Studies in Gender and Sexuality

ISSN: 1524-0657 (Print) 1940-9206 (Online) Journal homepage: http://www.tandfonline.com/loi/hsgs20

Who Am I? And What Makes Me Hot and

Bothered? Notes on Identity, Sexuality, Enigma,
and Desire

Vittorio Lingiardi

To cite this article: Vittorio Lingiardi (2018) Who Am I? And What Makes Me Hot and Bothered?
Notes on Identity, Sexuality, Enigma, and Desire, Studies in Gender and Sexuality, 19:4, 279-290,
DOI: 10.1080/15240657.2018.1531546

To link to this article: https://doi.org/10.1080/15240657.2018.1531546

Published online: 14 Nov 2018.

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STUDIES IN GENDER AND SEXUALITY
2018, VOL. 19, NO. 4, 279–290
https://doi.org/10.1080/15240657.2018.1531546

Who Am I? And What Makes Me Hot and Bothered? Notes on

Identity, Sexuality, Enigma, and Desire
Vittorio Lingiardi, M.D
Sapienza University of Rome

ABSTRACT
This article explores the links among identity, sexuality, enigma, and desire in
my work with 22-year-old Andrew as he explores his homosexuality. Sexuality
is discussed as a developmental and relational construction simultaneously
biological and social, inventive and defensive. Elaborating these vertices of
sexuality in the treatment opened space to discuss Andrew’s sexual experience
and fantasy. In this vein, the article questions the tendency to put aside frank
discussion of sex in analytic practice and proposes case vignettes useful for
clinically elaborating intimate fantasies rooted in the shared narration of
patient and analyst as between psychoanalyst/writer and reader. In doing so,
we turn from concrete definitions and explanations of sexuality that risk
getting bogged down in details and use narrative to facilitate the uncanny
experience of “finding” sexuality in clinical work.

There is at least one spot in every dream at which it is unplumbable—a navel, as it were, that is its point of
contact with the unknown. (Sigmund Freud, The Interpretation of Dreams, 1900)

One
“Why sex? Why does sexuality become the arena in which fundamental relational issues and
struggles are played out?” (Mitchell, 1988, p. 102). To answer this “unplumbable” question, I’ll
start putting together some “fragments d’un discours” sexuel (Barthes, 1977) from my favorite
psychoanalytic readings. You will recognize them: among others, Stephen Mitchell and Muriel
Dimen (I miss her so much), Jessica Benjamin and Peter Fonagy.
I rely on three theoretical streams: thoughts on sexuality, affects, and the social context, tying
them together in a kind of soft assembly or recursive relationship in which sex and sexuality, as well
as relationality and psycho-physiology, are all in play, making each other all the time. Moreover, I
will try to integrate the idea of sexuality as a developmental and relational construction: simulta-
neously biological and social, inventive and defensive.
Through this lens, “sexuality”—the name we give to something we know very little about,
especially in children—results from genetic and hormonal predispositions, family expectations and
social pressures, conflicts and defenses, fantasies, identifications and counteridentifications, projec-
tions and introjections. It arises from the incessant attempt to come to terms with one’s own
pleasures, anxieties, identities, and compromising solutions (Lingiardi, 2015). When I say “develop-
mental” I am not thinking about the tendency toward a normative aim (e.g., the Freudian normal
procreative aim), but I am viewing sexuality as moving in a dialectical, nonlinear and nonhierarch-
ical way between part objects and whole objects; oral, anal, phallic, and genital elements; pre-oedipal
and oedipal elements; self-regulation and mutual regulation; autoeroticism and object relations.

CONTACT Vittorio Lingiardi vittorio.lingiardi@uniroma1.it Department of Dynamic and Clinical Psychology, Faculty of
Medicine and Psychology, Sapienza University of Rome, Via degli Apuli 1, 00185 Rome, Italy.
© 2018 Taylor & Francis Group, LLC
280 V. LINGIARDI

“Since Freud cast the net of infantile sexuality over childhood,” says Seligman (2018, p. 1),
“analysts have used their ideas about infants and children to construct master narratives that
establish coherence between their theories of development, personality, psychopathology, and
hence, clinical work, with widely varying blends of observation and imagination.” In this sense, in
order to be “conceived,” sexuality needs a lot of “vertices” (Bion, 1965), that is, angles from where
the individual (and the individual in relation) may develop the capacity for approaching, experien-
cing, and understanding his experience from more than one perspective. In the case of sexuality, to
adopt multiple vertices means, for example, to look for a compromise between own desires and the
concessions of the external world.
How does the possibility to speak about, and understand, the sexual experience also reflect in the
clinical setting? Although there is still the tendency to put aside sexuality in analytic practice, in the
same way as it happens with children’s sexuality, we can’t ignore that the containment, mirroring,
and mentalization of, or empathy with, patient’s affective, emotional, and bodily states may also
imply experiencing together (analyst and patient) such states, and, as Stein noted (2008, p. 66),
“Sexual containment is no exception.” In the case of nonmirroring, when the patient feels shame
about what we could call his “experience of self states” on different levels (affects, emotions, bodily
sensations) and can’t communicate effectively with his analyst, or the analyst is resistant to the
sharing of such experiential states, it is conceivable that the patient will be left to fantasize the
containing, excited/exciting object by himself. For both the patient and the analyst this is a missed
opportunity to fully understand and facilitate the integration of the patient’s experience because it is
precisely that affect of shame that signals both a dissociated part in the patient’s mental life and the
overwhelming of his or her immature psyche (Benjamin, 2018).
It is inevitable here to see the correspondence between the analytical function and the parental
function of receiving holding and give meaning to the patient’s/child’s dysregulated emotions
(Winnicott, 1965).
I introduce 10 concerns in recent psychoanalytic literature that together inform my way of
conceiving sexuality. I illustrate the way these concerns come to bear in thinking through my
clinical choices with Andrew.

(1) Winnicott referred to “psyche” as the “imaginative elaboration of somatic parts, feelings,
and functions” (1949, p. 243). The first body experiences (feeding, evacuation, pain,
pleasure, etc.) thus provide semantic organization for the more complex and narratively
structured subsequent experiences that flow into the “idiom” (Bollas, 1989) of our
sexuality.
(2) Adult sexuality expresses residues of early intersubjective exchanges between caregiver and
infant (Benjamin, 2018; Benjamin and Atlas, 2015; de Lauretis, 2017). The caregiver and
the baby are not merely sensual, as there is a sexual component that belongs to that dyad.
According to Stein (1998a), when the infant cannot yet integrate his or her strong
sensations into his or her developing psyche, they turn into libidinal excitement, resulting
in a sexualition of the gap between the other’s excess and the child’s limited resources.
These untranslated residues, Laplanche noted (1999, p. 209), act “like a splinter in the
skin.”
(3) Moreover, mother–infant mutual regulation and recognition can be considered a container
for sexuality—and for the “too-muchness” of excitement associated with it, as noted by
Stein (1998a) and Benjamin and Atlas (2015), in keeping with Laplanche’s (1992, 1995)
idea of “excess as enigmatic message.” “To sum up”, says Benjamin (2018, p. 113), “once
we regard maternal responsiveness as not only satisfying needs or soothing anxiety but also
sharing affect states, giving meaning to emotion, to intentions and acts, and conveying
mother’s own subjective states, we can formulate a more complex understanding of how
failures of recognition and problems in affect regulation relate to the generation of excess.”
 STUDIES IN GENDER AND SEXUALITY 281

(4) However, from an attachment perspective, the containing function is leaky. Fonagy (2008)
suggested that a child’s sexual feelings are systematically (defensively?) ignored (or mini-
mized) by the caregiver—let’s say not mirrored in a manner that recognizes the infant’s
experience and presents it back to the infant as an experience worthy of symbolization and
thought. “The vast majority of mothers,” noted Fonagy (2008, p. 22), “claim to often or
mostly look away in response to the sexual excitement of their infants, whether girls or
boys [probably because] we have no conscious strategies available for mirroring sexual
excitement.” These feelings remain “dissociated” within the attachment bonds and, as a
consequence, sexuality remains “dysregulated.” Such a “dysregulation” could partially
explain our unconscious hope that our lovers see what has not been originally seen, and
mirror our desire that such “unseen” is now contained, symbolized, embodied, and
recognized. When our lovers touch us, they touch both our desire and our grief, awakening
our pleasure and our pain at the same time. Hope and dread dialectically coexist because in
every new object relationship we look for an occasion to re-transcribe the painful or
unmirrored experiences of our past.
At the same time, we fear such re-transcription because it is the “smoking gun” of what
we missed. It is precisely also on those missing experiences that our psyche and longing
have been constituted. In this sense, we can understand when Stein (1998a, p. 598) says
that the object with which we relate is “an object that is never itself but that one seeks
forever and in vain to refind,” or, invoking poetry, when Emily Dickinson (1960) says: “So
We must meet apart -/You there – I – here -/With just the Door ajar/That Oceans are -
and Prayer -/And that White Sustenance -/Despair -.” I like to remember at this point
something Andrea Celenza (2015) wrote in an IARPP (International Association for
Relational Psychoanalysis) online colloquium: “The longing to touch and be touched
derives from the awareness of the presence of something else, usually outside reach.”
(5) Inhibitions and facilitations promoted by the caregivers (on the basis of their values,
personal experiences, and culture) connect pleasure-seeking with myriad affective states
(often with sexual overtones), such as embarrassment, humiliation, shame, guilt, and so on.
These affects are tied to matters of identification along lines that trace normative uncon-
scious patterns (Layton, 2006). Such inhibitions and facilitations are inevitably burdened
by “the social,” which imposes what we must renounce —see as an example the idea of
“melancholy gender/refused identification” in Butler (1995)—or what we are misrecog-
nized to be—see as an example the idea of “interpellation” and dissociation in Guralnik
and Simeon (2010).
(6) The encounter with external solicitations meets the physiology of our excitement (excit-
ability as the interplay between arousal, hormonal pressure, and interactive field of
relationships with external and/or internalized objects). The physiology of excitement
and the biological economy of desire are different for everyone. Therefore, it will be the
absolutely idiomatic and idiosyncratic configuration between facilities and inhibitions,
physiological dispositions and internalized and external object relations, and social and
relational compromise formations, to constitute the specificity of our sexuality.
(7) The feeling of being “pushed” by a motivational system is another important topic. Joseph
Lichtenberg (1989) assumed the existence of five motivational systems—seven, for the
psychologist and neuroscientist Jaak Panksepp (Panksepp and Biven, 2012)—that are
associated with specific neurophysiological patterns and are based on behavior that is
observable in the neonatal period: the need to fulfill physiological requirements, the need
for attachment and affiliation, the need for assertion and exploration, the need to react
aversively through antagonism and/or withdrawal, and the need for sensual and sexual
pleasure. The cooperative or alternative relationship (a sort of psycho-physiological dance)
between these systems influences our search for a partner and our sexuality (think, e.g., of
the conflict between the attachment−affiliation system and the sensual−sexual one). In the
282 V. LINGIARDI

context of interpersonal relationships, the satisfaction and the balance of these systems
promote experiences that give strength and cohesion to the Self through sexuality.
(8) Relationships, where the endless configurations of bodies and their mutual positions set up
the way we experience the other. It is in fact in the interpersonal experience that our
idiomatic way to relate to the other—by controlling, suffering for, or adoring him or her,
just to cite few examples—may reveal our psychic structures, erotic templates, attachment
patterns or group affinities—in a word, our “identities.”
(9) Needs, desires, and experiences that contribute to shaping our defensive system shape in
turn the theater of our sexuality in its inherent diversity of expression. (A patient of mine,
with phobic and obsessive personality traits, expresses her sexuality in two different ways:
When she is engaged with a stable partner, she isn’t inhibited at all; on the contrary, with
casual partners, she only enacts a voyeuristic, exhibitionistic, and masturbatory sexuality,
one that is satisfying but “constructed” as a defense against the fear of contracting sexual
diseases.)
(10) We all have a “public” life, a “private” life, and a “secret” life simultaneously. Sexuality also
means privacy, secrecy, fantasy, mystery, and exploration—all elements that can allow
unexpected expression of ourselves in experiences that are relatively free from censorship
or conditioning (see, e.g., the many selves of virtual and cybersex) (Hartman, 2011;
Lingiardi, 2011). Is virtual reality a space that “opens up new kinds of fantasy and relational
possibilities, or is the net a snare, … a retreat from both psychological and social relations
to a dissociative place of suspended animation and compulsive usage?” (Hartman, 2011,
p. 477). Tech-wary arguments, says Stephen Hartman (2011), “typically default to a
normative conclusion that coming to terms with reality is in patients’ best interest. They
assume that selves, like reality, can only be organized one way at a time. Coherence is
privileged over experimentation … If we are to understand the new reality that is unfolding
all around us, I believe we always have to keep the current psychoanalytic notion of the
multiple self in mind.”

To summarize, I would like to adopt Stein’s perspective (2008) when she notes that in order to
emerge and be analyzed in the clinical setting, sexuality requires that we “unforget” desire as we have
come to organize it (Stein, 2008) and recuperate “primitive sensations, bodily and mental hopes that
have become illegitimate and unappealing” (Frommer, 2003), so that it is possible to overcome our
“shame of excess” (Stein, 1998b).

Two
Andrew is 22 years old, and he has just moved to Milan from a small town in southern Italy to
attend a graduate program in biology. Christmas is coming, and he will go back home for a few days.
His parents are waiting for him to celebrate his first full mark with distinction. They are genuine
people who gave birth to their only child when they were no longer young. They are trade unionists,
politically left-wing but aligned with the values of the Catholic Church. Socialists and Catholics make
a combination not uncommon in Italy. Andrew has a strong desire to see his family, but this time he
is also afraid. In Milan, he recently met Luigi, a man in his thirties, with whom he has engaged in a
romantic relationship. He has decided to tell his parents that he’s gay. This is his first love and his
first experience coming out.
“I have known that I’m gay since I was ten. It never was a big problem for me. I flirted with boys,
but I didn’t come out … My first kiss was with the baker’s son. I was fifteen, and he was a few years
older than me, but looked like a grown man. When I bought bread for my grandmother he winked at
me. I still remember it as a ‘disclosure,’ an experience that made me realize who I was and who I
wanted.” Andrew added, “The problem was at home when the telephone rang, and I had to answer.
Because of my non-baritone voice, people regularly mistook me for a girl.”
 STUDIES IN GENDER AND SEXUALITY 283

“And now? How does your voice sound to you?” I asked him.
“I’m used to it. After all, as you can see, I am not an alpha male! … But I like myself as well. Yes,
maybe today hairy and gruff gays are cooler … my friend Franco will only look at bears! But Luigi—
actually he is a very sexy masculine man—likes me for my twinky physique and my elegant posture.”
He laughed, looked at me and added: “Unbelievable, right? Once gay meant effeminate. Now they
are all hairy bears!”
This sounded to me smart, ironic, and a bit “nervous” at the same time. But Andrew was right: If
we use a gay app, we see that an increasing number of gay men are looking for “masculinity” or
“performed masculinity” at least: hair, beard, and muscles. The “old attributes” of masculinity, what
we might call “the archetypes” of masculinity, are back in fashion as one of the most appealing
features of the gay scene. If Joan Riviere (1929) talked about “womanliness as a masquerade,” we
could say “bearness as a masquerade” (Lingiardi, 2015). In the following sessions with Andrew, the
topic about straight men and straight-looking and straight-acting gay men recurred frequently. But
let’s go back to our first session.
“You said you have not come out to your family yet?”
“My parents will not be happy about it. My mother is depressed. She has always said that I’m
the best thing she has done in her life … After my coming out, she will begin to ask where she
went wrong. My father will be more than disappointed. He has always tried to make me more
‘masculine’ than I am … When I was young, I preferred to spend time with girls rather than
playing football.”
“And now you decided to come out. Why now?”
“We can’t pretend nothing happened. Now that I have met Luigi, things have changed. I feel more
confident with myself. I want to ‘discover’ who I am, and I want to be myself. That’s why I am
here … Sometimes I think that one of the reasons why I decided to study biology is to better
understand the roots of homosexuality. I think homosexuality is determined by genetics and not by
family issues. Nobody’s guilt.”
“Guilt?”
Silence.
The session began full of verve and then ended with that question. I felt that both of us were more
thoughtful and that our conversation would expand.
“I write poetry because my genes and chromosomes fall in love with young men, not young
women.” With this carefree and cheerful verse, Allen Ginsberg (1994) screws up centuries of dispute
about the role that nature and culture play in our lives. But we know that poets follow idiosyncratic
and arcane thinking. People, sooner or later, ask: “Are homosexuals born that way or do they
become homosexuals through outside influences?” This usually means: “Is homosexuality caused by
primary relationships and family structures? Or is it just a matter of genes and hormones?”
This question is inescapable but wrong because it is affected by two prejudices: The first is that we
are all born as tabulae rasae, ready to be shaped by external forces. The second prejudice is that we
are born already programmed for specific tastes, desires, and behaviors. Binary oppositions—nature
versus culture, inside versus outside, and black versus white—are always wrong. Life is made up of
shades, and hopefully not always fifty and gray. Moreover, this etiological conundrum becomes
inevitably etiopathogenetic because it pushes us to see homosexuality and heterosexuality as the
effect of something that went wrong in one case and something that went as it should in the other. In
a clinical context, in fact, the heteronormative germ often lurks just in the attempt to “find a cause”
to “explain” why a person is homosexual. People (and psychoanalysis) don’t ask, “Why are you
straight?” But many times homosexual people ask themselves, “How did I become gay? How did I
become a lesbian?” In addition to gender stress (Drescher, 1998) and minority stress (Meyer, 2007;
Baiocco et al., 2014), we should take into account the etio(patho)logical stress.
As Stephen Mitchell said (1981), “If homosexuality is approached, alternatively, as one deals with
any other analytic material, in the spirit of open inquiry, we find that homosexual fantasies and
behaviors reflect a multiplicity of meanings and themes, the analysis of which moves the treatment
284 V. LINGIARDI

forward, permitting the patient to make his own choices, free from influence, either overt or
covert” (p. 77).
Many psychoanalysts have written extensively about homosexuality—or to be precise, about its
“causes”—but very few about homosexuals. This fact should prompt us to question whether
homosexuality, as a disembodied category or psychological type per se, is a phantom.
Homosexuals, on the other hand, exist. I believe that one problem that has affected psycho-
analysts was their persistence in attempting to construct etiological theories concerning homo-
sexuality by conceptualizing homosexuality via forgetting homosexuals themselves. There are, of
course, exceptions. For instance, Christopher Bollas (1992) noted that any attempt to elaborate
upon a comprehensive theory of homosexuality succeeds only at the cost of a grave distortion of
the differences that exist between homosexual individuals, “an act that could in the extreme
constitute ‘intellectual genocide’” (p. 152).

Three
Because I sensed that some “splinters” under the skin (Laplanche, 1999) were emerging, I adopted a
“wait and see” attitude toward Andrew’s investment in genetics; while it gave Andrew a context of
security to explore, it didn’t indicate where he had to go. I thus went along with his curiosity, rather
than risk preempting it. I didn’t want, as perhaps other colleagues would have done, to challenge
Andrew’s scientific curiosity sooner. In my opinion, it was important to allow his critical stance to
unfold in the treatment more slowly.
Andrew was looking for an explanation. We worked quite a lot on this issue, trying to weave
together science, psychoanalysis, and personal curiosity, while I was distrusting the need for
scientific justification—that is, a gene telling me whether the way we are is ok. Andrew looking
for an explanation meant looking for his origin and his “meaning.” After all, “Born this way” has
become a generational anthem. “I was born this way. You have to accept me … And I have to accept
myself.”
During the first year of his analysis, Andrew’s “scientific” curiosity seemed satisfied. Session by
session (twice a week), we formulated the idea that his need to “know” the origin of his sexual
orientation stands for his need both to know his identity (in its biological, psychological, and cultural
aspects) and to find a scientific “absolution” from his fears, weaknesses, and shortcomings. “It’s
Mother Nature.” He gently provoked me with this ambivalent formulation that keeps together his
mother (and the “mother” of traditional all-explaining psychoanalysis) and the biology of contem-
porary all-explaining neuroscience. Finally, we came to agree that being homosexual might be
considered an emerging feature of the Self, a fact largely involuntary and often constitutive. But
we also decided that it is one thing to “be homosexual” and another to “be gay” (Isay, 1989, 1996).
As in the cases of heterosexual patients, psychoanalysis should be concerned about everything
happening “after” and concerned with environment and maturational processes. Psychoanalysis
should not be interested in what “causes” sexual orientation, but in what welcomes or rejects it—a
secure base or a pit of loneliness and self-hatred. In doing so, the word “homosexual” should dissolve
into our psycho-biological idiom. A sequence of DNA, a psychological theory, a slice of the
hypothalamus, or even a passage from the Bible will not give us the (re)solution. The problem, in
fact, is not the explanatory model, but how we deal with it. Early in the last century, Freud shifted
the attention from the moral level to the psychological one. As a result, we finally started to talk
about sexuality, and not about sin. Similarly, toward the end of the last century, a group of biologists
shifted the attention from psychology to genetics. In both cases, many people felt a liberating effect.
On the days of the discovery of what the media called the “gay gene,” an American boy was
interviewed on television and said, “I am happy with this because it demonstrates that my parents
are not guilty for my homosexuality.” On the contrary, others felt a sense of loss, as if the idea of an
unpredictable life, open to the vastness of desire, was fading away.
 STUDIES IN GENDER AND SEXUALITY 285

When we talk about sexuality, any unidirectional theory risks being misleading and dangerous.
Over time, many theories about homosexuality (psychological immaturity, regression, narcissism,
unresolved Oedipus and defensive fear of the opposite gender, just to make a short list) have proven
to be merely pathologizing, empirically unprovable, and biased by heteronormative assumptions.
Identities and sexualities are endless. Maybe some of them are more biologically wired; others find
their place in relational biographies.
In the modern era, if we explain sexuality and classify and interpret human behavior only relying
on biological or psychological models, we risk losing our contact with those images about sexuality
that constitute its relational matrix and its sensory and aesthetic quality. Psychopathological defini-
tions, in fact, tend to beg the basic question and leave us with the feeling that the meaning is
contained by the definition. “The model is perfect functioning: sexuality as a smoothly running,
conflictless apparatus” (Hillman, 1972, p. 146). In her book The Enigma of Desire, Galit Atlas (2016)
offers an original construction of sexuality as located in the tension between Enigmatic and
Pragmatic dimensions, challenging the binaries of known and unknown, seen and unseen, internal
and external, masculine and feminine, and oedipal and pre-oedipal experiences of the body.
Sexual desire is “a powerful, physiologically mediated response within a particular interplay of self
and other, within a larger, subjectively structured, inevitably conflictual, relational design” (Mitchell,
1988, p.104)—be it straight, gay, lesbian or bisexual. Indeed, just because it can be these ways.

Four
Finally, Andrew brought me into the following inevitably conflictual design. His etio(patho)logical
concerns, satisfied and apparently laid to rest, have given way to another analytic mood. Our work
on identity (Who am I? Why am I me?) was an essential prelude to work on fantasy. Beyond the
question of “where does homosexuality come from?,” having analyzed Andrew’s unresolved pocket
of internalized homophobia and discovering a social self worthy of love and respect, Andrew’s sexual
desire (What makes me hot and bothered?) remained an uncharted landscape. Rather, it was explored
with his body, but much less with words, our words.
In an article entitled “Status of Sexuality in Contemporary Psychoanalytic Psychotherapy as
Reported by Therapists,” Ofra Shalev (2009) described four factors that affect the status of sexual
themes in therapy: (a) the extent of the belief in the centrality of sexuality in human motivation, (b)
the level of expressiveness of therapy, (c) the narrowing of the concept of sexuality and the
separation between sexuality and intimacy, and (d) the tendency to avoid sexual issues because of
the discomfort their discussion causes to the patient or the therapist. We rarely connect the various
vertices that I have previously described in our treatments—since we shy away from certain very
important aspects of sex and/or sublimate them into questions about identity. My intention with the
experiment I describe next is to reunite these lines of inquiry.
While I was writing this article, I asked about 20 friends and colleagues, men and women, young
and old, gay and straight, whether the question “What makes you hot and bothered?” had somehow
emerged during their analysis. More than half of them were surprised by the question. They told me
that their sexual fantasies, what makes them “hot and bothered,” had never been a theme of their
sessions. To my question, “Why, in your opinion?,” they answered mainly in two ways: (a) “In my
analysis, I’ve always talked about my relationships, and my sexual experiences were considered a sort
of implicit appendix”; (b) “A sort of ‘don’t ask, don’t tell’ agreement between my analyst and me; my
sexuality was a sort of ‘abstract’ concept we only addressed in terms of ‘I liked it/I didn’t like it,’ or
‘Did you like it/Didn’t you like it?’”
“Has Sexuality Anything to Do With Psychoanalysis” is the challenging title André Green (1995)
gave to a paper in which he stated that “direct discussion of sexuality seems to have declined in
ordinary clinical presentations, and sexuality also seems to have become marginalized” (p. 871). If we
review the psychoanalytic literature, we will note that most of the time when patients’ sexuality
286 V. LINGIARDI

“speaks,” its voice is often referred to the so-called domain of “sexual perversions” (now paraphilia
or paraphilic disorders). Sex comes to provide empirical backup for sexuality.
One day, finally Andrew’s sexuality spoke: “I’ve never talked about my sexual fantasies. But
yesterday with Luigi something happened that I want to talk about.”
“Tell me.”
“I was tired of spending my desires on cyberporn or chat lines. For too long I masturbated
thinking about it, and so I finally came out. We were making love, and I asked Luigi to spank me. He
did it. Then I asked him to kiss me and spit in my mouth. He did it. ‘Let me lick your hairy chest.
And fuck my mouth all the way,’ I implored him.”
While I was listening to him, I realized that Andrew was “telling” me his desires only after he had
acted on them. I wondered why he had never shared them before, despite their unspoken presence
for “too long.” I was neither surprised by his sexual desires nor a victim of what Muriel Dimen
(2005) would call the “Eew! Factor” (a countertransferencial, excited disgust). Was I enacting a
defensive “puritanism”? Maybe not disgust, but discomfort? Perhaps it was something like “sexuality
is something you make, not something you talk about” (actually that was my parents’ attitude).
Perhaps Andrew’s determination in describing his “sexual scene” prompted me to come to terms
with the fact that I also contributed to the “marginalization” of explicit details of sexuality from our
psychoanalytic sessions. It was as if I were not “ready” to work on such a “concrete” level of
sexuality. Too much “concreteness” or, on the contrary, too much “metaphor”? Was I victim of
the tendency to treat sexual issues raised by patients “only” as mere expressions of deep psychic
patterns or as defenses against deeper difficulties? Do we uncounsciously reenact our parents’
discordant mirroring of our early sexuality when sitting with our patients—to work it out for both
us and them too?
In the end, the most reasonable question seemed to me precisely the “sad” one made by the
analysts who do not talk about sexuality:
“Did you enjoy it?”
“Yes, I liked it, and I was excited, excited and happy that Luigi had satisfied my requests, although
it seemed that he did it more for me than for himself. Then, after we came, I was not sure what to
think. I was scared.”
“Of what?”
“It was as if what had just happened wasn’t part of my life. It was my life, but I didn’t recognize it.
That kind of excitement was strange, maybe not wrong in itself, but it asked to be understood … I
don’t know if it arose from my problems or whether simply sexuality is like this … intense,
unpredictable. And we have to live it as it is, the way it appears to our imagination … You should
know, you should tell me.”
“Do you agree that when we try to understand an experience, what happened and why you were
excited about it, you are always torn between the pleasure of spontaneity and the search for an
explanation, sometimes a justification?”
In the following sessions, we connected his need for explanation to his need to have convincing
arguments for his both real and internalized parents, in order to relieve them of their disappointment in
having a gay son (moreover, not a masculine one). And we explored the possibility that sexuality can be
both reality and fantasy, a body–mind tension, a function that helps us to regulate our emotional states
and the dialogue among our many selves (including our many gender identifications).
Other thoughts coming to our minds: Andrew’s sexuality (both as identity dimension and
pleasure dimension) is always in tension between “something to live” and “something to under-
stand.” To live with his sexuality, Andrew looks externally for someone or some explanation
powerful enough to answer his questions and to regulate his desires: Science (biology),
Masculinity (Luigi), and Psychoanalysis (including me).
When he feels distressed (e.g., in conflict with his gender identifications), an external regulation/
regulator gives Andrew a sense of greater internal cohesion; it is a way to “hold off” (even to
“punish”) parts of himself that he does not know, or understand or appreciate. Once again, Benjamin
 STUDIES IN GENDER AND SEXUALITY 287

(2018, p. 125) offers an insightful framework for a larger understanding of what is therapeutic and
transformational in erotic life: “The integration of passivity and bearing of excess in surrender to an
erotic Third—the dance of love—allows us to metaphorize psychic pain rather than act it out
through a sadomasochistic complementarity. When erotic partners can transcend the fixed com-
plementary positions of active v. passive … gender conventions no longer need be used defensively.
Rather they can become conventions of play, forms of expression, available for use in our fantasy
elaboration of the inevitable enigmatic and excessive elements that mark sexual life.”
These days, Andrew has begun to trust a secret aspect of himself. An alien-self, as described by
Fonagy? According to Fonagy (2008), “Sexual arousal can never truly be experienced as owned. It
will always be an imposed burden unless we find someone to share it with.” He describes it “in terms
of an ‘alien part to the self’ internalized by the alienating parts of the mirroring object-mother. The
internalization of a distracting or seductive response to frustration gives the psychosexual core its
unique combination of urgency and playfulness. The enigmatic dimension of sexuality creates an
invitation that calls out to be elaborated, normally by an other” (p. 23).
Maybe sexuality is a physical way to “resolve” a mental dilemma. Sexuality is not only the
“symptom” of object relations. Maybe sexuality is a mental way to “resolve” a physical dilemma. I
think of Andrew as a baby left alone in distress, in states of arousal and dysregulation, not recognized
by a mother who was too involved in celebrating her “masterpiece, … the best thing she has done in
her life.” Andrew is struggling with the difficulty of distinguishing between excitement and anxiety.
He is excited when he tells Luigi what to do to possess him, and so Andrew gives orders to his
master, thus becoming the master of his master. Andrew gets back to my clinical judgement and at
the same time “directs” me (“You should know, you should tell me”).
Andrew negotiates the transition from one self state to another, trying to trigger and at the same
time control the other. I try to find a mentalizing, intersubjective dimension of recognition and
regulation. Therapeutic alliance is made of ruptures and reparations. We learn together to “stand in
the spaces” (Bromberg, 1998). Andrew learns to recognize and hold the tension between what is
intrapsychically mysterious and what is intersubjectively mystifying.
As Andrew’s analyst, what should I emphasize—the relational configuration? Yes, “sex is a
powerful organizer of experience.” Wasn’t Mitchell (1988) right when he stated, “The fact that
sexuality entails an interpenetration of bodies and needs makes its endless variations ideally suited to
represent longings, conflicts, and negotiations in the relations between self and others” (p. 103)? At
the same time, I feel that if we reduce all to the past and present relational configurations, we lose
“something” of the physical reality of sexuality. It’s as if in this “physicality” there is always an
element split off from those inspiring configurations that now lives its own life—separated from the
relational encounter—whereas “bodily sensations and sensual pleasure outline the skin, the profile
and the boundaries of the individual; and the dialectic of physical and sexual intimacy puts us in a
certain position with regard to another: above, below, inside, against, around, in a position of
control, surrender, adoration, abduction, and so forth” (Mitchell, 1988, p. 96).
While we are exploring, we have also to be able to tolerate that, as Virginia Goldner (2003) wrote,
“Sex trades on the thrill of discovering, over and over again, that we are unknown to ourselves”
(p. 123). Working psychoanalytically on sexuality looks like working psychoanalytically on dreams.
Something remains unexplored; there is at least one kernel in every sexuality “at which it is
unplumbable—a navel, as it were, that is its point of contact with the unknown” (Freud, 1900,
p. 111).
Where did our listening, translating, interpreting, reconstructing, participating, dreaming
(Andrew had a vivid oneiric life, dreaming military discipline but also little pets to feed), and
mentalizing bring us? In our “therapeutic tale” (borrowing Galit Atlas’s expression; Atlas, 2016), we
found what Emmanuel Ghent (1990) called the desire to “surrender” and also what he called the
“perversion of surrender, that is masochism.” This involves Andrew’s fear of “getting lost” in
masochism and his effort to control and “direct” it.
288 V. LINGIARDI

I think that I was able to help Andrew embody his sexuality when I was not afraid to embrace
his early need for a parental figure who holds and processes both excitement/desire and affect
through recognition. When I was able to surrender to such needs I could function as a regulatory
container.

Five
Andrew’s analysis is still underway. Other sexual fantasies emerged. Andrew has begun to “know”
how to cope with the complexity of his sexual world both in his body and in his mind. The poet
Rilke refused to be analyzed because “if my devils will leave me, I am afraid my angels will take flight
as well.” Many devils inhabit Andrew’s mind, but I think that today they are less dissociated and
friendlier. And his angels did not fly away.
Let me quote a short poem by a great Italian poet of the 1950s, Sandro Penna (1982):
Il problema sessuale prende tutta la mia vita.
Sarà un bene o sarà un male mi domando ad ogni uscita?
[The problem of sex consumes my entire life.
I wonder at each moment whether I’m doing the right thing or the wrong.]

Working with Andrew, I also realized that when we talk about sexuality, we must recognize that
words are limited. Beyond all schools of thought, certain notions remain open to interpretation and
resist any attempt at definitive systematization. I am thinking, for example, of the mysterious
connection between subject, object, and drive; the shifting nature of sexuality; the difficulties we
encounter in trying to tease out the role of the environment from that of individual nature; and the
complexity of the relationship between the development of sexual preferences and the development
of psychic function. To look for an answer raised by these issues is a fascinating intellectual
enterprise, as well as a task that neither psychology nor any of the other social sciences can shirk.
The clinical significance of this task needs no explanation. But the need for mystery remains.
Before concluding, I would like to say something more about me. I started working on
Andrew’s “therapeutic tale” because it speaks also about me when I was his age. My “needy”
curiosity for the roots of homosexuality (in the early 1980s, people turned to psychoanalysis;
nowadays, they turn to neuroscience, but none of them gives us the ultimate answer!) and my
fascination with “masculinities” were also the subject of the dissertation (beginning of the 1990s)
with which I became a psychoanalyst (Men in Love. Male Homosexualities from Ganymede to
Batman, Lingiardi, 1997).
Sexuality is a mosaic. We can neither grasp it nor interpret it as a whole. Sexuality is made up of
various sexualities. It’s a “soft assembly”—as Adrienne Harris (2005) calls gender—that can be very
“hard.” It can be forged by fear and produced by circumstances. Unplumbable, it is “a point of
contact with the unknown” that makes us inevitably hungry to know.
Then, as a “soft assembly,” sexuality in the clinical setting leads me to reflect upon one last issue:
Of what value is case material? Should we view it as akin to sexual fantasy somehow? I think that one
possible answer relies on the structure on my article itself. Links between my 10 “vertices” and
Andrew’s “therapeutic tale” are evident, though case material shouldn’t be only reassuring on a
theoretical level. Rather, it should enable us to identify fantasies belonging to the shared narration
between patient and analyst as between psychoanalyst writer and reader. In doing so, we turn from
mere definitions and explanations that risk getting bogged down in details and can approach a
narrative that embraces the uncanny experience of “finding” sexuality in clinical work.

Notes on contributor
Vittorio Lingiardi, M.D., is a full professor of dynamic psychology and past director (2006–2013) of the Clinical
Psychology Specialization Program at the Sapienza University of Rome, Italy. His research concerns diagnostic
assessment, process-outcome research in psychotherapy and psychoanalysis, gender identity, and sexual orientation.
 STUDIES IN GENDER AND SEXUALITY 289

He and Nancy McWilliams are the Steering Committee of the new edition of the Psychodynamic Diagnostic Manual
(PDM-2, Guilford Press, 2017). He is the author of several books and many international articles, including
“Psychoanalytic Attitudes Towards Homosexuality: An Empirical Research” (International Journal of Psycho-
Analysis, 85, 137–158, 2004), which won the American Psychoanalytic Association’s Ralph Roughton Award.

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