A Patient Brought to Genitality
Charles Konia , M.D.
Reprinted from the Journal of Orgonomy, Vol. 21 No. 2
The American College of Orgonomy
Orgastic potency is the capacity for complete surrender to the involuntary convulsion of the organism and complete discharge of sexual excitation in the acme of the genital embrace. Individuals with this capacity are genital characters.
Reich found from clinical observations of individuals and groups that the great majority of people suffered from a disturbance of orgastic potency. The significance of this ubiquitous condition was profound: It prevented the organism from regulating its energy economy. At the same time, the excess energy, not sufficiently discharged, manifested itself across the entire spectrum of human emotional and behavioral pathology. (The individual's characterological diagnosis was simply a description of the manner in which spontaneous orgastic sensations and movements were blocked.) The patient was quite literally locked into his armor. A correct characterological diagnosis was the necessary key that unlocked his neurotic structure. Clinical observation revealed over and over again that successful dissolution of the patient's neurotic character structure (armor), based on a correct characterological diagnosis, was ultimately followed by spontaneous movements of the total organism and overpowering sensations of pleasure in the genitals - both preconditions for orgastic potency. Without strictly adhering to the standard of orgastic potency with the aim of genitality as the criterion of health, it is impossible to practice medical orgone therapy. The orientation of therapy is strictly determined by this goal. This has been outlined elsewhere. 1 Without it, therapy is directionless, and its outcome, a matter of chance.
The follow case presentation illustrates some of the basic principles of medical orgonomy and stresses the therapeutic importance of establishing the goal of orgastic potency which is the hallmark of the genital character.
A 26-year-old single, white, Roman Catholic, female accountant came to therapy, because of problems with her family. She stated that she detested her mother, the dominant parent with whom she constantly quarreled. She described her as unhappy, wretched, and quite moralistic, especially in regard to sexual matters. She treated the patient "like dirt." The patient was close to her father and described him as an easygoing person who was a pushover and castrated by her mother. Although she was the only sibling who stood up to her mother, she always tried, nevertheless, to gain her parents' affection and approval by buying them gifts. She found it difficult to separate from her family, living at home until five years before starting therapy, when she decided to move out. Home visits proved to be agonizing.
She was in good physical health except for a menstrual cycle of approximately 40 days. For the previous 9 months she also suffered from premenstrual tension relieved by hot baths. During the last five years of living at home, she had embarrassing bouts of vomiting related to being emotionally upset by her parents. She was not bulimic. She had frequent nightmares and night terrors. When first seen, she was very frightened and huddled in a corner of the waiting room with her coat wrapped tightly around her.
Biophysical examination revealed a well-developed, serious young woman who appeared frightened and apprehensive, although in good contact with both herself and the therapist. Her body had good tone, and she was not heavily armored. She displayed a good deal of frantic behavior and a strong tendency to run from her anger through displacement onto non-threatening individuals. Despite her timid appearance, she was able to be straightforward and quite intense. Her speech was pressured, and she tended to talk excessively.
Her jaw was tightly clenched, and she had, on occasion, a characteristically defiant expression made by jutting her jaw forward when angry. Her face was stiff but mobile. The rest of the biophysical examination was unremarkable except for some excess fat around the lateral aspect of her upper thighs and hips. My diagnosis was: simple hysteria.
On the couch, she appeared tense and frantic. She spoke excessively and forcefully. Kicking relieved the tension in her legs. I asked her to scream to express her fear. She readily expressed anger toward me for bringing out her feelings but soon lost it and became frantic. I emphasized the necessity of tolerating her feelings and not behaving frantically.
I attempted to mobilize her rage by having her hit. This was followed by some crying and she spoke of constant quarrels with her mother which were embarrassing and guilt-provoking. I reassured her that it was acceptable to stand up for herself.
Mobilizing her eyes produced more frantic behavior. She admitted not wanting to come to therapy and also of being angry with me for some innocuous statement. Then she ran from her anger by whining and complaining in masochistic fashion about how miserably she was treated by her parents. I had her hit and kick, but her face had a martyred look.
She made plans to marry outside the Catholic church which was opposed by her parents. This became for her another sore spot and source of misery. She felt sick and nauseated. Gagging produced some relief. I supported her decision to have a private marriage ceremony and also her right to oppose her parents' meddling in her life. Tentatively, she began expressing some resentment toward certain friends who were also opposed to a civil marriage ceremony. This produced an expansive reaction.
It was clear from her biophysical reactions that she was capable of tolerating a strong emotional charge. I gradually began cornering her by working on her oral rage. I had her scream as I pressed on the masseters. She became frightened, her body gave in to generalized clonisms, but she felt no anger. Following this, she verbally displaced her rage onto her boyfriend.
The attempt to mobilize facial rage terrified her. Screaming produced some relief, but she was still unable to express anger. During the following session she was full of complaints regarding the marriage issue. I consistently focused on her rage and prevented her from running into masochistic behavior by pointing out how she behaved like a martyr. She expressed some rage, and hitting for the first time, the image of her parents' faces flashed before her. She realized intellectually that she had no choice but to emotionally rid herself of her family.
I kept cornering her by pressing on her jaw which again terrified her, but now she was capable of expressing partial rage with hitting followed by generalized clonisms. She associated the frightening sensations during these clonisms with those she had during intercourse. She reacted to this outburst of rage with anxiety and reported losing all of her sexual feelings with an increased frequency of nightmares.
Gradually, and firmly focusing on the emotions of fear and rage enabled her to tolerate more sensations without becoming frantic. I intensified efforts to elicit rage by asking her to make angry faces. Again she became terrified. This was relieved by screaming.
As her capacity to tolerate rage increased, her nightmares became more frequent. and she began having dreams of her mother dying. After each outbreak of rage, her body typically gave into intense clonisms which she tolerated well without going out of contact. These clonisms were accompanied by waves of pelvic cramping. 2
A deeper layer of rage then began to surface as she felt strong pressure traveling up her head and settling behind her eyes and occiput. She developed severe headaches and a rash over the posterior aspect of her neck and occiput and could not focus her eyes. I manually pressed on the occiput which was very tender. This moved the pain forward from the occiput to her temples and was followed by an explosive rage. Her body gave in to intense trembling, and she felt dizzy. She again was able to focus and her eyes looked brighter. Although terrified, she was capable of tolerating a greater degree of charge as strong outbursts of uncontrollable rage were succeeded by pelvic cramps.
In the ensuing weeks she had thoughts of her mother accompanied by the surfacing of more misery. She entered a session feeling pent up and nauseated. After a brief outburst of anger, she gave into crying. She cried, not for her actual mother who treated her so miserably, but for the one she wished she had. During the following week a great deal of crying surfaced together with memories of her mother and her early childhood. She recalled her mother's cruelty and moralism and her constant misery. She also recalled having a nanny for a brief period who was the only person for whom she felt any love.
She had a dream which clearly expressed her mother's moralism: The patient's breasts are exposed as she is nursing an infant. Her mother appears in the background and she covers herself.
This episode of misery ushered in stronger contact with herself and with me. She began feeling more sexual and realized with amazement that she did not necessarily have to behave in a hysterical manner. She began looking more expanded and genital sensations increased.
Next, a deeper layer of uncontrollable rage began to surface which she felt in her entire body, particularly in her vagina. This was followed by urges to touch herself erotically in the genital but she refrained because of embarrassment and guilt. Behind this was her fear of having genital sensations in my presence. I asked her if this prohibition was associated with her Catholic upbringing. She recalled her conflict with school teachers. Although not religious, she was nevertheless affected by their sex negative attitudes.
This phase of her therapy was typified by progressively stronger out-bursts of rage followed by genital excitation of greater intensity. These were accompanied by urges to touch herself genitally which she would resist out of fear. On one of these occasions she had the misconception that I was frowning on her. This produced more intense rage.
The frequency of her menstrual cycle continued at approximately 40 days. She developed bouts of diarrhea and had alternating pelvic cramps and genital excitation.
A routine gynecological examination revealed a class 2-3 Pap smear. Since her previous tests were always normal, my impression was that the inflammatory condition was a result of the onset of pelvic mobilization. Because of her high biophysical vitality, manifested by her strong emotional reactions, I felt this condition would probably reverse itself once she could tolerate a sustained strong charge in the pelvis.
Dreams of people breaking into her house supported my assumption that the pelvic armor was about to break down. Nevertheless, I kept focusing on the upper segments and on the expression of the vast amounts of rage still present toward her mother. Murderous impulses began welling up. Urges to strangle and tear her mother's eyes out surfaced. She appeared close to losing control. This alternated with the emergence of similarly uncontrollable genital sensations. The rage kept intensifying in the form of sadism and soon became directed at her father for not supporting her against her mother's attacks. She recalled going to her father after encounters with her mother for support and being told by him, "Take it for me." She was incensed by his cowardliness.
She began to lose some of her illusions regarding her father. She saw that he was incapable of giving her any real nurturing and slowly began to separate from him. More rage followed. She recalled her parents not being present at her wedding and realized more fully that she never had any genuine love from either of them. On the couch her throat began to bulge and she gave in to deeper shouts while hitting. Accompanying this outburst was a feeling of intense heat in her face and a burning sensation in her eyes. For a brief period she felt afraid of being alone.
At this time, she developed a vicious castrating rage which was displaced onto her husband during intercourse. It was clear she was expressing her mother's sexual moralism. In the session this genital rage became redirected at her mother resulting in further mobilization of the pelvis with strong cramping and a feeling that she was about to have her menses. This was accompanied by strong pleasurable genital sensations.
Her oedipal conflict began to crystalize and she had fantasies of her father during sexual intercourse. She saw how her mother was interfering with her sexual feelings for her husband.
More rage toward her mother followed for intruding in her sexual life. However, she suddenly stopped short and felt guilty for hating her so much. She recalled being always told by her mother that she was undesirable and that she would always remain alone. "No one will ever love you" were her prophetic words. She was caught between tolerating her mother's horrendous treatment of her and her own murderous impulses toward her.
She began running from her feelings by excessive talking in the session. Gradually, she expressed a vicious rage with pelvic squeezing and intense vaginal sensations with generalized pelvic twitching. She wished that her mother could be shot. As she expressed this, she had both a hateful look on her face combined with a fear of feeling it. I had the impression that it was her mother's face that she was beginning to express.
At this time, her periods first began to normalize. She developed intense sexual feelings and again had the urge to touch herself genitally. She realized it was only she, herself, who stood in the way of experiencing genital pleasure. This was followed by a fear of being destroyed by her husband's penis. She had a fantasy that it was going to pierce her vagina and destroy her. As a result she developed a fear of moving during inter-course. Although her sexual sensations were increasing, they became inhabited at a certain point. She identified this restraint with her mother's prohibition of her genital sensations.
Then more strong rage at her mother followed which she expressed by squeezing anger out of her face. Again, her head felt hot and itchy. Although frightened by what was coming out of her as a result of her hellish past life, she was tolerating a greater charge as well as strong currents and clonisms. Her rage was being expressed in a more total and sustained manner.
The orgasm reflex now began to appear at intervals. She felt terror stricken down to her pelvis, and her whole body gave in to clonisms. She held her genital, gave in to deep sobbing and had the thought that, had it not been for therapy, her mother would have destroyed her. The frightful thought of almost being destroyed was directly associated with the intensity of her genital sensations.
Now we were directly involved with mobilizing the pelvic segment. Because the hysteric is blocked at the genital stage, the transition into the end stage of therapy is not as clear-cut as in other character types. I was aware that in all likelihood the upper segments would probably clamp down again (pelvic mobilization flushes out residual armor in the upper segments). Nevertheless, I felt that, barring any unforeseen events, her biosystem was strong and capable of fully tolerating genital sensations and that her prognosis for achieving genitality was excellent. I also understood that, because of the powerful nature of her emotional reactions, a sufficient interval of time would be required to structuralize her health. 3 As a result of pelvic mobilization, a burst of energy brought her temporarily to a higher level of functioning. She experienced strong streaming sensations throughout her body. She became frightened and began holding her pelvis. Her menses again became irregular. Strong angry shouts directed at her mother immediately cleared the upper segments. This was again accompanied by the terrifying thought of almost being destroyed by her. Gagging was effective in relieving her sick feelings. As a result of inadequate genital discharge, these were particularly strong after intercourse. Blocked from genital discharge, her sexual excitation backed up and made her sick as if she had been poisoned. Her mother was interfering with her sexuality. Squeezing a towel while shouting was effective in expelling this sickness. She sorely wanted her mother out of her body. She again had the thought that she had come close to being destroyed, but now she knew she would come through intact. This hopeful thought had a pleasurable feeling to it, and she was able to see the bright side of what had, heretofore, been a nightmarish thought.
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1. See Dr. Blasband's article "Cyenitality: Myth or Reality" Journal of Orgonomy Volume 21 no. 2
2. Armoring of the pelvis during the initial phase of therapy is an essential prerequeisite for mobilizing the upper segments.
3. The structuralization process occurs for an indefinite period after genitality has been established.
© 2008 The American College of Orgonomy. All rights reserved.
