阴茎的首要地位,精神器官的致命弱点?对前列腺癌的思考

Anne-Sophie Van Doren , Benoit Verdon
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引用次数: 0

摘要

背景对前列腺癌的临床研究,尤其是从精神病理学的角度来看,仍然相对欠缺,但它是对阴茎的勃起能力提出严肃且往往是持久的质疑的场所,因此也可能是对其所受的幻觉投资提出质疑的场所。此外,这种常见的癌症尤其与衰老问题相关,它从根本上考验着患者的脆弱性和自恋资源。权力、表现、耐力以及对被动和抑郁的反投资,在与自己、与女性和与男性的关系中成为特别尖锐的问题。因此,在幼年性心理现实与衰老、疾病和社会表征等外部现实之间的衔接中,划定噬性需求的心理利害关系显得至关重要。本研究旨在了解前列腺癌的创伤性经历--衰老和脆弱性的尖锐认识和体现--如何揭示出不仅由噬性至上所塑造,而且由社会噬性逻辑所强化、平衡约束和理想的断层线。它试图揭示男性自恋与阳具需求及其影响相关的脆弱性和资源。本研究采用了多方面的研究方法:对绘画中男性形象的禁忌进行研究、半结构式访谈,以及对 20 名六十多岁、接受过前列腺癌治疗的男性进行投射测试。结果荣誉感和阳刚之气成为特别重要的自恋问题,助长了躁狂的男性气质,使男性将各种焦虑(死亡焦虑、被动焦虑和阉割焦虑)的利害关系转变为另一种焦虑的形式:植根于阳刚之气的自恋性死亡焦虑,即在他人眼中不再作为男人存在的恐惧。因此,在社会、性心理和躯体精神领域的交叉点上,前列腺癌揭示了一个禁忌的致命弱点。这是由阴茎需求(内部和外部)之间无意识的互动和忠诚以及对勃起感官维度的部分依赖构成的,这就需要重新评估男性气质、阴茎和独立于感官知觉的勃起。社会通过一种集体和文化想象,将力量、耐力和活力等特征与 "良好的 "阳刚之气联系起来,而将脆弱的特征与 "阳刚之气危机 "联系起来,从而在心理层面上强化了勃起的感官知觉与阳刚之气和男性保证之间的混淆。这些观察结果超出了器质性病理学的范畴,有助于就性别问题、意识形态的形成和极端虚弱主义运动展开更广泛的讨论。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Le primat du phallus, talon d’Achille de l’appareil psychique ? Réflexions autour du cancer de la prostate

Context

The clinical study of prostate cancer, particularly from a psychopathological perspective, remains relatively underexplored yet it serves as a site for serious and often lasting questioning of the erectile capacities of the penis, and thus potentially of the phantasmatic investments it is subject to. Moreover, this common cancer is particularly linked to the issue of aging, which radically tests the fragilities and narcissistic resources of patients. Power, performance, endurance, and counter-investment against passivity and depression become particularly acute issues in the relationship to oneself, to women, and to men. It then appears essential to delineate the psychological stakes of phallic demand in the articulation between the psychic reality of infantile sexuality and the external realities of aging, illness, and social representations.

Objectives

This study aims to understand how the traumatic experience of prostate cancer—an acute realization and embodiment of aging and vulnerability—reveals fault lines not only shaped by the primacy of the phallus but also reinforced by societal phallic logic, balancing constraints and ideals. It seeks to discern the fragilities and resources of male narcissism related to phallic demands and their implications. The primacy of the phallus and its associated infantile sexual theory are thus questioned in their organizing or disorganizing roles.

Method

The study is based on a multifaceted methodology: an examination of the taboo surrounding the representation of the male sex in painting, semi-structured interviews, and projective tests conducted with twenty men in their sixties who have been treated for prostate cancer. A case study allows for a thorough and heuristic articulation of theoretical and clinical questions.

Results

Honor and virility emerge as particularly significant narcissistic issues, contributing to a hypomanic masculinity that enables men to shift the stakes of various anxieties (death anxiety, passivity anxiety, and castration anxiety) into the form of another anxiety: a narcissistic death anxiety rooted in virility, the dread of no longer existing as a man in the eyes of others. At the intersection of social, psychosexual, and somatopsychic spheres, prostate cancer thus uncovers a taboo Achilles’ heel. This is composed of unconscious interactions and loyalties between the phallic demand (both internal and external) and a partial dependency on the sensory dimension of erection, necessitating a reevaluation of masculinity, the phallus, and erection independent of sensory perception.

Interpretations

Society reinforces the confusion between the sensory perception of erection and the sense of virility and masculine reassurance on a psychological level through a collective and cultural imagination that associates characteristics of power, endurance, and vigor with a “good” virility, and attributes of vulnerability with a “crisis of virility.” These observations, beyond the scope of organic pathology, could contribute to the broader debate on gender issues, the formation of ideologies, and ultra-virilist movements.
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