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formations in eating disorders (A. Freud 1956), suicidal attitudes (Menninger 1933, Volkan 1983), scores of dysfunctional personality traits, ‘romance’ (Blackman 2010), psychogenic sexual dysfunctions, and can become embroiled in political attitudes (Parens 1973, 2012). Blackman (2013) mentions that sadomasochism cannot be understood without recognition of pleasure in pain as well as in instilling fear (i.e., ‘bullying’) by either sex (Blackman, 2013). Intimidation acts partly as a defense (Blackman, 2003) against feelings of inadequacy but is only part of a compromise formation, which involves aggressive drive elements. Following Anna Freud, Marianne Kris and others (A. Freud, M. Kris, R. Eissler & A. Solnit 1977), who described the “distribution of libido” clinically, and Brenner’s (1982) formulation of aggressive and libidinal wishes as mental phenomena, which are clinically observed, Blackman (2003, 2010, 2013) lays out a detailed account of clinical and developmental manifestations of both libidinal and aggressive drives, as part of the overall assessment of dynamic and developmental personality organization. In this vein, he describes a developmental progression of libidinal and aggressive wishes throughout life as being 1) constantly developing operations of the mind, 2) conscious and unconscious pleasurable reactions to known anatomic-physiologic development, and 3) a motivation toward thought and behavior. The progression of libidinal and aggressive drive wishes, both conscious and unconscious, correlates with the well-known oral, anal, 1 st genital, latency, and mature genital phases (Freud 1905a, Auchincloss and Samberg 2012). As nodal biological developmental phenomena occur, they are perceived as pleasurable, remembered, then integrated with the persons (‘object representations’) involved (Loewald, 1978), to form each phase’s libidinal and aggressive drive wishes. As for the libidinal drive, the oral phase begins with the sucking reflex; the anal phase with the myelination of the nerves to the anal sphincter muscles; the first genital phase with the psychomotor ability to produce engorgement of the erectile tissue in penis and clitoris (corpora cavernosa); the mature genital phase with orgasm. Regarding the aggressive drive (taking in account Parens’ four types of aggression), the oral phase begins with the grasp reflex; the anal phase with verbalizing “no” and breaking things; the first genital phase with “rough and tumble play”; and the mature phase with the ability to hit and kill others (hostile destructive type) and ambition (nonhostile non-destructive type). These nodal biological phenomena are perceived, remembered, and then integrated with pleasure and with the images of connected persons. The two drives are much intertwined (Raphling 1998). Blackman avers that psychoanalytic diagnosis always involves assessment of ego functions, ego strengths, object relations, and superego development. He points out that although everyone experiences conflicts, which include drive elements, superego (Beres 1958, Brenner 1982a, b; Bernstein 1983, Blum 1985, Milrod 2002), affects (Brenner 1979, 1991, 2006), reality, and defense (Cooper 1989), individuals with severe pathologies also harbor deficits in reality testing, integration, and abstraction (Bellak, 1989), as well as object relations (Kernberg, 1975). In such cases, drive factors, defenses and compromise formations are
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