686793

research-article2016
APAXXX10.1177/0003065116686793Rosemary H. BalsamFreud, The Birthing Body, and Modern Life

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Rosemary H. Balsam 65/1

Freud, The Birthing Body, and

Modern Life

Freud early on had an astute sense of the psychic impact of the bodily
power of females’ biological sex and childbearing potential. His early
appreciation of the biological femaleness of a body, however, became
gradually obscured after 1908, distorted by an exaggerated male view
that was challenged in the 1920s and 1930s but then became fixed in
stone by his followers. This strange but hegemonic view was once again
challenged, especially in the U.S., in the 1970s. In spite of sporadic efforts
after that, however, the impact of the female body qua female, in analysis
and for the mind’s functioning, has never been acknowledged in general
in psychoanalytic thought (except as marked as an infantile archaic fan-
tasy or sequestered into a special adult “women’s issues” category).
Given the vibrant culture of enacted gender multiplicities that we
encounter clinically today, where does this confused lag in understanding
leave us regarding psychoanalytic ideas about natally sexed procreative
female (or male) bodies as they articulate with gender?

S ome of the most pressing issues for psychoanalysis today should be

our efforts to investigate—rather than automatically pathologize—
the newly enacted flexible gender roles now being lived out, especially
by some younger members of Generation X, the millennial cohort influ-
encing the development of the youngest iGeneration, or Generation Z.
“Investigate” seems an important emphasis because psychoanalysis still
has a great deal to learn about the body, sex, and gender. Foreclosure by
“knowing” may well reassure us as analysts more than it remedies our
genuine lack of certainty in this area.

Fellow, Royal College of Psychiatrists, London; Associate Clinical Professor of

Psychiatry, Yale Medical School; Staff Psychiatrist, Department of Student Mental
Health and Counseling, Yale University; Training and Supervising Analyst, Western
New England Institute for Psychoanalysis.
This paper was delivered as the Freud Anniversary Lecture, May 10, 2016, at the
New York Psychoanalytic Society and Institute. As Freud was born May 6, 1856, the
topic of childbirth seemed especially appropriate to the author.
Submitted for publication October 30, 2016.
DOI: 10.1177/0003065116686793 61
 Rosemary H. Balsam

Birthing is a clearly female body capacity, forever societally fraught

with moral judgments about life style, gender role identity, and sexual
object choice. This magisterial sign of mature female bodily capacity was
never granted full entry into the general psychoanalytic theory of mind,
even by Freud, who was far more interested in the body than most of the
theorists who have followed him, even after 1923 and the ascension of the
structural theory, in which the apothegm “the ego is first and foremost a
bodily ego” (p. 27) held sway among conflict/drive analysts as a central
tenet of psychic life. Once Freud published “On the Sexual Theories of
Children” in 1908, affirmed its findings in 1915 in a revised edition of the
1905 Three Essays, and enunciated once and for all that he was “obliged
to recognize that the little girl is a little man” and that early vaginal sensa-
tions “cannot play a great part” (1933, p. 149), he more or less ended the
field’s sustained discoveries about women’s development qua female.
Very late in life he did acknowledge that a girl’s desire for a baby pre-
cedes penis envy (Mack Brunswick 1940), but even then he regarded this
desire as the result solely of her “male”-driven eroticism toward her
mother—never, for Freud, as rooted in female merger or identification
with her same-bodied mother!
The second wave of feminist critique in the 1970s resurrected the
squelched dissidence that Horney (1924, 1926, 1932) and Jones (1927,
1933, 1935) had mounted in the twenties and thirties. This history has
resulted in a lack of sustained mention of the female body as a source of
pride and pleasure to its owner, and precluded the acceptance of these
features as standard baseline expectations in the many varieties of theory
that have evolved since Freud, on a par with the way body pleasure is
expectable in male functioning. If a body is assumed to yield pleasure,
then body displeasures, either female or male, are conceptualized as com-
plexities or negativities. A phallocratic view, however, presents female
body pain as the norm (e.g., after Deutsch [1945] or Freud, who proposed
that masochism is a “female” psychic trait—but then needed to employ
theoretical gymnastics involving passive/active attributes to claim it as a
male condition!).1 To make female bodily and sexual pleasures as obvi-
ous to psychoanalysis as they are to laypeople, one needs to include the
functional female genitals and reproductive organs into a developmental
theory from the very start of a girl’s life. Freud knew this until about
1This topic is one preoccupation of my 2012 book, Women’s Bodies in Psychoanalysis.

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 Freud, The Birthing Body, and Modern Life

1908, when he was fifty-two. His early clarity here I have only recently
come to appreciate. One wonders then what happened. Was it middle age,
or the advancing age of his children, that increased his distance from
child, adolescent, and adult female bodies? Or did his female patients,
caught up in envy (perhaps of him, too), and certainly affected by their
middle European turn-of-the-last-century phallocratic culture, themselves
suggest that their envy was a “foundational” state as opposed to a patho-
logical one? Did Fritz Wittels’s denigration of women influence Freud?
(See, for example, the scurrilous 1907 views about females and the “child
woman” Irma Karczewska, reported in Wittels’s memoir [see Timms
1995; Balsam 2015c]). Did Ferenczi, in beginning their rich correspon-
dence in 1908, both inspire and waylay Freud on the topic of women,
much more than did his earlier correspondence with Fliess or Jung? Why
did Freud shift toward the phallic form and away from his original, more
capacious sense of femaleness? This question is still open, but even larger
ones arise: Did Freud himself contribute to a trajectory of neglect of the
mature female body in psychoanalytic theory? When and how did this
happen? And were his followers even more responsible than he for its
elision and erasure?

Freud and Pregnancy

One might say that Freud waxed and waned on the issue of pregnancy.
There are about thirty references to it in the twenty-three volumes of his
work—less than a quarter of a column in the index, compared, say, to
“masturbation,” at two full columns. Freud (1918) was alert to the taboo
of pregnancy but did not single it out among the myriad other horrors
experienced by males encountering the anatomy of the mature female
body. Primitive man, he writes, “fears some danger. . . . [A] dread is based
on the fact that woman is different from man, for ever incomprehensible
and mysterious, strange and therefore apparently hostile” (p. 198). And in
all this, he insists, “there is nothing obsolete, nothing which is not still
alive among ourselves” (p. 199). In Three Essays (1905b), the most body-
aware of his works, written with excited curiosity and exploratory open-
ness, he points to the component instincts and the infantile drive for
deriving bodily pleasure from physical exploration of the erotogenic
zones and body parts. He speaks of the child’s pluripotential sexuality and
his “Riddle of the Sphinx” (p. 194) as the abiding question of all humans:

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 Rosemary H. Balsam

“Where do babies come from?” However, even as this is the central ques-
tion, he simultaneously omits the actuality of the pregnant mother. He
says with brusque authority: “Children also perceive the alterations that
take place in their mother owing to pregnancy and are able to interpret
them correctly” (pp. 196–197). Thus he suppresses the significance of the
sights, feel, sounds, and smells and the child’s curiosity about the preg-
nant body. In looking past the body itself as if to a “greater truth” in the
form of the baby hidden inside, the famous Riddle of the Sphinx may
seem solved to a child or to a grown-up in denial that is left unchallenged.
Freud thus inadvertently supports incomplete information gathering
about the child’s experience of the mother’s pregnant body, at odds with
his own analytic method. (For an example of information-gathering about
this topic that is unique in our literature, about a young girl interacting
with her pregnant mother, see Kleeman 1971.)

F r e u d ’ s F i r s t Gl i mp s e o f P r e g n a n c y

Interestingly, Freud’s first recorded glimpse of the female body was in its
pregnant state. Peter Newton calculates that when the forty-one-year-old
Freud wrote to Fliess about how his “libido toward matrem was awak-
ened . . . seeing her nudam” (Freud 1897a, p. 268), thereby recording for
posterity his first sexualized glimpse of his mother, the incident must
have occurred during the winter of 1859–1860 (Newton 1994, p. 40).
Little Sigismund, then three-and-a-half, was traveling by train from
Leipzig to Vienna. His nude mother at the time must have been heavily
pregnant with Rosa, the fourth child. The adult Freud remembers only
something vaguely sexual and fails to mention to Fliess the condition of
his mother’s body—its gravid metamorphosis—which tends to support
my thesis concerning his unconscious anxiety about the sight and about
pregnancy in general. During his self-analysis in 1897, he wrote to Fliess
about the long-standing puzzle about a memory, one that revealed itself as
a repressed memory that surrounded a suspicion of his mother’s preg-
nancy and her absence during the birth of his sister Anna, the third child
(Gay 1988, p. 7). In childhood, Freud was certainly surrounded by preg-
nancies up to the age of ten, his mother having had seven more children
after him. Harold Blum (2015), in his vivid reconstruction of Freud’s ear-
liest life in Příbor (now in the Czech Republic and then in the Austro-
Hungarian empire), writes of the extreme physical intimacy of the

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 Freud, The Birthing Body, and Modern Life

family’s second-floor accommodations during his first three and a half

years. In a single room without heat, a toilet, or running water, he lived at
close quarters with parental sex, pregnancies, births, nursing, and the ill-
ness and death of his brother Julius, a year younger. Suffice it to say that
if indeed he had experienced anxiety, there was good cause. Despite the
absence of explicit material about the maternal body, Freud—before he
enunciated the oedipus complex—is here still paying intense attention to
the female body as female, and also implicitly the male as male, as pre-
monitory to their engaging in sex and producing those elusive babies.

T h e T e e n a g e F r e u d a n d H i s B o dy I n v e s t i g at i o n s

The letters to his school friend, Eduard Silberstein, show a seventeen- and
eighteen-year-old Freud as the communicative, witty, urbane, and bril-
liant raconteur that we know in his adult writings, with his restless, reflec-
tive scholarly style also in place. Here is a portrait of Freud, the young
medical student. He is not a medical school “nerd,” who might have dis-
played a paucity of sexual information about the female clitoris, compar-
ing it, as he did much later, to a kind of inferior penis. In his late teens,
Freud was sensuously vivid in his avid zoological explorations of sex and
babies and origins. Very early also, he used birth and pregnancy as imag-
ery for his own highly valued writing and mental efforts. This analogy
appears throughout his career, in his letters to Silberstein, for example:
“Just see for yourself how the common man, . . . for whom it will be our
life’s work to think, writes his letters. What a mess! The mere fulfillment
of the meanest need! No trace of artistry! With all the signs of a difficult
birth but quite without its accomplishment!” (Freud 1874a, p. 48).
Or again, in being tardy posting a letter his friend was expecting, he
grants the process all the hallmarks of a mammalian birth, casting an
infant into the world:

I reflected on my last letter for five days, and when it had been written I carried
it around in my pocket for three days, like a marsupial harboring its young on its
body after birth. Next I encapsulated it in an envelope . . . and . . . dragged the
letter about again—because I was loath to be separated from it—for another
whole day . . . through the more remote suburbs of Vienna, until finally a yawning
abyss in the suburb of Alser received it and carried it the way of all letters . . .
[Freud 1874b, p. 72].

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 Rosemary H. Balsam

Or again, here are his epistolary associations from his search for origins
while working at the Zoologische Station in Trieste, which lead directly
to erotic, yearning thoughts about girls:

When, at 6:30 in the evening, hands stained with the white and red blood of
marine animals, cell detritus swimming before my eyes, which disturbs me even
in my dreams, in my thoughts nothing but the great problems connected with the
words ducts, testicles, and ovaries, world-renowned words—when, that is, I go
for an evening stroll after my work, I see precious little of the physiology of the
natives of Trieste. . . . The cats are beautiful and friendly, but the women are
especially distinctive. Most of them are true characters in your Leipzig sense,
and often have the typical Italian figure, slim, tall, slender-faced, with a longish
nose, dark eyebrows, and small raised upper lip. So much for the anatomical
features. Physiologically, all that I know about them is that they like to go for
walks. They speak the language . . . so prettily that their a’s and o’s, clearly and
openly enunciated, ring out over and over again. Unfortunately they are not
beautiful in our German sense, but I remember that on my first day I discovered
lovely specimens among the new type which I have not encountered since . . .”
[Freud 1876, pp. 142, 144].

Here he revels in his science:

every day I get sharks, rays, eels, and other beasts, which I subject to a general
anatomical investigation and then examine in respect of one particular point.
That point is the following . . . the eel. For a long time, only the females of this
beast were known; even Aristotle did not know where they obtained their males
and hence argued that eels sprang from the mud. . . . In zoology, where there are
no birth certificates and where creatures . . . act without having studied first, we
cannot tell which is male and which female, if the animals have no external sex
distinctions. That . . . is something that has first to be proved, and this only the
anatomist can do. . . . I have been tormenting myself and the eels in a vain effort
to . . . discover . . . male eels, but all the eels I cut open are of the gentler sex
[Freud 1876, p. 149].

St u d i e s o f T h e F e m a l e B o dy w i t h F l i e s s

We know well that Freud continued passionately in his medical and labora-
tory studies a relentless focus on the mind that took the sexed body as its
bellwether. We know that in his letters to Fliess and in the 1895 Project, his
themes included masturbation, coitus interruptus, and neurasthenia. Freud
wrote of “disturbed sexual discharge” and shared with Fliess a conviction
about the role of the nose in sexual matters. In clinically working out his

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economic theory, he often refers to procreation and the female body. He

notes a “cessation of migraine during pregnancy, when production is prob-
ably directed elsewhere” (Freud 1895a, p. 143). He was fascinated with the
mysteries of hysterical women who were posturing and swooning away with
their hysteria. He and Fliess were obsessed with “periodicity” and he
recorded in detail elements of pregnancy with timings even related to Martha
and an intrauterine Anna in 1896: Freud compliments Fliess on a paper with
“its wealth of glimpses of new riddles and new explanations” (1896a,
p. 174; emphasis added [a reference to the ever present Sphinx]).
I wonder if he was high on cocaine—after all, these were his “cocaine
years” (Markel 2011)—when in 1896 he wrote the following:

One must also trace the derivation of the different epochs, psychological and
sexual. You have taught me to recognize the latter as special multiples of the
28-day female period.

100π = 7 3/4 years, in addition 20π = 1 year, 6 1/2 months

200π = 15 years 50π = 3 years, 10 months

If I assume that all observed periods are such multiples. . . . I then note that I can
account for all psychic periods as multiples of 23-day periods (π) if I include in
the calculation the period of gestation (276 days = 12π) [Freud 1896b, pp.
210–211].

Incomprehensible, to the uninitiated! But the letters are also punctuated

with dramatic patient stories that are hot on the trail to origins:

I can scarcely detail for you all the things that resolve themselves into—excrement
for me (a new Midas!). It fits in completely with the theory of internal stinking.
Above all, money itself. I believe this proceeds via the word “dirty” for
“miserly.” In the same way, everything related to birth, miscarriage, [menstrual]
period goes back to the toilet via the word Abort [toilet] (Abortus [abortion]).
This is really wild, but it is entirely analogous to the process by which words
take on a transferred meaning as soon as new concepts requiring a designation
appear [1897b, p. 288].

To appreciate Freud in his early unguarded fascination and involve-

ment with the female birthing body, I note where he mentions his actual
experience of becoming a young father. For example, his letter to his in-
laws about the birth of his first child, Mathilde, is especially tender and
shows Sigmund in loving attendance to Martha, a sympathetic participant

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 Rosemary H. Balsam

in the intimacy and violence of her labor and labor pains, and in her sub-
sequent joy. He writes about her “screams” that she apologized for, and
her immense pleasure at seeing the baby: “nearly seven pounds, which is
quite respectable, looks terribly ugly, has been sucking at her right hand
from the first moment, seems otherwise to be very good-tempered and
behaves as though she really feels at home here . . . [she] does not give
any impression of being upset by her great adventure” (Freud 1887, p. 223).
He obviously attended that home delivery, rarely the case with fathers in
that era, unless they were royalty looking for their first heir.2 His admira-
tion and love for Martha seemed to increase:

I have now lived with [Martha] for thirteen months and I have never ceased to
congratulate myself on having been so bold as to propose to her before I really
knew her; ever since then I have treasured the priceless possession I acquired in
her, but I have never seen her so magnificent in her simplicity and goodness as
on this critical occasion, which after all doesn’t permit any pretenses. . . .
Goodnight; I trust you will soon write again to your little family consisting of
Martha, Mathilde and Sigmund [Freud 1887, p. 224].

In his early practice of hypnosis, Freud’s first case required him to

deal with a young woman unable to breast-feed her newborn infant; the
woman would vomit every time she tried. Nathan Kravis (2016), cur-
rently at work on a book about use of the couch, has recently illustrated
his presentations with striking images of couches from the seventeenth,
eighteenth, and nineteenth centuries; in almost all of the images a lush,
abundantly endowed woman is recumbent on the couch. Accouchement,
after all, is French for lying down to give birth. The regular use of the
couch in Freud’s medical life would have involved many women on their
sickbeds, as was his first young woman patient, who was literally “lying
in” with her newborn when he hypnotized her, planting a suggestion that
she would be a successful nursing mother. Freud was thus in very inti-
mate contact with his female patients as invalids, women who had some
ease with medical men being in their boudoir. He used era-appropriate
2Freud seems to have been present with his wife at the birth of this baby, which I think

would likely have been at home. I could not find any details. In this era men were usually shooed
out of the room, even a doctor husband, and the women took over with a doctor at the ready.
Wives would usually not want to be seen in this condition by their husbands, remembering that
in England in Victorian times many couples did not even appear naked to each other. Prince
Albert, however, apparently did attend some of Queen Victoria’s birthings. And male aristocrats
were more likely to do this, to attend hopefully the birth of their heir.

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techniques including hands-on massage. In a variant designed for his new

treatment of psychoanalysis, he pressed the patient’s temples to encour-
age free association.
The proximity of the female body to the practitioner in early psycho-
analytic treatment, and still today, is arresting when one contemplates it
visually. Erotically provocative, it evokes images of sexual and birthing
females, and one can speculate that it may also induce regression in the
observing psychoanalyst. It is no surprise then, given this ambience, that
Freud’s theories of mental and behavioral functioning would be based on
the sexual and procreative nature of human beings. This only increases
my astonishment at the paucity, since Freud’s early work, of consider-
ations of female birthing and its impact on the psyche (Balsam 2013a,b),
despite the enduring intimacy of the analyst, the analysand, and the couch
that has been Freud’s legacy to us.

F e m a l e B o dy F u n c t i o n i n T h e
I n t e r p r e tati o n o f D r e a m s

The Interpretation of Dreams is a treasure trove of Freud’s sensitivity to

genital imagery in dreams, sexual and body references, and his appreciation
of birth and its meaning to women and men alike, and the unconscious
symbols common to both sexes. Freud was free to conceptualize sexed
and procreative issues with males and females separately in those early
days. Then, in 1908, an important theoretical shift occurred. He blended
the two sexes into a unified theoretical notion of a one-sex “sexual devel-
opment.” The only way for an individual to grow, then, involved an
uneven “plus and minus” comparison of the sexes even after puberty and
into childbirth, when Freud could no longer avoid some biological dif-
ferentiation between the adult bodies. At every psychological stage in this
scheme the male was always perceived as the “plus” sign. An uneasy,
fruitless struggle (especially as imagined by the theoretician) compared
and contrasted the two fundamentally different sexes as if each were
merged and fighting to be free of the other (the “minus” female naturally
growing as fast as the “plus” male, but restrained by the superimposed
theoretical straitjacket of being perceived as a deficient “plus”).
When The Interpretation of Dreams was published in 1900, Freud
was forty-four, his youngest daughter, Anna, was five, and his oldest,
Mathilde, was thirteen. The family lived in close quarters. The children

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 Rosemary H. Balsam

must have been an ongoing source of sexual and bodily developmental

information for him. Famously, he had complained to Fliess of his lack of
libido at age thirty-eight, and supposedly a loss of interest in sex with
Martha. Sad as this may have been, for the purposes of this argument,
Freud’s remark is consonant with an awareness and appreciation of him-
self and his wife as two differing sexual entities. At this stage he also
theorized from a vantage point of curiosity toward two different sexes.
His writing shows body imagery that was applicable to the female body
qua female. Here are just a few examples, taken from the section on “The
Representation by Symbols in Dreams,” where he counsels analysts to
attribute “a decisive significance to the comments made by the dreamer”
and view only as “an auxiliary method” the direct “translation of sym-
bols” (p. 360). Freud articulates “the complexity of facts” (p. 358). At this
stage of his explorations he is acting as an objective scientist and is
respectful of the patient’s autonomous mind. Reciprocally, then, due
likely to the clarity of his boundary with his patient, two clearly differen-
tiated sexes shine through.3
For example, he reports an adult woman’s dream and recollection of
being age three or four, with other little children chatting as they sit on
their chamber pots. “She asked her girl cousin: ‘Have you got a purse too?
Walter’s got a little sausage.’ Her cousin replied, ‘Yes. I’ve got a purse
too’” (p. 373). The following is a woman Freud views as “normal”: She
is telling a dream that relates to her upcoming marriage: “I arrange the
centre of the table with flowers for a birthday.” Freud explains: “It was an
expression of her bridal wishes” (p. 374). He and the patient go through
the kinds of flowers, viewing “the floral centerpiece [that] symbolized
herself and her genitals.” “Expensive flowers, one has to pay for them,”
says Freud’s subject. They are led, he believes, to the “preciousness of her
virginity” (p. 375). Violets for “violate,” as Freud said; “in the language
of flowers, a pretty instance of the ‘verbal bridges’ [see p. 341] crossed by
paths leading to the unconscious” (p. 375). “Pinks” were “carnations,”
flesh-colored and phallic. “[S]he was making the gift of her virginity and
expected a full emotional and sexual life in return” (p. 376). In 1900–
1901, unlike his later portraits, Freud was describing women as both
capable of and expecting full sexual partnerships while exercising their
ability to have and bear children. True, he was guided by his view of a
3Even though subtly one can still see his famous proclivity to condescend to female

organs.

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woman’s role as in the home—but nevertheless, it is in this context that

we can learn about his acuity to the capacities of the body of a woman as
female. In 1910 Freud took a strong stand against some of his colleagues
to allow women for the first time to join the Vienna Psychoanalytic
Society (Balsam 2003), though around the same time he argued in the
society that women could never be psychiatrists.

B o dy P l e a s u r e s i n D o r a

Dora holds an historic place in the transition in Freud’s thinking regarding

psychosexual development in general, and away from a constructive curi-
osity about female development that seemed to have been piqued by or at
least survived the abandonment of the seduction theory in 1897, heralding
the role of fantasy in inner life. Dora was analyzed in 1899, but the case’s
publication date (1905) is also the date of Freud’s unrevised first edition
of Three Essays. Not until 1908, three years after Dora was published, did
he add his theory of ubiquitous penis envy to the description of girls’
development. (His famously male view of girls was not incorporated in
Three Essays until its third revision, in 1915.) His 1908 “On the Sexual
Theories of Children” included what turned out to be “bedrock” com-
ments about his one-sex male theory for girls. However, at the time of
Dora, Freud had developed only a partial and simplified oedipal theory
that concerned whole persons in the family rather than part objects or
body parts. The early oedipal situation held that a girl would normally
turn sexually to the father, as would the boy to the mother. The female
genitals were still viewed as whole and female. He had noted in corre-
spondence with Fliess that a girl could envy a penis because she wanted
everything; that is, in this iteration of Oedipus, she is left in basic posses-
sion of her own genitals, with the penis an added fantasy organ. With
Dora, as in The Interpretation of Dreams, he expected a female to have
sexual pleasure, and did not confine that asset solely to the penis, as he
would later.4 He also recognized bisexuality as a part of the human condi-
tion, meaning that under certain psychological conditions Dora could be
sexually attracted toward either a man or a woman.

4Hoffman (1999) speculated that psychoanalysts simply have had difficulty understanding

female sexuality: “The retreat in the 1930’s and 1970’s away from psychoanalytic exploration
of feminine sexuality, i.e. of women’s passions including intense orgasm, may have had to occur
because of the danger signals evoked by women’s passions in both men and women, and in both
patient and analyst” (p. 1159).

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 Rosemary H. Balsam

However, the stage was being set simultaneously in 1905 for a wrong
turn (Balsam 2015a). Though real female sexual pleasure and the plea-
sures of procreation were seen as expectable, this came at a price. Freud’s
view of how the woman should handle these pleasures was problematic.
She was not supposed to exercise her own autonomy. A woman may be
symbolized in dreams by “the house,” but sexually she was not mistress
in her own house! The master owned that house. Sociopolitically, Dora
was ahead of Freud in this respect, and rebelled against this oppression.
Blum (1994) has commented on her Jewish identity in this regard, remark-
ing that as both a woman and a Jew she was in a societally oppressed
position. Erikson (1962) noted Dora’s looking to Freud for validation of
the reality of her complaints against the grownups, and he affirmed her
mental health in this regard. But of course Freud’s theory of her denial
and negation of healthy, expectable genital pleasures, in his view due to
her unfair rage at the much older, married Herr K.’s arousal toward her,
invalidated both her autonomy and her aggression in response to this
actual sexual harassment. Erikson thought this undermined her identity
formation. Freud got it half right. He valuably saw Dora’s body as whole
and healthy in its expectable capacity for sexual arousal and responsive-
ness (a feature that the later theory of a male-sexed libido “phallic phase”
theory would undermine). He wanted Dora to own her own body as a
woman. However, seeing Herr K. in any negative light, or her father, or
his own cigar-smoking self as a focus of negative transference to a woman
was hard for him. Freud had not yet met Karen Horney, and in any case,
when he finally did he greeted her insights with hostility. She might have
suggested that Dora’s fear, horror, and disgust when exposed to Herr K.’s
or her father’s sexuality may have been influenced by her reactions and
fantasies regarding the disparity between the size of the man’s erect penis
and her sense of the smallness of her vagina, or that her rage may have
been due to wounded disappointment in her love for her father. Freud
neither imagined nor took kindly to such ideas.

F r e u d ’ s B o dy W o r k w i t h D o r a

In his body work with Dora, Freud is direct and free. He uses the dream
image in her second dream of the train station and woods, and her asso-
ciation to nymphs playing, to elaborate elegantly on the “symbolic geog-
raphy of sex” (Freud 1905a, p. 99). He received and translated Dora’s
vaginal references: the “forecourt” of the vulva; nymphae as a reference

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to the labia minorae with pubic hair behind, as in a wood; her fantasy of
defloration; and the big book she read in at the dream’s close as likely an
encyclopedia where she was looking up details of sex, pregnancy, and
childbirth. Marian Tolpin (2004) wrote admiringly about Freud’s poetic
symbolic understanding of Dora’s female organs. Other images of Dora’s
body were the “reticule” (purse) she wore at her waist as a vaginal sym-
bol, and the “room” (“apartment”) she wanted to lock at night that also
represented her vagina. Further, her associations to the “closed” door of
her “room” represented being closed to intercourse, while a door “opened”
by a key meant being open to the penis in intercourse. “All these,” Tolpin
notes, are described by Freud as “‘once again only a substitute for the
shell of Venus, for the female genitals’ (1905a, p. 77). What more compel-
ling and appreciative symbol of feminine beauty and desirability (in gen-
eral) or of female anatomy (in particular) could Freud evoke than the
famed Botticelli Birth of Venus and the lustrous shell on which the god-
dess of love is artfully enthroned as she is born from the sea? What more
powerful ‘mirroring’ affirmation of a woman’s anatomy and sexuality
could a psychoanalytic theory provide?” (p. 172). Tolpin thought it not
surprising that these transient “early affirmative views have been virtu-
ally obscured by Freud’s ‘relentless investigation’ [Marcus 1990, p. 85]
of Dora’s sexuality.” Freud’s critics, she believed, have conflated “his
later castration theory of women’s genital injury, mortification, penis
envy, and hostility with his earlier theory of the purse as female genital
and the wish for intercourse with Herr K. which Dora angrily rejected” (p. 172).
Tolpin’s observations are well taken.

F e m a l e B o dy W o r k w i t h L i ttl e H a n s

By contrast, four years later, in 1909, the case of Little Hans was filled
with concepts of the female as a castrated being, compensating for her
lack of a penis.5 Thus, Freud thought about the body of Hans’s mother or
sister differently from how he thought about Dora’s. In 1909 Freud does
attend somewhat to the mother’s pregnancy and birthing, but now the
father’s hostility toward the new arrival is stressed, becoming the com-
mon analytic understanding of birth from that point onward (see
5Hans’s mother was ridiculed by Freud, Hans’s father, and generations of analysts

afterwards—and still is today—for simply saying “Yes” to Hans’s query whether she had a
“wiwimacher.” I understand from educated nonanalyst German friends that that baby word merely
means any anatomical organ to urinate from! I sincerely hope she did indeed have a “wiwimacher”!

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“Followers” below). The understanding of female and male procreation

in Little Hans’s family case study was by now male-centered: “With your
big penis you ‘bored’ me and put me in my mother’s womb,” parrots Hans
to his father (p. 128). Freud, however, also notes: “The falling horse was
not only his dying father but also his mother in childbirth” (p. 128).
Yet there are few notes about Frau Graf’s pregnant body in Hans’s
voice, considering the child had regularly “coaxed” with her in bed. One
wonders what Hans thought of the basins he passed by in the opening
pages that indicated a bloody at-home childbirth, according to the vivid
narrative. The associative connections made by Freud and the father also
bypass any worry about the mother’s body and speak only to Hans’s penis
worry; his erotic masturbatory fantasies; his fear of his father because of
his male oedipal love of his mother; and his theories of childbirth that
relate not to the mother but to his own “lumf ” and anality. Hans’s wish to
imitate the caregiving of his mother seems a direct reference to his want-
ing to be “the mother” himself, but the focus of the adults in this material
is selectively on Hans’s own “excretory functions.”

Hans: “This morning I was in the W.C. with all my children. First I did lumf and
widdled, and they looked on. Then I put them on the seat and they widdled and
did lumf, and I wiped their behinds with paper. D’you know why? Because I’d
so much like to have children; then I’d do everything for them—take them to the
W.C., clean their behinds, and do everything one does with children.”
After the admission afforded by this phantasy, it will scarcely be possible
to dispute the fact that in Hans’s mind there was pleasure attached to the excre-
tory functions [1909, p. 97; emphasis added].

Hans’s often remarked smallness is always interpreted in relation to his

father’s big penis. But his sense of the deficiency of his little phallic body
could be related to the mother’s actual large and pregnant and birthing
physicality. Such a concept would have been anathema to Freud, and cer-
tainly does not fit into the story of the battling males of the oedipal theory.

F r e u d ’ s T u r n Away f r o m T h e F e m a l e
B o dy, a n d “ T h e M o v e m e n t ”

In 1908, as I’ve noted, Freud announced his first turn away from females as
possessors of female bodies. He had already (about 1897) rethought the
seduction theory and its role in neuroses. He shifted from the certainty of the

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impact and repression of a real-world father’s actual seduction of a child,

toward emphasizing the child’s fantasies about the external world that ema-
nated from his or her inner world. Freud never denied that actual seduction
in reality does sometimes occur. This shift toward fantasy may have been a
step toward his privileging the role of a female’s fantasy of being a male6 in
the beginnings of normal female development. I would argue, however, that
despite his appreciation of the power of human fantasy, for a decade or so,
until 1908, he still thought of all sexed bodies as intact entities. Thereafter,
however, he claimed that embodied females’ minds essentially were “built”
upon the delusion “I have a penis.” There was but one sex. The female’s path
forward, then, was a fierce struggle gradually to acknowledge her own
body—at a minimum, I suggest, the sensations and feel that her own vulva
and vagina yielded her, and the sight of her mons pubis. A girl’s wishful
fantasy of having a penis would not necessarily involve annihilating the
equipment of her own body, but the initial reactions of Freud’s girl to her
own sexed anatomy are extremely absent in his account. In contrast, through-
out all the phases of development he was theorizing, Freud had no trouble
keeping in mind men’s bodies as male, and in attributing men’s fantasies and
mentalized reactions to elaborations about their own body parts.
Freud then took his second definitive turn in his thoughts about women,
in the 1925 paper “Some Psychical Consequences of the Anatomical
Distinction between the Sexes.” Sadly, he recanted there the importance of
the child’s fundamental question about how babies are made. He substituted
instead the question of sex distinction. That paper was read by Anna Freud
at the Ninth IPA Congress in his absence due to his cancer. (One wonders
what this must have felt like for her as a female.) The paper had been written
to forcibly silence the dissidence of Horney (1924), Jones, and others who
dared speak noisily of “primary femininity” and challenged the major role of
penis envy (Fliegel 1973). Their notions about women as basically “female”
Freud rightly believed threatened his insistence on the universality of phallic
dominance in both sexes and in the oedipus complex. The latter tenet was
the theoretical cornerstone of his entire psychoanalytic movement (Makari
2008). The fight over women carried the peril of heresy in early psycho-
analysis, and many were painfully extruded for pursuing it: Jung, Adler,
Hilferding, Rank, and, later, Horney (Balsam 2013a). But in 1905, with
Dora, such issues were not on Freud’s mind.
6However, in truth, it appears in Freud’s new disembodied account as a female delusion,

rather than a fantasy; it is not presented with any confusion, ambiguity, or playful as-if quality.

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 Rosemary H. Balsam

The story of Freud’s avid adherence to the value of “The Oedipus

Complex” as a brand name for building a Freudian psychoanalytic iden-
tity within die Sache (“the movement” or, literally, “the thing”), as he
called the growing international group who studied his theories, is com-
pelling. The central truth of Oedipus in all psychic operations fueled his
fierce insistence even as it brought as collateral damage the great neglect
of female development in our field. The Oedipus myth itself, and the way
that theoretical story is told, still commits the field automatically (and
damagingly) to pathologizing the mother-daughter relationship as belong-
ing to an immature developmental stage. Clinically, however, it is pre-
cisely the mother-daughter intercorporeal relationship as internalized that
holds the keys to a young female eventually being comfortable growing
in her own skin (Balsam 2012, 2015b).
Psychoanalysis proves to be afraid of the significance and procre-
ative powers of the female body. Unconscious (and perhaps conscious)
fears seem to be mobilized by the topics of childbearing and childbirth.
The manifest evidence of this dread in our field is the absence of clinical
attention to these topics in everyday history-taking and case write-ups.
The maternal body in the theory of the developing child, by contrast, is
now a privileged site for the possessor’s affects, reactions to environmen-
tal messages, reception of sensory cues, retranslations of these into the
life of the family, and transmission of “enigmatic” sexual and sexualized
messages involving her children. The non-Lacanian French theorists
alone have managed to keep alive the vitality of Freud’s original fascina-
tion with corporeality encoded in the mind, and thus the topics of sexuality
and gender. The theory of Laplanche (1997), for example, is a theory of
exogenous origins both of the unconscious and of the sexual drive (as
distinguished from the instinct). It also is a theory of the instantiation of
most sexual messages by the mother to the infant as “enigmatic” and
potentially overstimulating and traumatic. Loewald (1978), very close to
Freud’s texts (as was Laplanche), also views the mother as igniting and
shaping the sexual and sensual shared atmospherics between her and her
infant, but Loewald does not invoke trauma in his view of how maternal
stimulation molds the infant’s drives, together with her object relations.
Neither Laplanche nor Loewald, however, especially privileges the power
of procreation in his work. Procreation is better celebrated and focused
upon in Kleinian theory, but limited due to its focus on infantile rich
archaic fantasy, especially in relation to the primal scene and the child’s

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imagined relation with fantasy babies in the mother’s insides, images that
linger within the two more or less early psychic “positions” that for the
Kleinians encode development. The experiential role of sexually procre-
ative capacity in a biologically growing female was better represented by
the ego psychologists (even if the female was misrepresented), but such
biopsychological growth is not viewed as central to her psyche by any
contemporary strand of theory. One can thus appreciate the decline in
psychoanalytic interest in these topics since Freud.
American ego psychologists from the 1940s to the 1970s, as well as
child analysts in that tradition, were laudably in touch with the phenom-
ena of physical body growth, but for the most part they stuck closely to
the oedipal complex and a girl’s phallic existence (see Lewin 1933).
When mothers became more visible in psychoanalytic theory in the
1960s, they perforce were automatically placed in the “preoedipal” regis-
ter. Experiences of inhabiting the body as female, in preparatory proto-
forms of childbearing and delivery during childhood, failed to attract the
theoretical development that would reflect anything like its ultimate
importance in the everyday life of our patients throughout their lives, and
in all cultures. To the extent that girls are recognized as engaging in doll
play, for example, analysts of the 1950s and 1960s scrambled to negate
their toys as experimental fantasy about their female bodies and the
potential fruit of their wombs, and leapt to phallic certainties about play-
ing with their missing penises. Such topics have tended to drop from view
in the literature over the years, simply being viewed as old-fashioned,
rather than being actively challenged. Our literature these days does bet-
ter with adult patients’ abstract talk of their “sexuality,” or, say, with
“power” relations between objects (Benjamin 1995), as topics split off
from a longitudinal perspective on their bodies, and from their ongoing
positive or negative fantasies of procreation. Contemporary gender dis-
cussions are often split-off topics too, as if in a separate category from the
natal body, its history, and the child’s developing perceptions of its use as
mentally filtered by the impact of the surrounding world.

F o llo w e r s

Anna Freud seems to have perpetuated her father’s blind spot regarding
evident reactions to embodied procreation. The following vignette will
show clinical opportunities to notice and explore the affective, bodily

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impact of a mother’s pregnancy on a child, a situation quite common in

child therapy. The reader will observe how the child’s comments about
the mother’s body are ignored, and are diverted instead into other chan-
nels of interpretation. These attitudes support Freud’s foreclosing state-
ment that a child interprets pregnancy “correctly,” so that supposedly
there is nothing of interest or concern to the little patient to explore,
except for the baby as an anticipated rival.
Barbara Rocah, in 1966 a candidate at the Chicago Institute, published
the visiting Anna Freud’s supervisory comments on her first control case
(Rocah 2008). The paper is a fascinating historical document. This was a
six-year-old boy, Sam, born out of wedlock in the U.S. to his mother, who
was fleeing her divorced first husband, who had won custody of their six-
year-old son in England. Sam’s father was then the mother’s second hus-
band. Sam grew up close to this mother, who idealized her lost little son in
the U.K. At three years of age, during his mother’s pregnancy with a third
son, Sam became symptomatically aggressive, was poorly adjusted, and
began wetting the bed. During the boy’s treatment at age six, Rocah her-
self became pregnant. The little boy’s comments about his analyst/moth-
er’s physicality and his own body are right there in the material7:

About six months into his analysis he seemed to sense my pregnancy. He bur-
rowed into my body, hit me, and wanted to be held by me. He was curious about
my body, he wanted me to undress, and he wanted to undress. As his awareness
grew in intensity over the subsequent sessions, I told him I was pregnant. He
shouted at me to “shut up” and covered his ears. He asked what would happen
to us when I had my baby. Would I see him? Sam became ill with German
measles and missed three sessions [p. 11].

Anna Freud commented as follows:

Children react to the mother’s pregnancy before it is visible, which means they
react not to the physical fact but to the mother’s mental reaction to her preg-
nancy. Often, when one looks back into the past of the patient, one wrongly dates
his reaction by connecting it to the birth of the next sibling or with the visible
pregnancy of the mother. One should connect it with maternal preoccupation
with the new baby [p. 11; emphasis added].
7This account is particularly interesting to me because it has been my experience in listen-
ing to cases that child therapists frequently seem to look through or away from the mother’s
body, and to look past the child’s physical reactions and the child’s frightened comparative
relation to his or her own little body. Instead, the focus immediately falls on the child’s relation-
ship to the new baby and on being supplanted in the mother’s affections, just as was established
in the case of Little Hans (Freud 1909).

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Sam had wanted Rocah to undress, and wanted to undress himself.

Surely this indicated anxious curiosity about her body—perhaps its size,
or shape, or holes for the baby to get out? And perhaps reactive fantasies
about his own little body? “Where do babies come from?” is a very physi-
cal question. Anna Freud, though, is sure that it is wrong to date a child’s
reaction to the visibility of a pregnancy. This certainty makes the mater-
nal body invisible. Rocah then writes that Sam

wanted to know whether it would hurt the baby to “cut the cord,” [another
graphic bodily reference] and he denied that he anticipated it would hurt him
when we separated. He called me a “liar” and said that I had “betrayed” him. He
tried to restore himself by phallic grandiose fantasies that he was as powerful as
my husband and could “shower [me] with seeds,” which he accomplished by
spitting at me. He said, “I can make a thousand babies” and “you only have one,
and not even one.” He jabbed me with paper airplanes. He also imagined his
own pregnancy: a “magic box” that contained something precious that only he
could access [p. 12].

Making himself an agitated giant anatomical male seems a direct

response to dealing with the giant anatomical female (erased in the dis-
cussion with Anna Freud, except by the implications of Rocah’s case
reporting).
Sam, now speaking to Rocah after her maternity leave, says:

“You have a hole now, but it will get filled up. I am a thousand men in your head
kissing you.” Later he told me angrily, “You are full of holes, and no one can fill
them.” . . . Finally, he said rather helplessly that “my parachute is full of holes,
and I will tumble to the ground.” I was confused about which aspect of the
“hole” fantasy I should comment on. I chose to comment on his despair and lost
hope in finding anyone he could look up to and count on” [p. 15].

Anna Freud’s insistence about the mother’s maternal preoccupation

with the new child is of course not wrong. Neither were the analyst’s
comments about the child’s fear of separation and being abandoned. In
both instances, however, attunement to the child’s vividness about how
their bodies compared, and to the child’s desire to explore his ideas about
the maternal body, was missing. Later in this case the boy made several
anxious mentions of “holes” to the analyst, whom he knew had just given
birth, as he was being seen in her home office, where he spotted the new
baby. Sam’s angry terror of the crumpled postpartum female body was
overlooked by the analyst, who instead heeded what she took as an alert

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to attend to relational concerns. (Recall that Little Hans’s similar possible

allusion to the postpartum female body in the dream of the crumpled
giraffe was interpreted as castration anxiety by Freud and the father.)
Anger and disgust in reaction to the postpartum female would seem to
suggest the aptness of Julia Kristeva’s sense of the abject maternal body
(1980). Kristeva is one of the exceptionally few contemporary theorists
who acknowledge its centrality in life, and therefore to psychoanalytic
theory. “Abjection,” she writes, “preserves what existed in the archaism
of pre-objectal relationship, in the immemorial violence with which a
body becomes separated from another body in order to be” (1980, p. 10).
The postpartum body is a good example of a common but underrecog-
nized (and thus unexplored) clinical area in the psychology of females,
and its symbolic significance is still uncharted territory in the interior life
of the mind.
In Freud’s Three Essays (1905b), the genital organs themselves, as
well as mouth, anus, and thumb, hold center stage along with childhood
fantasies of conception and birth. Yet even in this, Freud’s most earthy,
passionate, and physically explicit developmental exposition, girls’ and
boys’ intimate reaction to the mother’s body in its massively altered preg-
nant and/or postpartum state goes unattended.

“ T h e B o dy a s P h a ll u s ”

Given the ubiquity of Freud’s followers’ zealous interpretations of his

phallic theory of female development, I present here just one example,
pars pro toto. In 1933 Bertram Lewin (1896–1971), an eminent New York
analyst and teacher, wrote a widely read paper titled “The Body as
Phallus,” which was accepted as received theory at least till the early
1980s, and perhaps beyond. Its content underlines how mainstream was
Freud’s 1925 idea that all females, rather than merely some, operate with
a male orientation until sorrowfully coming to terms with their deficit and
compensating themselves, in a second-class way, with a baby.
In the “Body as Phallus” Lewin begins with a précis of Freud: “In
psychoanalysis, we are accustomed to a shorthand statement of this fact;
we say, there is an unconscious equation of body and phallus, or of child
and phallus” (p. 24). We note his emphasis on “fact” and “equation” as a
measure of certainty, and right away it is unbelievable to many young
analysts these days to appreciate this unselfconscious erasure of women’s

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bodies. Throughout the paper Lewin refers frequently to symbolism aris-

ing from the aims and use of “one’s own penis,” as a way of addressing
his readership! This writing fashion, aware only of men, shapes the think-
ing in this piece. Lewin refers to Ferenczi, who said that all parts of the
body, including the internal organs, can unconsciously be thought of as
being like genitals and can thus be eroticized. Yet, although this idea
could apply equally to female and male bodies, there did not then exist in
theory two common forms of bodies. Thus, body organs, if eroticized,
could only be “in erection” (p. 24). Instead, the following was the explicit
body model used (as universal) for symbolization by the mind: “When the
body is used to symbolize the phallus, the mouth may represent the ure-
thra and the ejection of fluid from the mouth an ejaculation or urination”
(p. 25).
In his paper, Lewin presents a dream reported by a young woman:

“I was on board a small boat during a heavy storm. The boat pitched, and I slid
back and forth in it and became seasick. I awoke vomiting.”
Besides many associations dealing with pregnancy and prenatal existence,
the patient associated the dream picture to a coitus. The motion of the boat sug-
gested the motion of coitus; she herself was the penis sliding back and forth in
the vagina etc. The vomiting . . . . [and the] waves, also, brought out associations
relating to enuresis. Here again we find the body equated with a penis and the
mouth with the urethra [p. 26].

Thus, associations to pregnancy are heard, noted, but not permitted to

advance to morning sickness as a female experience associated with the
pregnant body. We see the rapid slippage into the analyst’s search in the
female patient’s associations for a urine fantasy to match his theory of the
penis-with-a-mouth that emits urine/vomit. Later in the paper Lewin
explains to the uninitiated, citing Helene Deutsch’s authority, that distur-
bances associated with early pregnancy in fact concern phallic issues.
Such statements show the lack of impact, the dismissal, with which the
“dissident” work of Horney and Jones in the early thirties (work that rep-
resented females as female) was met.
Lewin further instantiates this erasure of the pregnant body in report-
ing a female patient’s associations. She mentions

bodily sensations . . . which might arise from an erect penis. As she lay in bed
her body felt as if it were swelling and getting hot. It seemed to get longer; and
as the tension and anxiety . . . increased, she felt an overwhelming urge to

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 Rosemary H. Balsam

scream. Screaming she associated to a loss of sphincter control. The analysis

showed that this tension repeated phallic sensations which she had had as a child
when she was an unwilling passive witness to adult coitus. They were then fre-
quently followed by enuresis; later by violent impulses to scream [p. 29].

Clearly, this body experience might just as easily be interpreted as her

fantasy of future pregnancy and birth, with loss of sphincter control and
screaming, all of which terrified her. And a pregnancy fantasy could per-
haps be associated also with her parents’ intercourse. Who knows? The
point is, as noted earlier in Anna Freud’s supervision of Rocah’s case: What
is not in an analyst’s imagination can be accessed or recorded in a patient’s
associations, but cannot be “interpreted” or used in the analysis.

M o d e r n L i f e : T h e T h i r d Wav e o f F e m i n i s m

A “third wave” of feminism is currently under way in the United States. It

began in the 1990s. Young feminists, dissatisfied with the generation of
the “second wave,” continue to address the full range of issues in society
and the workplace, but with major changes in their attitudes toward “girlie
culture.” Jessica Baumgardner, an author and activist of the third wave, in
an internet interview with Tamara Strauss (2000) says, “What we were
responding to [in Second Wavers’ accusations that girlie culture is not real
feminism] is that they are doing to younger women what men have done
to them. Second Wavers are saying to us, ‘You’re silly. That isn’t an impor-
tant issue. What you talk about is dumb. Let me tell you what real femi-
nism is. It’s what we talk about.’ We focus on the intergenerational issue
because we think it has gone unexamined.” This current wave of interest
in the war on women by women studies the subjugation of the individual
woman—an area that is psychodynamically a “hot” war intimately waged
between mothers and daughters in which psychoanalytic feminist writers
have indeed expressed an interest. Take Susan Kornfeld (2003):

Adrienne Rich suggested in 1976 that daughters reject their mothers because of
“a desire to become purged once and for all of our mothers’ bondage, to become
individual and free. The mother stands for the victim in ourselves, the unfree
woman, the martyr” (p. 194). Third-wave feminists Jennifer Baumgardner and
Amy Richards sounded the same note nearly twenty-five years later in Manifesta:
Young Women, Feminism, and the Future, published in 2000. “Many daughters
are scared of falling prey to the indignities we witnessed our mothers suffer
[such as sacrifice, low pay, and entrapment to men’s careers]” (p. 208). Whatever

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advances feminism has made in the courts and in the workplace, motherhood, at
least to the cultures represented by Baumgardner and Richards, is still viewed
by daughters as a site of oppression [p. 169].

Young “lipstick feministas” are passionate about celebrating their embod-

ied role as women. Psychoanalytic interest in the female body as female,
therefore, is today more relevant than ever.

S e e k i n g A Way O u t o f T h e Pa s t

Had he been alive, would Freud have gone as far as Anna Freud, or as
Lewin and many others, along the theoretical path of phallocentric exclu-
sivity in gender studies? There were women doing important work in psy-
choanalysis then who did not question the centrality of male “castration
anxiety” and “penis envy” in females. Helene Deutsch, who focused clini-
cally on women and their bodies, was one. Her volumes on female devel-
opment (1944, 1945) are gold mines of clinical information about female
behavior, and she is one of the few people ever to write about childbirth in
a psychoanalytic book. But she declared masochism and narcissism to be
part of the normal female condition, and not pathological variants in both
sexes. Phyllis Greenacre (see, e.g., 1958) offered some correctives in the
area of preoedipal sexuality in her work with female children, and women
like Clara Thompson (1956) and the later Karen Horney moved toward
interests in the social realm and environmental impacts on women’s lives.
But no one directly challenged Freud’s view of women in the way Horney
and Jones had done in the 1930s, offering the possibility that they could be
definitively rebutted and alternative views put in their place.
The conversation seriously shifted in the 1970s with the second wave
of feminism and the social turmoil, challenge to authority, and general
upheaval surrounding the Vietnam war. There is no need to retell the story
of the battle over the impact of society’s phallocratic ideals for women, but
the first major book to emerge in this second wave was Kate Millett’s 1969
Sexual Politics. It was one of the first attacks on the patriarchal domination
of psychoanalysis—subsequently reattacked as a misunderstanding by
Juliet Mitchell (1974), who at the time was influenced by Lacanian lin-
guistics, and thus persuaded of the rightness of female “lack” in the lin-
guistic unconscious. Mitchell is credited with resurrecting an interest in
Freud among feminists, many of whom had come to consider him passé.

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Chodorow (1978) led the field in reassessing the impact on society of the
internalized transmission of motherhood from mother to daughter.
Clinically, writers from the 1980s on up to the present have tackled
different elements of the basic Freudian misunderstandings that linger.
For example, insistence on the centrality of the Oedipus myth for female
development has been challenged by Kulish and Holzman (2008), who
propose the Persephone and Demeter story as a better mythic parallel, in
that it captures the crucial relationship between mother and daughter. The
Electra myth has also been offered to highlight female aggression, which
has often been overlooked. Elise (2015), Holtzman and Kulish (2012),
and I (Balsam 2008) have brought forward the missing factor of female
sexual pleasure and the pleasures of exhibitionism. Castration anxiety has
been substantially questioned, and female castration anxieties of various
kinds have been suggested by writers like Bernstein (1990) and Dorsey
(1996). The original developmental staging for girls has been challenged
by Parens (1990). Heterosexuality as a dominant mode is no longer
accepted as a “norm,” evidenced by frequent allusions and articles in
Studies in Gender and Sexuality (edited by Virginia Goldner and Muriel
Dimen [2000]), and contributions on lesbianism, bisexuality, and queer
expressions of femaleness have appeared in all the journals. Gender is
re-presented with an emphasis on the individual (Chodorow 2011).
Specifically female aspects of the body and the development of genital
sexuality have been studied in the work of Phyllis and Robert Tyson
(1990), Arlene Richards (1992), Barbara Stimmel (1996), and others.
Joan Raphael-Leff (1993, 2015), for example, has written books specifi-
cally on infertility, pregnancy, childbirth, and childrearing.

In Conclusion

Many discrete elements of the original Freudian theory of female devel-

opment have been rightfully questioned, while most of these writers have
maintained a connection to the basic tenets and stances of Freudian psy-
choanalysis, including ways of working clinically with the unconscious;
some version of object relations theory; the role of affects and trauma;
and the notion of a developing sense of self and others. But there is no
longer any single overarching theory of female development as once
existed for, say, Anna Freud or Bertram Lewin that analysts might agree
on. Rather, we today have a plurality of approaches in the field, including

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an interest in gender and chaos theory (Harris 2004). The cumulative

effect of all this work is that we are left with a complicated situation in
which Freud’s theory of female development has necessarily been splin-
tered. And there is no one set of ideas to take its place.
One direction, given this fragmentation of the theory, is to return spe-
cifically to the contemplation and exploration of the female patient’s
associations to her material body (Balsam 2012). This is a path back to
beginnings: partly because the body became so distorted in a phallocen-
tric system (one that can still operate silently today); partly because our
“housing” is a generalizable physical and material entity common to all
females (and, equally, all males); and partly because even from the begin-
ning the most obvious aspect of mature femaleness8—the capacity to bear
children—was erased. Though we have no common psychoanalytic the-
ory and certainly no single mental developmental path, we at least have
the cohesion of a body morphology in common with half the population.
We can no longer pretend, as did Lewin and others, that we actually
“know,” for example, the complete map of the unconscious symboliza-
tion of the female body. Much is yet unsettled as we confront the newest
phenomenon facing gender studies: a person becoming “transgendered.”
It is a psychodynamic situation of which we can (usefully) say that as yet
we know very little. As we do not have any agreed-upon theory about the
journey from girlhood to mature womanhood, its differing sexual expres-
sions, the psychodynamics of different object partnerships, and possible
pregnancies and birth histories, we cannot expect to have “a theory” in
2016 about how a person psychologically navigates a body’s journey
from its natal condition to its transformation into a different sex.
We seem to have come full circle from Freud’s post-1908 “certainty”
about sexuality to a rich and complex state of knowledgable uncertainty
about sex and gender, while we have taken on board his method and help-
ful approach toward exploring the mind. In the spirit of his pre-1908 atti-
tude to females, we can affirm and opt to nurture our willingness to
explore and to be prepared for surprise, wonder, and discovery, when
honored by our patients’ free associations about sex, gender, and their
procreative bodily experiences, epic but still unsung.
8I am careful not to use the word feminine. I believe feminine and femininity to be quite

specific qualities known to an outsider only from information received from the individual
person. Use of these terms encodes too many value judgments (for the preferable locution sense
of femaleness, see Elise 1997). They are mostly obfuscating in discussions centered on sex and
procreation as the body’s functional equipment.

85
 Rosemary H. Balsam

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