What can we expect as the ideal of a mature capacity for sexual love, as expressed by an integration of eroticism and tenderness, idealization and responsibility, enjoyment and passion?

This is precisely the question Otto Kernberg raises in his book Treatment of Severe Personality Disorders: Resolution of Aggression and Recovery of Eroticism (2018). 

According to Otto Kernberg, the mature sexual love is a complex emotional disposition that integrates: 

1) sexual excitement transformed into erotic desire for another person; 

2) tenderness that derives from the integration of libidinally and aggressively invested self and object representations, with a predominance of love over aggression and tolerance of the normal ambivalence that characterizes all human relations; 

3) an identification with the other that includes both a reciprocal genital identification and deep empathy with the other's gender identity; 

4) a mature form of idealization along with deep commitment to the other and to the relationship; 

5) the passionate character of the love relation in all three aspects: the sexual relationship, the object relationship, and the superego investment of the couple. 

By ideal of a mature capacity for sexual love, Otto Kernberg does not imply unrealistic goals with the implication that patients should live up to them, but a frame of what might be optimally possible in order to highlight the greatest difficulties to achieve such a condition.

For example,

One patient falls in love easily but, within a few weeks, begins to see only the partner's flaws.

Another is able to maintain a relationship for years but avoids sexual intimacy.

A third has an active sexual life yet cannot tolerate emotional intimacy.

A fourth patient is only able to maintain relationships at a distance.

A fifth is in a long-term relationship characterized primarily by ongoing conflict.

On the surface, these are very different stories. Yet they all reflect an impairment in the capacity for mature love.

What are the most severe limitations determining the distance that separates the patient from the rich life that he or she might have? 

For Otto Kernberg, it is important not merely to identify a specific problem in a patient's love or sexual relationships, but to understand which psychological limitations underlie it and how profoundly they impair the person's capacity for mature love. After all, seemingly different clinical manifestations may reflect impairments in the same fundamental capacities. 

Thus, Otto Kernberg is not talking about an ideal of “normality,” but a theoretical outline that facilitates the diagnosis of problematic issues that restrict the capacity to love. To begin with, such an outline should include a sharp focus on the capacity to experience sexual pleasure proper, to establish object relations in depth, and to establish one’s own and joined value systems in the relationship within a couple.

According to Otto Kernberg, an optimal way to evaluate the capacity for maturity in loving is to evaluate a patient who is involved in a love relationship or has been in a love relationship that can be explored as such. 

This is why, for Kernberg, love relationships are not merely one domain of the patient's life, but one of the most important avenues for understanding the structure of the patient's personality. 

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(c) Yuliia Holopiorova,

Ukrainian Association of Transference-Focused Psychotherapy