Psychoanalytic Reflections on the Implications of Recent Physiological Studies of Female Orgasm

This paper examines questions about the validity of the clitoral-vaginal transfer theory arising from anatomical and physiological evidence that vaginal orgasm, as distinct from clitoral, does not exist. Psychic rather than physical satisfaction seems to determine the preference of most women for vaginally induced orgasm, despite the fact that clitorally induced orgasms may be equally or more intense. This preference, biologically adaptive, is the result of an ego maturation influenced by self and object representations which contribute to a feminine identity based on woman's anatomy and species characteristics of lactation and intrauterine gestation of the fetus. Erogenous sensitization of the clitoris occurs during the nursing experience, accompanied by the psychic representation of the nipple-breast as part object. Loss of this part object contributes to the differentiation of the self from the object and together with other factors aids in the establishment of a complex of interrelated representations which form the basis for the well-known unconscious equation "body-nipple (breast)-phallus" and a continued cathexis of the clitoris. Although there is evidence that early vaginal sensations occur, the sensations are ill-defined, and invisibility of the female organs limits their perception and inclusion in psychic representation. The ego reacts passively to vaguely experienced sensations, and its passivity contributes to fantasy and poor reality testing in respect to the boundaries of the organs. Lack of ego control over the vaginal opening and inner organs also gives rise to anxiety and a need to repress awareness of the vagina, with a return to clitoral masturbation, defensive clitoral

hypercathexis, and penis envy. Pubertal changes re-establish erotism of the nipple itself with a reinforcement of clitoral cathexis until menstrual function, intromission of the penis, pregnancy and parturition complete the psychic representation of female structure and function. These vicissitudes of development contribute to greater cathexis of varying parts at different periods and determine whether sensation from the cryptic structures involved in orgasm are associated with the clitoris or the vagina.