For Her Own Good: Two Centuries of the Experts Advice to Women

by Barbara Ehrenreich

  Mid-century Masochism

  Mid-century psychoanalytic theory repeatedly insisted on the need for female self-denial. The path to healthy adult femininity, according to the experts, was paved with sacrifice. In her authoritative two-volume study of women, psychoanalyst Helene Deutsch described all the things that a woman had to give up in order to be feminine. First she had to give up all adolescent ambitions and submit to the necessity of motherhood—the feminine “reality principle.” True motherliness, according to Deutsch, “is achieved only when all masculine wishes have been given up or sublimated into other goals. If ‘the old factor of lack of a penis has not yet forfeited its power,’ complete motherliness remains still to be achieved.”1

  A woman could renounce her “masculine” ambitions by transferring them to the child (if the child was a son). Deutsch quotes with approval these words of Freud’s: “the mother can transfer to the son the ambition that she was compelled to repress in herself. She expects him to gratify everything that has remained in her of her own masculinity complex.”2 But no sooner has the mother reconciled herself to her diminished ego expectations by projecting them onto her child than she must give up any hope that the child will actually fulfill her ambitions: “A mother must not strive to achieve any other goals through her child than those of its existence,” Deutsch warns. At last she makes the final renunciation: she gracefully gives up the child itself. “Woman’s two great tasks are to shape her unity with the child in a harmonious manner and later to dissolve it harmoniously.” Deutsch described all this as “the tragic destiny of motherhood” and proposed this solace: “Probably the path traced by nature is the most successful: having many children is the best protection against the tragic loss.”* 3

  It was hard to reconcile the self-denying “essence” of woman’s nature with the cultural atmosphere created by a consumption-centered economy. Here was a society that claimed to value individualism above all and exhorted everyone to devote themselves to the search for personal gratification. Yet one half the population seemed to be destined by their very anatomy, to a life of renunciation and self-denial. The obvious objective sorts of reasons—that most women were economically dependent on their husbands, that abortions and day care were virtually unavailable—had no place in the psychoanalytic world-view. The only logical way to reconcile woman’s commitment to suffering with the over-all cultural commitment to pleasure was to assert that, for women, suffering was pleasurable. The psychoanalytic construction of the female personality found mounting cultural acceptance from the thirties on, and by the forties and fifties—the height of the permissive era—the Freudian belief in female masochism stood almost undisputed.

  For women, even sex was to be an exercise in happy self-denial. Female sexual pleasure had become respectable enough, by this time, for therapists to prescribe it in cases of overprotection or other forms of maternal maladjustment. But a woman’s journey to mature female sexuality, like the way to “true motherliness,” was a mournful pilgrimage. First—as she outgrew her girlhood—a woman had to renounce the pleasures of the clitoris and attempt to transfer all sexual feeling to the vagina. In Freudian theory the clitoris was a tiny—and laughably inadequate—version of the penis. To cling to the clitoris was only to invite humiliation by comparison to the large and masterful male organ.† When a woman accomplished the task of abandoning the clitoris, she symbolically set aside all masculine strivings (penis envy) and accepted a life of passivity. The “rich reward” for all this was supposed to be the pleasure of heterosexual vaginal sex, which the penis-envying, clitoris-identified woman could never achieve. (Lundberg and Farnham said of the penis-envying bed partner, “The woman’s unconscious wish to herself to possess the organ upon which she must depend militates greatly against her ability to accept its vast power to satisfy her when proffered to her in love.”6 But in psychoanalytic theory vaginal sexuality actually provided a fresh experience of powerlessness and debasement; Helene Deutsch described it as an experience of “being masochistically subjugated by the penis.” Psychoanalyst Marie Bonaparte took the theory a step further, commenting that woman’s masochism, “combining with her passivity in coitus, impels her to welcome and to value some measure of brutality on the man’s part.” Bonaparte seems to chuckle reassuringly as she adds, “actually, normal vaginal coitus does not hurt a woman; quite the contrary.”7

  Needless to say, masochistic sex was intimately linked to masochistic maternity.

  The wish for maternity … is a factor so favorable to vaginalization [the transfer of sexual feelings to the vagina] that … highly domestic women are often best adapted to their erotic function … Psychical inacceptance of the maternal function and defective maternal instinct [are] … frequently related to the normal failure in women to establish the erotic function.8

  Carrying the theory of female masochism to an extreme, Helene Deutsch argued that the relationship between orgasm and labor was so great that the two experiences were really “one process,” and one might speak of orgasm as a “missed labor.”9

  The idea that women were masochistic seemed to solve everything. Woman’s lot, from a masculinist point of view, consisted of menial labor and sexual humiliation. But as a masochist, these were precisely the things that she liked and needed. (The explanation of “masochism” is so convenient and totalistic that we can only wonder why the psychomedical experts didn’t think to extend it to other groups, like the poor and racial minorities.) But at the same time, the idea of female masochism signaled the mounting bankruptcy of sexual romanticist theory. Once, women had been lured into domesticity with promises of intellectual challenge, activity, and power over the household and children. No one had argued, in the early-twentieth-century mothers’ movement or domestic science movement, that women had to resign themselves to motherhood, that they had to give up anything. Energy, intelligence, and ambition were precisely the character traits the scientific mother needed to run her household and raise her children. To say now, at mid-century, that it was not energy, but passivity, that held a woman to her home, not ambition, but resignation, not enjoyment, but pain—was to say that from a masculinist point of view the female role was unthinkable, and that those who fit into it were in some sense insane. The theory of female masochism stood as an admission from the psychomedical experts that the feminine ideal they had helped construct was not only difficult to achieve, but probably impossible.

  If the task of becoming a woman was so arduous, it followed that “real women”—mature, vaginal women—were the exceptions. The psychomedical experts, themselves in the grip of the mid-century crisis of masculinity, became convinced that America was suffering from an epidemic of unwomanliness. With the zeal of medieval witch hunters searching out the marks of demonic possession, doctors and therapists organized to flush out the millions of women who must be “rejecting their femininity” in one way or another.

  Psychotherapists found “rejection of femininity” in every frustrated or unhappy patient. Under any circumstances woman must “travel a twisted road in order to reach her ‘true nature’ ” wrote Dr. Hendrik Ruitenbeek in the introduction to his anthology, Psychoanalysis and Female Sexuality, but under modern social conditions the “female movement to passivity has been made more difficult.” There were too many women, he explained, who “want to do or to get something for themselves rather than merely to reflect the achievement of their husbands.” These “clitoridal women,” even when they avoid professional training, marry early, and have large families, show their resistance to their lot in their inability to have vaginal orgasms:

  In a world where male activity sets the standards of worth—and analysts point out that both physiologically and psychologically, male sexual performance is an achievement—female experience in sex as in other aspects of life takes on the character of a peculiarly ambiguous struggle against male domination.10

  It was clear then, that all the women who complained of sexual frigidity were really “in a state of rebellion
against the passivity which nature and society impose upon them.” But even the apparently feminine woman might be cleverly “overcompensating” for her inner masculine strivings. Analyst Joan Riviere alerted her fellow therapists to “the female who dons womanliness as a mask to conceal her anxiety and to ward off the retribution she fears from the men whose prerogative she wishes to usurp.”11 Ruitenbeek concluded that the possibility that modern women could ever achieve “normal” vaginal sexuality was so remote that most women should reconcile themselves to being satisfied with simpler pleasures, such as “awareness that she is desirable, ability to excite a man sexually, child-bearing, and the aim-deflected sexual pleasures of affection and tenderness.”12

  Gynecology as Psychotherapy

  In the nineteen fifties, gynecologists joined the psychiatrists in the search for “rejection of feminity” and, sure enough, began to find it in every patient. The gynecologists’ claim to the female psyche as a terrain for intervention and investigation had been challenged early in the century by Freud himself. Then, in the twenties, the discovery of hormones had given the doctors a new license to extend their practice into female psychology. To the gynecologists, hormones provided the long-suspected material link between the brain and the uterus: female reproductive functions are in part regulated by the pituitary gland, which is in turn subject to the activity of the hypothalamus in the brain (the apparent locus of many basic emotions and drives). The link between the hypothalamus and the uterus paved the way for a new interdisciplinary approach to women. Obviously the psychiatrist, whose professional turf included the hypothalamus, had a great deal to say about the lower regions claimed by the gynecologists. Conversely, the gynecologist, through his access to the uterus, was in a position to detect malfunctions in the psychiatrist’s traditional realm.

  The doctors accepted their new areas of responsibility with enthusiasm, almost abandoning the female reproductive organs in their haste to pass judgments on the female psyche. An article in the professional journal Obstetrics and Gynecology stated:

  As evidence has accumulated linking pelvic function and psychological factors, the obstetrician-gynecologist has tended to undertake a broader role in the management of the total patient … He has also found it appropriate to relate the presenting pelvic symptoms to underlying emotional stress rather than to organic disease.13

  Thus millions of women who would never have sought help from a psychotherapist and perhaps were unaware of any emotional stress, were, without knowing it, being analyzed by their gynecologists. The pelvic examination itself could be a valuable aid in diagnosis of the patient’s mental problems. In the doctor’s imagination, the pelvic exam simulated heterosexual intercourse. Thus the examination could be used to evaluate a woman’s sexual adjustment. All the doctor had to do was to redirect his attention from the patient’s cervix, uterus, etc., to her reactions to the exam:

  The overly seductive patient may have underlying hysterical symptoms, and vaginismus and extreme anxiety during the pelvic examination may be linked with frigidity—and occasionally with failure to consummate a marriage.14

  Psychoanalysts like Therese Benedek (whom we quoted in the last chapter on the subject of maternal regression) encouraged gynecologists to join the hunt for “rejection of femininity”:

  … women incorporating the value-system of a modern society may develop personalities with rigid ego-defenses against their biological needs. The conflicts which arise from this can be observed clinically not only in the office of the psychiatrist, but also in the office of the gynecologist and even of the endocrinologist.15

  Echoing Benedek, gynecologists Sturgis and Menzer-Benaron wrote in the introduction to their 1962 monograph, The Gynecological Patient: A Psycho-Endocrine Study:

  We feel this discipline [gynecology] should embrace those disturbances in function or structure of any part of the female organism that influence or are affected by the performance of the reproductive system. We are impressed in particular with the dictum that much of the physical and mental ill health of the individual woman can be properly understood only in the light of her conscious or unconscious acceptance of her feminine role.16

  Once this “dictum” (note: not “fact,” “hypothesis,” or “theory,” but “dictum”) was accepted, there seemed to be few, if any, gynecological complaints which were not actually symptoms of the rejection of femininity. Among the conditions that gynecologists in the fifties and sixties began to view as psychogenic, or caused in one way or another by “incomplete feminization,” were: dysmenorrhea, excessive pain in labor, menstrual irregularity, pelvic pain, infertility, a tendency to miscarry or to deliver prematurely, excessive nausea in pregnancy, toxemia of pregnancy, and complications of labor.17 Women everywhere seemed to be “battling their femininity,” and the gynecologist must have felt at times overwhelmed by the stream of casualties that poured into his office. In the beginning of a section on gender, a 1959 child-raising advice book offers this sketch of the gynecologists’ task:

  At the end of a hard working day, a woman gynecologist sat in her office smoking a cigarette and reflecting on the many patients she has seen during office hours. Some had mysterious functional disorders for which she could find no physical cause. Others had come just for a pre- or post-childbirth check-up and had asserted with smiling emphasis that they felt fine.

  As the doctor reviewed the two types of patients in her mind, an idea dawned on her with the shock of a great realization. The women with the “mysterious” functional disorders had one thing in common: they regretted being women. They thought men had the best of it. It was their discontent with their gender that had caused these functional disorders. The other women, the happy, healthy ones, were glad to be women, diaper-dirty babies and tobacco-smelling husbands and all. Unfortunately, hardly half of modern womankind can be said to belong to this truly feminine category.‡ 18

  Pregnancy offered the doctors a chance for long-term surveillance of women during a critical period of their feminine development. During pregnancy, psychoanalysts gravely observed, a woman is confronted with undeniable “proof” that she is a woman. In their view, her reaction might understandably be revulsion and horror. A chapter by Dr. Stuart Asch in a 1965 textbook of obstetrics tells us that pregnancy

  … will shake the most mentally healthy person. Thus one finds that some manifestation of anxiety is always present during pregnancy. In the most serious reactions this can take the form of any possible psychiatric picture, including phobias, depressions, and psychoses.

  It was only logical for pregnant women to resent their condition, this author continues, since pregnancy “gives us [sic] pain” and “makes us ugly.”19

  Thus all pregnant women must be regarded as temporarily neurotic and in need of the gynecologist’s covert psychotherapy. Particularly “dangerous,” according to a chapter by Marcel Heiman in the same text, were

  … those patients who consider themselves more “socially aware.” They are not necessarily more mature but are trying, by their active interest in everything “avant garde,” socially as well as medically, to persuade themselves and others that they are … This is the patient who is interested in such methods as “natural childbirth,” hypnosis, or using childbirth as an “experience.”20

  In fact, the “socially aware,” assertive patient who was interested in participating in her own childbirth experience was probably more infantile and neurotic than the average patient. Heiman warned that “the childlike suggestibility of the pregnant woman has been wittingly and unwittingly used and/or exploited by some of the proponents of ‘natural childbirth’ methods,”21 implying that the pronatural childbirth patient was really a dupe. Dr. Asch offers this “note of caution” with reference to “the occasional woman who is fanatic in her zeal for ‘natural childbirth’ ”:

  The intensity of her demands and her uncompromising attitude on the subject are danger signals, frequently indicating severe psychopathology … A patient of this sort is not a ca
ndidate for natural childbirth and requires close and constant psychiatric support.22

  For all women, prenatal care was to be regarded as an opportunity for psychiatric care, in which the patient could gradually be brought to accept her femininity. A 1969 case study reported in the professional nursing journal Nursing Forum showed what success could be achieved by blending subtle counseling with the physical side of prenatal care. “Judy,” a twenty-year-old prenatal patient and object of intensive counseling by the nurse-author of this article, was one of those unfortunate failures of family sex-role socialization. Her father could hardly be faulted. He had been so conscientious about his instrumental role as sex-role imparter, that, when Judy won an athletic prize in sixth grade, he was “horrified” and presented her with a pair of ruffled panties with a note urging her to work harder at being a girl. Despite all this, Judy’s nurse-therapist noted, “she appeared unable to assume the culturally accepted passive, yet creative, role of housewife and homemaker.”23 She wore “blue jeans with her husband’s sweaters,” and dominated her husband, who, the nurse observed, “spoke in a high-pitched voice.” (Another failure of sex-role socialization?) But, with prolonged help from the nurse-therapist, who evidently considers herself a role-model of successful femininity, Judy comes to accept her own maternal destiny and develops a more appropriate, submissive attitude toward her husband.

  Once gynecologists had accepted responsibility for the mental health of their patients, it was only a short step to begin to take responsibility for the social well-being of the entire nation. Since gynecological problems were really psychological problems and psychological problems inevitably manifested themselves as social problems, the gynecologist was not really treating vaginitis or menstrual discomfort or whatever—he was really treating the “family life of our country.” In the conclusion to their monograph on The Gynecological Patient, Sturgis and Menzer-Benaron cited as an “index of the gynecological health of our country’s women” the “tally of sexual unhappiness, broken homes, illegitimacy, septic abortions and sterility,” later adding sexual deviancy and delinquency. After making a quick and alarming estimate of the numbers of divorces, abortions, illegitimate births, etc., plus the “10 million married couples in our country battling with the frustrations of infertility” the authors blame the whole mess on the “state of ill health in the reproductive functioning of the women of our nation.”24