Psychosomatic Medicine 10:95-106 (1948)
© 1948 American Psychosomatic Society

Psychiatric Implications of the Kinsey Report

¹ Clinical Professor of Psychiatry and Mental Hygiene, Yale University School of Medicine

If this report by Dr. Kinsey and his co-workers does no more than present us with incontrovertible statistics concerning the incidence of manifest infantile sexuality and of manifest adult polymorphous sexual tendencies, it will be a major contribution to our understanding of human development and of human culture. Psychiatry and psychology will always be in their debt for this. Nevertheless, two of the basic implications of their report must be rejected. One is that the overt manifestations of sexual patterns are all that we need to know about human sexuality. The other unacceptable implication is that where any behavior pattern is widespread among human beings, it is superfluous to attempt to explain it. The physiologist does not feel that he does not have to explain the mechanism of the heart beat merely because everybody's heart beats. Nor does the epidemiologist dismiss the problem of the common cold merely because everybody catches cold. Universality is not synonymous with normality; and our obligation to explain every variety of sexual activity, whether heterosexual, homosexual, or anything else, is not lessened in any way by the fact that every form of sexual behavior is widespread.

Nevertheless I want to restate my conviction that this report is a significant contribution and that in balance it will undoubtedly do more good than harm in spite of its errors and its exaggerations. Thus, almost all of the statistics on the incidence of various patterns of sexual behavior are probably somewhat excessive, because of errors in sampling, errors in interviewing, and errors in the treatment of the statistics. Furthermore the important role of chronic compulsive inflation of instinctual needs and of their phobic inhibition is scarcely recognized. This oversight is particularly serious in the case of compulsive sexual athleticism, because in the report one finds the implication that we should remake our culture and our laws to conform to "high scores," as though such compulsive exaggerations of sexual need constituted the ideal for all men. This is just as misleading as are the pseudo-moralistic restrictions which are placed on our sexual mores by unrecognized phobic inhibitions. My fear is that the overstatement of Kinsey's case will lessen the effectiveness of the report in freeing our sexual mores and our laws from the domination of neurotic anxiety and neurotic guilt.

Freud related the universality of deviant sexual trends to the development of the neurosis, indicating that it is neither the latent nor the overt trend which in itself produces the neurosis, but rather the conflict between these trends and the intrapsychic forces which oppose them. I believe that it would help to bring into harmony the observations of the biologist and of the psychoanalyst if we could agree that it is never the deviant drive as such which is abnormal, but 1) the conflict which arises around it and 2) the compulsive and obligatory quality which may attach itself to the drive. Thus an obsessional furor can manifest itself in heterosexual activity just as readily as in masturbation or in homosexuality or in any other deviant form of sexual conduct. It is this obsessional furor plus the phobic exclusion of alternative outlets which is the mark of abnormality, rather than the specific pattern of sexual behavior itself.

The failure of Kinsey and his co-authors to give full and consistent consideration to the powerful psychologic forces which influence the objects, the aims, and the quantity of sexual activity is a source of errors in many conclusions which they draw from their data. It would add immensely to the value of all of the observations made by Dr. Kinsey and his co-workers if we could know more about the physiologic and psychologic setting of the various forms of sexual behavior whose incidence they have determined. To this end it would be essential to make intensive individual physiologic, anatomic, psychiatric, and social studies of individuals who would constitute a statistically adequate random sample of each form of sexual behavior. This would give us vital additional information as to their general life adjustments and the ways in which they handle instinctual processes other than sex, particularly those having to do with food and fluid intake, with excretion, with exercise, and with sleep. The addition of such information as this would be of great importance for our understanding of human nature in general and of sexual nature in particular.

I hope that I have succeeded in making several points clear:

We need a detailed study of enough individuals to constitute a statistically adequate sample of each of the many subgroups which are here described.

Dr. Kinsey and his co-workers were wise not to allow themselves to characterize any individual as good or bad, as sick or well, as neurotic, psychotic, or psychopathic. Certainly from the point of view of establishing their contacts and gathering their material this was essential.

On the other hand, from a social and scientific viewpoint the work must not stop at the gathering of this raw material. Not for the purpose of pigeon-holing individuals, but in order to learn more about the significance in human life of all variations in patterns of sexual behavior, representative individuals should be studied in great detail so that we may learn more about their personality make-up and general life adjustment. We must know what variations there are in each sexual pattern and what different kinds of people manifest the same or different types of sexual deviations, so as to establish what correlations there may be between such deviations and all other aspects of human nature.

For this purpose it will be essential to bring to this work a mature understanding of fundamental principles of dynamic psychopathology, both conscious and unconscious, latent and overt. This will require the cooperative effort of teams of psychoanalysts, clinical psychologists, neurophysiologists, endocrinologists, cultural anthropologists, and psychiatric social workers, as well as biologic taxonomists. That such a study will present formidable difficulties is evident; but that it is essential is equally true.