Page    1   2   3   of this article. A Case of Masochism, E. F. Baker, Jour. of Orgonomy V 6 no. 1   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. His mother made a second trip to visit him; this time for medical consultation about a cancer which had been discovered. She was finally operated on with an unfavorable prognosis, returned home in a month or two, and grew steadily worse. He went to take care of her and was with her until she died a month later. This was a very trying time for him. He had harsh words with his older sister and was a constant attendant to his mother's every need. He returned to therapy contracted, discouraged, and depressed. His head was blocked, he felt foggy, and his body was stiff. His eyes were far away. When I asked him to breathe, he ignored me, and when I insisted, he said, "You do not understand. I am not here, my chest is foreign to me. I don't know how to breathe." As I worked on his chest and back, he whined and groaned, looking very miserable. I started on his legs, to allow some energy to flow down. He would not tolerate it at first and held his legs tightly crossed. I told him he acted like an adolescent virgin. His reply was "Are you as rough on them?" Finally, I relieved some of the spasm and had him kick to generally loosen him up and produce some movement. Returning to his face, I worked on the supraorbital ridges, had him roll his eyes, move his forehead, and open and squeeze his eyes. He began to show spasms in his neck, chest, and abdomen. I repeatedly had to relieve these before continuing, but kept him breathing. I then turned him on his side and manually compressed his chest. He began to sob with misery. I felt this was encouraging and should give him some relief, but his head was as tight as ever. I pressed on his occipital muscles, and he became very frightened. He did not know why, because it was not very painful. He complained that he was getting nowhere and never would. And what did I have to offer him. He could not go on much longer. Then he said something that finally clicked with me. It was, "You never think of me after I leave the office." I asked, "What are you really saying? You are saying I don't love you." I started to reflect on all of his characteristics, his constant whining and complaining, his always putting me in a bad light, his complaints of an inability to think and concentrate, his feeling hopeless and worthless, his rigidity and extremely spastic pelvis, and his marked sexual timidity and inadequacy; also, his repeatedly falling brick to original levels, and his inability to maintain progress. I suddenly realized I had a masochist here. Now I could see why I had had such a difficult time. I felt chagrined that I had not recognized it before, until I reread Reich and had his assurance that when there are no masochistic perversions, diagnosis may not be made until late in therapy. I could now better understand the 600 hours we had now spent with little apparent success. He left during one session, saying he was quitting. I merely said, "Okay, but what will you do then?" Two days later, he called for an emergency appointment. This time, he had a better attitude. He was friendly, did not dwell on my deficiencies, but just talked about his childhood. A nursemaid threatened to make him eat his feces when he had soiled himself at three years of age. His father was very anal, always insisting his mother give him enemas. He said he had received a very good offer on the West Coast but did not know if he should take it because of therapy. I suggested he could see someone out there, but he did not want to start with anyone else, and, besides, he was not interested in analysis, which would be the only available treatment where he was going. Later, he brought two dreams: He had to take an exam in which there were two questions. He sat through the whole period and did nothing. After the time was up, he went up to the proctor, a muscular woman, to try to explain. He is good at getting out of things, but, when he got to her, he realized that he couldn't get away with anything with her. The same night, he dreamed that a man with a huge penis was sitting on a chair, and people were sitting on the penis. The patient made the following interpretation himself: He couldn't get away with anything with his mother and couldn't compete with his father. He always complained of his small penis. He was immobilized. He came to the next session very contracted and stiff. I loosened his abdomen, chest, back, and eyes. Rolling his eyes, he developed momentary anxiety, which passed. He said he could never let it out without my help and encouragement. We tried again. I held his hand and patted him. He became very anxious and saw a woman lying on top of him. His throat became very tight, and he choked but could breathe. He said it was sexual but nothing definite. He let himself go further than at any previous time. When next he came, he brought the following dream: He was in a house with a woman. Another man was there. All got in the car to go to the laundry. He thought the woman would get his laundry (although he had none.) She went in the laundry and returned empty handed. He was angry, and out of spite, went in the laundry himself. There was a Negro man there, who asked him to lie on a couch. Then the Negro came after him with his hands to choke him. He awoke very frightened. The patient made the following association. His father ran a dry-cleaning establishment, and, in the early days, his mother used to help out by sewing and mending articles of clothing. At this stage, I refrained from interpreting the oedipal nature of the dream. Here, again, are the choking hands of his mother. The Negro male replaces the mother, just as, clinically, his homosexual fantasies were replacing his incest fantasies. I began to wonder if the only solution was to try to gradually open the pelvis in spite of his continued contraction in the upper segments, especially his head. Certainly, until he could tolerate some movement there, we would have an endless job of trying to keep his energy free from being held in contraction. I proceeded cautiously, working on his thighs and buttocks, and asked him to repeatedly contract and relax his anal sphincter. This he should also practice at home. This time no great adverse reaction appeared, but he continued very tense and out of contact. One day, I had the impulse to stroke his arm and the side of his chest. He became very upset and curled up on the far side of the couch. When I continued, he insisted that I stop, that he could not stand it. I persisted, and he got up, dressed, and stalked out. The next day, he asked for an emergency appointment. He said he had left because it seemed like a sexual assault, that it was filthy, and it reminded him of a time, when he was 16 years old, that a man had done the same thing to him. I explained the need to increase his tolerance to sensation and tickled him some more. He still reacted, but to a lesser degree.     next page   Page    1   2   3   of this article.