A revised psychoanalytic view of menopause

The traditional psychoanalytic view of menopause regards it as inevitably accompanied by reactive depression resulting from the loss of reproductive function. This view is grounded on a theory of female sexual development that stresses the centrality of the phallic castration complex. The inevitable menopausal depression involves a remobilization of this complex and a reexperiencing of castration fears. The new view, based on the concept of primary feminine identity, complements the concept of a phallic castration complex with the related concept of female castration anxiety. In this view menopause, though it typically involves physical discomfort and a reworking of maternal identification, involves an interplay of both types of castration fears. By understanding and analyzing these fears, progressive adaptation to menopause, including the opportunity for enhanced creativity and emotional fulfillment, is possible. A clinical case example is presented to illustrate these ideas.