Page    1   2   of this article.

A Patient Brought to Genitality   Vol 21 no. 2   Charles Konia

She was amazed at how well she was tolerating very strong sexual charges in the embrace. But still discharge was not total.   4   In session, more rage toward her mother followed. She felt that she was literally pushing her mother out. Her body felt as if it were being rocked and she again gave in to the reflex. Her sensations of streaming and the involuntary pelvic clonisms,were terrifying, but she did not run. Finally, she expressed grief over what was done to her by her mother.

She then had a dream in which a negro man cut her throat with a knife. Her association to it was a memory of having the croup at 3 years of age. On the couch she expressed a deeper layer of rage directed at her mother accompanied by vigorous pelvic thrusts. She began choking on this rage. Her lips and tongue became cyanotic, and her throat clamped down and felt painful. The thought accompanying this outburst was "you can't keep me down."

On the following day she called to say that her throat was again closing. Crying at home produced partial relief. This was followed by a flood of childhood memories of being unloved. She recalled being shown affection only when sick, yet it was her mother who made her ill to begin with. She was still holding on to the last vestige of hope that her mother did actually love her. It was the expression of this intolerably painful sadness that was getting caught in her throat. To relieve her throat block, I had her shout while strangling a towel.

At this time, close emotional contact became indispensable. She was reliving the horror of her early childhood when there was absolutely no one to respond to her needs. She had nightmarish dreams of infants who were abandoned and crying. In the following session she kept her mouth tightly clenched. I worked vigorously on mobilizing her mouth and throat. Expressing her deep painful childhood misery gradually opened her throat. Strong pulsations were felt in this segment. She recalled a childhood fear of dying through suffocation and related it to choking her misery and rage. Now she understood the reason why she gagged spontaneously in childhood. It was an attempt to relieve her throat block.

Recollecting this period at the end of her therapy she wrote:

The throat block was one of the strongest. What a horrifying realization as a small child having the croup to be in a steam bathroom not able to breathe and having my mother sitting next to me. Then to make contact with the fact that she was the reason for it. I sat there choking off my rage toward her.

After this episode, her throat remained open, and there followed a recurrence of rage in a more powerful form. Her shouts were stronger and louder than ever before. She expressed her rage for entire sessions at a time. Expressing the hateful faces of her mother effectively discharged this layer of anger. She realized that the disapproving facial attitude of her mother was identical with her own reproving look. She lived her entire life trying to gain her mother's love. She began feeling a deep loss at never having had it. A deeper layer of misery ensued. She needed to be held and consoled almost constantly by her husband. Her entire past life was seen as a waste. The only way she could survive in her mother's house was to deaden herself.

This breakthrough was followed by periods of greater well-being. Feeling more hopeful, she was experiencing deeper sexual feelings in the embrace. Her face appeared more relaxed, and a natural calmness began to appear. She enjoyed being at peace with herself and began giving up her franticness.

After several weeks, however, she began having the following dreams:

1. She is having a baby, and there is no one present to help her.

2. Her sister starts therapy. She feels good because now she has someone to be close to.

These dreams heralded the emergence of an earlier period of infantile separation. She was able to withstand the deep terror of this separation as she relived her maternal abandonment more intensely than before. Accompanying this terror was the dredging up of more deep feelings of sickness from her pelvis. She felt her pelvic armor disintegrating in a tactile manner, like cracking clay, together with intense anxiety. She vividly saw images of her parents looking over her crib as she cried and not reaching out to hold her. She required a great deal of reassurance while reliving these experiences.

She had a dream in which she is alone with a group of strange men. Her father appears and tells her "you must go to a convent!" This dream expressed her disappointment at her father for not supporting her against her mother's sexual moralism.

A dream followed in which she experienced her own birth. In the dream she felt terrified and full of physical pain. Her mother's hatred of her and reaction were being experienced in greater force. She felt deep waves of misery traveling up from her pelvis with her throat remaining open.

During the following several sessions, she vividly and in the most minute detail experienced the events of her birth. She felt pain over her scalp (passage through the birth canal), burning in her eyes (silver nitrate drops), abdominal pain (cutting the umbilical cord), pain in her throat and hoarse speech (images of being suctioned).

A deeper layer of terror surfaced as she had images of her mother's hateful face looking down and through her without actually making contact with her. Deep crying gave her relief. Her body gave into soft generalized clonisms. She recalled her recurrent early childhood night terrors. She realized that it was her mother's face that had terrified her.

This was followed by a new layer of rage pushing up and out of her head. The intensity of this rage was so great that her eyes felt as if they were popping out of the their sockets, and she had waves of sensation rushing down into the pelvis. Sharp, vigorous pelvic clonisms developed following each shout. Staying fully in touch with her terrifying sensations, her body gave into full clonisms accompanied again by the orgasm reflex.   5   She had a dream in which she was drugged but still was able to destroy her mother. This indicated that she was able to fight through her armor (being drugged) and face her murderous feelings for her mother.

Strong clonisms and genital sensations followed. She was more capable of relaxing and enjoying these pleasurable sensations over a greater period of time. Her sexual pleasure was intensifying and alternated with more genital anxiety.

She then developed a hysterical pain in her right arm and shoulder. This was related to her childhood masturbatory wishes and maternal prohibition against them. She required constant reassurance that her genital sensations were acceptable.

She had a dream in which her father died. There was a great deal of grief associated with it. The dream presaged the end of her oedipal wishes for her father.

In her outside life the issue of relinquishing her neurotic dependence on her husband came to the surface. This dependency was masked by a strong tendency on her part to mother him. She realized that she could not be well until she gave up this behavior.

During the following week she had a violent outburst of hysterical anger in the form of uncontrolled genital sadism directed at her husband. The intensity of this rage and the accompanying irrationality were extreme even for her. It resulted from a strong mobilization of the pelvis and a temporary block in her sexuality producing overpowering impulses of blind sadism.

On the couch she expressed a violent, explosive outburst of rage followed again by uncontrolled, generalized clonisms. A murderous rage directed at her father appeared with uncontrollable urges to bite off his penis. She felt that since she was not allowed to have sexual feelings, she would destroy anyone who evoked them in her.

This outburst of sadism provided a great relief for her. She finally felt that she was regaining all the feelings that had been taken away from the very beginning of her life. She was finally letting go of both parents.

At this time she developed falling anxiety during intercourse and falling dreams. Her episodes of well-being became more sustained as her pelvic sensations remained unblocked. In therapy, she was able to breathe out fully with her eyes rolling up, and she felt intense dizziness. She felt a deep sense of calm and a closeness with nature and the cosmos.

In the session, breathing produced the strongest genital sensations thus far, and the orgasm reflex was coming through more consistently and softer. During intercourse she was able to feel the penis more intensely. Her work function was gradually improving and there she felt strong and confident. She was highly respected in her field. This change in her functioning was reflected in her physical appearance of attractive, lively radiance.

Her sexual sensations were both stronger and softer. These experiences were entirely new to her as she gained another jump in her energy level. Her menstrual cycle became regular, and her capacity for full genital discharge became more firmly established. She felt profoundly grateful to me for having been given the opportunity to regain her health.

The remaining sessions continued the restructuring process and involved keeping her from running from her sexual sensations. It was simply a matter of recognizing the familiar ways she blocked her sensations. She was given the support and encouragement to tolerate her newly gained health. She was pleased and expressed amazement at herself for actually being able to tolerate intense genital sensations. These became deeper, fuller, and qualitatively different from before. She could feel herself losing consciousness during the acme and regaining it after ward. She began having sensations of her brain moving, something she had never felt before.

She had a dream in which she is in a shower with a man. Her mother is at the door. She begins to run but remembers that she does not have to run. She returns to face her mother. She felt a great sense of freedom and integration that she could do exactly as she wanted with her life. Therapy consisted of approximately 500 sessions.

The following impression written shortly after completion of therapy gives a picture of therapy from the standpoint of the patient.

So many times I was going through the worst of it, I tried to write about what I was going through, but never was able to. It was all I could do to stay with it, let alone write about it. Perhaps now with some distance, I'll briefly outline what I remember as most significant . . . I felt for years that there was something missing in my life. My sense of myself was fairly strong. The health in me which is now flowing seemed to be wanting to come forth. The memory of the first few years (of therapy) was that I just got used to feeling, slowly becoming aware of the anger and how I'd run from it my whole life. When I started to make contact with my past, my first instinct was to not even allow myself to admit I was remembering these things . . . As time went on the terrible sadness at the loss of so much time, to have been so alive and for there to have been no one there to say it's okay, between my mother who spent her days trying to destroy the life in me, my father who couldn't take a stand on anything, and the icing on the cake, Catholicism (all with the same goal to take the life out of you, cut the feelings out and keep them out the rest of your life). It goes to show you my health was stronger than all of that.

Everything in therapy was intense for me. I had to get used to that and accept my own intensity. Nothing ever seemed to happen in a slow delicate manner. Anything that came up was certainly textbook and always intense. I can remember days and days of crying, throwing up, remembering as a baby pleading to my father with my eyes to make contact with me, to make it all better. There were times that I felt I was dying.

It was rough going for many years, the rage, sadness, misery, and always there too was my husband . . . His love for me was so strong, so selfless . . . He really, protected me.

I always thought from my reading that people had vague recollections soon after they were born. As time went on mine were not vague at all. I started by remembering being in a large cold room. This man grabbed me by the shoulder and squeezed it tightly. I was terrified, looked around, begged for contact, and there was none. (The shoulder pain was excruciating.) I stopped therapy for a short time thinking it was time (maybe I had to rest up for the most intense time was yet to come). I felt better than I ever felt but . . . there was more to it than that. I was running from my feelings. I'll always have to remember that my first instinct is to run, and not run . . . I still wonder how she wasn't able to kill me off. She got N with cancer, C is a wreck, J doesn't know the difference. I'm convinced it's in the genes or protoplasm. I think the fact that she had me 11 months after N, she was as alive as she ever was. Her body hadn't clamped down totally. It was open in spite of her.

There were many times when I wasn't sure we should have done this. I did realize it had to be, otherwise it would not be happening; but I still couldn't help but feel that maybe we shouldn't have done this; maybe we should have left well enough alone. My body was in charge . . . The terror of not being able to move was all remembered.

What a shame she was so tight and couldn't tolerate me. I'm convinced that sexuality in utero and the orgasm of birth, if allowed to flow can and should be the sweetest, most tender beginning for a child.

Conclusion

Some have suggested that genitality is a myth. This case, as well as others published in this Journal, illustrate that genitality is a clinically attainable goal. Its requirement - full orgastic discharge during the genital embrace - ensures against a relapse into illness which can either be in the form of symptomatic behavior or pathologic character attitudes.

The transition from hysterical to genital character in this patient was accompanied by fundamental changes in her personality. She relinquished her neurotic character traits, such as her franticness, tendency to mother her husband, superficiality, and excessive talking. These neurotic traits, which were also attempts at maintaining substitute contact with the world, were replaced by a genuine calmness, an increase in her work functioning, a sense of depth, and a strong contact with both herself and her environment. These changes were a direct manifestation of her newly found capacity for orgastic discharge.

Page    1   2   of this article.

Footnotes

4.  She was experiencing genital anxiety in the embrace.   back to text

5.  The orgasm reflex at first appeared in a harsh manner since it was still being opposed by armoring. Later, the reflex smoothed out became a gentle movement.  back to text