Working with Sexuality: Bodies, Desires and Imagination

Brett Kahr gives an overview of Freud’s pioneering theories of sexuality and its role in the development of the psyche. He gives fascinating details of his own extensive survey that gathered the sexual fantasies of 25,000 British and American people aged 18 to 94. As one of the few therapists trained to work with both individuals and couples Kahr also shares the unique perspective this has given him on the role of sexuality in the couple relationship.

Video interview with slides – 1 hr 10 mins

This presentation argues that perversion serves both a defensive and destructive function. The patient with a perverse psychopathology operates a paradox: he knows something and does not know it. These two attitudes are held simultaneously and yet are apparently reconciled, and an internal world is created in which reality is distorted and misrepresented. The perversion arises in an attempt to create this false reconciliation between contradictory ideas that can no longer be kept separate and it is when the perverse solution proves inadequate to contain the patient’s internal conflict that violence erupts. Ronald Doctor describes a male patient who uses cross-dressing as a perverse solution to his outbursts of uncontrollable violence.

Video lecture with slides – 33 mins

The Role of Violence in Sexual Perversion – Q and A

Video talk – 7 mins

In this witty talk, Professor Dany Nobus describes the origins and development of the concept of ‘perversion’ and details the many attempts psychoanalysts have made to define perversion in a way that reflects the breadth and extent of human sexual practices. He concludes that whilst Freud was perhaps right in thinking that the infant’s psyche is polymorphously perverse, he may have been wrong to conclude that as adults we ever entirely outgrow this aspect of our sexuality.

Audio lecture with slides – 34 mins

Christiane Sanderson shares her perspective on how therapy can best support survivors of childhood sexual abuse as well as her extensive knowledge of how this kind of trauma can affect a person’s sexuality and capacity for intimacy.

Video Interview – 1 hr 23 mins

Dr Thaddeus Birchard gives an overview of his Cognitive Behaviour Therapy group work with male clients who experience sexual compulsivity, which can encompass a wide range of behaviour including internet porn addiction and paraphilias. His discussion of ‘Charles’ also sheds light on the internal shame-ridden world of the sexually compulsive and suggests that repeated childhood wounding influences the sexual blueprint in adult male survivors.

Video Interview – 1 hr 12 mins

Janice Hiller explains the male and female hormonal reactions that take place during the life cycle of a relationship. She describes how the three evolutionary phenomena of lust, attraction and attachment (that are often in conflict) trigger neurobiological reactions that give rise to the human behaviour that poets and agony aunts have been writing about since the beginning of time. She also briefly outlines how competing male and female arousal systems and reproductive priorities affect the couple’s sexual and relational behaviour over the course of meeting, mating and sometimes, moving on.

Video lecture with slides – 50 mins

The Neurobiology of Falling in Love and Intimate Relationships – Q and A

Video talk – 8 mins

Understanding Female Arousal

Janice Hiller explores the various biological and social factors that influence women’s experience of desire and how these affect their sexual behaviour. She gives an overview of the main historical research and theories of female sexual desire and details some of the sexual problems women experience along with factors to consider when treating their psychosexual issues.

Video lecture with slides – 43 mins

Understanding Female Arousal – Q and A

Video talk – 15 mins

Neuroscientist Dr Stephen Porges discusses how trauma affects the body’s tolerance for intimacy with reference to his pioneering Polyvagal Theory. He gives a detailed yet accessible account of how overwhelming experiences cause the brain to automatically enact various embodied survival strategies like dissociation that make relating painful and difficult.

Audio interview – 42 mins

Queer writer Meg-John Barker explores what we can learn about this current sex/gender moment by turning our attention to gender, sexual, and relationship diversity (GSRD). What can queer, kinky, asexual, and polyamorous communities teach everyone about how to navigate sex – and wider relationships – with consent?

Video talk with slides – 30 mins

The Conditions of Consent – Q and A

Audio – 8 mins

Anton Hart discusses the importance of therapists being open to and curious about their own and their clients’ sexuality. As infants our sense of mind and sexuality develops in relation to caregivers and, as adults, our sexuality and our attitudes towards it reflect much about our individual human experience. Issues of privacy, shame and otherness contend with desires for connectedness, union and fulfilment in ways that are unavoidably and revealingly re-enacted in relational psychoanalysis. Hart believes therapists should strive to empathically inhabit all aspects of their patients’ desires, fantasies and behaviour so as to expand aspects of their own identities and thereby their analytical capabilities.

Video interview – 1 hr

Good In Bed? Power and Ethics in Psychoanalysis and Life

In reflecting on the present moment, which involves revelations of high-profile rapists, sexual assailants, and those using their power to sexually coerce and exploit (including iconic figures Harvey Weinstein and Donald Trump), this article considers the relationship between the destructive and oppressive forces that underlie these abuses, and aspects of “ordinary” sexuality that people struggle to integrate in their relational lives. The author explores the ways that such ordinary sexuality, particularly under ubiquitous conditions of patriarchy, is likely to include aspects of objectification, coercion, and exploitation. Further considered is the psychical and relational fallout of the counteractions currently being mounted against such violations and abuses. Two brief case vignettes, one of a heterosexual man, the other of a heterosexual woman, are used as exemplars of the tolls that coercive abuses and their remedies may be taking on sexual relatedness.

Audio reading – 27 mins

Alice Waterfall, our Conference Programme Development Manager and an experienced couple therapist, interviews Dr Joyce Slochower. What constitutes sexual transgression with clients? Why does it happen? And what needs to be done to support therapists and protect their clients?

Video Interview – 27 mins

Don’t Tell Anyone – Ghosts That Haunt: Sexual Boundary Violations in Our Communities’

Sexual boundary violations-and their perpetrators-are ghosts that haunt us within (and of course outside) the psychoanalytic world. Reverberating well beyond the particular analytic dyad within which they occur, these violations invade nearly every professional community. Sexual boundary violations cast a long shadow over us; they generate horror, anxiety, curiosity, and sometimes excitement. Our need to deny what we know and to protect exalted mentors from scrutiny has led to a toxic collective silence; by and large, we have remained publicly mute while engaging in plenty of private gossip. Anxiety about the destructive consequences of “telling” further complicates our experience and can result in disavowal-a near total foreclosure of the reality of the breach along with our experience of it. In this paper, Joyce queries the dynamics driving our complex responses to sexual boundary violations and explore their collision with our professional ideal, using a personal experience to illustrate some of these issues.

Video talk to camera – 39 mins

Integrative Psychosexual Therapist Cabby Laffy supervises Nicole Scott with a focus on showing how therapists can best support themselves and clients and work more authentically courageously and responsibly with issues of sexuality and the process of erotic transference.

*Further Case Study Transcripts (see attached) – Through these transcripts Cabby Laffy shows her way of working psychosexually with clients through dramatising three sessions with an imagined (but representative) couple who are experiencing distress in their sexual relationship.

Video Role-play – 55 mins

Psychoanalyst Chris Oakley argues that both analysts who deny any erotic feelings for clients and analysts who stress ethical behaviour towards clients misunderstand the psychoanalytic method and the altered state generated by the analytic encounter. By its very nature, psychoanalysis allows all feelings and thoughts, including sexual ones.

Drawing on the candour of analyst Harold Searles, Oakley suggests that sexuality is always present between analyst and client and that this generates the ‘alive’ quality that patients experience during the encounter. However, it is only the non-enactment of that sexual possibility that allows the client to become more fully alive to them-selves, which is the therapeutic goal. Sexual restraint on the part of the analyst is therefore not so much a ‘moral’ issue per se but more intrinsic to the basic method, aim and successful outcome of the analysis.

Audio lecture with slides – 45 mins

In this interview psychoanalyst, Dr Andrea Celenza details the opportunities and challenges of working with an erotic transference and counter-transference. By thinking about and exploring patients’ erotic attachment, therapists can uncover the long-buried unconscious meaning of life-constricting neurosis, and in the process help liberate them into a full and rewarding relationship with self.

Video Interview – 54 mins

Dr Christopher Clulow discusses the particular challenges and rewards of working with couples and gives an insight into how the therapist can foster intimacy by creating the space in which partners can hear themselves and each other non-judgementally.

Video interview with slides – 32 mins

Sexual Fantasy, Unconscious Fantasy and the Dynamics of Attachment

This talk explores sexual fantasy as an articulation of unconscious phantasy in couple relationships. Drawing on patterns of attachment and attending to “pretend” and “psychic equivalence” states of mind, it considers the potential of partners to combine in enacting shared unconscious phantasy through fantasy-driven sexual encounters. Observations about different forms of narcissistic object relating are made in this context, as are some implications for couple therapists.

The full version of this talk was published in the journal Couple and Family Psychoanalysis under the title ‘Sexual fantasy, unconscious phantasy, and the dynamics of attachment’. 2019: 9(1) pp 1-14.

Video talk to camera – 58 mins

Dr Stephen Kuchuck explores with the authors the ideas contained in their ground breaking joint paper on the role of infant attachment in the development of sexuality and the adult’s ability to tolerate sexual pleasure.

Video interview – 56 mins

Dr Estela Welldon suggests the principle cause of violent crime is the need to express rage, helplessness and humiliation rooted in unconscious childhood memories of abusive experiences and domestic violence. When these experiences have been extreme, and there has been a lack of loving containment by an attachment figure, something powerful is held inside the psyche until it is released in adulthood through loss of control, often triggered by a repeated trauma. Although the violent act may appear irrational, in the context of the patient’s past experiences it may be very meaningful. The violent act, furthermore, provides a sense of agency, of being seen and experienced by others. The key to forensic psychotherapy is for the patient and therapist to uncover the unconscious meanings of the act, through language. Hopefully this will be aired before the ‘splash’ – the moment when the crime is committed – if that person has access to therapeutic help. By gaining an understanding of their own past experiences of rage, impotence and humiliation the patient may resolve the unconscious impulses underlying the crime. We see that in effective psychotherapy, talking and thinking replace the acting-out.

Video talk to camera – 26 mins