Why we don't pay attention to "psychoanalysis": Female anatomy and hysterical duality

Female anatomy and hysterical duality. Aya Zaidel. The American Journal of Psychoanalysis, Feb 7 2019, https://link.springer.com/article/10.1057%2Fs11231-019-09180-8

Abstract: This article attempts to add another layer to our understanding of the phenomenon of hysterical duality. The author postulates that hysterical duality can be explained based on the dual-aspect model of feminine sexuality, which exhibits two initially contradictory paths: one derived from primary vaginal sensations and the other from clitoral pleasure. At first, these two paths create a fundamental split between representations of internal space, containment and motherhood and representations related to auto-eroticism and the effacement of the Other’s presence and needs. The author argues that this manifest contradiction makes the attainment of integration in feminine development an intricate and protracted process, which involves an act of inversion. This inversion entails a post-Oedipal disavowal of primary vaginal sexuality, pending its rediscovery through the encounter with the Other. Hysteria is thus viewed as the result of a failure to perform this inversion and an inability to extract oneself from the position of a “Vaginal Girl”, who defines herself through the desire of the other. This pathological course of development leaves the hysteric’s sexuality in a split state and traps her in the duality of clitoral pleasure versus penetration, which unconsciously represents humiliation and exploitation.

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By sketching this process along a timeline, we could argue that the girl knows what she is not supposed to know and thus cannot wait to rediscover what she already knew. Her premature knowledge of her vaginal sexuality operates as a trauma which halts time and development. Thus, she is denied of the suspension and incubation processes that are deemed so vital to feminine development by Freud, Montrelay and Braunschweig and Fain. In other words, the girl cannot perform the required act of inversion: to shift from pre-symbolic sensuous knowing (her primary knowledge of the vagina) to not-knowing (denial of her own sexuality and being part of a group) and then to mature knowing (acknowledging the vagina as part of a whole). Instead, we can theorize she is faced with three options: to adhere to her initial state, to adopt the opposite position or to keep alternating between these two states. All three options entail an incomplete transformation and a constant return to the same position.

It seems that one can notice the connection between the impossible predicament of the ‘‘vaginal child’’ and the phenomenology of hysteria. In fact, when one views hysteria as a failed inversion, one can see how it entails three potential presentations: the first entails acquiescing and holding one’s ground. In this state, the woman identifies herself as a container, a ‘‘cesspit’’, and presents the position of a good, placating and obedient girl. Under the surface, one finds outrage and a phantasmatic sadomasochistic world, where feminine sexuality is subjected to ‘‘vaginal logic’’ (i.e., operates in line with a devouring oral scheme). This state resembles what Montrelay called the first psychic economy, which is a continuation of the primary vaginal sensations which have an annihilating effect. As this state involves an unsymbolized sexuality which subverts the processes of representation and symbolization, this psychic position is related to somatization, dissociation, hysterical ‘‘excess’’ and ‘‘masquerading’’ and additional phenomena that express regions that were left without representation, as blind spots or dark continents. The second presentation entails a transition to an inverted position, but the inversion seems to stop midway. The woman is ‘‘stuck’’ in an oppositional stance that is linked to ‘‘clitoral logic’’, which states that only what is visible is  significant. This is a constant state of resistance and protest against the feeling of not being recognized by the group and it may manifest in symptoms of nausea, vomiting or vaginismus. However, as mentioned, this attempted rebellion merely betrays the woman’s surrender and her acceptance of phallocentric law. In this state, the anger and the outrage are on the surface, while underneath there is an inability to disengage from primary vaginality in order to eventually turn it into a source of pleasure. The third and perhaps most advanced presentation entails a constant motion between the two previous states, an oscillation between a state of inviting submission which conceals defiance and rejection of the Other and its opposite. This precludes any opportunity for completing the inversion and is rather a closed-off fluctuation between the two poles.

The various hysteric presentations, all of which involve being trapped midway between seduction and isolation—a result of being a ‘‘vaginal girl’’—can be depicted through different prisms. In sexual intercourse the woman cannot associate sexual pleasure with the vagina and penetration. This is because the vagina, with whom she is identified, is the very reason of her disappearance. Therefore, there is often a tremendous gap between the capacity for sexual arousal and enjoyment and different degrees of vaginismus and an unconscious notion of intercourse as humiliating. In other words, because the vagina is the locus of trauma, one can witness a ‘‘healthy’’ and often even a promiscuous and licentious sexuality, so long as the vagina is not involved. The trauma surrounding the existence of the vagina may account for the hysteric’s strange amalgamation of seductivity and disgust. According to this position, the hysteric is seductive because she is truly interested in sexual contact with the Other. In fact, she can only stay in the safe and visible areas of sexuality, where there is no risk of revelation, which equals  effacement. When consummation draws near, she becomes constricted and overwhelmed with shock, disgust and repulsion. She appears to be saying ‘‘I am willing to be sexual as long as no one needs anything from me, as long as I can keep from surrendering—thus simultaneously revealing and erasing myself’’.

The same dynamic, with its various presentations, is evident on the level of object-relations. Sometimes, the woman yearns for a ‘‘real’’ strong man who could rescue her from her intolerable identification with her mother. Unfortunately, that same man, whose presence indicates the existence of the vagina, symbolizes the very identification from which she is trying to liberate herself and paradoxically sends her back into her mother’s lap. In other words, her potential liberator is also her subjugator and she cannot reveal herself because this revelation means effacement. At other times, an opposite, ‘‘clitoral’’ logic may prevail, which is the very same logic under a different guise. In this case, the explicit presentation is that of a woman who defies her vaginal identity (which she had, in fact, failed to deny), who rejects the mother and identifies with the father, to the extent that she may sometimes argue that she has no need for a man at all. Nevertheless, this defiance can be intuitively recognized as a profound wish for a relation that could actualize and even force upon her the unattainable submission. That is, the origin and the outcome of this maneuver are identical to the previous one: intercourse is perceived as ‘‘providing a service’’ and penetration is not pleasurable. Yet another option, which may be more common, is the constant alternation between these two states, as described by Kohon (1984): identifying with the mother and rejecting the father at one moment and identifying with the father and rejecting the mother at another.

This dynamic, which is often evident in the transference of hysterical patients, places the analyst in an impossible situation. When the patient accepts and takes in an interpretation, she feels humiliated, erased and inferior in relation to the analyst. In her eyes, that which revealed her (an adaptive interpretation) had erased her; that which liberated her—had subdued her. Similarly, one can notice the constant motion between groveling and stubbornness, between a saccharine and a contentious attitude. Thus, there may be sudden shifts between struggle (accompanied by a sense that the analyst is superfluous), and undifferentiated yearning (accompanied by a sense of utter dependence). As mentioned, these two states seem to operate in a separate and detached manner.

In many ways, this description is similar to that of borderline personality disorder. Therefore, it begs the question of why not define these binary shifts as a derivative of a dependence/independence conflict and a good/bad split? This will not only offer a sound depiction of this dynamic but may also sever the offensive and perhaps even reductive link between hysteria and femininity. Unfortunately, history has shown that any depiction which ignores the sexual aspect makes hysteria disappear and erases its unique character. The hysterical woman, who traps the analyst in an impossible and intolerable dynamic, is often a woman who is capable of an integrated view of the Other, who can contain the Other, show empathy and be a kind and devoted mother to her children (or a sensitive and skilled therapist…).18 In other words, defining the hysteric split in terms of the basic Eros/Thanatos or good/bad split would be inaccurate and would hinder an integrated view. More than any difficulty in maintaining a complex, multi-faceted, intimate and close relationship, hysteria entails a constant sense of rage, victimhood and a difficulty in feeling satisfaction and enjoyment.

AFTERWORD
It sometimes seems that hysteria has no clearer indicator than its elusiveness. The plasticity of its symptoms, its ability to manifest as both a structure and a state and its way of bending itself to fit various suggested etiologies—these give the impression that we are looking at a mirage. Hysteria seems to absorb everything into it, to constantly reshape itself to suit the mold of what is projected onto it, to keep reinventing itself. It needs an audience and it lives for one, it fades when you look away and reappears according to the spectator’s will.

But hysteria is not only elusive, it is also difficult to understand and decipher: when you touch upon early experiences, you lose your grasp on later ones; when you focus on the mother, you lose hold on the father; when you treat endogenous factors, you let slip actual traumas and so on. Perhaps more than any other disorder, hysteria reveals to us just how limited our sight is, the extent to which the sense of sight itself is hysterical—obsessed with exteriority and beauty, incapable of representing things hidden and unknown, disguising what is secret behind a thousand masks.

In this paper, I have nevertheless tried to tackle a certain structural layer of this deception. I have described the complexity of feminine development, which disobeys the Aristotelian demand for a sequential plotline where one thing leads to another and instead moves in two separate channels at once. These channels, a product of how feminine anatomy may be registered in the unconscious, are supposed to progress towards a functional sexual unity in which vagina and clitoris, passivity and activity, maternal and paternal identity converge to create a being that is somewhat more whole. This is a highly intricate task because, as mentioned, progress in a given channel is in diametric opposition to its counterpart. The unification of these two modalities and their integration as two reciprocating positions occur through an act of inversion, which suspends the primary vaginal sensations pending their rediscovery. This inversion may lead to a more complete feminine position—which includes the ability to look beyond the visible and represent the ‘‘nothing’’.

According to this position, the hysterical woman is one who remained a ‘‘vaginal girl’’—who rushed along and began to shoulder the weight of knowing about the vagina and about the existence of an inner space prematurely—with the burden, the accelerated maturity, the victimhood, and the alienation this entails. Such accelerated maturation, stemming from external or internal circumstances, prevents the hysteric from cathecting her body as a whole and completing the course of feminine development. She thus fails to attain functional unity and her sexuality remains in a state of duality. She is caught in-between, in a closed world of duality, where she is either seductive or disgusted, inviting or isolated, groveling or stubborn. This perspective, which focuses on endogenic sexuality—which stays mysterious and hidden—may offer a clue. We can thus make the conjecture that the trauma of the hysteric lies not only in the encounter with the external world or with overwhelming sexuality in general; rather, it is simultaneously born from the body itself, from inside—as a premature and precocious representation of the vagina: the part of her sexuality that can offer pleasure and enrich the ego when sexual integration is achieved but, when it acts independently, grounded in primary, pre-symbolic sensations—it erases and is erased, annihilates and devours and, most of all—it is subservient to the Other.

Therefore, after trying not to be tricked by the deceptions of the gaze, but to find what is hidden and constant, we may return to Charcot’s immortal dictum:

‘‘C’est toujours la chose ge´nitale, toujours … toujours … toujours’’ [It’s always a question of the genitals, always … always … always …] (Gay, 1988, p. 92).19