Sex and Shame: Clinical Dilemmas

In her introduction to the panel, Ellen Helman noted that while shame has recently been the subject of attention in the psychoanalytic literature, the relationship between shame and sex has not. Freud initially considered shame to be an affect within a social context, only later viewing shame as a defense against the drives. He described shame as “a feminine characteristic par excellence,” relating it to the concealment of genital deficiency and a wish to hide (Freud 1933, p. 132).

Helman gave examples of contemporary psychoanalytic thinking about sex and shame. Peter Fonagy (2008) believes sexual feelings are dysregulated because sexual arousal and excitement go unmirrored by early caregivers. Mothers find it difficult to mirror their infant's sexual excitement and, without mirroring, the infant has no full experience of containment or sense of ownership of these feelings. This in turn can generate an intensification of arousal in the infant. Helman wondered if the caregiver's nonmirroring response might plant the seed for an eventual experience of shame in the developing child in relation to feelings of sexual excitement.

Christopher Bollas (2000) notes that maternal love is the first field of sexual foreplay: the mother caresses the infant in countless ways and experiences a wide spectrum of responses to her infant's body. Because conscious or unconscious shame in relation to sexuality can be transmitted to the infant through maternal attitudes of disapproval, Helman imagined that a mother, troubled by an erotic response to her infant, communicates her ambivalence toward her child's sexuality.

Ruth Stein (2008) believes excess to be a crucial part of the sexual experience, identifying the antithetical nature of the term excess, which “denotes both liberated pleasure beyond bounds and abominable transgression and destructiveness” (p. 43). Aside from the deep-rooted cultural