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Kestenberg, J.S. (1968). Outside and Inside, Male and Female. J. Amer. Psychoanal. Assn., 16:457-520.

(1968). Journal of the American Psychoanalytic Association, 16:457-520

Outside and Inside, Male and Female

Judith S. Kestenberg, M.D.


Analyses of children and adults reveal the obstacles encountered in the development of the external orientation of men and inward orientation of women. Both sexes fear the destruction of their insides, but this more archaic form of the castration complex is typical for women.

There seem to be two "inner genital" stages in which anxiety-provoking inner genital sensations give rise to a reorganization of pregenital, inner genital, and outer genital component drives. The first "inner genital" stage ends with the subordination of all component drives to phallic dominance. The second "inner genital"

stage in prepuberty ends with the integration of all component drives, including the phallic, in the sex-specific genital primacy that begins with the onset of biological puberty. Adult genital organization cannot be achieved without the acceptance of the role of internal genital organs in coitus and reproduction.

The developmental trend toward externalization, common to both sexes, promotes adjustment to reality and facilitates the formation of psychic structures at the expense of sexualization of internal genital organs. However, this very trend obscures and retards the developmental steps that prepare the acceptance of the vagina as the primary erotogenic zone of the adult woman.

Throughout development the girl depends on external objects to alleviate her inner genital tensions. To completely overcome her fear of losing her "inside," woman depends on man to protect her against the danger of ego dissolution, represented in the loss of contact with reality at the peak of orgastic experience.

Analysis can free man from the fears and defenses which prevent him from accepting and carrying out his role of teacher and organizer of feminine sexuality. Analysis can free woman from the defensive masculinization that supports her externalization, denial, and repression of the vagina, and prevents the cathexis of vaginal excitation. Analysis can make woman teachable, but it cannot teach her. Woman's orgastic capacity develops to its full potential only when man can help her to achieve it.

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