Panel on 'Disturbances of Male and Female Identity as Met with in Psychoanalytic Practice'

At the onset of this report I wish to offer my regrets and apologies to all participants for not doing justice to the diversified richness of their comments. This holds true especially for the discussants from the floor; owing to the excellent steering of the Chairman, Dr Morgenthaler, there was enough opening for the participation of an interested audience.

The panel was introduced by the Chairman who, not contented with his prepublished paper, gave an almost new presentation. He chose his example from identity disturbances in male homosexuals.

He focused on Anna Freud's concept of the disharmony between the development of instinctual drives and of the ego, and on Heinz Kohut's elucidation of the dynamics and treatment of narcissistic personalities.

In his view, disturbances of sexual identity can be understood as a particular result of a disharmony between ego and drive development, which for one reason or the other proceeds at different speeds in an early or late pre-oedipal phase. If we take into account the cases in which there is a disturbance of sexual identity, the damage to the personality as a whole not being such that a diagnosis of psychotic development would be necessary, we are faced with a large number of clinical pictures and also of non-pathological traits. A more or less severe disharmony between developmental lines may have as consequence the fact that the child discovered the anatomical characteristics of the sexes before a certain level of maturity in the development of the object- and self-representations had been reached. For that reason the child could not effect a realistic assessment of his observations. Patients with severe disturbances of sexual identity are often seen to experience practically every kind of sexual differentiation in a regressive manner, namely in maintaining an undifferentiated shape within sexual representations. Analytical observations show that the self- and object-representations have been permeated with distorte