Psychosexual Development


Psychosexual Development is a broad term that can be considered the process of growing and maturing physically, emotionally, intellectually and spiritually so that there is a healthy balance between the physical/biological aspects of sexual behaviour and the psychological and emotional context in which the behaviour occurs. Originally, psychosexual development was defined by Sigmund Freud, who proposed specific stages of psychosexual development (e.g., oral, anal, etc.). Modern research on cognitive, physical, and emotional/moral development has provided a much richer context in which sexual attitudes must be considered. It is thus more appropriate to view a child or adult's sexual feelings, knowledge and behaviours within the context of that person's physical, cognitive, and emotional development. Assessment of a person's psychosexual development must also include consideration of environmental influences, such as the modern media, ethnic/cultural beliefs, family practices, past exposure to sexuality, possible abuse (physical and emotional, as well as sexual), and sexual knowledge. Therefore fully understanding a person's level of sexual maturity involves integrating of all aspects of development in the context of a person's experiences.

Assessing a child's level of psychosexual development can be an involved, although not necessarily complex, process. Children do engage in sexual behaviours, although the meaning of "sexual" is very different for a child than for a post-pubertal adolescent or adult. However, there is no evidence that children progress through a natural series of developmental "stages" in terms of their sexual behaviours. As infants, children are capable of sexual arousal and "orgasm," although there are no vaginal or seminal secretions until puberty.

Children also "masturbate," which usually takes the form of touching themselves or rubbing against an object as a form of self-stimulation. In its natural form, such behaviour is usually self-soothing and is readily amenable to inhibition placed on the behaviour in the form of parental or societal restrictions: children readily learn that they are not supposed to touch themselves in public and thus inhibit the behaviour in public. Children also often engage in mutual exploratory play (such as "house" or "doctor") with their playmates.


This behaviour is usually very innocent and again under the control of social restrictions. If the behaviour is not under the child's control, when sex play happens with others (children or adults) who are not the child's usual playmate, when behaviours are intrusive and/or harmful to the child, or when the child has knowledge that is outside his/her expected level of awareness, then it is likely that the child's sexual development has been disrupted in some way. It is at that point that a thorough evaluation is necessary. It is also important to recognize that while children do engage in some "sexual" behaviours, they are not emotionally, cognitively, or intellectually prepared to deal with adult sexuality or adult emotions.

Psychosexual health is very difficult to define in adults, partly because of the wide variety of sexual behaviours that can be engaged in. In general terms, psychosexual health refers to a state in which adult needs for sexual behaviour are driven by a desire for contact with a loved person, and in which mutual sexual activities in the context of an intimate relationship are satisfying. Although sex outside intimate relationships is an accepted fact within our society, when such behaviour becomes the norm or preferred behaviour rather than an occasional outlet, it is likely that such behaviour reflects interference in the person's ability to achieve emotional intimacy within relationships. Ideally, a person would be able to be physically, emotionally, and spiritually intimate within a relationship in which both partners desire intimacy, and in which neither partner is consistently domineering, controlling, or hurtful of the other. Health thus refers to a situation in which a person is able to achieve emotionally intimate relationships, and in which the sexual behaviours arise out of a desire for physical and emotional intimacy rather than out of a distorted attempt to meet some other emotional need.

Dr. Louise MacKay has a clinical interest in assessing and treating difficulties related to sexual development and sexual disorders. Please contact her for more information