Psychoanalytic Reflections on a Gender-Free Case: Into the Void (Book Review)

Author:  Toronto, Ellen L.K., Ainslie, Gemma, Donovan, Molly, Kelly, Maurine, Keiffer Christine, and McWilliams, Nancy
Publisher: Brunner-Routledge, 2005
Reviewed By: Helen K. Gediman, PhD, ABPP, Vol. 26 (3), 58-62

I will begin my review of this most illuminating output of Section III with a caveat: The title is misleading because the book does not begin, as it claims, with a gender free case. It begins with a psychoanalytic case presentation of “T” by its chief editor, Ellen Toronto, in which the patient’s gender is not designated in the write-up. The patient is in fact gendered, but we are never told in what way, and are left to fill in the purposefully ambiguous void with our imaginations, projections, and theoretical and personal biases. When I read the commentaries on the five parts of the book and its seventeen chapters by my fellow Section III psychoanalytic colleagues, I fully expected to find, as the title promises, surmises and hypotheses generated by the “void” of gender markers as conceptualized today by many modern Freudian, relational, postmodern, feminist and other psychoanalytic scholars. I found, instead, a congery of papers written between 1987 and the present, some, as promised, in response to the case write-up, most not. The book might be more aptly characterized by some other title, such as one suggested by Jill Salberg (personal communication, 2005) “Reflections in the Key of Gender.” Some, but not all of the contributors stress the false binary and stereotypic aspects of traditional and contemporary gender constructs, emphasizing, instead the ambiguities and uncertainties that constitute the gender “void” that the title of the book purports to capture. However, the book achieves its mission of identifying the pitfalls of gender caricatures, the main one being that many sex and gender categories have historically been presented not only as polar opposites but as hierarchical and patriarchal.

Mainly, Toronto’s patient, T, suffered from penetration anxieties, a lack of agency, an inability to express feelings, and an array of other problems that could be read as either stereotypically male, stereotypically female, or neither. Toronto alleges that her patient presents a striking picture of gender ambiguity, yet also, much to her credit, concedes that’s gender is more fluid and negotiable than we ever imagined, despite the fact that incessant biological feedback shapes us in nonverbal ways as irretrievably as does cultural interaction, and concludes, rightly, that we cannot separate the mind from the body. Toronto thus allows room for a primary feminine experience of women’s conscious awareness of reproductive and relational capacities as well as primary cathexes of female genital organs, an “essentialism” that is not categorically hierarchical in tilting toward patriarchal feeling, a position that many of the contributors unfortunately disagree with.

Molly Donovan, in her commentary on Part II, “Suspending Certainty in the Consulting Room” takes delight in the “gender-bending” elements of the exercise of this book, supporting, as I do, the idea of “playing in space” without undue certainty about gender that forecloses on analytic exploration. Thus, Donovan gets to the important relationship between material or essential reality, and a psychic reality that is not simply an endless proliferation of limitless and fluid possibilities. Toronto breathes new life into some pre-relational views that some authors in this collection have cast into their own void in order to promote a new and sometime fallaciously one-sided relational, postmodern moralism, instead of what postmodern feminism actually is—a new turn, and not an extirpation and replacement of older historically valuable perspectives on sex and gender.

Toronto and her co-workers at times seem to have exhumed old ghosts that psychoanalytic theorists of sex and gender have tilted at over the generations in order to kill them off again. Besides this ghost exhuming, there is also an apparent booting out of much of the ancestral good in modern psychoanalytic theory. Postmodern deconstruction need not be nihilistic, but it sometimes reads that way when it assumes an exclusively pejorative emphasis on essentialism or material reality. The reader is referred to Chodorow’s (2005) recent work on the connection between the Freudian–Relational divide and its relation to the modern–postmodern divide, to clear up some of the confusion that this book understandably suffers from, as this conceptual clarification is still a monumental work-in-progress (see also Gediman, 2005).

The point of view adopted by most of the contributors is the relational, feminist postmodern turn in psychoanalysis, which embraces gender multiplicity, ambiguity and uncertainty while criticizing gender “essentialism.” Many, but not all contributors would replace or overthrow just about all of traditional as well as contemporary Freudian views of gender, and that erasure constitutes the gap, absence, lack, and void that was most noticeable and that cried out to me for correction, because I am very troubled with the current tendency to ignore and rewrite past history.

Other contributors, particularly Diane Elise in her chapter on female desire, also emphasize a primary femininity, but I am concerned that with all the advances achieved in this new look on primary femininity, we risk reviving a matriarchal version of the old “anatomy is destiny” concept, which I know Elise herself does not accept and is, in fact, fairly criticized throughout this book. According to Elise, absence of desire in women is like a “castration” of sexual desire. Elise is to be applauded for her forthright recognition of the girl’s primary erotic tie to her mother: “I suggest that a woman wants an erotic experience that does not lack in the qualities of desire that she initially experienced in the sensuous bodily contact with her mother” (p. 199). I totally agree with her belief that we have bisexuality to thank for female heterosexuality and for a fulfilled male heterosexuality. Without acknowledging mother–daughter erotics as normative, primary femaleness, she says, becomes stripped of agentic erotics and becomes a painful and stereotypic waiting game. In this primary feministic reverse view of anatomy is destiny, male fears of the sexually agentic woman replace the female waiting game for men to take the initiative in all-important matters with them. Nonetheless, I worry lest primary femininity, which is not a gender-free view, risks, when taken to its extreme, replacing a simple one-sided patriarchal view with the other side of the same coin exclusively matriarchal worldview. For Molly Donovan, as well, gender contains something essential and not merely constructed. In her chapter on Demeter and Persephone revisited, she asserts, “…mother and daughter are inextricably linked by their like biology and their conscious and unconscious psychology. Similarly, Ruth Lax, in her paper on “Boys’ Envy of Mother and the Consequences of this Narcissistic Mortification,” claims that womb envy in males implies certain normative and essential aspects of gender.

It is not surprising that Polly Young-Eisendrath’s chapter, “The Female Person and How We Talk about Her” was written as long ago as 1987. I find her ideas extremely sexist “in reverse” when it comes to characterizing men. She seems to be imprisoned, defiantly, in a patriarchcally biased epistemology in splendid isolation from the work in psychoanalytic feminism of the past two decades. As a Jungian, she does not match the clinically persuasive archetypal “maternal–paternal split” that McWilliams uses to stretch gender characterizations across sexes, but would opt to limit all epistemology as being patriarchal in its social origins. Therefore, Young-Eisendrath feels that “individual women and girls unavoidably strive to validate theories of personal inferiority in a patriarchal society.” (p. 183). Furthermore: “Ideals of personal responsibility and self-determination are directly in conflict with ideals for womanly behavior” (p. 184). Gwendolyn Gerber, too, in her chapter on gender stereotypes claims for them one positive function: Making stereotypes real such as: women are accommodating, men are self assertive; men are leaders, women followers, establishes a stable interaction free of conflict. There is also a matriarchal twist from penis envy to womb envy in Lax’s view of primary masculinity. There are some unfortunate overtones of sexism, sometimes in reverse, and the battle of the sexes—when we make too many or too hardened essentialized categories of what is normative.

An emphasis on present-day relational theory on occasion leads to gaps in accounting for historical antecedents. The most glaring absence of historicity occurs in two contributions, by Christine Kieffer and Lynne Layton, on women’s tendency to choose and identify with men who are selfobjects, and who project repudiated aspects of their idealized selves onto the idealized man. Kieffer‘s topic is a self-psychological appraisal of the female “Oedipal victor,” which contains classical overtones as well a focus on both the female ideal of becoming the paternal phallus, via identification with the idealized male object. Thus, a woman’s male “selfobject” can become the basis of a subservient relation of a woman to a man. Layton’s chapter, “Beyond Narcissism: Toward a Negotiation Model of Gender Identity” reviews traditions proposed by both relational and postmodern feminists that hold that woman’s gender identities are narcissistic structures. Layton states: “The strategy of femininity is to seek recompense in idealized love for the loss of agentic capacities” (p. 230), a precondition of narcissism. Kieffer and Layton both leave out any reference to the groundbreaking work, “Narcissistic Object Choice in Women,” written by Annie Reich and which appeared in the very first issue of JAPA in 1953. Reich broke then with traditional psychoanalytic classical patriarchal trends by suggesting that a woman’s pathological attempt for self-esteem regulation often was a narcissistically driven quest to connect with a man as a substitute for connecting with the agentic power within herself.

A couple of chapters focus on child abuse, one by Judith Alpert and the other by Joan Sarnat. While not written explicitly for this book, they pertain in that they deal with what reasonably could resemble or at the very least stand as an analogue for a gender void: the uncertainty as to how psychic reality corresponds with material reality. Representations that are filled in, by both patient and analyst, that are not veridically or isomorphically representative of what actually occurred in cases of early childhood experiences of abuse, echoes the theme of allowing versions of gender to emerge that do not actually reflect any essential gender reality. Sarnat puts it well in her belief that trauma-oriented listening means receiving the trauma story the way a witness receives a historically factual narrative. Psychoanalytic listening entails receiving the trauma story in a way that preserves analytic space and the potential for finding multiple and sometimes unconscious meanings in the narrative without giving up belief in the patient’s idiosyncratic understanding of the facts, that is, the patient’s psychic reality.

To me, these chapters underscore that issues of psychic reality preceded historically, issues of hermeneutics, and historical and narrative truth, movements in psychoanalysis leading up to the postmodern turn. I would see the ambiguity in oscillating between the objective truth of real trauma and the psychic reality of that trauma’s symbolic meaning in the present transference-countertransference as one meaning of a void. Yet, we want to encourage the ambiguity “void” as unavoidable properties of psychic life and experience before jumping to conclusions about arbitrary gender categorization, paradox, and internal contradictions. Memory as accurate reflection of historical events, and memory elaborated over time both hold as true, and the therapist’s commitment or lack of commitment to either one or the other of these apparently contradictory positions is very valuable. Similarly, Barbara Gerson’s chapter on the analyst’s loss of a pregnancy touches on when and whether the analyst should disclose her experience, filling in or allowing the patient to live with a knowledge void, issues that are at the cutting edge of psychoanalysis today. However, the positions Sarnat and others advocate, and that I am also endorsing, are not uniquely relational or feminist. That claim is overdone frequently in this otherwise most valuable and challenging book.

A number of authors, mainly Nancy McWilliams, Molly Donovan, Polly Young-Eisendrath, Kimberlyn Leary, Ruth Lax, and Gemma Ainslie, as commentator, are more comfortable than others with the fact of gender differences between males and females, but approach these differences with variable underlying assumptions. Ainslie wonders how we talk about one another without some gender marking. McWilliams, in her commentary to Part III, Family Relationships and Shifting Perspectives, asserts that children abhor the void of no categories or universals. Children suffer over the fact of difference and over the biological implications of difference. She reminds us of Lax’s point that “boys will never nurse infants, no matter how much they want to, and girls, no matter how much they don’t want to bear or nurse infants, will have to deal with the risk of impregnation” (p. 114). Although gender is more fluid than once thought to be, it is not endlessly elastic. McWilliams discloses that she resisted the temptation to rewrite her original 1991 chapter, “Mothering and Fathering Processes in the Psychoanalytic Art” in less essential and binary terms. She cites empirical evidence for an archetypically conceived maternal–paternal polarity, the former consisting of devotion and soothing, the latter integrity and stimulation, yet also argues that analysts of both sexes can express either or both of these and that these gender-linked qualities are not totally gender or sex-bound. That is, mothers can be fatherly and fathers can be motherly. In a 2004 footnote she notes that the divide between drive–conflict theorists and leaders of the current relational movement can also be framed as a paternal–maternal split. She notes how the dialectic about therapeutic technique has contained maternal and paternal polarities. “If I am right that both attitudes are necessary for effective therapy, it becomes clearer why our efforts to evaluate which position is ultimately ‘correct’ have been doomed” (p. 160). Her voice is the loudest and most persuasive of all the contributors in questioning the blurring, or sometimes conflation of feminism, patriarchal binaries, relational psychoanalysis, feminism and postmodernism. For her, gender is real and not just a construction.

Throughout the book, distinctions are made between constructionism and essentialism in the meaning of gender. My overall impression is that most authors pay tribute to both strategies. Steven Knoblauch, the only male contributor to this book, in his sensitive paper on “The Music of Masculinity: Clinical Attention to Gender Construction in Tone and Rhythm” is not literally essentialist. However, Knoblauch respects real, material gender differences and how both patient and analyst influence gender constructions in the psychoanalytic situation. It became possible for Knoblauch and his patients to know the meanings at any moment of boy, girl, masculine, feminine—the patient’s non-linear experience of the waxing and waning of the variability and uncertainty of gendered experience. There may be a contrived void when it comes to gender certainty, as when Toronto’s report leaves out any mention of her patient’s gender. In contrast, Knoblauch and his patients had joint and reasonable certainty regarding shifts in their shared experience of the patient’s gender experience based on affective tone and the many voices that provided clues about gendered identifications as one degree or another of masculine and feminine self-exposure. He attends to shifting versions of gendered experience, including macho sadomasochism and ritual confusion of power and submission. Knoblauch has put the drive, oomph, and force back into gender. In his emphasis on affect and tone in the musicality of the voices of gender, I am reminded of the movie, Transgendered America, in which the protagonist, who has changed his sex from male to female, emphasizes finding exactly the right “speaking voice” that would not feel gender-dysphoric to her. This paper strongly underscores my belief that a gender void is not the same as gender shifts, flexibility and multiplicity, which sing out in the many voices of multicolored multitonal gender regardless of innate or transformed sexual assignment.

Part V, the last in the book, is devoted to postmodern revisions of gender. Kieffer, in her introductory commentary, summarizes well the postmodern position that gender as multiplicity, as co-constructed within a relationship, contrasts with a classical model of gender containing a binary male–female split that does not capture all its nuances and forms of expression. However, she concedes that gender is located within the tension of material and social-construction experience, a much-softened departure from some recent postmodern claims that the material or essential cannot be applied to our understanding of gender. Virginia Goldner, in her fine contribution, “Ironic Gender, Authentic Sex,” reminds us that the late John Money, as recently as 1950, was the first to propose that sex was formally conceived as separate from gender, and that the word, “gender” is not found in Freud’s Standard Edition. Nonetheless, as I see it, classical as well as relational analysts both have challenged the anatomy is destiny creation of gender meanings in favor of early genital awareness emerging from early childhood family experiences and psychic representations of the genital and genitally related interpersonal experience. Although Goldner says that gender is made and sexuality found, she also rightly states that we should neither essentialize gender, that is, take it literally or concretely, nor dematerialize it, that is, take it solely as metaphor. “Whether we privilege sexuality or object relations as our ultimate psychic starting point, psychoanalysis still remains in the thrall of its search for embodied origins” (p. 250). By recognizing that sexuality and gender are special forms of truth telling, Goldner questions any absolute void as useful to a psychoanalytic understanding of gender today. She accurately summarizes the current state of our knowledge of gender when she says we have gone from duality to multiplicity, even though the binary may be culturally ubiquitous.

Kimberlyn Leary picks up the subtleties and complexities of Goldner’s contribution to Part V without missing a beat in her most original chapter on “Race in Psychoanalytic Space.” She reminds us that not just gender, but race and ethnicity have focused on hierarchically ordered binaries. “Difference exists as both a material fact in the world and as a rhetorical device” (p. 287). Although she represents many relational postmoderns, she speaks in a Freudian postmodern key as well. Leary holds that the “postmodern invitation to include multiple perspectives in its ‘bedrock suspicion’ of any theorizing involving universalistic or essentialist conclusions about human subjectivity has permitted more complicated understandings of gender experience than traditional psychoanalytic experiences have allowed” (p. 287). Yet she does not overlook the fact that there are non-bedrock commonalities as well as multiplicities. Postmodern gender theorists have come a distance in countering the tendency to tell narratives of African American subjectivity in ways that are not elastic and cannot be told differently. Some postmodernists, she says, disavow race as an essentialist construct while at the same time maintaining “that race speaks to something real beyond abstraction… Although potentially open to a variety of narrative possibilities, race also has a factual status not amenable to revision” (p. 289). Those of us who are women limited by being whatever color we are can most assuredly learn from Leary that “The radical openness so central to postmodern gender theory gives way to a view that with respect to race we cannot afford to let the certainty of some things slip” (pp. 289-290). Although race exists in transitional space, like gender experience, it cannot either be reified or wholly indeterminate. “Race effectively functions as a fact even as it needs to be permitted to vary in each clinical dyad as a narrative possibility with meanings unique to the pair” (p. 290). Her au courant opposition to a total racial void fits to a tee my own earlier comments that there is no genuine gender void and nothing that is completely gender-free, despite the book’s misleading title.

I could not agree more with Muriel Dimen in her afterword: “Gender, deconstructed, is not done away with. You can strip it from a printed case, but it is still there in the mind of the analyst who writes up the case, the reader who reads it, the commentator who discusses it” (p. 303). “This book reminds us that we are in the squirmy spot of being modern and postmodern at once” (p. 298). Dimen asks how the contradiction between stability and flux can be resolved and concludes that in reacting to modernism’s commitment to absolute truth, postmodernism privileges difference, heterogeneity, and distrust of universalizing totalizing discourses. The clinician’s problem, she says, is how to negotiate between difference and hierarchy. You want to eliminate inequities that promote female subordination, but also recognize the differences that matter in the lives of men and women. While ostensibly promoting the relational feminist view as a paradigm to replace the traditional classical one of gender essentialism, Dimen draws our attention to the incredible similarities between the two, highlighting the paradoxical closeness of multiplicity, flexibility and fluidity, openness, foreclosure, rigidity and moralism: “Insofar as essentialist-categorical thinking returns us to the bad old days when men were men and women were the second sex, deconstruction acquires political correctness, its moral implications warping unfortunately into moralism (italics mine), a state characterized less by ethics than by rigidity” (p. 302). The contemporary, even postmodern Freudian, as well as the enlightened relational feminist reader will undoubtedly welcome Dimen’s conclusion that gender should not be thrown into the void: “…If gender is not biologically essential—not ‘natural’—but a construct that varies cross-culturally, then perhaps gender might be whatever we want to make of it. Gender might be a dispensable category” (p. 302). Then, although we might be done with hierarchy, feminist thought had not counted, however, on psyche. “It was in response to difficulties of disentangling gender and power that feminism erroneously proposed that gender might be done away with.

In concluding, nothing can be more fitting that Dimen’s recognition that some authors and commentators in this book were not comfortable in doing away with gender, or even with Toronto’s obliterating any clue as to her patient T’s gender. Readers, she says, and I agree, will be grateful for McWilliams’s admission of guilt in her residues of universalism and essentialism in her thinking. I, for one, am most definitely among the grateful to Dimen for getting us out of this miring bind and for returning sanity and common sense to those of us who have found profound value in psychoanalytic thinking before as well as after the postmodern turn, and for giving us the high sign to feel O.K. that we can be feminists on either or both sides of the present-day thinking of the classical–relational divide.


Chodorow, N. J. (2005). Gender on the modern-postmodern and classical-relational divide: untangling history and epistemology. Journal of the American Psychoanalytic Association, 53: 1097-1118
Gediman, H. K. (2005). Premodern, modern, and postmodern perspectives on sex and gender mixes. Journal of the American Psychoanalytic Association, 53: 1059-1078.
Reich, A. (1953). Narcissistic object choice in women. Journal of the American Psychoanalytic Association 1: 22-44.

Reviewer Note

Helen Gediman


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