan·
also included a chapter (Chapter 14), which is a compendium of the
psychosexual physiology and patholo1=,ry of both sexes. This chapter.
however, is to be regarded as only a bird's-eye-view comparison of
the psychosexual prohlems oi men and women.
I wish to express my gratitude to my patients, not only to those
whose cooperation made these investigations possible but also to all
those whose need helped train my understanding. I acknowledge
my indebtedness to Dr. Boris B. Rubenstein, co-author of the mono
graph, whose interest remained active in the later studies although he
did ~ot participate in them. I owe thanks to all my colleagues at The
Institute for Psychoanalysis, especially to Dr. Franz Alexander, at
whose request one of the papers was written, and to Helen Ross.
whose helpful interest has been a steady source of inspiration. I am
also gra!efut to Roberta Collard for her editorial help and for the
preparation of the index to this volume.
Fo~ permission to reprint these articles I extend my thanks to the
foll~wmg publications and publishers : the American Psychosomatic
Societr, Inc., the American Journal of Orthopsychiatry, The Psycho
aNnalytytc Qkuarterly, and W. W. Norton & Company Inc all of
ew or. ' .,
THERESE BENEDEK
Chicago, March, 1952