Creativity and Perversion: Waiting for the Muse

Trauma, Aggression, and Annihilation Anxiety

Much has been written about trauma and aggression as central features of perversions and as factors that may contribute to creativity. I include helplessness with these factors because it is the child’s subjective experience of helplessness that determines whether a situation is traumatic (Freud 1926). These three elements—trauma, aggression, and helplessness—contribute to a variety of psychopathologies, but in sexual perversions the aggression is transformed into sadism and sexualized, and feelings of helplessness are surmounted in the perverse act, as sexual excitement and the experience of genital potency allow the adult to triumph over childhood trauma (Glasser 1986; Stoller 1975). Several authors consider aggression essential for authentic creative work (McDougall 1995; Parker 1998; Segal 1991), while others believe that the works of some creative individuals are attempts to rework and master childhood trauma (Rose 1996; Richman 2013). In some creatively inclined individuals with perversions, however, their sexual deviation seems to distort or block their creative activity and their trauma remains unresolved.

To understand why this happens, I propose a theoretical formulation in which the individual’s inner world is characterized by the presence of a powerful internal bad object that generates castration and annihilation anxieties and attacks links with internal good objects. I conceptualize this threatening internal object as derived from both real trauma experienced in childhood, inflicted usually by a cruel or excessively controlling mother, and the oral-sadistic and anal-sadistic impulses the child projects onto her. ² In this regard my views differ from authors who prioritize either childhood trauma or unconscious fantasies in the pathogenesis of sexual perversions. Welldon (2009) and Verhaeghe (2009), for example, believe that perversion is related more to traumatic reality than to unconscious fantasies. I agree with them, however, that the primal anxiety in many patients with perversions is not about castration by the father for forbidden oedipal desires, but rather is about annihilation by a powerful mother who hurts and damages her child by abusing rather than protecting him, or who uses the child to compensate for a lack in herself. ³

For a male child whose mother uses him to compensate for this lack, and with a father who fails to protect him from the mother’s influence, an identity separate from the mother cannot be formed. This produces a dread of inner emptiness and depression, which the boy experiences as annihilation anxiety regarding not having an identity and life of his own (Verhaeghe 2009). ⁴ How can the boy escape from someone who engenders these feelings but whom he needs at the same time? I suggest that perversion offers a partial solution, as it allows the male individual to experience closeness to a female without feeling the threat of engulfment, while at the same time getting revenge and asserting independence from her. This conceptualization of the perverse individual feeling trapped and needing to escape from the mother contrasts with Chasseguet-Smirgel’s view (1984a) that male perversion stems from the child’s failure to relinquish his desire to be an adequate sexual partner for the mother. And whereas her theory proposes that it is the boy’s feelings of smallness and genital inadequacy that lead him to maintain the illusion that he can satisfy his mother with his pregenital sexuality, I suggest that the child’s smallness intensifies his feelings of helplessness against his much larger parents, especially when they are threatening rather than protective.

Another type of annihilation anxiety often present in individuals with perversions, one amplified by a frightening mother during childhood (Hurvich 2003), stems from unconscious fantasies associated with a male child’s misperception of the vagina as a devouring organ and thus a threat to survival. This dread was first emphasized by Horney (1932), ⁵ and later by Lussier (1974), who argued that the young boy’s disavowal of the vagina is not a defense against feelings of genital inadequacy but rather is due to a fear that the organ is “an abyss, a terrifying ‘chasm’ recalling the most archaic fantasies of devouring orality” (p. 359). Thus, the fantasy of a phallic mother (considered ubiquitous in perversions) is not only a defense against castration anxiety but also an expression of preoedipal anxieties linked to fantasies of a powerfully aggressive oral mother and a sadistic anal mother (Kulish 1986). In my view, the fear of annihilation by the threatening “anal” or “oral” mother is projectively linked to the female genital, thereby intensifying the perverse individual’s dread of the vagina.

The perverse individual’s ability to transform aggression into eroticism allows him to create a pleasurable sadomasochistic scenario in which the relation with the threatening internal bad object is externalized and enacted with a partner or in a masturbatory fantasy, the individual identifying with both the victim and the persecutory internal object, and obtaining temporary relief from painful emotions. My formulation overlaps with that of Cooper (1991), who links perversion with the child’s helplessness when at the mercy of a frustrating, cruel mother, and with unconscious fantasies in which the child is no longer helpless and frightened because he has dehumanized the mother and himself and thus can triumph in the perverse fantasy that he is “in total control because no matter what cruelty his squashing, castrating, gigantic monster mother-creature visits upon [him, he] can extract pleasure from it, and therefore she (it) is doing [his] bidding” (p. 24). As I will illustrate with my case example, this dynamic is very evident in the perversion of macrophilia.

The sexual scenarios developed by perverse individuals are often innovative and creative, but I agree with McDougall (1980) that they lack the fantasy and imaginative freedom of authentic artistic creations and typically have a compulsive and static rigid quality. Chasseguet-Smirgel, based on her theory that perversion involves denial of the paternal phallus and regression to the anal-sadistic phase with idealization of its derivatives (1984a, 1992), regards the creative paintings or writings of perverse patients as “false” or inauthentic. Yet like McDougall (1995) and Segal (1991), Chasseguet-Smirgel (1984b) considers aggression necessary for authentic creative work; as I have mentioned, she proposed that creative acts are often attempts to repair the self, which in her view requires destruction of the object in the unconscious, working through the guilt, and discharging sadistic impulses in a sublimated way. It is my clinical impression that because aggression is transformed into sadism and sexualized in individuals with perversions, it is less available for authentic creative activity. Some individuals with perversions may write stories or make drawings or paintings with perverse content aimed at intensifying sexual arousal, but such work is generally repetitive and, like their sexual fantasies, may reveal aspects of their childhood trauma but not resolve it. I suggest that it is not until the aggression is desexualized and possessed by the individual as a self-preservative response to threat, and thus aimed at survival (Glasser 1986), that it can facilitate reparation of the self and be available for successful creative work. Indeed, according to Meg Harris Williams (2014), the art critic Adrian Stokes believed that successful art must present an image in which “destructive or hateful elements encounter not denial but rather transformation, under the greater aegis of the ‘good object’” (pp. xv–xvi). A major aim of analysis or psychotherapy therefore is to help the perverse individual with creative aspirations to connect with an internal good maternal object, as well as to strengthen his identification with a potent father. By the end of treatment the internal bad and good objects are likely to alternate between a state of integration as a whole object and coexisting as part-objects because the transition to the depressive position is never complete; moreover, for creative individuals “there are alternations of integrated and unintegrated states in the very process of making art” (Stokes and Meltzer 1963, p. 7).

The Concept of the Muse

As described by Winnicott (1958), an internal good maternal object is introjected from the experience of good-enough mothering and is equated ultimately and unconsciously with the loving mother. It is within the early mother-infant relationship that Winnicott (1971) also places the origins of creativity, with a male element (the father) coming into play as the infant struggles to recognize that he is separate from the mother. Like several other psychoanalytic authors writing about creativity, I associate an internal good object with the supernatural concept of a muse. In Greek mythology there were nine muses, the daughters of Zeus and Mnemosyne (the goddess of memory), who were the inspirational goddesses of literature, science, and the arts. And since ancient times artists, writers, and scientists have considered an imaginary muse the source of inspiration for their creativity. Although the imaginary muse is depicted in paintings as a young and sensual woman, she is not an attainable lover. As Greer (2008) points out, the role of the muse is to penetrate the creative individual and bring forth a work from “the womb of his mind.” The muse is not always available, however, often leaving the creative individual bereft of inspiration; as Williams (2005) indicates, it requires hard work, plugging away at one’s craft, and waiting for the muse to turn up. ⁶ Moreover, a sharp distinction cannot always be made between what Chasseguet-Smirgel (1984a) describes as “genuine” versus “false” art. I suggest that the former is more likely to be created when the artist feels inspired and imagines something new that he or she can represent. Also, rather than regarding the works of artists with perversions as “false” and springing from an idealization of pregenital and anal-sadistic values, I agree with McDougall’s observation (1995) that many creative people unconsciously experience presenting their work as an act of defecation rather than of birth, and so fear rejection, shame, and humiliation.

Psychoanalytic authors have conceptualized the inspirational muse as either an internalized good object based on early experiences with the mother (Parker 1998; Williams 2005; Richman 2014), or as a selfobject that contributes to the cohesiveness of the self (Kainer 1990; Shaddock 2006); she may also be an actual person onto whom the internal good object has been projected (Modell 1993; Tutter 2017). Though I employ the traditional conception of the muse as an imaginary presence rather than an actual person, I differ slightly from other authors by regarding the muse not as an equivalent, but rather as a manifestation, of an internal good object. Like Davies (2016), I am interested in the question of what happens to artists and writers who were traumatized in childhood and for whom the muse or internal good object is inaccessible or barely exists. Davies suggests there may then be “an internal war between [the] good object muse and the internalized bad objects who have the power to attack and destroy the work [the artist] strives to create” (p. 234). I similarly propose, and will illustrate with my case example, that the creativity of some traumatized individuals with perversions may be inhibited because good and bad internal objects are split off from one another and a destructive and omnipotent bad object prevails in the foreground of psychic life.

Some analysts (e.g., Kainer 1990; Lichtenberg 2017) suggest that the therapist can function as a muse through an affirming and mirroring transference and by facilitating the patient’s quest to realize more of his or her potential. Alternatively, I argue that in the case of traumatized artists whose creativity is inhibited or distorted by a perversion, psychoanalytic therapy must lead to the retrieval of an internal good object that can reduce the influence of a terrifying bad object and inspire the artist or writer. This may come about through experiences in the transference that reawaken memories of the self in relation to the affectively attuned and loving mother. As Parker (1998) writes, “The analyst or therapist is not the Muse, [but] merely one of the key relationships that enables the establishment of the muse—the internal good object—to take place” (p. 771). The addictive nature of perversions, however, and the sexual pleasure that patients obtain from the perverse act, make it extremely difficult to weaken the patient’s tie to the familiar internal bad object and to connect with an internal good object. ⁷ As Fairbairn (1943) described many decades ago, it is as though the patient is “possessed” by evil spirits; and the resistance to weakening the tie can only be really overcome when through the transference the analyst has come to be experienced as an unfailingly good object, which in my view facilitates the patient’s establishing links with an internal good object. Because this takes a long time, the muse is not likely to show up until a late stage in the therapy, when her appearance in dreams or fantasies signifies the emergence of an internal good object; a change in the quality of the artist’s creative work might also suggest that links have been established with an internal good object that help inspire the artist. ⁸

Case Example

Eric was thirty-two when he first consulted me. He had been married for three years and reported having a good relationship with his wife, who he thought might have recently become pregnant. He was seeking help for feelings of low self-esteem and symptoms of depression, which he had experienced for two years. Despite having a university education and a background in art and writing, for many years he had felt unmotivated to pursue his ambition to be a creative writer or artist; instead, he had drifted into a bookkeeping and accounting line of work, which he described as “soulless and meaningless.” Eric linked his depression to an incident in his mid-teens when a psychic told his parents he would be highly creative and write two novels before he was thirty. As the firstborn child in a religious family, he had felt obliged to meet his parents’ expectation, especially since his mother had expressed her view, when he was thirteen, that it would be a sin if he did not use his God-given creative talent. Eric’s mother also championed her son’s ability to draw, especially portraits, but she pushed him during his adolescent years in ways that met her own narcissistic needs. Needing to enhance his mother’s self-esteem through his creative achievements, Eric felt that he lacked his own sense of identity and was living his mother’s destiny. He experienced guilt if he failed her, but also resentment that she had taken possession of his artistic ability. Feeling trapped, he rebelled at age twenty by ceasing to draw, even though it had been a source of great enjoyment for him. He experienced the approach of his thirtieth birthday “as a looming deadline, as though it was a timeline for [his] own life.” Having failed to fulfill the psychic’s prediction, he was unable to forgive himself and became increasingly depressed. Now, at age thirty-two, he was awakening every morning with “a sense of dread”; he felt “emotionally and intellectually paralyzed” and believed he was “living on borrowed time.”

In the early assessment sessions I learned that throughout Eric’s childhood his mother had frequent “hysterical attacks of rage” that terrified him and his younger siblings; she also occasionally threatened to end her life by jumping in front of the subway. Eric had assumed he was the cause of his mother’s rages and had been afraid to do anything wrong that would provoke her ear-piercing screams and repeated slamming of doors. His mother was the dominant parent, often criticizing her husband; and although she was frequently frightening to her children, she was also at times affectionate, but the alternation between frightening mother and affectionate mother was unpredictable. Eric’s father failed to intervene as a buffer between his wife’s rages and the frightened children; it was not until Eric was in his mid-teens that his mother began to receive psychiatric treatment. During his adolescence his mother induced guilt by telling him that he had hurt her whenever she was upset about something. She had even told Eric that it had been difficult carrying him in her womb, which made him feel undesired and very guilty.

Eric described his father as a quiet, unassuming, and emotionless man, much like Spock from Star Trek. Only once did the father get into an argument with his wife and challenge her crazy behavior. Eric was eleven then and it was the first time he realized his mother was not normal. He had feared being abandoned by her when she threatened to kill herself, and he wanted a father who would foster his masculine development and with whom he could identify. As a boy he felt excited after learning that his father had some military experience, and seeing photographs of his father holding a rifle “fired up [his] imagination.” But like his father he was passive and unassertive when situations required him to take a firm stand with other people. It “bugged the hell” out of him that his male friends were “rooted in masculinity.” He was pleased, however, that he had been able to grow a beard, as he thought “it gave more definition to [his] chin”; he had worn the beard for eleven years, and his wife liked it.

I offered Eric psychoanalytic psychotherapy and had some time available two months later. Because he lived a considerable distance from the city, for the first four years we could meet only once weekly for face-to-face sessions; we then met twice weekly for another four years. Given the duration of the therapy and the constraints of publication, I have had to select material that conveys the main themes and a sense of how the treatment unfolded. To protect confidentiality I have also omitted some of the patient’s associations to several of his dreams.

During the first few months of therapy, Eric spoke mostly about feeling unmotivated and depressed and unable to write creatively. He reported several dreams in which he had missed an examination or failed to complete an assignment, as well as some dreams in which he or someone else was being threatened. He was also self-critical that he had complied with his mother’s demand that he draw several commissioned portraits when he was a teenager, but glad that he had finally resisted her. He said that the psychic’s prophecy was always in the back of his mind, and he felt guilty that he had not used his talent. Although it was evident from his history and the content of the early sessions that Eric’s depression was related to his failure to achieve an identity as a writer or artist, and to the pressure he felt to fulfill his mother’s desires, it took many months before I realized the depth of his annihilating dread of not having an identity separate from the one desired for him by his mother. The extent to which she had compromised her son’s developing identity was suggested by a dream during the fifth month of therapy:

Eric was alone in his parents’ bedroom and saw several rows of drawers. He opened one drawer and was delighted to find that it was full of folded newsprint of drawings he had done in high school. He was pleased to see them again; several were drawings of naked life models. But he quickly became disappointed as he discovered on second glance that only 5 percent of the content of the drawer was his work, the remainder being his mother’s craft work. He felt strongly let down, as he initially thought he had found a treasure trove of his own work.

Associating to the dream, Eric expressed regret that these were the only drawings he had not kept from high school art classes. He said that he had enjoyed the life-drawing classes, but his prudish mother had disapproved of his drawing naked models and would not allow him to watch movies with scenes of nudity or violence. He expressed annoyance about her ongoing intrusiveness and insistence on kissing him on the lips whenever they met. I made no interpretation, but after the session I wondered if the dream revealed the extent to which a maternally derived internal object dominated his inner world.

After we had been meeting for almost six months, Eric’s first child was born, a son. When he came to the next session he had shaved his beard. Eric said he thought the beard was like a mask hiding his “true self,” a weakness about himself that he should confront. Recalling his previously expressed pleasure in having a beard, and his lack of confidence in his masculinity, I challenged him and suggested that the beard was not a mask but an expression of his masculinity, and perhaps removing it was to disavow his sexual potency, evidenced publicly by the birth of his son, making the shaving a kind of self-castration. Eric responded by saying he thought it was a woman who had accused him of hiding behind the beard. He wondered if he might be blocking something from childhood and associated to his mother’s becoming terrifyingly angry, often screaming so loudly that he had to block his ears. He recalled an occasion when she threw him to the floor and tore his shirt. He said that she was “a Hydra-like monster,” whom he tried to avoid provoking by being well behaved and never expressing anger.

Although I had disagreed with the patient’s self-understanding of why he had removed his beard, I believe that my comment about castration reflected a correct intuition that Eric’s view of his “true self” was of an inadequately masculine (i.e., “castrated”) man, an intuition that was supported in later sessions. And although I did not interpret the polyphallic symbolism of the Hydra, ⁹ Eric’s immediate associations to the violence of his mother and the image she conjured up in his mind suggested the unconscious fantasy of a phallic mother, an image that both threatens and denies castration. A few sessions later, Eric told me about a dream in which a barefoot woman had wanted him to make love to her; he then revealed that he has a foot fetish and finds the female genitalia gross. Several weeks after that he told me that his masturbatory fantasy involved becoming sexually aroused by images and fantasies of a female giant (macrophilia), such as the woman straddling a freeway with a car in her hand in a poster that advertised the movie Attack of the Fifty Foot Woman. Eric traced the origin of these fetishes to age three or four when he was first aroused by drawings of the female foot in a Dr. Seuss book. At fifteen he began drawing pictures of giant women. He told me that he spends several hours at a time searching the internet for pictures of women’s feet and giant women, and that he easily goes into a trance. He prefers seeing the foot in a high-heeled shoe, as it conveys the power of the woman. In his masturbatory fantasy the giant woman is chasing very small men in a threatening way. She is usually fully dressed, shows a small amount of cleavage, is assertive and domineering, and lacks any scruples. He is always an observer rather than a participant in the fantasied scenes. Sexual arousal requires a certain tension that occurs when he imagines the giant woman behaving in a threatening or disdainful way toward the helpless tiny men. For her sexual pleasure, she sometimes inserts the men into her vagina, where they are trapped, suffocated, crushed, and sometimes die. The arousal and sexual excitement immediately dissipate if the giant woman becomes violent, and would not be experienced if she behaved in a loving and nurturing way. I thought that the giant woman represented the sadistic phallic mother who threatens annihilation.

Eric spent a lot of time drawing pictures of giant women, which he sometimes posted on an art website to be viewed by other men with macrophilia. The reliance on the giant woman felt “like being enslaved to an addiction”; it was “like a ball and chain,” he said, and he wished he could overcome it, as the compulsion distracts him from his work and has a stronger appeal than having sex with his wife, which is infrequent. He relied on the fantasy of the giant woman to achieve an erection when having sex, and would lose it if his wife became tender and loving. He described her as a soft and gentle person, very different from both his mother and the only girlfriend he had had before he met his wife.

Eric had frequently enacted the giant woman fantasy with the girlfriend; she would dress up in clothing similar to what Eric’s mother wore when he was a child, and derive pleasure from humiliating him. Lying on the floor, he would ask her to imagine shrinking him to an inch in size and doing whatever she wanted, such as dropping a shoe and almost killing him. His sexual excitement increased when he felt small and helpless and when the girlfriend behaved in a tantalizing way. She refused to have sexual intercourse, but they engaged in mutual masturbation. He said that this girlfriend was his “narcotic,” and that he still wanted her even after she broke off their relationship in a cruel way. Now he feared giving up the giant woman; “I would then feel as though I do not have a penis, and would have no way of achieving pleasurable orgasms.”

We came to understand that the macrophilia had multiple functions for Eric; it enabled him to achieve erections; he engaged in the perversion when he felt lonely, as it brought a sense of relaxation and relief of tension; he also turned to the fantasy when his self-esteem was low and especially if he felt inadequate as a man. Consistent with Stoller’s formulation (1975), he unconsciously reenacted the childhood trauma, but through erections and orgasm made a triumph out of the trauma. The enactment with the former girlfriend linked the origin of the perverse fantasy with the helplessness Eric must have experienced when he was a child and felt terrified by his mother’s rages. My approach was to acknowledge that the giant woman fantasy was a source of comfort for Eric, but I said that the fantasy also allowed him to overcome feelings of helplessness and to transform the hatred and anger toward his terrifying childhood mother into sexual excitement. Eric’s response was to say that he had always assumed that his preference for the perverse behavior was biologically based, as it felt driven by something chemical in his brain, and that he had never imagined it might have something to do with his childhood.

Almost six months after Eric removed his beard, I noticed he was growing it back; when I inquired, he said that he still thought it hid a weakness and that he experienced “a gap between appearing masculine and feeling masculine.” He complained that he becomes anxious and tongue-tied in debates with male friends, and he envied their masculinity. He recalled having difficulty defending himself when other boys bullied him in elementary school. The focus of the therapy over the ensuing year was primarily on analyzing Eric’s fear of his own aggression, and ways his father had failed as a masculine role model. He said that he felt let down by his father and feared being like him. Although Eric had taken some rifle training in his early twenties and was a good shot, he was fearful of the power of the weapon. He recalled feeling guilty over a fantasy he once had of crippling or killing a boy who frequently tormented him.

During the third and fourth years of therapy, as Eric’s conflict over experiencing aggressive feelings diminished, he began behaving more assertively in his relationships with male friends; he also resumed drawing and painting and writing short stories. However, the harshness of his superego was strongly evident—he was highly critical of his creative work and expected perfection; he also anticipated harsh criticism and rejection if he showed his work to others. In the transference I was perceived as an external judge who would privately criticize him for his sexual behavior and for not being more productive and having a larger income. Moreover, rather than being quietly inspired to create by an imaginary muse, the giant woman would intrude and find her way into his stories or drawings. Eric found her exciting and got more pleasure from the masturbatory fantasy than from the creative work. But he was now taking the risk of exhibiting his drawings to the public. The night after a woman had complimented him for a new drawing, Eric had a dream in which

a bird that looked like a crow, but was a little smaller, clamped onto a hiking boot he was wearing. He felt pressure on his foot and it seemed stronger than a bird. Without the boot he feared his foot would be shredded. He tried to push the bird off the boot, but it wouldn’t budge; nothing would dislodge it. The leather of the boot was torn and he saw torn flesh inside. There was no blood, but it did not seem to be his foot because he felt no pain. It looked like uncooked chicken breast that had been shredded. Other people did not seem alarmed, as though it was a common occurrence. He could see the cavity inside the boot, and the expensive boots were now destroyed.

Eric thought the bird symbolized a witch. He associated to a story he had been writing about shape-shifters in which a character turns into a wild animal and is going to rip out the throat of a woman with its claws. I reminded Eric that he had recently told me that his mother’s use of guilt was now her way of getting her claws into him. “Perhaps,” I said, “the bird symbolically represents your attacking mother.” His response was simply to say, “The bird’s claws resembled the claws of the wild animal in my story, and the flesh looked like pre-cooked turkey legs I remember seeing on a barbeque at my stag party.” After the session I thought about possible meanings of the dream: the bird may have symbolized the “witch mother” who traumatized him as a boy, and against whom he was helpless to defend himself; the lack of reaction by other people suggested that nobody had paid attention to Eric’s childhood trauma; there was also a foot-penis-breast equation allowing for expression of oral-sadistic impulses both from the “witch mother” and in retaliation against her. The dream also suggested an envious attack by a persecutory internal object following the compliment Eric received from the woman who admired his drawing. There was also a possible transference meaning, namely, intense anxiety that I had removed his defenses (represented by the shredded boot) and exposed an extremely vulnerable aspect of the patient. Eric had recently referred to the therapy as “a living autopsy”; when I had suggested that perhaps he experienced me as the pathologist, he said, “I am coming of my own volition.” But the metaphor of a living autopsy came up several times during the therapy.

Eric brought another disturbing dream to the next session:

A town is under siege by aliens similar to those in the movie Alien. They were a blend of organic and mechanical materials with elongated heads, no eyes, and rather frightening mouths that include a secondary mouth that shoots out and attacks. The aliens were attacking at random in a fast and vicious way, and there was no way to defend oneself. He was on a street; there were no cars and no place to hide, but he eventually ran into the stairway of a narrow building and looked out the window to see if there were any aliens outside. He and other people were in a state of constant terror as they went about daily life with a sense of foreboding.

Eric’s associations were to the aliens in the movie; he told me that these creatures have humanoid bodies and an elongated phallic-shaped head with a secondary mouth that can be used as a weapon to punch through a person’s head. If resisted they kill; otherwise they latch onto the face and implant an egg that later kills the person as it hatches. Eric then recalled a prey/predator game he played in elementary school in which he was a tiny animal being hunted by larger animals; he would try to hide from them, as they intended to eat the smaller animals. He emphasized that the aliens in the dream were a threat to his life. ¹⁰ I said, “Perhaps the aliens represent the mother who terrified you as a small boy, and also your own disavowed retaliatory anger projected onto them.” He replied: “I enjoy imagining myself as an aggressive villain or a shape-shifter, and in my teens I even pretended to be an alien monster and frighten other kids, but my desire to write stories about aggressive shape-shifters and assassins has now subsided.”

It took many months and analysis of several dreams for Eric to recognize the killer inside himself; this was represented in one dream as a dormant cancer in his body detected by a doctor. Eric said he would never act aggressively, as he cannot even kill flies and spiders. Although he grew to resent and hate his mother in his late teens, he felt tremendous guilt because he was not allowed to use the word hate as a boy. In his early teens he had confronted his mother with how she had terrified him when he was younger, but she deflected the confrontation, “as though she was deflecting a bullet fired at her,” and made him feel guilty. The analysis of further dreams revealed that Eric experienced his penis as a powerful weapon, which led me to say, “Your ejaculation is like a gun going off, for as soon as you ejaculate, the giant woman disappears as though you have killed her.” Eric replied: “Yes, she is then vanquished and immediately disappears from my mind as though turned to ashes.” I asked, “What would happen if the giant woman became violent?” He replied, “I would become angry and lose my erection. I would go from one extreme to the other, and probably kill her if she continued to be violent.” Repeating earlier interpretations, I said, “The sexual fantasy deceives you by transforming your anger into sexual excitement. Moreover, the fantasy also protects you from experiencing deeply buried painful emotions.” Eric replied: “When I recently told my mother about problems I am having with my work, she expressed no empathy but instead accused me of upsetting her. I felt angry; it was a sneak attack that felt like I had been knifed in a kidney or between the ribs. She has a habit of doing this and I don’t see it coming. If I met a giant woman in real life and saw her causing suffering to others, I would kill her.”

By the fifth year of therapy, the lure of the fetish was weakening and Eric felt he was getting back in touch with his imagination. He realized that though his drawings of giant women looked good they were not really creative art. I said, “They are multiple variations on the same theme, and they reflect your childhood trauma and your need as a boy to be attached to your mother despite her unpredictable rages.” Eric accepted this interpretation and then said, “I am enjoying being a father, teaching my son how to do press-ups and sit-ups and having him admire my muscles.” I replied, “You need to also be a father toward the injured child part of yourself.” But despite the repeated analysis of the latent meanings of his perverse behavior, Eric continued to have difficulties applying himself to his business and creative work and wasted much time engaging in the masturbatory fantasy. In the countertransference I experienced some frustration and sensed a resistance in Eric against making greater use of the insights he had gained, and especially his failure to use me in his mind as a paternal figure who could help free him from the threatening giant woman. Eric then admitted that he did not think about our discussions between sessions and said he realized this was limiting his progress. I silently wondered whether he was the giant woman who was crushing me, a passive-aggressive way of ensuring that I would be impotent like him. Was he keeping me out of his mind the way his father had failed to think of Eric’s needs? Eric then said that he finds me objective and not reactive emotionally, but realizes this is necessary. He said he trusts me fully but was somewhat envious that I had been successful in my career. After we explored these thoughts and feelings, Eric said that he now had more time and was soon able to increase the sessions to twice weekly.

In the next session Eric said the giant woman was now “out the door,” but he had nothing to replace her with. He reported he had had sex with his wife and for the first time the giant woman was not in bed with them. As I anticipated, this proved to be a temporary change, but the analysis of the negative transference in which Eric perceived me as an external judge and resisted allowing me into his mind by avoiding thinking about our discussions, along with his decision to increase the frequency of sessions, helped advance our work. A few months later Eric dreamed of Arnold Schwarzenegger as the Terminator coming toward him in a threatening manner; he realized that the actor represented a feared aggressive part of himself. He was becoming more aware of aggressive fantasies toward his mother and was now feeling anger toward his father for not standing up to his mother when she was in a rage or being highly critical. Around this time Eric made the decision to give up his bookkeeping business and focus entirely on creative work. He said that the quality of his drawings and paintings had improved over the past two years and he had developed a much freer style, with more emotion and movement in his drawings. But these feelings could quickly be replaced by strong negative thoughts. If he produced a good drawing he thought it was a matter of luck and would not happen again; most of the time an inner voice (his critical superego) would tell him that his art was shitty and that he is not really an artist; his mind would be filled with disparaging thoughts. He would feel shame and procrastinate about working. The appeal of the giant woman fantasy competed with a desire to do creative work, but he now heard my voice in his mind. I made a link between the negative thoughts he had about his art and his mother’s complaints about carrying him in her womb. I said, “Your mother’s lack of desire for you as a child extends to your view of yourself and your work as undesirable, like excrement.” He replied, “I fear that other people will consider my art crap, and I doubt the genuineness of any praise or compliments people express.”

Shortly before the summer break in the sixth year of therapy, Eric thought he might be late for a session and phoned to leave me a voicemail message. He was surprised when a very pleasant woman answered the phone; he realized he had accidently called the office of a doctor with a name similar to mine. He did not tell me about this incident, as he managed to arrive on time for the session. That night, however, he dreamt that

he was trying to phone a mean and belligerent boss he once worked for; he got a woman’s voice and assumed he had reached the answering service and hung up. But the woman then phoned him and he saw on his call display that she was a well-known and popular radio news reporter. She called him by his name and was initially very pleasant; but as he tried to explain why he was calling, she suddenly became unpleasant and declared that he was fired.

The contrasting ways in which the woman in the dream behaved toward Eric suggested a switch between good and bad internal objects. I said, “Perhaps the pleasant news reporter represents the gentler and affectionate aspect of your mother, and the belligerent boss together with the unpleasant aspect of the woman represents the angry aspect of your mother.” Eric replied, “Yes, my mother could abruptly switch from one to the other; she was like Jekyll and Hyde, or the Hulk.” The day residue for the dream (mistakenly phoning the wrong doctor and speaking to a pleasant woman instead of hearing my voice) seemed to link me with the emergence of a split-off good internal object, represented in the dream by the pleasant aspect of the news reporter. In hindsight, I am not sure why I did not interpret this transferential meaning; perhaps I was too focused on bringing into the patient’s consciousness the positive aspect of his mother.

Several sessions later Eric spoke about his religious upbringing as a child and how he was taught that any talent belonged to God. Thus, his artistic ability did not belong to him, he said; he was merely a vehicle for God to use. He associated to his godfather, whom he rarely saw while growing up, and contrasted him with a friend’s godfather who was a very involved and creative man, and a lot of fun. Eric agreed when I said, “The role of a godfather is to be a backup for the father and to help protect the child; your godfather and father failed to protect you from your mother and help you develop a strong masculine identity.” I then asked, “Where do you place me in this regard?” Eric replied, “You are like a surrogate parent—mother and father—I can talk to you about anything and you do not judge me, unless you keep your judgments to yourself.” I said, “You are the one who severely judges yourself, and you end up depriving yourself of the pleasure of enjoying your creative work.” I commented also that his fear of retaliation if he stands up to his internal judge was likely linked to his fear of becoming angry with his mother when she terrified him as a boy. Eric’s response was to compare himself to his son, who he said was not afraid of doing things that he himself found scary. He recalled some earlier comments I had made linking his anxiety to an insecure family environment, and said that his son felt secure inside himself.

In the next session Eric reported a dream:

He is at the foot of the stairs in a house; the stairs lead to an upper landing and beyond that to a higher level. A larger than normal size horse is on the landing; it is beautiful and healthy looking with a reddish-brown coat and black eyes. The horse is looking at him and he is anxious but tries to goad the animal to come down the stairs, although he is fearful that it might trample him to death if it does so. But the horse seems a bit timid and does not move.

Associating to the dream, Eric said, “The stairs and landing in the dream were similar to the entranceway to your office and also to the stairs that lead to the office in my home where I do my painting. I think the horse represents my masculine identity and aggression; the dream may have been triggered by my success with some recent creative work that I am proud of and for which I received many compliments.” I said, “Perhaps the horse also represents a strong paternal figure, and it might be an alternative to the giant woman. In contrast to the helpless small men looking up at the giant woman, in the dream you are looking up at a powerful masculine symbol, perhaps representing freedom and your own masculine potential.” Eric’s response was to again speak positively about his friend’s godfather and how much he enjoyed visiting him and talking about World War II and the Vietnam War.

During the course of the therapy I sometimes commented on the absence of love in the masturbatory activity and on Eric’s resistance to making love to his wife. I pointed out that depriving his wife of love and sexual pleasure was a reversal of how he had experienced his mother withholding love. As Eric came to rely less on the giant woman fantasy he became more affectionate with his wife, but often hesitated approaching her because he feared she would reject him, even though she had never done so. I learned also that Eric avoided making love if he thought his wife expected him to. I suggested that his resistance was similar to his giving up creative activity when his mother expected him to write two novels before he was thirty or had him paint commissioned portraits of her friends. Eric agreed and said, “I felt trapped by my mother’s expectation of making me into an extension of herself. I was like a wolf caught in a hunter’s trap and having to chew off its leg to escape.” ¹¹ I asked Eric, “Do you feel you have to meet expectations from me?” He replied, “No. You are like the therapist in the movie The King’s Speech; he developed a nurturing and close relationship with the king and was like a good father who compensated for the emotional traumas the king had experienced with his parents.”

Eric had relied on a fetish—an imaginary female phallus—to achieve erections. Without it he was impotent; he needed to identify with a phallic father and take possession of his own penis. But his fear of a devouring vagina remained. In a later dream,

he is in a department store and sees several women and girls with flip-flops on their feet, which would have attracted him except there was a threatening monster. It had a huge mouth with teeth that curved inward such that if you inserted your arm you would not be able to extract it. It was like a large sea monster that could swallow a person whole. Eric attacks the monster but is only able to minimally weaken it and it comes after him.

Associating to the dream, Eric said, “The monster was like a vagina.” I said, “Like a vagina dentata and thus like your mother’s threatening mouth when you were a small boy.” He had not previously heard the term vagina dentata; it evoked in him an emotionally powerful image of a large mouth-shaped pit belonging to Sarlacc, a creature in the movie Return of the Jedi, which devours whoever falls into it. Eric then mentioned his fear of alligators lurking in the water close to the edge of the bank, and how one might leap out and drag a small child into the water. Thus, underlying Eric’s intense castration anxiety (the threat of losing an arm in the dream) was further evidence of annihilation anxiety as proposed initially by Horney (1932). ¹²

Following the Boston Marathon bombings, which occurred during the seventh year of therapy, Eric thought he detected the smell of gunpowder as he entered the stairway to my office. He imagined a gun had been fired, that someone had shot me and the killer was now hiding in the bathroom and would kill him. Guided by my understanding of the patient’s internal object relations, I silently made a quick formulation that the killer represented a projected murderous part of Eric, and that I stood for his cruel mother; based on the law of talion, the killer then becomes the persecutory superego that kills him. I said, “The killer seems to represent a part of you that wants to kill your raging mother represented by me, but because of guilt you fear retaliation and losing your own life.” I then asked, “Why have you not killed off the giant woman?” Eric replied, “I recently had a fantasy in which a movie actor ties up the giant woman in a spread-eagle position and then drives a bomb attached to the front of a steamroller into her vagina. The character aggressively and repeatedly penetrates her with the bomb until it explodes inside of her. The townspeople then eat her flesh.” ¹³ In a subsequent session in which Eric spoke again about fantasies involving aggression directed at his mother, I emphasized that he was primarily dealing with an internal mother rather than his actual mother, and that behind his rage lay love. He said, “My anger was partly over feeling insufficiently loved as a child. I felt innately bad and responsible for my mother’s rages, but would now like to reach a point where I can forgive her.”

Throughout this year of the therapy, Eric was more engaged in creative work. He was drawing more male characters, and his drawing of a giant woman was now of a friendly woman with an attractive smiling face and she was no longer sexually arousing. I thought she represented an internal object encompassing the previously split-off good aspects of his mother. Although I did not introduce the idea of a muse, it was in my mind, as Eric’s recent drawings and paintings seemed more inspired than his drawings earlier in the therapy. He was moving to a more painterly style and using techniques that lent lighting and movement to his paintings. He felt gratified by the quality of his work, and now got more pleasure from creating, where before he had always experienced tension when drawing or painting. Moreover, the work no longer had to be perfect at the first pass (he could now work and rework each piece).

In a dream,

Eric is in a basement and there is a female art teacher there to teach a class; he is one of five or six students. He notices among her papers one of his drawings, a conceptual work, and is surprised and apprehensive as to whether she will be critical or complimentary.

The setting was the basement of his family’s home when his mother first got professional help for her illness; my office, not coincidentally, was in the basement of my home. Contrasting this dream with the much earlier dream of being in his parents’ bedroom and finding only a small number of his high school life drawings, I thought the teacher represented an internal good object and was probably related to the positive maternal transference. I said, “The teacher seems to represent a positive figure in your mind who would be supportive of your work.” Eric replied, “Yes, I have been feeling anxious about an upcoming show in which some of my work will be exhibited. When my mother got psychiatric help, I felt for the first time that her rages were not my fault.”

Toward the end of the year, Eric was becoming more affectionate with his wife, and he told her all of the positive qualities he finds in her. He said that she became quite emotional because she felt valued and loved. He was quite distressed when he came to one session, having attended a child’s funeral the previous day. He was feeling very sad, as he identified strongly with the deceased child, who he said had lost so much. While walking in the cemetery he was touched emotionally when he saw a monument depicting love between a naked man and woman seated on a bench. I said that love was what he had needed more of as a child. Eric then recalled occasions when his mother comforted him, but said he rarely sought closeness to her, as “she could become like a wild animal and suddenly erupt with anger.” In the next session he reported feeling somewhat better; talking with me, he said, had eased the painful feelings. He agreed with me that for many years he had turned to the sexual fantasy for comfort whenever he felt miserable, but said he now recognized that the giant woman was also an unwelcome intrusion when he was trying to work, much as his mother’s rages had disrupted any good times they might have been sharing.

In the eighth and final year of therapy, Eric had become more playful in his art and was trying to bring more emotion to the viewers. Although he reported that the giant woman fantasy was less sexually arousing, like any addiction it returned from time to time. But then Eric reported a dream:

He is in his house and sees a cockroach on the floor that he thinks was brought in as an egg on someone’s clothes or shoes either accidentally or on purpose. He is grossed out, thinking this is the beginning of the end, as it will lay eggs and quickly multiply, and he will be helpless to get them out of his house. He thought the eggs would remain even if he crushed the cockroach.

Eric realized that the house represented his mind, and he connected the invasion of the cockroach with the fetish and how in the past he had sometimes compared it to a viral infection. He associated to the giant woman crushing the tiny men, but also to a scene from the TV show Orange Is the New Black in which a wealthy white woman is sent to prison, where she inadvertently steps on a cockroach. The other inmates, who are Black and Hispanic women, are angry because they used this cockroach to smuggle cigarettes between prison cells. Recalling the story of the eggs implanted into victims by the Alien creatures, I initially thought this was yet another dream about Eric’s perversion; but I later realized that the dream might have a very different meaning. I interpreted the cockroach and cigarettes as phallic symbols; the intrusion of the cockroach into Eric’s mind then represented my interpretations over the years of therapy and how these ideas (the eggs I implanted) could be disseminated throughout his mind. The eggs also represented the potential for generating creative ideas and giving birth. ¹⁴ I then said, “The giant woman fantasy crushes me out of your mind.” Eric replied, “Yes, it drowns out your voice.” I said, “You have relied on a penis from your mother rather than your father all these years.” We then discussed his fear of losing the giant woman and reflected that he has a male phallus in his mind as well as a womb. Eric went on: “I have a close bond with my son, who now seeks me out more than he seeks his mother. I experience you like a surrogate father, nonjudgmental and accepting and calm. You have been a good mentor and guide through the wilderness of my mind. I want to give my son what I did not receive from my father.”

After the summer break, Eric reported he was better able to confront his inner critic. He was feeling more confident and brought some of his drawings and paintings to show me, including one of a giant woman with a pleasant welcoming smile on her face. In a dream,

Eric is with a woman about half his age; she wanted to be with him and hang around. They did not speak, but at one point they are seated on a couch with an armrest between them, like two chairs side by side. Eric remains somewhat aloof, and the young woman goes and lies on the couch, her legs outstretched as though she felt ignored by him but still wanted him to see her. He regretted not speaking to her, as he wanted close companionship but feared that other people might judge him for doing something inappropriate with a younger woman. He felt inhibited, fearing he would experience guilt and shame from criticism.

Eric said, “I think the woman might represent my muse. She reminds me of the actress Emma Watson, whom I recently heard give a speech at the United Nations on the need to end gender inequality.” I said, “There are two types of powerful women—one type, represented by the giant woman, who is a threat to men; the other type is like the muse, who can empower people by inspiring creative thoughts and facilitating the release of their potential.” Eric replied, “I think the giant woman does not want me to link up with the muse.”

During the ensuing months Eric reported that the giant woman fantasy could be a distraction, but he was more successful in fighting it by focusing on the satisfaction and pleasure he was now getting from his creative work. He said he realized he had assumed he was born with his sexual inclination and had avoided trying to understand what lay behind it. He said he now often thinks about his muse as a way of countering the giant woman and silencing the voice of his inner critic. He also spoke about being attracted to young women he saw on public transit while traveling to my office, but assumed they would find him undesirable and reject him. On one occasion, however, he had a fantasy of a young woman being threatened by four thugs on the subway. He went to protect her, and although three of the thugs ran off at the next stop, he managed to pin one man to the floor. When the police arrived they handcuffed him as well as the thug until the woman came and hugged him and explained the situation. He felt protected by her, just as he had protected her. Eric said he thought that the woman represented his muse and the thugs represented his inner critic.

During the final weeks of therapy, Eric devoted time to a new type of creative work, which involved constructing, from carefully selected fabrics, smaller versions of womb-shaped objects he had previously created; he was very proud of the result, and carried the first one in his pocket all day. He said it gave him greater pleasure than he got from the sexual fantasy. He received many compliments for creating these objects, and they sold quite well.

In our final session together, Eric said that he had been enslaved to the addiction when he first came to see me, but now understood what it all means; he said that he now has an inner voice that more successfully challenges the giant woman when she tries to intrude and take him away from his work. For a long time he had felt he was undesirable, including by me, as he thought he was wasting my time. Although the income from selling his work was small, he was planning some ways to increase sales. He said he no longer tolerates being demeaned by others because his self-esteem has improved considerably and he can now quickly assert himself. Moreover, rather than feeling apprehensive about exhibiting his art, he said he had recently “blown [his] own horn” when proudly showing some drawings to a relative. He said that therapy had been like going through a second adolescence.

Discussion

Although a wide variety of psychodynamics can be found among patients with perversions, and there are different ways for conceptualizing how perversions can inhibit the creative process, the case example illustrates the usefulness of an object relations approach with an emphasis on analyzing the impact of childhood trauma on the inner object world. The patient had abandoned authentic creative work for more than a decade because of pressure from his mother, and his artistic ability had been hijacked by the compulsive need to draw pictures of giant women. Consistent with McDougall’s views (1980), the content of these drawings was repetitive, lacking in imaginative freedom, and created for the sole purpose of enacting the perverse sexual scene. Although macrophilia might suggest a denial of generational and sexual differences, as proposed by Chasseguet-Smirgel (1984a), the helplessness and vulnerability of the small men were related to my patient’s unconscious perception of the vagina as a devouring organ rather than to feelings of genital inadequacy. This annihilation anxiety was traced to the patient’s childhood experience of being traumatized by his mother’s frequent hysterical outbursts of rage, and also to his mother’s expectation that her son fulfill her desire that he become a successful writer and painter. Rather than being in conflict over a repressed desire to be an adequate sexual partner for his mother, as Chasseguet-Smirgel’s theory would have it, Eric was conflicted between his need for connection with an inner representation of a safe and loving mother and the need to escape from entrapment with an internal representation of a dangerous mother. The danger was related to an amalgam of the mother’s actual behavior and oral-sadistic and anal-sadistic impulses projected onto her, resulting in an internal alien “third form” (Grotstein 1997) represented as a destructive and omnipotent giant woman in the perverse fantasies and in Eric’s dreams as a predatory bird and as alien monsters that seek to kill. Eric’s father had failed to rescue him from the mother’s influence, and had also been inadequate as a role model for masculine identification. From the perspective of Welldon (2009) and Verhaeghe (2009), the patient’s depression masked the annihilating dread of not having an identity separate from his mother’s desires.

When my patient first entered treatment, his drawings and perversion seemed to represent failed efforts to repair the self and free himself from a persecutory internal bad object. The removal of his beard, and the analogy he later made to a wolf amputating its leg to escape from a hunter’s trap, suggested that his impotence and inhibited creativity were symbolic self-castrations (Taylor 2016). Indeed, Eric said that without the perversion he would feel as if he did not have a penis. The drawings, fantasies, and role-playing evoked sexual arousal and a sense of masculine potency and thereby allowed him to triumph temporarily over the traumatic childhood experiences with a frightening phallic mother. Through a positive paternal transference, he was able to gradually strengthen his sense of masculinity and harness the aggression and hatred that had always felt dangerous to him and been transformed largely into eroticism or incorporated into a severely critical superego. This effect of the transference on assisting Eric in repairing his damaged self was reflected in the way he learned to love and father his own son. But the prevailing internal bad object remained a powerful influence and was strongly resistant to being weakened. After many years of therapy, however, and following fantasies of destroying the giant woman, a good maternal image emerged that was interpreted by the patient as his muse and represented in some of his paintings as a friendly smiling woman. The inspirational muse probably represented an aspect of the previously split-off affectionate image of the mother that was awakened gradually by a positive maternal aspect of the transference. This change in Eric’s inner world was consistent with Davies’s view (2016) that a goal of analytic work with trauma patients is to facilitate movement of a split-off good internal object into the foreground of psychic life. The strengthening of the patient’s phallic identity, the desexualization of aggression, and the slow but eventual emergence of an internal good object were accompanied by a parallel return to producing authentic art without a compulsive need for perfection. It is possible that the changes in the patient may have been effected more rapidly had he been able to increase the frequency of his sessions, but the analysis of childhood trauma, and of castration and annihilation anxieties, effected a marked weakening of his tie to the perversion and restored a sense of personal identity and his capacity to take pleasure in creating authentic art.