Personal Reflections on the Role of Sexuality in the Etiology and Treatment of the Neuroses

SACHS OPENED THE PANEL BY DESCRIBING the evolution of its title. In discussing the original title, "Sexuality and the Neuroses," Sachs and the panelists made the discovery that marked changes had occurred in their approach to the topic over the course of their professional careers. They then decided it would be worthwhile to describe, trace, and attempt to understand these changes. This turned out to be a difficult task indeed. In Sachs's opinion, each panelist was successful in providing a highly personal vision of his understanding of the relation between sexuality and the neuroses and of the changes that had occurred in this understanding over the years. Sachs noted that each paper showed the problems the panelist had struggled with as a young analyst, the solutions found at that time, and how the old solutions compared with the panelist's current understanding. The panelists' careers spanned a crucial period in the history of psychoanalysis. They were candidates in training at a time when ego psychology was the dominant theoretical framework. Since that time, they have had to confront and integrate radical new understandings of transference and countertransference as well as the development of new models of the mind. This historical perspective added significance to the panelists' papers.

Spruiell began by describing his furtive discovery of Freud as a fifteen-year-old high-school student. Reading Freud then stirred up intimations about his own mind which called for exploration. The question of how to know one's own mind led Spruiell on to other questions—how to know one's own body and how to know the body and mind of another. Spruiell emphasized that a requirement of psychological health in adulthood is the capacity to re-contact these erotic