The ability to make a mature, healthy, adult sexual relationship is one of the criteria by which emotional health can be judged, and if we enter psychotherapy unable to do this the progress we make towards being able to do it could be one of the ways we measure our progress in psychotherapy as a whole. Every aspect of our personality, our behaviour, our feelings about ourselves, and our whole orientation to life is bound up with the way we deal with our sex drive.

Sexual phantasy

We all carry within us the seeds of every sexual deviation. . . the study of sexual deviation is the study of sex without love. [Storr 1964] If we continue in psychotherapy beyond the initial stages we are almost bound to have to deal with sexual phantasies, both conscious and unconscious, at some time, but any reluctance we may feel about doing so should be offset when we find out that as far as the psychotherapist is concerned, no matter what the particular nature of our phantasies, there is absolutely no need for guilt or shame, and there will always be a perfectly logical reason why we have such phantasies.

Deviant sexual behaviour

The comments made above about sexual phantasy are equally applicable to deviant sexual behaviour. If we are actually engaging in deviant sex rather than just phantasising about it we are said to be 'acting out' our phantasies, and this can make the treatment of the problem more difficult.

Incest phantasy

The closer one comes to the deeper disturbances of psycho-sexual development, the more unmistakably the importance of incestuous object-choice emerges. [Freud, S. 1905]

Whether we are talking about Oedipal conflicts in boys or corresponding conflicts in girls we are talking about conflicts that stem from deeply rooted human desires. There is no escaping it - incestuous desires are at the core of human psychology. [Forward; Buck 1981]

The subject of incestuous phantasy will, in some way, probably have to be touched on in all but the most superficial courses of psychotherapy. Neurosis is almost always found to have its roots in the Oedipal phase, which by definition takes place in the context of incestuous phantasies.

False Memory Syndrome

A special case of the emergence of sexual phantasy during psychotherapy which has caused bitter controversy [see for example Pendergrast 1996] is the 'False Memory Syndrome', where a patient uncovers repressed memories of having been sexually abused by his parents but the parents have no recollection of it ever taking place and vehemently deny that it ever happened. Both patient and parents are convinced that their memory is accurate and a situation of irreconcilable conflict is set up in which everyone, including the therapist, and the reputation of psychotherapy as a method of treatment, suffers.