Артрит – Arthritis

Another element germane to the homosexual picture is that of narcissism. Freud once commented that the homosexual is often so intensely narcissistic that he cannot love a being that is other than himself, that is, a being without a penis (in the case of the male). The narcissistic wish often expresses itself as the substitute for oedipal strivings, that is, once the homosexual has identified himself with his mother, he begins to behave as he had once wished his mother to behave toward him. This leads to a choice of libidinal objects such as men or boys who are quite similar to the individual himself and toward whom he then expresses the same sort of tenderness and affection that he had once desired from his mother. While he acts out the maternal identification in this way, emotionally the narcissism plays itself out insofar as the love object is like himself and the psychic situation is equivalent to one in which he is able to enjoy being loved by himself. This particular dynamic may prevail when male religious are in charge of young boys, or females in charge of young girls. This is particularly noteworthy for young adolescents in whom the resolution of gender identity has not been completed and the titre of homosexual impulses runs high.

Often when such narcissistic elements are predominant in the genesis of homosexuality, the character structure tends to be more primitive and pathological. It should be noted that similar mechanisms can be found in heterosexual individuals as well, when narcissistic men fall in love with a woman whom they see as a reincarnation of their own feminine wishes and yearnings. This relates to their own wish to be treated as a little girl by their mothers with results similar to those found in homosexuals, that they then treat these women as they themselves would have wished to have been treated by their own mothers. Consequently, the love relationship is not based on an objective love of the feminine partner as a separate entity in her own right, but rather as a reflection of the repressed feminine parts of the man’s own ego.

Certain types of character organization show a tendency or a need to give to others what they did not get themselves and are able to gain the satisfaction of «getting» through an identification to the one to whom they are giving. This is a form of «altruism» in which certain pleasures that the individuals cannot have themselves may be given to others and relished through an identification with these others. But the wish to give and the affection for the other is often intensely ambivalent and mixed with extreme degrees of envy, which may turn into rage and resentment if the one given to is not as pleased as the giver expects him to be.

The identification with the mother may also be mixed with other pre-genital components, including an anal fixation. The oedipal wish for sexual gratification from the mother is transformed through the identification into a wish to enjoy it in the same way that the mother does. This dynamic makes father the object of the child’s love and leads to a masochistic striving to submit himself to the father in the way that the mother does, in a passive and submissive way. The anal fixation in these cases combines with a maternal identification in the wish for anal intercourse. While patients of this sort may behave in a feminine way with passivity and tenderness, these aspects of their behavior may mask unconscious hostility toward the very father figures to whom they are submitting. In such cases the passive submission to the father or father-substitute replaces a more unconscious intention of stripping the father of his masculinity so that homosexual intercourse can begin to signify active castration.

In this sense, these apparently feminine and passive men have not at all given up their unconscious striving to be masculine and to replace their father. By becoming the feminine part to a more masculine man, they thus can gain the strength and masculine power of the partner. Thus, the retreat from castration anxiety in the feminine identification does not completely replace the wishes for identification with the father. The wish to be like the father, to learn from him, to gain strength and resourcefulness and power by being more like him is always ambivalent, since its ultimate aim is in the oedipal context to replace the father. Once the child places his father in such a position of power and omnipotence, he may try to regain some sense of strength by sharing in the father’s power. The tension remains between the extremes of killing and getting rid of the father in order to take his place, and total obedience and ingratiating submission so that the father will grant the son a share in his power and strength.

It should be remembered that narcissistic and passive-anal fixations may occur in the same individual and may express themselves in various combinations in different forms of homosexuality. It should also be remembered that the same dynamics may exist in apparent forms of heterosexuality. Not uncommonly the excessive involvement in heterosexual activity serves as a defense against passive and narcissistic homosexual longings. In situations in which these homosexual inclinations are excessively stimulated, such individuals may be severely threatened and may experience an overwhelming anxiety which has been described as «homosexual panic.»

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Most people do not question their own or others’ established gender identity and role as male or female. They are readily accepted at face value. What is said and done by men and women in different societies varies and may overlap, since dimorphic norms of gender role are culturally and historically determined. But once an individual’s identity and role as a male or a female become differentiated, they remain stable and are unlikely to be shaken even by major crises in life, physiological, social, or accidental.

The greater proportion of gender identity/ role differentiation takes place after birth. It develops on the basis of prenatally programmed sex differences in body morphology, in hormonal function, and in central nervous system (CNS) function, but is not preordained or preprogrammed in toto by prenatal determinants. Prenatal antecedents lay down a predisposition to which postnatal influences are added. A prenatal defect, skew, or bias may be either augmented or counteracted by postnatal influences.

The dimorphism of gender identity/role as male or female begins with the genetic dimorphism of the sex chromosomes, ÕÓ for the male, XX for the female. It is followed by the differentiation of the gonads with H-Y antigen on the Y bearing sperm governing the differentiation of the testes. Fetal hormonal functioning then programs differentiation of the internal reproductive anatomy, and the external genital morphology. Then follows differential sex assignment at birth, rearing as a boy or a girl, and differentiation of the childhood gender role and identity. The differentiation process is continued through the pre-pubertal and pubertal phase with, in adolescence, a sexually dimorphic response or, more accurately, threshold of response manifested in erotic attraction, falling in love, courtship, mating, and parenthood.

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The industrial revolution pulled out thousands of women from behind the hearth and crib and forced them into the labor markets of the budding capitalist economy. Women’s participation in national economy has changed their social roles. The privileged role of provider which was the backbone of the traditional, male-dominated family structure began to crack, and currently it is heading toward an unprecedented crisis (Ackerman).

The erosion of the traditional male-female relationship took place first in the lowest and then in the highest social classes. The middle classes have been the notorious bulwark of conservatism, and Freud’s patients came from highly conservative, middle-class families in which fathers exercised absolute power and penis envy was probably an almost general phenomenon among Freud’s female patients.

The current family constellation has deprived the father of his authority but has not replaced it by any other. One cannot help wondering what is going to happen in our times to the Oedipus complex, latency period, and the whole area of male-female relationships. Modern women have destroyed the myth of their intellectual inferiority and denied, in vivo, the assumption of either cherub or witch personality (Wolman).

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The question of how sexuality influences the development of personality has become a central focus for many clinicians, investigators in the field of human behavior, and developmentalists. It has become more important during the last three or four decades, as the role of early experiences in the final shape of the personality has become better understood. It also has been recognized that early individual differences among infants have a lasting effect throughout life (Escalona).

The civil-rights movement of the sixties, started by black Americans and other oppressed minorities more conscious of their conditions and seeking to remedy them, renewed interest in the nature of the social forces influencing the development of personality. Investigators were impressed by the devastating impact of isolation, poverty, and chaotic family situations.

In the seventies, women and those with different sexual orientations, such as homosexuals, began to examine sexuality within the culture and to re-examine some of the accepted concepts of the development of both normal and pathological sexuality. They questioned particularly the stereotypic definitions of what is masculine and what is feminine. This in turn stimulated research on the roots of sexuality and sexual identity from the cultural, psychological, biological, and developmental points of view. In addition, clinicians began to examine the causes of atypical gender-identity development among their child patients. All this research activity still has not settled the controversy over the role of sexuality in personality development but has greatly softened some of the rigid and dogmatic attitudes towards sexuality.

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The experience of orgasm by the female has been variously valued, even during the present century. Kinsey, for example, commented on the «post-Victorian» development of the idea that respectable women should enjoy marital coitus. Even so, he cited a 1951 study which found evidence in the British working class that responsiveness in the wife was hardly expected and if too marked, was disapproved. Kinsey’s research suggested to him that orgasm was not nearly as important to the female as it was to the male. Without orgasm, she could still feel pleasure in the «social aspects» of a sexual relationship: «Whether or not she herself reaches orgasm, many a female finds satisfaction in knowing that her husband or other sexual partner has enjoyed the contact and in realizing that she has contributed to the male’s pleasure». Even so, «persistent failure of the female to reach orgasm in her marital coitus, or even to respond with fair frequency, may do considerable damage to a marriage».

About 36% of the married females in Kinsey’s sample had never experienced orgasm from any source before marriage. By contrast, over 99% of the late adolescent male samples were responding sexually to orgasm more than twice a week. While almost all marital intercourse of his male sample resulted in orgasm, the average female reached orgasm in only 70% to 77% of her marital sexual experiences. The longer the women were married, however, the more likely they were to experience orgasm. For example, the percent of females who never had orgasm in marital coitus decreased from 25% by the end of the first year to 11% by the end of the twentieth year. Likewise, the percent of those having orgasms more than 60% of the time increased from 51% in the first year to 64% in the twentieth.

In addition to length of marriage, some factors which were strongly related to occurrence of orgasm in Kinsey’s sample were decade of birth and premarital experience in orgasm, whether through coitus, petting, or masturbation. For example, 33% of women born before 1900 were unresponsive in the first year of marriage, compared to only 22% of those born after 1909. As for experience, no factor showed a higher correlation with the frequency of orgasm in marital coitus than the presence or absence of premarital experience in orgasm. Among those women with no premarital experience of orgasm, 44% failed to have orgasm during their first year of marriage. Among those with even limited experience only 19% failed to reach orgasm in the first year.

Neither the Hunt nor the Redbook data can be directly compared with Kinsey’s figures, since neither is broken down by length of marriage. Hunt did, however, compare his females with fifteen-years-median-duration of marriage with Kinsey’s females in their fifteenth year of marriage. Of the Kinsey wives, 45% reported having orgasm 90% to 100% of the time, compared to 53% of the Hunt wives who had orgasm «all or almost all of the time». Of the same Kinsey group, 12% never had orgasm,,, compared with 7% of the Hunt group.

Figures for the Redbook sample show that 63% of these wives have orgasm all or most of the time, 7% never. These data are more recent than Hunt’s and as we have noted, the sample consists of younger, more educated individuals, all of which could account for the higher orgasmic figure.

Hunt collected some interesting data on the incidence of orgasm among married men. Contrary to Kinsey’s assertion that married men achieved orgasm in nearly 100% of their marital coitus, Hunt found that 8% of the husbands aged forty-five and up did not have orgasm anywhere from occasionally to most of the time; 7% of the men between twenty-four and forty-four did not have orgasm at least a quarter of the time; and 15% of the under-twenty-five husbands failed to have orgasm a quarter or more of the time.

Kinsey’s stress on the relationship between length of marriage and sexual responsiveness in his married sample was challenged in part by Clark and Walfin. Proposing that women’s responsiveness is influenced by the quality, not just the duration, of their marriages, they did a twenty-year longitudinal study which began with 1,000 engaged couples, 602 of whom were studied after a «few years» of marriage, and the 428 remaining couples again after sixteen or more years of marriage. They found a strong relationship across time between positive ratings of the quality of the marriage and sexual responsiveness. Sexual responsiveness increased from 65% to 91% among those wives who rated their marriages as positive, and from 61% to 69% among those rating them negative. The authors suggest that increased responsiveness does not inevitably follow as a function of length of marriage, but rather is interdependent with the perceived quality of the marital relationship.

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