The Psychodynamics Of Gender And Gender Role (Book Review)

Author:  Bornstein, Robert F. and Joseph M. Masling
Publisher: Washington, DC: American Psychological Association, 2002
Reviewed By: Aaron L. Pincus, Fall 2002, pp.46-51

The Psychodynamics of Gender and Gender Role is the tenth volume of the “Empirical Studies of Psychoanalytic Theories” series published by the American Psychological Association. The considerable difficulties psychoanalysis has had in conceptualizing female development and dynamics has been documented from both within and outside of the field. Given our checkered history, some may be dubious of the payoff to be found in the efforts reviewed in this volume. However, the editors side strongly in support of empirical research (in combination with clinical observation) as a necessary element in revising and strengthening psychoanalysis, and perhaps even saving us from extinction (Bornstein, 2001). They argue fervently and persuasively in this regard. In response to critics suggesting empirical methods are misplaced in the study of psychoanalytic theory, they implore us to think broadly about the scope of our field, asserting, “The great power of psychoanalytic thought is its potential to clarify universal problems of human existence, not its ability to explain the single case. To confine psychoanalysis to hermeneutics is anachronistic and resembles a Luddite devotion to paper and pencil in the hopes of recapturing a computerless world” (Bornstein & Masling, 2002b, p. xxiii). Certainly the understanding of gender and gender role qualifies as a universal problem of human existence!

The editors and their colleagues have even examined the role of gender in conducting psychoanalytically informed empirical research. In summarizing their recent meta-analysis (Masling, Bornstein, Fishman, & Davila, 2002), Bornstein and Masling (2002b) note that, “contemporary research based on psychoanalytic theories is primarily a male activity conducted on male participants, with male participants producing more positive results than female participants” (p. xviii). Combining these meta-analytic results with our history of theoretical misfires in the area of gender leads me to agree with Bornstien and Masling in welcoming the chapters in this volume as genuinely needed in advancing psychoanalytic understanding.

I’ll begin with the obvious here. Five of the seven chapters’ sole or first authors are female investigators; and with the exception of Fowler, Brunnschweiler, and Brock’s chapter on bulimic women, all contributions review or report research findings on both male and female participants. All but one of the chapters discusses core psychoanalytic constructs, including primary process thinking, defense mechanisms, superego functioning, object-relations, and unconscious cognition. Three of the chapters explicitly focus on issues of gender or gender differences, while the other four review basic research with an eye toward articulating gender differences in the trends of accumulated results. Chapters range from broad integrative reviews of research to specific reports of one or more empirical investigations. As might be expected, the research reviewed and reported utilize a broad and impressive array of methodologies that are psychoanalytically informed, including Rorschach coding, Thematic Apperception Test coding, tachistoscopic Subliminal Activation, and a variety of self-report methods (questionnaires, narratives). The variety of methods presented and referenced makes this volume of the series invaluable for psychoanalytically informed investigators in any area of interest.

Russ’s chapter provides an excellent synthesis of psychoanalytic and cognitive theories on the relationship between primary process thinking and creativity. She provides both classical background on the conceptualization of primary process in terms of energetic and economic psychodynamic principles and contemporary approaches that consider primary process in terms of affectively organized cognitive processing. Russ derives a contemporary view of primary process as a subtype of affect in cognition that consists of content around which the child had experienced early intense feeling states (e.g., oral, anal, aggressive). Both psychoanalytic and cognitive theories predict a relation between primary process thinking and creativity. Psychoanalytic theory suggests that greater access to primary process is concomitant with less restriction (i.e., defense) in general mentation, leading to fluidity of images, ideas, and cognitive associations. Cognitive theories converge in suggesting that affect-laden cognition should generate more and richer associations, activate broad and diverse associative and neural networks, and increase the individual’s ability to transform personal experiences, memories, and images into more universal symbols. Russ notes that neither of these interrelated theories would predict gender differences in the relation between primary process and creativity, yet research consistently finds the predicted relations much more frequently in males than in females.

This valuable review of empirical approaches to assessment of primary process emphasizes Rorschach methods such as Holt’s scoring system, especially the Adaptive Regression (AR) score, and Russ’s Affective Play Scale (APS), a coding system for scoring children’s free play. When these measures are related to creativity, operationalized in terms of divergent thinking and transformational thought, boys often show the expected relationship and girls do not (or show weaker trends). Is it the case that psychoanalytic theory is applicable to males but not females? Russ points out that boys exhibit significantly more primary process content in both Rorschach responses and free play, but this is mainly due to greater levels of aggressive content. She hypothesizes that in western culture boys are freer than girls to express primary process thinking in play and thus learn to use it more adaptively. Developmental studies reviewed suggest girls express less primary process as they mature, reflecting the influence of external controls. Beyond such socialization issues, Russ reminds us that physiological differences in hormonal and brain functioning as well as possible evolutionary trends are potential explanations as well (e.g., reduced primary process thinking may provide an evolutionary advantage in cooperative interpersonal functioning for females). While no explicit discussion of treatment implications is offered, psychodynamic practitioners may benefit from an understanding of the cognitive-affective bases of primary process thinking and facilitate access and adaptive use in treatment with the goal of increasing creativity and insight. Psychodynamic researchers will benefit from the review of Rorschach and APS methods to further investigate primary process in any relevant context of inquiry.

Cramer’s chapter is another excellent example of a psychoanalytically informed research program investigating a central psychoanalytic construct--defense mechanisms. Informed by both classical and contemporary psychoanalytic views of defense ranging from Spitz, A. Freud, Erikson, and Valliant, Cramer summarizes nearly 20 years of research investigating the use of defense by children and adults utilizing her TAT-based coding scheme, the Defense Mechanism Manual (DMM). Anyone interested in empirical investigation of defenses will be impressed with the reliability and validity she has established for the DMM assessment of denial, projection, and identification. In doing so, Cramer also examines a number of theoretical propositions derived from psychoanalytic theories of defense employing both cross-sectional and longitudinal designs. Based on her research program, convincing evidence is presented that these defenses can be reliably coded in TAT responses of children and adults. In addition, the use of these defenses changes with maturation in accordance with a psychoanalytic model of defense chronology (i.e., denial is prominent in young children but decreases rapidly, projection is most common in middle childhood and early adolescence, and identification increases in prominence by late adolescence). Cramer presents evidence that indicates increasing understanding and awareness of a defense mechanism is associated with its decreased employment, supporting the psychodynamic assertion that defenses operate unconsciously. She also clearly shows empirical support for three additional tenets of defense theories: a) negative affect arousal or threats to self increase defensive functioning, b) use of defenses protects individuals from psychological upset, and c) prominent use of immature defenses by adults is associated with psychopathology.

Cramer notes that neither classical nor contemporary defense theories posit central assumptions regarding gender differences. However, informed by the works of S. Freud, Deutsch, and Erikson, she derives two basic dynamic hypotheses. First, defenses that are directed outward and externalize conflict and affect (e.g., projection, turning against the object) should characterize males more than females. Second, defenses that modify internal reality (e.g., denial, turning against the self) should characterize females more than males. Cramer reviews a broad range of studies utilizing the DMM and other methods supporting her psychoanalytically informed predictions, particularly in regard to the use of denial and projection. Her final discussion of gender differences in the implications of using the same defense is less clearly written and digestible, if only because the DMM results appear much more complex than those presented earlier in the chapter. Consistent with basic distinctions in internalizing vs. externalizing clinical problems, it appears that females who use characteristically feminine defenses are more prone to psychological difficulties such as depression, whereas males who use characteristically masculine defenses tend to exhibit suspiciousness and paranoid trends. In contrast, females who use more masculine defenses tend to exhibit healthy adjustment. When adults of either gender rely predominantly on denial, they tend to exhibit immature, anxious, egotistical, and unstable personalities. Where does this leave us? This exemplary empirical research program clearly supports many tenets of psychodynamic theories of defense. Significant advances are made in theorizing about gender differences as well. Although complex at times, the empirical results tell us that further exploration of gender and defense is an especially fruitful domain for advancing psychoanalytic theory.

Brody, Muderrisoglu, and Nakash-Eisikovitz provide a second chapter on defense mechanisms, and their relations with gender and affect. This chapter is a theoretical tour de’ force! The authors synthesize psychoanalytic theories of defense (e.g., Kernberg, Valliant, Waelder) with contemporary analytic views of gender (e.g., Chodorow, Benjamin, Pollack, and Bergman among others), and then further contextualize their synthesis in terms of the interpersonal meta-concepts of agency and communion (Bakan, 1966; Helgeson & Fritz, 1999). Compared to men, women’s sense of self is more strongly defined by relationships (i.e., communion). Compared to women, men’s sense of self is more strongly defined autonomy and achievement (i.e., agency). Because of this, the authors propose a number of hypotheses regarding gender differences in defenses, reasons for their deployment, and their relations to affect. Women’s negative affects should be more intense than men’s when threatened by loss of a relationship. Women thus employ more internalizing defenses in the service of relationship preservation. Men’s negative affects should be more intense than women’s when threatened by loss of autonomy. Men thus employ more externalizing defenses in the service of preserving the self as separate from others. That is, men and women differ in their use of defenses because some defenses facilitate agentic goals and others facilitate communal goals. These differences may give rise to gender differences in the relations between use of particular defenses and psychological adjustment. This is a sophisticated proposal. The authors go even further, distinguishing between defenses against emotional experience and defenses against emotional expression. All this serves as prelude to a study employing a variety of self-report measures of defense, affect, and adjustment. The number of hypotheses, direct effects, and mediational effects tested via regression methods are so voluminous that the key results are summarized in two tables. As is often the case, the results are not as clear and elegant and the theoretical efforts that give rise to them. However, most of the main propositions outlined above were supported. The authors end with clinical recommendations, including reminding practitioners not to assume that certain defenses are adaptive and others maladaptive regardless of gender. This chapter complements the chapter by Cramer, and together they demonstrate a wide variety of empirical methods for investigating defenses. And, consistent with the editors’ admonitions, the chapters clearly advance psychoanalytic theorizing on gender.

In contrast to some of the more complex theorizing on defenses found in the volume, the chapter by Tangney and Dearing demonstrates how the evaluation of a single psychoanalytic hypothesis across methods and contexts can be an equally powerful approach to advancing psychoanalytic theory. The authors set out to review empirical literature pertinent to Freud’s proposition that due to differences in the developmental tasks of the Oedipal period, men and women differ in superego strength. The authors propose that inferences regarding superego functioning can be made from evaluations of gender differences in moral emotions, moral reasoning, and moral behavior. Moral emotions such as shame and guilt are developmentally more mature emotions than those basic affects experienced from birth. Shame and guilt require the cognitive abilities to differentiate self from other and the establishment of standards for the self and behavior. Thus, they are likely to be influenced by gender differences in socialization. If Freud’s hypothesis is correct, men should exhibit a greater propensity for shame and guilt than women. Reviewing studies of children, adolescents and adults using Tangney’s Test of Self-Conscious Affect (TOSCA), the results are consistently in opposition to Freud’s hypothesis. In all samples, women report greater shameful and guilty reactions to the scenarios presented in the TOSCA. In addition, the authors report that across the lifespan, shame-proneness is related to maladjustment (e.g., low capacity for empathy, destructive strategies for managing anger and interpersonal conflict). In contrast guilt-proneness is associated with better adjustment (e.g., higher capacity for empathy, constructive anger management strategies). The authors poignantly state, “Compared to males, females of all ages report a greater propensity to shame and guilt. In this regard, girls and women are the beneficiaries of the best and the worst of superego emotions” (p. 258). In terms of moral behavior, research is reviewed suggesting that woman consistently show higher levels of empathy and more constructive responses to angry feelings. In addition, the authors point out that males are significantly more likely than females to commit crimes, be aggressive, and be diagnosed with conduct disorder and antisocial personality disorder. In terms of moral reasoning, the authors note that previous reviews of methods such as Kohlberg’s classic Moral Judgment Interview show no gender differences in moral reasoning level and that gender differences in moral reasoning tend to reflect Gilligan’s (1982) assertion that men tend to be guided by an ethic of justice whereas women tend to be guided by an ethic of care. Thus, in all areas of research reviewed, the authors assert that the empirical evidence refutes Freud’s hypotheses regarding gender differences in superego strength. This chapter may provide the most definitive answer to any of the theoretical propositions evaluated in the book. In addition, the authors are quick to point out that most of the gender differences are small in magnitude and remind us that males showed good capacity for experiencing moral emotions, exhibiting moral behaviors, and demonstrating moral reasoning. They conclude that, “The gender differences refute Freud’s notion of a weak feminine superego, but they do not argue for the notion of “man as beast” either” (p. 261). While the chapter may provide the most definitive of answers, the review of research emphasizes results and does not provide many methodological details beyond the description of TOSCA. Thus investigators may have to turn to the primary literature to learn more about the methods for use in future investigations.

Fowler, Brunnschweiler, and Brock’s chapter is unique among this collection in its clinical emphasis and its exclusive focus on females. The latter a result, in part, of the remarkable fact that between 1993 and 2000, only 4 male inpatients at the Austen-Riggs Center were diagnosed with an eating disorder (all anorexia). The authors synthesis of family systems and psychoanalytic theories is the context for a detailed investigation comparing 56 bulimic females and 64 female patients without an eating disorder diagnosis, all of whom were involved in long-term inpatient treatment at the center. Following a brief description and history of eating disorder diagnosis, the authors review both psychoanalytic and basic research on disordered eating to derive a model of intrapsychic disturbance in bulimic women to guide further investigation. They propose that the bulk of theory and data converge in suggesting that bulimic women exhibit strong dependency-autonomy conflicts and blurred object-relational boundaries of self and other. Conflicts and structural problems give rise to ego deficits in affect recognition and regulation that are expressed via physical sensations and actions. The authors make a strong theoretical contribution in their consideration of the interaction between socialization of young girls and the unique tasks of adolescent separation-individuation for women. Female teens must concurrently differentiate themselves psychically from their mothers, while adjusting to post-pubertal physical changes that make their bodies more similar to their mothers. This developmental challenge, combined with inhibition of both hostility and independence in family socialization of females may interact to give rise to disordered eating in women, where the body becomes the medium through which conflicts and affective expression are communicated.

The study itself uses logistic regression to predict diagnostic status from a) demographics, b) Rorschach indices of oral dependency, autonomy, conflicted hostile-dependence, primary and secondary process aggression, and primitive defenses, and c) variables based on observations of ward behavior (e.g., conflicts with nurses, isolating, socializing). Results are generally consistent with the proposed model (note there is an error in Table 4.3). Compared to the control patients, bulimic patients were younger, had longer hospitalizations, and a greater number of co-morbid diagnoses. Of theoretical relevance, the Rorschach data suggested bulimic patients had higher secondary process (conscious) aggression scores, lower oral dependency scores, and higher hostile dependence (conflict) scores than control patients. In addition, when compared to control patients, bulimic patients exhibited greater conflict with nursing staff, were less likely to isolate themselves in their rooms, yet they were also less likely to socialize informally with other patients. The authors conclude that the intrapsychic and behavioral data support their model suggesting that bulimia in females is associated with dependency-autonomy conflicts and difficulties regulating hostility. In addition to providing an exemplary picture of psychoanalytically informed research, the chapter provides investigators with references to a number of well known Rorschach scales by Lerner, Holt, Urist, and Masling, as well as introducing Fowler’s promising Hostile-Dependency Scale. The study also demonstrates the utility of combining psychodynamic data with behavioral data to strengthen the empirical support of theory. Although the authors do provide a limited number of clinical descriptions to exemplify their discussion, it would be interesting and useful for these psychoanalytic scientist-practitioners to articulate how their results might inform the treatment process.

Sohlberg and Jansson’s chapter focuses on experimental investigations of psychoanalytic constructs using the tachistoscopic Subliminal Psychoanalytic Activation (SPA) paradigm that presents participants with brief visual stimuli that are not consciously detected yet have (unconscious) effects on subsequent experimental tasks. The classic stimulus used most often in the literature and again by these investigators is the phrase “Mommy and I are one” (MIO). The strength of this chapter is in the authors’ ability to contextualize experimental methods and results within psychoanalytic thinking on defense, internal object relations, and symbiotic functioning. This can stimulate future efforts to apply cognitive experimental methods to investigations of psychoanalytic constructs and principles. The authors assert that the MIO stimulus likely activates an “associative relational network” that, consistent with object relations conceptions, influences self-concept, expectancies, motivation, emotion, and procedural memory for interpersonal relations. In particular, they suggest this involves symbiotic themes and possible defenses against them. While the authors write with an impressive level of familiarity and detail in terms of the SPA of MIO paradigm and their own experimental work, less familiar readers may be left in the dark. The authors present a series of extremely detailed experimental results from a series of studies. Although the majority of results are not significant in terms of sampling statistics, the authors make use of effect-size magnitudes to highlight their implications. I admit to some personal bias here, but I found the presentations tedious and difficult to reconcile with psychodynamic phenomenology at times. In addition, after reading through the experimental data, we are left with only one consistent finding: gender doesn’t matter much in SPA of MIO studies. Effect sizes appear to suggest that effects for females do tend to be smaller in magnitude (repeating the general pattern noted in Masling, et al, 2002), and the authors conclude that females are less predictable utilizing this paradigm. Explanations provided for this result range from untested moderators to developmental hypotheses regarding the complexity of female adolescent identity development. The authors make an interesting point relating their general finding to the activation of internal object relations and transference in female vs. male patients. If response to activation of MIO is more complex and less predictable in females, then this could have relevant implications for therapeutic situations where the therapist or the therapeutic relationship activates patients’ unconscious associative “mother-with-self” network. The chapter certainly demonstrates the promise of integrating experimental cognitive techniques with psychoanalytically informed thinking (e.g., Bornstein & Pittman, 1992), and the SPA of MIO in particular (e.g., Weinberger & Silverman, 1990). However, despite extraordinary effort on the part of the authors, the results provide only a starting point for further efforts to understand gender and gender role using such methods.

The lead chapter by Cain seems somewhat out of place. She presents a well-written review of social-cognitive theory and research related to individual differences in children’s helplessness, articulates the major emphases of a social cognitive model of children’s helplessness related to task achievement motivation, reviews extensive empirical literature on the topic, and presents a compelling social cognitive developmental model of helplessness. However, the chapter is rather limited from a psychoanalytic perspective and doesn’t seem to fit well in a series devoted to evaluation of psychodynamic theories. Less than 20% of the chapter discusses psychodynamic concepts or theory, no psychodynamically informed research is reviewed, and no psychodynamic conceptualization of helplessness is derived. The two short sections on psychodynamics are elementary and almost completely separate from the main thrust of the chapter. This is not the type of synthesis of social cognition and psychoanalytic theory urged a decade ago by Westen (1992). What may be of greatest benefit for psychodynamically informed investigators is the plethora of research methods reviewed that are applicable to studies of child behavior and parent-child interaction. Novel experimental manipulations and investigative paradigms are highlighted that move well beyond basic observational techniques. Such approaches could be incorporated into empirical investigations that more directly address psychodynamic concepts and processes.

Clearly the volume as a whole confirms the editors’ perspectives on the value of empirical research for the evaluation of psychoanalytic theory. In many of the domains covered, psychoanalytic theory posits either no gender differences or potentially incorrect hypotheses. This volume advances theory by providing empirically tested extensions and elaborations as well as pointing to where we might be wrong in our assumptions. In addition, the variety of methodologies provides an invaluable resource and inspiration to continue such efforts. Although clearly not the goal of the book, gender and gender role clearly have implications for therapeutic practice (e.g., Lax, 1995) and it would useful to expand these discussions in that direction. I also noted there is no mention of gay and lesbian experiences in the chapters, although issues of gender and gender role are certainly important in understanding the experiences of homosexual individuals (e.g., Blum, Danson, & Schneider, 1997). Despite these minor quibbles, it is clear the entire series is a highly relevant resource for the field of psychoanalysis, and this most recent volume is another strong contribution.

References

Bakan, D. The duality of human existence. Chicago: University of Chicago Press.
Blum, A., Danson, M., & Schneider, S. (1997). Problems of sexual expression in adult gay men: A psychoanalytic reconsideration. Psychoanalytic Psychology, 14, 1-11.
Bornstein, R. F. (2001). The impending death of psychoanalysis. Psychoanalytic Psychology, 18, 3-20.
Bornstein, R. F., & Pittman, T. S. (1992). Perception without awareness. New York: Guilford.
Freud, S. (1923). The ego and the id. Standard Edition,. 19, 12-59.
Gilligan, C. (1982). In a different voice: Psychological theory and women’s development. Cambridge, MA: Harvard University Press.
Helgeson, V. S., & Fritz, H. L. (1999). Unmitigated agency and unmitigated communion: Distinctions from agency and communion. Journal of Research in Personality, 33, 131-158.
Lax, R. F. (1995). Freud’s views and the changing perspective on femaleness and femininity: What my female analysands taught me. Psychoanalytic Psychology, 12, 393-406.
Masling, J., Bornstein, R. F., Fishman, I., & Davila, J. (2002). Can Freud explain women as well as men? A meta-analytic review of gender differences in psychoanalytic research. Psychoanalytic Psychology, 19, 328-247.
Weinberger, J., & Silverman, L. H. (1990). Testability and empirical verification of psychoanalytic dynamic propositions through subliminal psychodynamic activation. Psychoanalytic Psychology, 7 (Suppl.), 299-339.
Westen, D. (1992). Social cognition and social affect in psychoanalysis and cognitive psychology: From regression analysis to analysis of regression. In J. Barron, M. Eagle, & D. Wolitzky (Eds.), Interface of psychoanalysis and psychology (pp. 375-388). Washington, DC: American Psychological Association. 

Reviewer Note

Aaron Pincusis an associate professor of psychology at the Pennsylvania State University, University Park Campus. He regularly teaches graduate seminars in personality theory and personality assessment, and supervises a clinical training practicum emphasizing contemporary psychodynamic psychotherapy for personality disorders.

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