PSYCHOANALYSIS AND SEXUAL DISORDERS: THE ORAL STAGE
The earliest of the psychosexual stages Freud described was the oral stage. At this earliest phase of infantile development, the infant’s needs, perceptions and behaviors are centered primarily on the mouth, lips, tongue, and other organs related to the oral zone. Pleasurable excitations and affects arise from stimulation of the mucosal surface of these organs. The primary model of oral stimulation and satisfaction is breast feeding, in which hunger pangs give rise to oral sucking movements which are then satisfied by active sucking on the mother’s nipple and the consequent feeding.
The oral zone maintains its dominance in the libidinal organization for approximately the first eighteen months of life. Oral sensations would include thirst, hunger, sensations related to swallowing, satiation of hunger, and the pleasurable tactile stimulation evoked by sucking on the nipple or nipple substitute. Libidinal satisfaction at this stage of development, how-
ever, may not be restricted solely to the oral zone but may also arise in connection with the multiple forms of tactile stimulation that are connected with mother-child contact, not only in the feeding situation but in the multiple contexts of infant mothering. There is some evidence, particularly from animal studies, that such maternal contact and tactile stimulation has an important influence on the infant’s affective development.
The oral drives are generally regarded as consisting of separate components, the libidinal oral drives and the aggressive oral drives. States of oral deprivation or tension tend to stimulate a seeking for oral gratification which is typified by the state of satiation the infant reaches at the end of a nursing period. Lewin has suggested that there is an oral triad which consists of the wish to eat, the wish to sleep, and the wish to attain that quiescence and relaxation which occurs at the end of sucking just before the onset of sleep. It is generally thought that the libidinal needs of oral erotism predominate in the early phases of the oral stage, but that they become compounded with more aggressive components later on in the stage of oral sadism. The development of oral sadism can express itself in biting, chewing, spitting, or crying. For many analysts, particularly those of the Kleinian persuasion, such oral aggression is associated with primitive wishes and fantasies of biting, devouring, and destroying. Such fantasies, for example, may be directed against the mother’s breast as an expression of primitive incorporative wishes. Although such fantasies can often be recovered in primitive regressive states (in psychotic or border line patients) and may even be elicited in the more regressive associations of even healthier patients, there is no good evidence to substantiate the operation of such fantasies at early infantile stages of development.
In developmental terms, the objectives to be attained in the oral period are among the most important for establishing a well functioning personality and for establishing the rudiments of a significant capacity for an accepted relationship with objects. If the oral period can be carried through successfully, the child should be able to establish a trusting dependence on the nursing and sustaining object and to establish a comfortable expression of oral libidinal needs and to find their gratification without significant conflict or ambivalence from the oral-sadistic wishes to attack, devour, or destroy the object.
The failure to achieve these objectives in one degree or another can lay the foundation for the development of pathological traits. Excessive oral gratification or deprivation can result in significant libidinal fixations. The traits deriving from such infantile fixations can include excessive optimism, narcissism, pessimism, and demandingness. Oral characters are often excessively dependent and require others to give to them and to look after them. Such persons want to be fed and supported and nurtured, and may be selfishly demanding in their attempts to have these wishes gratified; but they may be also exceptionally giving to others as a way of eliciting a return of being given to in kind. Oral characters are thus often extremely dependent on their objects and on a return of support and narcissistic supplies in order to maintain a fragile and often faltering self-esteem. Characteristics of envy and jealousy may often be associated as pathological manifestations of such basically oral traits. Such oral traits are often associated with fairly primitive degrees of narcissism, but these dimensions should be considered separately.
Nonetheless, the oral phase may find a successful resolution and thus provide the basis for character traits positively contributing to personality functioning. Such individuals may develop capacities for giving, for giving to and supporting others, and for receiving from others without a sense of excessive dependence or envy. They may develop a capacity to rely on and trust others and to be capable of relying on themselves and of trusting themselves in their complex dealings with others and in facing the difficulties and challenges of life. The continuing capacity for trust and reliance, either as an enduring possession of one’s own inner life or in one’s relationship with the significant others in his environment, rests ultimately on the development of the basic sense of trust during this earliest oral phase of psychosexual development.
Erikson has characterized these complex aspects of character development deriving from pregenital phases of psychosexual development as phases of psychosocial development. He envisions the phases of psychosocial development arising out of the psychosexual phases as being characterized by certain definitive crises in the development of the individual personality, leading finally to a phase of identity formation. The specific psychosocial crisis associated with the oral phase is the resolution of basic trust versus basic mistrust. The capacity for enduring trust in oneself or in others represents a successful resolution of the early object related crisis in the oral phase, while the failure to resolve that crisis results in a basic and perduring mistrust which provides the basis for a lasting impairment in the capacity to relate to others and to rely on one’s own inner resources.
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