Sexuality in the Therapeutic Process

The topic of this Round Table immediately brings to mind that it was Freud who courageously broke the conspiracy of silence regarding the subject of sex, which was tabooed by the culture and even the psychiatry of his time. Reevaluating Freud's pioneer work, an increasing number of psychiatrists and psychoanalysts find themselves today in disagreement with the libido theory which, while it was the first attempt at a comprehensive system of psychodynamics, appears too mechanical and too limited to provide an adequate answer to the problems of human existence, human motivation, and human growth. Nevertheless, all of us, definitely including the “non-libidoists,” consider it highly conducive to the advancement of psychoanalysis that Freud gave so much significance to the role of sex.

This is not because we see sex, even if conceived in the wider sense of libido, as the core of human nature, as the basic motivational force which determines the formation of character and which dominates the rich symbolism of our life and dream experience. We welcome the emphasis on the somatic, the vegetative, the primary, which is so close to total emotional experience, and closer, as Horney would say, to our “wants” than to our “shoulds.” It is significant that Freud, having decided to base his psychological system on instincts, did not select hunger but sex, which has a particularly high symbolic value in our intrapsychic and interpersonal experience. The categories “oral,” “anal,” “phallic,” and “vaginal” acquire a powerful holistic meaning if they are no longer seen as limited expressions of partial instincts but as dynamic symbols of total attitudes to ourselves and others.

Sexuality, while not the cause, is a highly important expression of healthy or neurotic growth and of our total interpersonal relationships. It forms an integral part of the inner life history