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Synopsis of Psychiatry, 9th Ed. (pp. 200-203)

Ona 2012 Med C
Infantile Sexuality
Freud set forth 3 major tenets of psychoanalytic theory when he
published Three Essays on the Theory of Sexuality:
Broadened the definition of sexuality to include forms of
pleasure that transcend genital sexuality
Established a developmental theory of childhood sexuality
that delineated the vicissitudes of erotic activity from birth
through puberty
Forged a conceptual linkage between neuroses and
Male penis
Female vagina and clitoris
Infants needs, perceptions and modes of expression are
primarily centered in the mouth, lips, tongue, and other
organs related to the oral zone
18 months of life
Thirst, hunger, pleasurable tactile stimulations evoked by
the nipple, sensations related to swallowing and satiation
Libidinal and aggressive drives
Oral tension -> oral gratification
Wish to eat, to sleep and to reach that relaxation that
occurs at the end of sucking just before the onset of sleep
Libidinal needs (oral erotism) -> oral sadism
Oral aggression: biting, chewing, spitting, crying
Primitive wishes and fantasies of biting, devouring,
To establish trusting dependence on nursing and sustaining
To establish comfortable expression and gratification of oral
libidinal needs, w/out excessive conflict or ambivalence
from oral sadistic wishes
Pathological traits:
Excessive optimism, narcissism, pessimism, demandingness
Excessively dependent and require others to give to them
and to look after them
Want to be fed but may be exceptionally giving to elicit a
return of being given to
Extremely dependent on objects for the maintenance of
their self-esteem
Envy and jealousy
Character traits:
Capacities to give to and receive from others without
excessive dependence or envy
Capacity to rely on others with a sense of trust, sense of
self-reliance and self-trust

Stage prompted by maturation of neuromuscular control
over sphincters, particularly the anal sphincter, permitting
more voluntary control over retention or expulsion of feces
Extends from 1 to 3 years of age
Intensification of aggressive drives mixed with libidinal
components and in sadistic impulses
Acquisition of voluntary sphincter control associated with
shift from passivity to activity
Increased ambivalence, struggle over separation,
individuation, independence
Anal erotism: sexual pleasure in anal functioning (both in
retaining the precious feces and in presenting them as a
precious gift to the parent)
Anal sadism: expression of aggressive wishes connected
with discharging feces as powerful and destructive weapons
These wishes often displayed as childs fantasies as bombing
and explosions
Period of striving for independence and separation from the
dependence on and control by the parent
Sphincter control w/out over control (fecal retention) or
loss of control (messing) are matched by the childs
attempts to achieve autonomy and independence w/out
excessive shame or self-doubt from loss of control
Pathological traits:
Maladaptive, inconsistent
Orderliness, obstinacy, stubbornness, willfulness, frugality,
Heightened ambivalence, lack of tidiness, messiness,
defiance, rage, sadomasochistic tendencies
OC neuroses
Character traits:
Personal autonomy, independence, initiative without guilt,
self-determining behavior with a lack of shame or selfdoubt, lack of ambivalence and capacity for willing
cooperation without excessive willfulness or sense of selfdiminution or defeat

Transitional stage
Urethral erotism: pleasure in urination as well as urethral
retention analogous anal retention
May be invested with a sadistic quality often reflecting
persistence of anal sadistic urges
Issues of control and urethral performance and loss of
Pathological traits:
Competitiveness and ambitions related to compensation for
shame due to loss of urethral control
Start for the development of penis envy, related to feminine
sense of shame and inadequacy in being unable to match
the male urethral performance
Issues of control and shaming
Character traits:
Sense of pride and self-competence derived from
Urethral performance: small boy can imitate and match his
fathers adult performance
Budding gender identity and subsequent identifications
3rd year to 5th year
Primary focus of sexual interests, stimulation, excitement in
the genital area
Penis becomes the organ of principal interest to children of
both sexes (females being considered as castrated)
Increase in genital masturbation accompanied by
predominantly unconscious fantasies of sexual involvement
with opposite-sex parent
Threat of castration is connected with guilt over
masturbation and oedipal wishes
Oedipal involvement and conflict are established and
Focus erotic interest in the genital area and genital
Gender identity and serves to integrate the residues of
previous stages of psychosexual development into a
predominantly genital-sexual orientation
Oedipal situation -> basis for important and enduring
dimensions of character organization
Pathological traits:
Castration anxiety in males and penis envy for girls
Character traits:
Emerging sense of sexual identity, sense of curiosity without
embarrassment, initiative without guilt, sense of mastery
over objects and persons and internal processes and
Powerful internal resources for regulation of drive impulses
and direction to constructive ends (superego); based on
identifications derived primarily from parental figures

Stage or relative quiescence or inactivity of sexual drive
(5-6 years until about 11-13 years)
Institution of superego at the close of oedipal period and
further maturation of ego functions allow greater control of
instinctual impulses
Quiescent sexual interests
Period of homosexual affiliations for both boys and girls as
well as sublimation of libidinal and aggressive energies into
energetic learning and play activities, exploring the
environment, more proficient dealing with the world of
things and persons around them
Period for development of impt skills
Obsessive and hypercontrolling
Further integration of oedipal identifications and sex-role
identity and sex roles
Development of ego apparatuses and mastery of skills
Pathological traits:
Lack of control: failure of a child to sufficiently sublimate
energies in the interests of learning and development of
Excess control: premature closure of personality
development and precocious elaboration of OC traits
Character traits:
Unimportant inactivity
Sense of industry and capacity for mastery of objects and
concepts that allows autonomous function with a sense of
initiative without running the risk of failure or defeat of
Ages 11-13 until young adulthood
Physiological maturation of systems of genital functioning
and attendant hormonal systems leads to an intensification
of drives particularly libidinal drives
Regression in personality organization
Ultimate separation from dependence and attachment to
the parents and the establishment of mature,
nonincestuous object relations
Mature sense of personal identity and acceptance and
integration of a set of adult roles and functions
Pathological traits:
Identity diffusion
Character traits:
Fully mature personality with a capacity for full and
satisfying genital potency and self-integrated and consistent
sense of identity
Capacity for self-realization and meaningful participation in
the areas of work and love and in the creative productive
application to satisfying and meaningful goals and values