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The editors of this book must have struggled for some time before deciding on a title. The one they chose is not so much an indication of its contents as an attempt to steer around the many pitfalls in addressing such a topic.
Take the phrase ‘in clinical practice’. One must suppose that this was added to distance the book from the raging academic debate about the nature and function of sexuality in society - a debate that is characterized by polemics and political posturing, in which the reality of people's sexual lives remains elusive. In fact, though all the chapters, with the exception of the last two by literary critics, are written by psychoanalytic clinicians, there are relatively few detailed case accounts. There is a contribution on the treatment of an obscene telephone caller, a mode of sexual expression that will soon be of only historical interest because such calls are now much more easily traced. However, for the most part this is not a book on psychoanalytic technique or practice and the authors are largely concerned with theoretical issues.
One of these is the complex interplay between social attitudes towards sexuality and its meaning for a particular individual. Clearly a sexual act taken in one social context will have quite a different meaning when viewed in another. For example, fellatio in the adolescent boys’ hut of a Papua New Guinea tribe is an act of conformity, while in the Western equivalent, a boys’ Public School, it is more likely to be one of rebellion. This attests to the close relationship that Freud always insisted on between sexuality and the moral order. This can pose considerable problems for psychoanalysts, and these are extensively explored here by Joyce McDougall, who suggests that analysts may be drawn, consciously or unconsciously, into either supporting or criticizing a particular variety of sexual expression. The provocative or seductive attempt to bring about the abandonment of neutrality belongs, uniquely perhaps, in an ag