Meetings of the Psychoanalytic Association of New York

September 29, 1975. SCOPTOPHILIA AND SEPARATION ANXIETY. Renato J. Almansi, M.D.

The coexistence of scoptophilia and separation anxiety in four cases of simple voyeurism previously published by Dr. Almansi pointed strongly toward a genetic relationship between object loss and scoptophilia. In the case under

discussion (a patient with a severe voyeuristic perversion and marked separation anxiety) crucial reconstructions implicated trauma connected with the nursing situation. From the age of nine months through the age of fifteen months, the patient had suffered from an illness with bloody diarrhea, associated with crying fits and periods of semi-stupor, during which he was a source of revulsion for his mother. He reacted with depression and manifest anger, passively watching his parents but missing them when they were not present. Other notable details of the history included the patient's observing his mother masturbating while she listened in on party-line telephone conversations, adolescent spying on his older, seductive and exhibitionistic sister, and primal scene experiences between the ages of twenty-four months and forty months, involving a mirror in his parents' bedroom.

The long analysis with its reconstruction of his early intestinal illness brought out evidence of intense oral cravings, marked oedipal problems, severe castration anxiety, and a feminine identification with well-defended, passive, feminine fantasies. When the primal scene material was reconstructed, there was a recurrence of the voyeurism and increased resistance to the analytic work. These developments and understandings supported the assumption that object loss in early life promoted the visual search for the object, which is at the base of voyeurism. Working through of the separation anxiety was as crucial for the cure of the perversion as was the understanding of the subsequent sexualization of the original impulse in the phallic and oedipal phases.