A Case of Masochism
Elsworth Baker, M.D.
Reprinted from the Journal of Orgonomy, Volume 6 Number 1
The American College of Orgonomy
Masochism is one of the most difficult problems the therapist has to meet. Most patients show some masochistic features and, in the end stages of therapy, go through what is essentially a masochistic stage. However, the true masochist is quite rare. I saw only one in analytic therapy. This case under discussion as the first I have had while practicing medical orgonomy. Reich cites the following characteristics, all of which must be present for a diagnosis of masochism:
1. A constant whining and complaining, which mirrors an inner sense of chronic suffering.
2. The compulsion to torture others in order to wring from them a violent reaction, possibly even a beating, which will bring relief of tension.
3. An awkward, atactic gait, secondary to severe tension.
4. A chronic need to damage and derogate the self, a defense against exhibitionism.
5. An excessive demand for love, stemming from a fear of being abandoned. His need for love (warmth) is as boundless as it is unattainable. With it goes skin erogeneity. The masochist is chronically contracted and feels cold. He likes the warmth of the bed.
6. The sexual behavior is specifically pregenital in character.
Most masochists do not show the typical masochistic perversions, and, as Reich has pointed out, the diagnosis may not become clear until late in therapy. This certainly was true in the present case. At the outset, I was aware of some masochistic traits but did not discern the full-blown masochistic picture until further symptoms became evident and confirmed the diagnosis. I only knew that I was dealing with one of the most difficult and frustrating cases I had ever worked with.
The patient was a 27 year-old, single, white, foreign-born male. His father was Jewish, his mother English. He was extremely intelligent, had a good scholastic record, and, when he came to me, he was a college instructor. He complained of the following symptoms: stuttering, which was especially troublesome and embarrassing to him, as his job required extensive lecturing, and, secondly, his fear of women. He had a few married women friends, but he never went out with girls and had had no sexual experience. The female body was unexciting to him, although not repulsive. His sexual interests and fantasies were all of men, and, although he had never had a homosexual contact, he considered himself a homosexual.
He was also much ashamed of his penis, which he considered unusually small, and found it extremely painful to appear nude in front of other men, which he avoided whenever possible. It did not, however, prevent him from attending a men’s club for physical exercise, massage, and baths, where nudity was frequently necessary. He had a morbid curiosity to look at the other men’s penises and felt absolutely miserable with envy whenever he saw a man with a large phallus. Masturbation was usually accompanied by fantasies of fellatio, when he massaged his penis.
He was rather stiff and formal, but likable, and seemed to make good contact. He was highly thought of by his superiors in college for his ability and efficiency, and, during the course of his therapy, he progressed to associate professor and second in his department. He wrote many scientific papers and gave lectures throughout the country. Physically, he was well built, athletic, but rather small of stature. Biophysically, he was quite rigid, with anxious, piercing eyes, sharp features, and spastic jaw; the neck muscles were rigid, the occiput very contracted and hard, the chest did not move, and there was marked spasm in the epigastrium. The pelvis was immobile. Thighs and buttocks were tender and spastic. His spinal muscles were spastic. My first impression was that he was basically phallic, with anal features and a throat block.
He was cared for in his early years mostly by two young English nursemaids, sixteen and eighteen years of age, but had little memory of their treatment of him. He was the youngest of five children, having two brothers and two sisters. His oldest brother was already away at boarding school when he was born, and he never had much contact with him as a child. His oldest sister was unpleasant and treated him badly. He never got along with her, but he had quite a good relationship with his other sister. His second brother, just slightly older than he, was a real problem. He always demanded his own way and would refuse to eat or throw temper tantrums if thwarted. The mother, to avoid such scenes, always gave in to the brother and made the patient do likewise despite the fact that the patient was his mother's favorite-The mother was superficial and contactless, and he never felt any rapport with her, nor did he ever feel loved. Later, he came to despise her but felt obliged to cater to her whims. As a child, he was alone with her a great deal and played with dolls while she sewed. The father was cold and stern but was always telling jokes of an anal nature and frequently insisted on his wife giving him enemas. He was at business most of the time.
My patient was the only child in the family not sent away to boarding school; instead, he went to a Catholic school where he felt alone and unwanted. Later, during his high school years, he lived with a relative and eventually went to college. After he completed college, his father expected him to return home and find employment nearby. He was very upset when his son not only refused but insisted on going to America, and he threatened the son with never seeing him again, saying he would die. This turned out to be true. The father shortly became ill and died, leaving the mother independent financially.
As he lay on the couch, the patient was asked to breathe through mouth. This was not very successful, as his chest did not move and even his abdominal muscles were rigid. It helped some to massage the epigastrium, which was very painful. Pressure on the chest during expiration was of little value, and, when I proceeded to the intercostal muscles, he would not allow me to try to reduce the spasm as it was extremely painful. He grabbed my hand and said he could not stand it, that it only made him tighten up more and inhibited him. I then tried his spinal muscles and had somewhat more success here in freeing some of the spasm. The chest moved slightly, but I could not claim any brilliant success. I now turned to his eyes and asked him to open them. This created a great deal of anxiety and suspicion, and he froze. I asked him to scream, which he did in a stifled way. After several screams, I had him roll his eyes while focusing on the walls of the room, which brought out still more anxiety. Opening and squeezing his eyes seemed to produce no effect, and he was quick to tell me it would be useless, so I concentrated on having him roll his eyes while I massaged the supraorbital area, which was immobile, and worked on the occipital muscles. Frequently, I would ask him to scream and look at me suspiciously. I told him he didn't trust me, and he was frank to admit that he wasn't very impressed and doubted my ability.
Work on the eyes, together with attempts to mobilize the chest and soften the epigastrium, remained more or less standard procedure for the first year. I saw him twice a week. Occasionally, pleasant sensations would travel down his body, which he would stop almost immediately by tightening his muscles, especially the abdominal, which would go into spasm. This would have to be relieved before proceeding. Eventually, when I had him open his eyes and scream, he became very panicky, stiffened all over, grabbed my arm with an iron grip, and could not breathe. His head was pulled sharply back by his occipital muscles. I brought his head forward with difficulty, and be could breathe again and relaxed. I asked him if he had had any thoughts or seen any pictures. He said he saw a pair of hands momentarily in front of his throat. Immediately he had gone into spasm, and the hands had disappeared. He could tell nothing more about them, nor did he have any memories that could relate to them. His nursemaids had never mistreated him as far as he knew, but I felt rather suspicious of them.
I continued to work on his eyes, and several times he went into panic. His head would jerk back violently; he would scream and grab for my arms or legs and hold on. I had to manually bring his head forward, and each time he would report seeing a pair of hands at his throat. Sometimes, they looked like claws. On one occasion, a face also appeared, but he could not identify it. I felt that this was a screen memory of an actual event and questioned him at length about the nursemaids. He could add nothing more. I then asked him about his mother. He remembered nothing significant here, either, except that he was the last child and his mother had told him that she was upset over the pregnancy and tried to induce an abortion. I began to pay more attention to the possibility that his mother's face was behind the hands.
At this time, he went to visit his mother for two months. When he left, he was feeling in somewhat better spirits, but the visit set him back so much one felt he was right where he started. He returned contracted, depressed, and pessimistic. He could not stand his mother and knew he should stay away from her but always felt duty-bound as an obedient son. It took several weeks before he again was at the point where he had been before the visit. Finally, I could produce no more effects from his eyes. They were open, frank, and freely moveable.
I then proceeded to his jaw. His masseters were spastic. His throat was tight, and of course he stuttered. He tolerated considerable pressure on his masseters and sternocleidomastoids. I had him scream, roar, and hit the couch. He could do so rather vigorously but would always complain that it accomplished nothing. I gave him a sheet to choke and bite, but he said he could not tolerate the sensation of the cloth in his mouth. He would try to but could not continue long, as it made him gag. We vocalized a great deal to mobilize his lips, tongue, and throat. His stuttering began to subside, and at times even his chest moved freely. I told him to gag every morning as a standard procedure. The chest was peculiar: Although it seemed very rigid, and I could produce little effect by manual work, it could at times give spontaneously and completely with the expression of the right emotion. At the same time, he would object to any work on the intercostals, saying that it only made him tighten the more and accomplished nothing. He was extremely fussy about what he would allow me to do to him, complaining that anything else only made him more inhibited and tense.
Another problem was that he had an extremely acute sense of hearing, and, if anyone came into the waiting room, he would freeze completely, become immobile, and nothing could proceed until I went out to ask the person to leave. This problem continued throughout his therapy, although it was discussed many times. He could not make a noise or move if anyone could hear him. His only association to this was that as a child he would hear his mother groaning and making noises and thought his father was beating her up. He became disillusioned when he ran into the room and found his parents in the sexual embrace and his mother screamed at him to get out. He would lie very still while he listened to them.
We continued the work on his throat and jaw, with screaming, vocalizing, gagging, and biting. Again he went into panic, pulled his head back sharply, and clutched at me. Again he saw the hands but could add no more to solve the mystery. This was repeated a couple of times as his jaw and throat began to give. His stuttering improved to the point that I would forget he was a stutterer until he would remind me that, outside of therapy, his stuttering returned whenever he became excited.
He definitely began to feel better and more self-confident. With my approval and encouragement, he decided to take a girl to dinner and a show. Afterward, they returned to his apartment, and she seduced him. To him, this was a disaster. He felt embarrassed, awkward, and had an emission before entering. He felt utterly crushed and was sure the girl reacted negatively to him and felt contempt for him. He was so chagrined he never saw her again and held it against me for a long time for encouraging him. He said I should have known he wasn't ready for such an experience.
He began to show another trait, which, I may say, affected me a great deal until I saw the motive behind it. He would frequently say that, if I had only done so and so a moment before, he could have responded and got a lot of feeling out but now it was too late; that he couldn't respond if he had to tell me what to do. I asked him why he didn't tell me or give me some sign at the time as to what he wanted me to do. He said that would have stopped everything, that I had to see it myself. I began to feel inadequate and tried hard to foresee such events. Of course, I never could hit on the right thing at the right time. I finally told him I was so stupid that he would have to let go himself at these times, as I could never see them. I finally began to see that he got a great deal of satisfaction out of plaguing me this way, and he admitted it. More and more spite came into evidence, and he rather took pride in confessing how spiteful he really was and said I must not overlook it. I tried not to and did much work on his spinal muscles. At times, he had a good sense of humor, but mostly he was very serious and would not let me forget that if therapy was not successful he would kill himself.
During work on his jaws and throat, it was necessary to return repeatedly to his eyes, but mostly now he began to complain of tightness in his forehead and scalp. This was always difficult to relieve. I felt that behind this was defense against the terror of the hands, and I was anxious to solve that problem. I proceeded to his neck, which was quite spastic, both in the superficial and deep muscles. Working on these spastic muscles, I asked him to scream and yell. This he could now do very well and soon again went into panic, his head drawn back, his body rigid, even his back arched. This time, he saw a face, as well as the hands. He doubted that it belonged to either of the English nurses but could not identify it. He continued yelling and screaming with his eyes wide open. This brought on another panic, and this time the picture was clear. His mother's face appeared. But what actually had happened in the past still remained a mystery. He was inclined to believe he had made it up out of thin air. I believed it was real.
At this time, his mother made an extended trip to the United States and arranged to stay with him for about three weeks. I was much opposed, but he did not feel he could get out of it, although he promised to be away from her as much as possible. The visit had its usual bad effect. In spite of continued therapy, he contracted, became discouraged, and could not stand his mother. He said she was completely contactless, superficial, and interested only in herself. We were both glad when she left.
Again it was several weeks until we were back to the previsit status. More and more, his forehead and scalp presented a problem. He began to complain that it interfered with his thinking, although to me he seemed as sharp as ever, and he even started telling me where to work on him, usually on his intercostal muscles, to which he had objected so strenuously before. I encouraged him to give in to any feelings he had, whether I specifically asked him to or not. This he was always reluctant to do. I had to request it.
His chest was now quite mobile but would vary a great deal from session to session; and always, when breathing was full, his abdomen would go into spasm. On the whole, he was feeling much better, had a more active social life, and went to the club regularly to maintain his physical condition. This was rather an issue with him. He reported many homosexual fantasies and feelings of excitement for the nude men at the club, but he never considered an actual relationship. Once, when I told him I did not consider him a homosexual, he scored me for my stupidity. I asked him if he would consider one a painter who only fantasized painting. His reply was, "He could have artistic tendencies." For a long time, he insisted on being considered a homosexual. He went out occasionally to a dinner or a show with one of his women friends but was always afraid they would expect sex, the thought of which was rather repulsive to him; but even more, he was afraid he would fail, and he didn't want them to see his small penis.
There seemed to be some real progress, since he felt easier and more confident, but one could not forget the tight scalp and forehead, the unsolved problem of the hands, and his quick and easy return to former total contraction. I could not feel complacent about the status of the case. However, he soon became involved with one of his married women friends. She made a great play for him, flattering him and insisting that she wanted only to be his good friend. She would invite him to dinner when her husband was away, and he told her of his sexual fears. She understood perfectly and set about to help him. She really did a wonderful job, seducing him and making him feel so much at ease that he was successful without feeling embarrassed or chagrined. This relationship went smoothly for a couple of months until she began to talk of leaving her husband and marrying him. This she had previously assured him she would never do. He became frightened, felt betrayed, and left abruptly, again dismayed at his relationship with women. He was, however, still functioning well, his chest and abdomen were soft, and I decided to proceed to his pelvis. At this point, I had seen him for about three hundred sessions, which, although slow, I felt was not bad for a very difficult case involving a constant return to and freeing again of upper segments. If only the pelvis would respond without too much disaster and difficulty, then energy could flow through his body and relieve the tightness, still a problem, in his scalp and forehead. I had, of course, done considerable work on his legs in the meantime, to allow some energy to come down. I knew his pelvis was very spastic. Breathing would stop abruptly above the pelvis and the musculature would balloon out. One felt there was a real brick wall here.
His thighs and legs never remained free, and now they were quite spastic. I relieved some of the spasm and had him kick; then I went to the buttocks and sacroiliac region. His pelvis was immobile. I had him kick some more. So far things went well, and I turned to the suprapubic and lilac areas. I had scarcely started, when he went into a chaotic spasm of his whole body, with violent jerking movements of the abdominal muscles, pulling back of the head, and arching of the back. Any breathing would immediately bring tension. I started over again from the beginning, very alarmed and dismayed. Repeatedly, the slightest movement would produce irregular jerking of the whole body, ending in opisthotonos. I had precipitated a chaotic situation. It took me a whole year before I could get him to breathe at all without this effect, and even then we were right back where we started. He became very discouraged, made frequent suicide threats, and once, when he left, he said I would not see him again. I telephoned as soon as I knew he would be home, called him by his first name, and told him I was concerned about him. He was very grateful for this, as he had complained that I was too professional and not friendly enough.
During this time, I tried to delve more into his past. He had been very lonely as a child, never belonged, and was always sad and forlorn. He could never remember being happy. His mother had given him many enemas as a child and was always concerned about his bowel movements. Sex was never mentioned and was a taboo subject. Once his older sister asked a question about sex at the table, and the father made her leave her meal and go to her room. I felt a great compassion for him but found it difficult to show it as his attitude was one that warded off any show of kindness. At the same time, he would say he needed a kind word and that I never gave it to him. Whenever I did, he would reject it, saying that I did it just because he said he needed it. One could never do anything right with this chap.
More and more, he began to complain of an inability to think and a loss of memory. He could not remember the simplest words or the names of his friends. Writing papers became impossible, and he said his working ability had dropped to almost zero; he would sit at his office all day unable to concentrate or do any work. However, during the worst of this period, he successfully passed his comprehensive exams, which he was certain he would fail. In the session, I never observed any evidence of his inability to think or loss of memory. His scalp and forehead remained very tight, and he complained constantly about it.
Up to this point, he had never been able to sob fully. Tears of course would come to his eyes, and he would cry momentarily but he could never give in completely, to the sadness and loneliness I knew were there.
© 2008 The American College of Orgonomy. All rights reserved.
