Saturday, January 28, 2017

Psychogenic Impotency due to Misogyny

A patient brought the following dream which he labelled as "A dream of hidden erection." 

"The dream lasted almost all night long, or perhaps not,  but it certainly felt that way. Every now and then I woke out of it, startled, to check if my penis was erect or not and then fell back into sleep and resumed the dream."  

The dream:

In am on a long motorcycle ride. A cousin of mine is my companion. She is driving while I am in the sidecar. She is reaching out with her hand to my penis as if it is the motorcycle's pistol (accelerator) grip. There is a great effort going on my part for my not wanting her to know that I am having an erection. I do want to have an erection but not because of her.  The whole emphasis on the dream is to have an erection but for her not to know that it is there. I think when she reaches out to grip the pistol she does not find erection.

The patient has a huge number of cousins so I asked why this particular one was chosen by the dreamwork to take the ride with. The way he talked about the long ride - something that went forever, it left little doubt that it symbolized life journey, in which, by the way, he has been unsuccessful in that he is 38, unmarried, still lives with his mother, has no lasting relationship, has paranoid delusions and hallucinations when off Abilify (a dopamine blocking agent), and has great difficulties in consummating the sexual act if he does find a woman willing to sleep with him (he is good looking, but women after initial attraction can sense that he is not altogether there and break off with him) and has to resort to indirect and deviant fantasies and sexual positions to manage erection and emission. 

"This question has puzzled me too," the patient replied. "But actually I know the answer.  You will recall I have related to you a recurrent dream that I have been having for the last six months or so of another cousin in which I am trying to have sex with her. The most surprising thing about those dreams, which but for some minor details portray the same theme, is that the cousin who I lead into sexual intercourse is someone towards whom I have not a shade of sexual interest, for she is not attractive at all. From our youngest years I never thought of her as attractive. And even the sex in the dream never progresses beyond going through the motions of making love, for I have no feelings for her, and it is done without even taking our clothes off. 

"So this new dream may be just a new version of that recurrent dream. For this cousin is the sister of the cousin with whom I have been making love to, without having any attraction towards, for the last six months." 

Now this recurrent dream we had subjected to analysis in a previous session and had concluded that it expressed hostility towards women, with the cousin representing his mother. The sexual act in it was less an expression of union (eros) and more an assertion of aggressive masculinity, with an intent to humiliate, the essence of which could be summed up in the phrase "I am screwing you." However the fear of getting too aggressive had watered down (repressed) the act by limiting it to just going through the motions of sex, without any feelings, and doing it without taking off clothes. 

We could not solve in the analysis of that earlier recurrent dream as to why this particular cousin was chosen by the dream-work to express his hostility towards women.  

The patient now claimed it was really the cousin in the current dream that was the object of his hostility and her sister had been replacing her because he must have been scared of expressing his hostility towards the one with whom he really had an ax to grind. 

"And what was your beef with her?"

"This cousin is 44 years old now. And I am 38 so she is 6 years older than me. Now when we were young, I was about 10, for almost a year I had to sleep in the same bed with her, because we were living with my aunt, her mother and there was not enough space in their house. I was afraid of the dark. I am afraid of the dark even now. As tough as I am, and fear nothing, I am still afraid of the dark. Even now I cannot fall asleep without the TV on, and my mother hates that - patient lives with his mother - and she comes to my room and cuts it off as soon as I fall asleep. 

"My cousin had a similar attitude towards me when we were sharing the bed. She would not let me keep the light on. And I would be so afraid of the dark I would go and be up against her and she would not like it. She thought so little of me she never faced me so it would always be like ever increasing 'spooning' as night would progress. I would often get erection and she would then push me away.    

"And that would make me so mad. Especially since I had no interest in her, for she was as ugly as her sister, so full of acne that I thought of her as pizza-face."

"Then why would you get erection?"

"Thats a good question. It must have been that I would fall asleep and then the erection would occur not because of her but because of the things I was exposed to during the day. I had access to playboy magazines, a lot of them, they were hidden in a closet, and Marvel Comics and there was one particular comic character, Linda Carter, the wonder woman, whose tight clothes and semi-nude body in pictures would get me so aroused.  So the excitement from those sexually exciting objects from the day I must have been transferring to the cousin who I found not at all unattractive because of sheer physical closeness as I would drift into sleep, where distinctions between one person and another kind of melts.

"In fact in the dream I do want to have an erection but not because of her and that is what I want her to know when she reaches out to check for erection that it is not for her but for others. Yet in my attempt for her not to feel my erection I think I am sabotaging my ability to have erection altogether and ruining my ability to make love normally. I grew up getting put down by my mother and all the women and girls that were always around me. I have so many cousins and aunts. And my inability to perform well as a man with women arises from this anger at them for treating me badly."

"How do you know this is the cause of your sexual difficulties?"

"I have been reading a lot lately about misogynists and there they tell you that they hate women because of bad relationships with their mothers. Verbally or physically abusive mother will turn you off towards all women."


Saturday, January 7, 2017

An exhibitionistic dream

A prolific dreamer brought this dream to the session.

I went to Susan and Gary's house. Gary was alive [In reality he passed away last part of the year]. I was surprised that he was alive. Gary said he would show Susan around and then left me alone. I put on one of his t-shirt and I was going to put on some underpants, but it was a pillowcase. Larry then said "Can't we leave you alone" and I said "probably not". Susan then came in. I felt embarrassed and humiliated.  I said I will wash everything and bring it back.

When asked for associations it turned out that the patient thirty years ago had dated Susan, but only a few times. His mother, whose strong influence had prevented him, despite being an exceptionally good artist and a highly intelligent man, from ever getting married, had put a block to his budding love for Susan through making a statement that one should go out only with someone who has a lot in common with oneself. Since Susan is Jewish and he a Catholic, he had given up on her.
He did admit, after some reflection, that this explanation is a superficial one and the real reason he did not pursue Susan further was because she was very popular when young and was going out with a number of boyfriends at the same time that she was dating him, and it was his fear of competition that had held him back. He rather defer in favor of others than face the dread of defeat. He was bullied as a child and has deep fear of other men who he rather placate than fight when confronted.  He has very little confidence in himself and admitted that his dreams are often about his bungling and making other mistakes at work and elsewhere inviting wrath of others. These inadequacies and lack of self confidence were interpreted to be symbolic representation of his lack of confidence in performing sexaully, turning him into a man who had never made love to anybody. "I am not good enough for anybody," is how he put it.
"You think you are at their house to resume your relationship with Susan now that Gary has passed away?"
"I no longer have interest in her. Yes I was interested in her when she was 18 but now I feel no attraction towards her. But you are the doctor."
The last sentence confirmed that my conjecture was right. The repressed wish could not be acknowledged but indirectly; imputing that he is not conscious of this rekindling of interest but I, as his doctor and with my superior medical knowledge, had guessed it correctly.
Gary said he would show Susan around and then left me alone could only be interpreted as wish fulfillment that Gary was exhibiting Susan and making her available. Leaving him alone perhaps alluded to his being permitted by Gary to pursue her but only in onanism not in actual physical contact.
Wearing of Gary's t-shirt and attempting to wear his underpants by pulling them up was interpreted to be his taking Gary's place with Susan.
"But why pillowcase?"
Patient said it was perhaps a wish to sleep in Gary's bed putting his head on his pillow.
I wondered if pillow was symbol of  female genitals, a place to rest head (penis) not unlike how the man's most restful place is inside the vagina (when making love) and finally in mother earth's womb (eternal rest).
Patient said the interpretation was quite likely correct and then added, "You know why I am pulling up the pillow case, because it is the opposite of pulling down the underpants."
Was it then 'reversal', a technique so often used by dreamwork to distort the true state of affairs, in this case to hide his pulling down the underpants, a preliminary step one must take before intercourse.
"Where is the humiliation part coming in from?"
Patient then confessed that he had hid this part of the dream when first telling it to me for it was so ridiculous.
The pillowcase came into the dream because it has no opening at the other end and so his legs could not go through and he was unable to pull it up higher than his knees and was thus forced to expose himself. It was this exposure/exhibitionism which was giving rise to the embarrassment and humiliation.
"How do the exchange of dialogues 'I cannot leave you alone' and 'probably not' add to the meaning of the dream?"
It is accusation by Gary that I cannot be trusted with his wife and I am agreeing with him. It is no different than how when I get really paranoid the security guards start appearing at the windows of my house  and how black cars follow me when I am on the road to keep a tab on me."
Patient all his life has slipped in and out of paranoia.
"Why are you promising them that you will wash the clothes and bring them back?"
"It is washing away the guilt of wishing to have sex with Susan. Though it hardly goes beyond my exposing myself." patient concluded the analysis of the dream.