Chapter 10 Sexuality and Aggression in Pathogenesis and in the Clinical Situation

Sexuality and aggression, in their varied forms, so deeply and thoroughly permeate our individual and social existence that their clinical and theoretical importance seems to require no further justification. History, religion, art, and literature throughout the ages document their centrality in everyday human affairs. Who could question their basic motivational role in human behavior? Small wonder, therefore, that psychoanalysts of all persuasions, ever since Freud, have recognized the ubiquitous presence of these two complex human proclivities in health as well as in nearly every form of psychopathology. Thus, there has long been a broad consensus about the fact that on a clinical-empirical level sexuality and aggression are inevitably aspects of both emotional health and emotional illness. Questions and controversies have arisen only in connection with determining the origin, development, and nature of human sexuality and aggression and in specifying their role and function in patho-genesis.

What is normal sexuality and what is normal aggression? When does each become pathological? Or, to ask it more pointedly, in reference to the controversies about their role in development and pathogenesis: How do they develop so that they, in turn, affect personality development, and when are they primary and causative in psychopathology? And when are abnormal sexuality and aggression the results of an unfolding psychopathology that has other fundamental or primary causes? Furthermore, what are the relationships