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Benedek, T. (1950). Climacterium: A Developmental Phase. Psychoanal Q., 19:1-27.

(1950). Psychoanalytic Quarterly, 19:1-27

Climacterium: A Developmental Phase

Therese Benedek, M.D.

SUMMARY

The climacterium is characterized as a period of intrapersonal reorganization in women. Parallel with the declining hormone production—menopause is a manifestation of that aspect of

ageing—proceeds the desexualization of the emotional needs which, in turn, releases psychic energies for sublimation and further integration of the personality.

Anthropological data concerning menstruation and menopause are cited to indicate that cultural patterns determine to a high degree the anticipation of and the reactions to a physiological experience of the individual. In our culture, the climacterium is anticipated with exaggerated fear. The psychiatric symptoms which often accompany the menopause are, however, not related in simple causality to the physiology of that event; they are rather motivated by the psychosexual history of the individual.

Study of the sexual cycle affords the clue to the psychopathology of the climacterium. The sexual cycle represents the correlation between the hormonal function of the ovaries and the conscious and preconscious manifestations of emotions. The highest level of psychosexual integration corresponds to the peak of the hormone production; parallel with the premenstrual hormone decline a regression takes place. The manifestations of this regression represent the premenstrual neurosis.

An instance of premenstrual depression is cited to illustrate that disturbed psychosexual development may lead to inhibition of the gonadal function, and that inadequate production of hormones may be perceived as a lack of libidinous emotions causing a sense of frustration from within. The individually characteristic methods of mastery of psychic tensions—as they may be studied in the sexual cycle—serve as indications of the psychic reactions to be expected about the time of menopause. Two cases of severe climacteric depression are presented to demonstrate that the failures of adaptation to the internal frustration of the menopause were determined by the already previously exhausted and rigid adaptive mechanisms of those individuals.

In the female, the two psychodynamic tendencies of the propagative functions—the need for heterosexual gratification and the need for reproduction—are separated; cyclical repetition

of these two trends of the sexual drive prepares the woman for the complex physiological and emotional processes of her reproductive function. Motherhood is a further step in the integration of the personality. Physiologically, it completes sexual maturation; psychologically, it channelizes and sublimates the specifically feminine trends of the sexual drive. The accomplishment of the reproductive period, and its lasting sublimations, sustain the personality during the climacterium so that after the woman has succeeded in mastering the adaptive task of her climacterium, she can plan an active life which promises ego satisfaction.

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