Sexuality: What does society want, what do I want?

Upheavals can, on a small scale, bear the characteristics of generational conflicts, typical struggles for separation and individuation, development crises in which some no longer understand others and feel provoked by new ways of life and loudly demanded new norms.

Since the Enlightenment paved the way for democratic negotiation processes, sexuality has been one of the main arenas of debate. What began as women’s struggle for social participation and self-determination – at the same time as Breuer’s and Freud’s studies on hysteria were published – we now encounter, for example, as gender discourse or gender dysphoria. Topics that also find their way into our therapies.

A young woman* calls me. She is a student and should probably get therapy again. Then her voice breaks and she falls silent. I can only hear her breathing. As if she had lost her voice. I tell her, “I notice that you are feeling very poorly. I suggest we arrange a time to talk to see what we can do.”

Intense silence

When the student appears for the initial interview, the scene from the telephone is repeated. She sits down, starts to speak and falls silent as she stares at me intently, as if she wanted to get under my skin or literally crawl into me. I feel increasingly uncomfortable and maximally controlled. However, there is enough space within me to rêverie, i.e. to pursue my spontaneous ideas and associations. After a while I say, “It would be wonderful to be understood without words.” Be silent. Again after a while I add, “But I’m afraid I don’t have that magical ability.”

Here the patient smiles awkwardly and tries to speak. I learn that she finds it difficult to get in touch with others, that she becomes very withdrawn, and that her previous therapist had advised her to continue treatment. She had been treated for a “moderate depressive episode.” She couldn’t do anything with this diagnosis. She remained a stranger to her.

Just don’t touch below the belt

She doubted her studies and had no concrete ideas for the future. She had a boyfriend with whom she had a long-distance relationship. She is “asexual”. Also her boyfriend. Cuddling is nice, otherwise touching doesn’t go below the belt. “I don’t understand sexuality.” A connection between this realization and her psychological suffering, which led to hallucinatory-like symptoms and resulted in “conditions” that she could hardly tolerate but could not name because she did not “know” how to “understand” physical sensations – she could not recognize such a connection.

Talking to her, it was as if we were living on different planets. I repeatedly thought of a famous line from pop music: Ground Control to Major Tom – Ground Control to Major Tom from the song Space Oddity by David Bowie. Major Tom, drifting in space far away from other people.

Talking about sexuality is difficult

It took some time until the patient was able to tell me the actual reason for her call: after the start of the study, she had suffered a depressive breakdown, with insomnia, social withdrawal, sadness, self-esteem doubts, the feeling of being excluded, and experiences of derealization and depersonalization. The trigger was a joking, flirtatious remark among friends about her boyfriend’s good looks, which was equally well received by all genders. This had caused unbearable jealousy and fear in her of losing him to possible rivals and to a lived sexuality in general.

Talking about sexuality and physicality was difficult. The patient perceived the issue as a normative pressure imposed by society. As being forced to choose a gender. As an unbearable requirement, generally to develop your own identity. She experienced my interested questions not as an attempt to understand them better. Rather, I became a representative of a system that only had unreasonable demands on them. “This society is not designed for me.”

Ideological discussions and the gender debate

The patient repeatedly got tangled up in ideological discussions with me in order to avoid talking to me about her feelings and fantasies, which unsettled and overwhelmed her. This could lead to some remarks towards me: “I don’t know to what extent you are familiar with gender discourse.” So she kept me at a distance by turning me into a dull-witted counterpart who was no longer living up to date. Just like her parents, who are also “from yesterday”.

Inwardly I had to smile, because even an analyst who was no longer fresh was once young, and at this point I thought of my own conflicts about self-determination and boundaries. But my main feeling was one of a certain sadness that, in her asexuality, this young woman was and perhaps remained barred from the joys of physical love, the intoxication and transgressiveness of sexual intimacy. Here we actually lived on different planets.

Price for a self-determined life

However, the patient’s asexuality grew as a result of a general, severe, depressively processed post-adolescent identity crisis, which is not uncommon at this age. The young student didn’t know what to do with herself. She felt uncomfortable in her own skin and consciously avoided the topics of completing her studies, work, planning for the future and relationships. She avoided conflicts and the aggressive feelings associated with them. She separated from her boyfriend in order to have peace from all the difficult feelings that emotional and physical closeness aroused in her, only to realize with shock that sexuality and Aggression is part of our human drive, which follows its own (also hormonal) laws.

The case of this patient shows the dialectic of psychological development in the light of social change processes: Whatever decisions we base our life plans on – we still live in a “hot culture” that gives us a relatively large amount of freedom in this regard that was once fought for – emotional growing pains are unavoidable. In a sense, it is the price for a self-determined life. My young patient floated unconnected in orbit for a long time. Talking openly with me about her feelings and fantasies meant becoming familiar with her own inner world and her fear of losing control. It meant returning to Earth, if you will. And to recognize that internalized norms that we work through in conflict are not always just unreasonable, but often also offer protection and support.