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This paper reviews a network of evidence which suggests that men and women differ in their prevailing mode of superego functions, and that this difference in superego mode may be one determinant of sex differences in “choice” of psychiatric illness. There is evidence for a connection between patients' perceptual style and their proneness to shame or guilt. There is a well-established connection between sex and perceptual style; from adolescence onward, women are more field-dependent than men [l, 2]. There is also a connection between field dependence-independence and “choice” of psychiatric symptoms [3]. Sex differences in proneness to psychiatric illness may be mediated in part by a sex difference in mode of superego functioning.

La «tension» entre les observations cliniques de Freud et sa metapsychologie peut etre interpretee comme dues a l'etat lacunaire du savoir psychologique de son temps. A l'epoque on n'etait informe ni de l'anthropologie culturelle, ni de la nature des interactions mere-nourrisson, ni de la physiologie du sommeil (mouvements oculaires rapides), ni du role des emotions dans la communication

Just before World War I, Durkheim and Freud each independently proposed that guilt is an internalization of cultural values. Since then, the field of personality and culture has burgeoned into its now massive proportions. Interdisciplinary studies, involving psychology, sociology, and anthropology, have developed into what is now the field of psychoanalytic anthropology.

Lewis’s work on the role of shame and guilt in personality, psychopathology, and psychotherapy draws from psychoanalytic theory, experimental psychology, and a wealth of personal experience as a practitioner and teacher of psychotherapy. In this chapter, she begins by elucidating the long-standing problems in distinguishing between shame and guilt as separate and important motivational conditions. She shows how the problem began when Freud failed to distinguish between the ego and self and explained the superego solely in terms of instinctual drives (especially the working of the death instinct), emphasizing the role of the affective state of guilt. Within this framework, Freud saw no place for shame in superego functioning, nor did he see a role for shame in depression. Hartman included cognitive and social learning components in his conception of superego functioning, but the impact of his contribution on affect theory was simply to strengthen the role of guilt.

In 1923 Freud published the “case history” of Christoph Haizmann, a painter living in the seventeenth century who had become possessed of the Devil and then been granted a miraculous cure through prayer to the Virgin Mary. This paper of Freud’s, though brief, is nevertheless full of the clinical detail that has been so informative in psychiatry. The case account also illustrates very clearly the difference between Freud’s clinical descriptions and his theoretical formulations. Let us spend a few moments with Christoph Haizmann’s story, since it contains so many of Freud’s insights as well as so many of the psychological problems that remain today.

Freud’s insights about the emotional meaning of dream content (like his clinical observations about hysterical symptoms) were placed by him in a theoretical straitjacket that not only created a schism among his followers but also discouraged fresh observations about dreams. The blow to Freud’s theory of dreams that resulted from the discovery of the REMS was felt as a relief by some clinicians, including myself, who had long been irritated by classical psychoanalysis’s slavish adherence to “rules” forbidding dream interpretation outside the analytic situation. The discovery of the REMS has actually made it possible to study dreaming on the spot, with control over presleep emotional input. As we shall see in the next chapter, a firsthand study (in which I was one of a team of researchers) of REM period dreams collected from normal people demonstrates the freshness and vitality of Freudian dream interpretation, although dream theory remains obscure.

Freud extended his use of the concept of “primary process” in two books after The Interpretation of Dreams (1900), a book on everyday mistakes (1901b) and a book on jokes (1905a). These two books turn our attention away from the problem of the social nature of human nature back to the narrower problem of the relation between cognition and affect. As we shall see in this chapter, these two issues are related. They become connected in the problem of how to understand the obviously high level of intellectual functioning that can produce the “compromise” content of mistakes, and the even more dazzling intellectual feats that are the “joke work.” These intellectual feats occur under the press of maintaining affectional ties.

Freud's discovery of an emotional basis for mental illness led him to pursue the emotional basis of human behavior in general. This pursuit led him to undertake observational studies of dreams (1900), everyday mistakes (1901), sexuality (1905b), character formation (1908, 1931), jokes (1905a), and the origin of guilt (1913). Volume 2 of Freud and Modern Psychology examines the texts of each of these major writings in general psychology, continuing to explore the contradiction between Freud's observations about the power of emotions and his narrow the oretical formulations about human behavior. Volume 2 also reviews the remarkable power of the uniquely moral emotions of shame and guilt not only to create psychiatric symptoms, as discussed in Volume 1, but to infiltrate our nightly dreams, create everyday parapraxes, influence the development of sexuality, specify the emotional release in jokes, shape personality, and "create" human culture. As we saw in Volume 1, we shall see again in Volume 2 that Freud's theoretical difficulties arose from the absence of a viable theory of human nature as cultural, that is, social by biological origin. In a the oretical framework based on the cultural nature of human nature, the emotions and the social cohesion are reciprocally related to each other. The emotions are the means of the social cohesion which, in turn, is the means by which the emotions, including shame and guilt, are formed in infancy."

In many ways, Freud’s views on the personality differences implicit in being a man or a woman illuminate the political basis and the political implications of psychological views on human nature. To the extent that Freud saw human nature as sexually repressed by civilization, his work tended toward the liberation of both sexes from their culturally stereotyped sex roles. However, he embedded his clinical observations about sexual repression and resulting neurosis in a scientific framework of instinct theory. The instinct theory that he devised, though progressive in the sense that it was materialist, could also be used as an implicit justification for domination, specifically for domination by men over women. These issues are still being hotly debated today in discussions of social Darwinism (see, e.g., Tobach & Rosoff, 1978).

Freud’s main point about dreams was expressed in the title of his book: Dreams can be interpreted in a way that makes emotional sense even though they may appear to be meaningless and to be about trivial events. Nowhere in Freud’s work, however, is the contradiction between his insights about the power of emotions and his theoretical neglect of them clearer than in his work on dreams. As Richard Jones (1974) points out, there are, for example, really two distinct books in Freud’s The Interpretation of Dreams (1900). One book, in six chapters, is about the interpretation of dreams into their emotional content. The last chapter (Chapter 7) of The Interpretation of Dreams is another book on the theory of dreams, in which emotions are hardly mentioned.

Let me first express my delight at the chance to discuss the psychoanalysis of shame and guilt with neuro-behavioral scientists. I have been devoting the past 25 years of my life to these two grisly states — in my view human beings’ principal moral emotions. And of course it does not take much thinking to realize that the reason I have had to focus on shame and guilt is that in psychoanalytic work and psychotherapeutic work of any kind these are the two prevailing emotions with which clients address us.

Freud’s Three Essays on the Theory of Sexuality (1905), Interpretation of Dreams (1900), and Studies on Hysteria (Breuer & Freud, 1893–1895) are publications in which he set down his discovery that forbidden sexual longings were somehow transformed into neurotic symptoms. Although Freud’s theorizing in Three Essays emphasized the primacy of instincts, the outcome of this work has been to focus attention on the primacy of human emotional—specifically, affectional-social—bonds as governors of human behavior.

Sex differences in proneness to depression and paranoia are seen as reflecting caricatures of women s and men's stereotypical role in a male-dominated, exploitative society Following its major hypothesis that mental illness arises out of failures in the sociability that is inherent in our species, the paper discusses some of the evidence for sex differences in sociability, and some evidence from studies of sex differences in field dependence which, taken together, suggest a sex difference in proneness to shame and guilt This sex difference in ‘superego” style is a mediating factor in proneness to depression and paranoia

This chapter complements the preceding chapter on shame, yet it shows how the dynamically related emotion of guilt has different evolutionary roots, different effects on consciousness, and different consequences for personal and social adjustment. Lewis holds that it was the shift in the conception of guilt as an essential aspect of one’s relationship with God to its conception as a signal of violation of internalized cultural values that brought it within the pale of science. With this secularization of the concept of guilt, social scientists began studying its enculturation and socialization, and psychologists and psychiatrists began studying how its presence in excess produces psychological disorders.

Freud’s interest in the origins of guilt came relatively late in his work, as he himself acknowledged (1933). It was only after his major clinical accounts had been written that Freud undertook a study of the origins of guilt in Totem and Taboo. In his clinical papers, as well as in his books on dreams and jokes, “disgust, shame, and morality” were simply the counterforces against which sexual longings (libido) contended. Moreover, the origin of these counterforces was at first located in the sexual instincts themselves (see Chapter 4) as sublimations and reaction formations of the sexual instincts. Hostility arose out of frustrated libido; sublimations and reaction formations of hostility (although in the service of the “ego-instincts”) also made use of the energy of the sexual instincts to deflect them into social and moral purposes. In this account, libido theory is the centerpiece of the explanation. Our path might have been easier if Freud had indeed regarded his libido theory as a theory of the emotions (as he said he did in Group Psychology, 1921, p. 90). If one permits libido to stand for the attachment emotions, the origin of hostility and morality in a single source becomes a viable hypothesis. Morality is the affective-cognitive outcome of attachment. Threatened attachment, which first evokes protest aimed at the caretaker—“other,” is then transformed, mainly by identification, into states of shame and guilt that aim at maintaining the attachment.

As has become apparent in each of the preceding chapters, psychoanalysis as a model of psychotherapy invented by Freud shifted its focus away from symptom relief after catharsis of guilt and shame toward character reorganization. Today, symptom relief is not an important criterion for termination of analysis (Firestein, 1978). Intrinsic in this shift has been a change of emphasis away from unraveling the patient’s states of shame and guilt over forbidden longings (as these resonated with childhood longings) toward locating the patient’s psychosexual (instinctual) regression or childhood ego-impairment (as this forecast the present illness). As Freud made these shifts in emphasis he also became less enthusiastic about therapeutic success and more interested in the implications of psychoanalysis for general psychology and the social sciences. As I have suggested in previous chapters, Freud’s diminution of interest in therapeutic success paralleled and may have been influenced by the relatively quick successes he achieved with the ready affects of hysterical women patients as contrasted with slow progress and fluctuating outcome of the work with the obsessional Wolf-Man, that champion representative of the affect of indifference. Whether or not there was a causal connection, Freud’s own (self-fulfilling) prophecy (1926b) was that psychoanalysis would ultimately be more influential in general science than as a mode of therapy.

A number of hypotheses about the effects of presleep stress on dream recall among field-dependent and field-independent Ss were tested to explore the role of repression and of dream affect in dream recall. The effect of presleep stress was to increase arousal during REM sleep and affect in dream reports. The data also suggest that the most affectful dreams are best recalled. Among field-dependent Ss dream content was reported less frequently on stress than on neutral nights, but no stress effect on dream report frequency was found among field-independent Ss. The results are discussed in terms of repression theory, and in terms of a possible alternative explanation that stress-produced anxiety interferes with attentional processes required for dream recall at the moment of awakening.