Another subject of great importance for the study of the mind-body relationship in the female sex is the one regarding the several ways through which women experience the breasts. Considering that the breasts and the genitals constitute the two principal poles of femininity at the somatic level, there are considerable differences in the ways women experience and relate to these organs. These differences concern not only the obvious anatomical, physiological and topographic aspects but also the archetypal and symbolic ones.

As to the very intense and rich corporeal consciousness and experience that characterizes the female sex, the immediately visible and palpable feature of the breasts contrasts to the inner, intrapelvic and, therefore, hidden and "mysterious" feature of most of the female genitals. While of all the female genitals only the vulvar structures are exposed on the surface of the body and, therefore, to direct perception, the breasts constitute the only woman's sexual organs that not only are entirely exposed but also "project" themselves into space.

As glands that originate from the skin, the breasts are part of the very surface of the female body and, therefore, part of what is more external in women's body image. The very special aesthetic attributes of the breasts, allied to the fact that they are one of the fundamental poles of femininity, greatly increases the intensity of narcissistic libido projected by women on this part of their bodies.

The profound, deep location of most of the woman's genitals, hidden in the intimacy of their pelvis, is one more element that, associated with other physiological peculiarities of these organs, greatly contributes to an intense "interiorization" of the female sexual functions. Here I must remark that this "interiorization" is experienced by women not only at the anatomical and functional level, but also at the symbolic and archetypal one.

However, this intense "inner feature" of female sexuality is, to some extent, partly counterbalanced just by the evident outer feature of the breasts, which appear as the main sexual "protuberances" of the surface of the woman's body. This is one of the reasons why the breasts constitute the most important external pole of femininity. It is mostly by means of women's bodies external shape, of the several elements that constitute the surface of their bodies, that the strong self-erotic and narcissist feature of female sexuality becomes evident.

The differences between the patterns of relationship of women with their breasts and genitals are very important in Psychosomatic Gynecology. Female neurotic attitudes regarding their sexual organs tend to be less frequent in relation to the breasts than to the genitals. In the absence of mammary pathologies and neurosis specifically related to the breasts, in some aspects women seem to demonstrate a more "relaxed" relationship with these organs than with their genitals.

This fact can be shown even in patients' reactions to gynecologic examination. While during the pelvic examination many women become very nervous and anxious, during the breast examination the degree of nervousness seems to be much reduced or even absent. ( See Note below. ) Remember that, for women, due to the anatomical peculiarities of their genitals, these organs are always surrounded by some "mystery"; they represent the way into the innermost part of their bodies, and this may often generate anxiety. Conversely, the breasts constitute evident and notorious visible and easily palpable parts of the body's surface, being, for that reason, a "widely known" place.

Regarding the symbolism of the breasts, various manifestations of the aphrodisiac and maternal archetypes related to these organs can be found in continuous interaction in the human mind. In a similar way to what happens to women's other sexual organs and everything that is typically female in their bodies, regarding the breasts we can verify that aphrodisiac and maternal archetypes, as representatives of principles of different nature, interact through an extremely complex, ambivalent and often conflicting way.

As to the manifestations of the aphrodisiac archetypes related to the breasts, they are directly associated to the enormous erotic charge inherent to these organs. This erotic charge becomes evident through the high sexual sensitivity of the breasts, through their capacity to reinforce female narcissism and to arouse fascination in men. At the psycho-socio-cultural level, the worship of the erotic aspect of the breasts in our civilization is one more typical example of the power exerted by the aphrodisiac mammary archetypes. For the great majority of modern women, the breasts are much more important as sexual organs than as glands capable of feeding babies.

The maternal archetypes become manifest in relation to the breasts by being essentially related to the nourishing potentiality of these organs, which, biologically, is made real through the production of milk during breast feeding.

Note: Considering the high incidence of breast cancer, this apparently reduced - or even absent - degree of nervousness on the part of the patients during the usual clinical breast examination becomes especially curious. I say that because, taking into consideration the aforementioned high frequency of breast malignant disease, rationally women should be expected to become much more anxious during breast examination than pelvic examination - despite some physical discomfort caused by the procedures of the pelvic one. But, as I said, the especially curious fact is just that many patients who clearly demonstrate considerable degrees of anxiety regarding genital examination seem to demonstrate almost no anxiety regarding breast examination.

Nelson Soucasaux is a gynecologist dedicated to Clinical, Preventive and Psychosomatic Gynecology. Graduated in 1974 by Faculdade de Medicina da Universidade Federal do Rio de Janeiro, he is the author of several articles published in medical journals and of the books "Novas Perspectivas em Ginecologia" ("New Perspectives in Gynecology") and "Os Órgãos Sexuais Femininos: Forma, Função, Símbolo e Arquétipo" ("The Female Sexual Organs: Shape, Function, Symbol and Archetype"), published by Imago Editora, Rio de Janeiro, 1990, 1993.

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Email: nelsons@nelsonginecologia.med.br