Unmastered Masturbation Conflict
<< Some Aspects of a Young Boy’s Masturbation Conflict >>
Erna Furman<sup>1

1</sup> Assistant Clinical Professor of Child Therapy, Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Instructor, Cleveland Institute of Psychoanalysis, Cleveland Center for Research in Child Development.

In Masturbation from infancy to senescence, pp. 185-204. NY: International University Press, 1975

Randy was five years, three months old when he started his analysis. He was conspicuous for his large build, dark bushy hair, menacing, angry facial expression, and loud, threatening voice. His forceful, intimidating appearance and behavior contrasted strangely with the babylike softness of his body, his anxious, clumsy movements, and the momentary gratitude when an adult sympathized with his inner turmoil. From within, Randy’s life was dominated by numerous compulsions, restrictions, and a fear of being overwhelmed. From without, people and events forever threatened his precarious obsessional equilibrium. He avoided people as much as possible and preferred things, for which he showed care and regard. With his mother, however, he maintained a tumultuous interaction in which he externalized his conflicts and made her a party to his struggles for control. At dressing time, for example, he alternately raged and sagged limply while his mother forced his clothes on him, but when left to himself, he either did not dress at all or was for hours helplessly caught in a doing-undoing compulsion, putting on a shoe, then taking it off. Any interference with his symptomatic activity reduced him to an anxiety tantrum.

Unaware of the neurotic nature of Randy’s difficulties and of his acute though often disguised distress, the parents’ chief complaint was that they could not control him and that he had proven impervious to all their increasingly harsh disciplinary measures. They were also concerned about his inability to get along with his peers and to show consideration for others. They did not know that, in spite of their love for Randy, they, too, lacked empathy with his feelings and needs.

The parents’ description of their daily life as well as their sketchy recollections of Randy’s personal history illustrated this. From his first year on, the parents had confronted Randy with difficult situations without affording him opportunities for healthy mastery and without allowing him appropriate affective responses. Sudden separations, changes of plans, exposure to unsuitable playmates and frightening events, lack of bathroom and bedroom privacy, inappropriate expectations in terms of self-control and frustration tolerance, all were a regular part of Randy’s haphazard, adult-oriented life. Among other things, the mother related that Randy was sent to his grandmother in another city for three weeks at age one when his only sister was born. When I wondered whether this had upset him, she responded with genuine conviction, “But he was just a baby. Babies don’t have feelings.” Yet, the parents were doing their conscious best with and for Randy and wanted to help him. They were particularly taken with his precocious verbal and intellectual facilities. Unbeknownst to them, even these areas had suffered considerable interference and were not available to Randy for neutral adaptive functioning.

Several months of observation at the Hanna Perkins Nursery School prior to treatment rounded out our picture of Randy’s severe obsessional disturbance, but it was only during his first two analytic sessions that I learned something about his masturbation conflict. In the first session he played with the plastic zoo animals, placed “Mr. Wolf” in an enclosure, and surrounded him by a solid fence “so that no one will touch him.” The fact that his “Mr. Wolf” was really another wild animal bearing Randy’s family name linked the symbolic with the real personal meaning. In the second session Randy compulsively touched and mouthed all knobs and switches and deteriorated into excited wild behavior.

In subsequent sessions Randy showed how his great wish not to touch had been displaced to an inhibition to use his hands for bodily activities, such as dressing and washing, and for play activities, such as drawing and cutting. He even restricted himself from looking so that he was often blind to what was going on around him. Unexpectedly, however, Randy would be overwhelmed by a need to touch “all the wrong things” as he swayed around with drunken abandon calculated to incur hurt and to seek punishment. Until recently this wish had always been satisfied by parental spankings. Although Randy was keen to come for help, he blamed me for having influenced his parents against physical punishment, for now he was more anxious than ever and found no relief.

After several months Randy one day soberly told me of his compulsive masturbation: “I want to cut off my penis. I push it to make it go away, then I get scared it’s gone, then I need to touch it to see if it’s there, then I push it to make it go away, and I can’t stop.” “How does it feel to push and to touch?” “It doesn’t feel anything.” Just as his affects were isolated from his statement, so his feelings and fantasies were isolated from the compulsive masturbation. This occurred during the morning hours when he quietly lay awake while his parents slept late. The feelings and fantasies threatened to overwhelm him throughout the rest of the day, in spite of his widespread defensive maneuvers.

Over four years of analysis encompassed many areas of work, some more, some less directly related to Randy’s masturbation problems and their vicissitudes. I should like in this report to describe three aspects:
    (1) Randy’s use of two prominent defenses against phallic sensations —one, by treating his penis like a foreign body, and the other, by substituting his whole body for his penis. The analysis traced the use and genetic origins of these defenses to a certain extent.
    (2) Randy’s masturbation fantasies —these derived primarily from his experiences of seeing the members of his family in the nude and of witnessing parental primal scenes at different stages in his development. The contents, reconstructed from the symptomatic behavior, analytic material, and transference reactions, were related to his phallic sensations and masturbatory activity.
    (3) Randy’s masturbation conflict in the later years of his analysis—this manifested itself in a different form, but persisted in its unusual intensity. Some of the reasons for this could be understood to arise from the nature of the ongoing mother-child relationship.

Two Prominent Defenses Against Phallic Sensations

Randy’s professed wish to get rid of his penis was followed by numerous other examples of this defense. He repeatedly warded off affects and thoughts by regarding a part of his body as an independent source of feelings or behavior that had nothing to do with him, but which he sometimes treated like a naughty child. Once, we discussed an episode of his hitting a boy in his kindergarten class with a block. This had upset Randy’s teacher, but Randy considered the incident in an offhanded manner as though unrelated to himself. When I pointed this out, he said, “I thought I might hit Larry, but then the hand with the block did it.” He was drawing a picture at the time and followed his remark by repeating several times “Cut it out” as he looked at his hand. His parents often used this phrase when Randy misbehaved. Now he used it against the offending hand. Later he was able to connect it with “Cut it off,” which he had said about his penis. When he was leaving kindergarten, he again had no feelings, but he rubbed his eyes because “they are runny all the time. Stupid eyes.” On a later occasion Randy’s beginning insight and ability to integrate showed in the following incident. He caught a glimpse of my husband from the office window. His mouth opened wide, he spilled a glass of water he was holding, touched his penis, and ran to the bathroom to urinate. Upon returning, he was surprised that I thought he had some feelings. No, he had felt nothing, but he hit at his nose playfully saying, “Nosey, nosey.” At such times I could suggest to Randy that he disowned and punished a part of himself when it did something that reminded him of a feeling too big to be comfortable with. Later, we noted his attempts to suppress his phallic sensations either by running to urinate or by pushing his penis between his legs, which Randy once described as, “Pushing in the angry-excited.” These most dreaded feelings arose in his penis and manifested themselves in its uncontrollable behavior.

This defensive maneuver had widespread parallels in Randy’s attitude to anxiety-arousing situations. He readily “cut off” parts of his personality when they caused him conflict, sometimes simply denying them, sometimes externalizing them to another person. He blamed me for criticizing him when his own primitive guilt proved unbearable. He did not think about what he had done at home or at school, assuming that I knew. He did not bother to restrain himself, expecting that I would control his wild actions. He would not look for what he had mislaid, for this was my responsibility. He took it for granted that I would function as his ego to an extent unwarranted by his level of development whenever he experienced tension in utilizing his own abilities. I pointed out how sad it was that he sometimes had to get rid of the best parts of himself, just like with his penis, because they were a bother to him rather than a help or pleasure.

We could trace a similar pattern in his relationships. After a day away from treatment because of a school trip, Randy described how he had watched a chickadee on a feeder dive to the ground as though falling. “That must have looked scary,” I commented. “No, it’s just a bird. Birds don’t have feelings.” I told him that a boy would not talk in such a careless way unless he had a trouble. We then learned that he had identified himself with me who, he assumed, had not missed him but “cut him off” because “Randy is just a patient.” I recalled his mother’s, “Randy was just a baby. Babies don’t have feelings,” but I did not mention this to Randy. Much later in his analysis, transference manifestations of this kind became frequent. Randy would sit motionless or look too preoccupied to respond to me. We were able to reconstruct his mother’s chronic depression during his second and third year and, later, recurrent for shorter periods. Randy responded with, “She heard me, but she did not listen.” He experienced her lack of cathexis as being cut off, disowned, attributing it to his own badness. Randy’s attitude to body and mental parts of himself appeared to be patterned on this aspect of his early relation to his mother and contributed to his difficulty in integrating his self-image.

Anal meanings also influenced Randy’s special form of isolation. He often detached himself from his problems, especially his “penis problems,” by “producing” them in the session and then “handing” them over to me to take care of. We could trace this to his toilet training: his mother had been very demanding and Randy very rebellious, so that it was dominated by intense sadomasochistic battles. When Randy experienced his penis as dirty and angry he wanted to throw it away as his mother had thrown away his feces and urine. Randy had never fully “isolated” himself, however, from his body products. Unconsciously they were carefully guarded as precious parts of himself. Similarly, he had often consciously wished to get rid of his penis, but had never really harmed it and greatly feared that others might devalue and remove it. His compulsive masturbation activity reflected both sides of his struggle.

In contrast to his masturbatory activity, which was unaccompanied by any feeling, Randy’s intensely excited and aggressive fantasies were acted out throughout the day in episodes of overwhelmed and overwhelming behavior. Randy gave the appearance of a completely uncontrolled child as he yelled at his mother and pelted her with his boots and jacket, ostensibly because she had come to pick him up at school and thereby interrupted his activities. On closer observation, however, one could detect an element of an excited, sadistic performance with which he appropriately awed his mother. We learned much later how these defensive regressive attacks had their prototype in his earliest exhibitionistic urinating. Randy’s use of his whole body as a displacement from the penis could first be understood better in another context; Randy had just moved to a new home in which his bedroom door was closed. This disturbed his equilibrium, increased his anxiety, and intensified his compulsions. His sessions, and often his behavior at home, were characterized by frequent wild periods in which he threw himself around the room as if drugged, suddenly attacked things and people, his face distorted and his mouth producing odd shrieks and grunts. An observer felt himself faced with a monster and compelled to control it, yet helpless to do so. Gradually he himself became aware that these episodes were preceded by his touching himself and sometimes running to the bathroom. I suggested that in order to ward off his phallic sensations, he himself became the unpredictable, unmanageable penis and scared others instead of having to be scared himself. “My penis does not behave right. It is dumb, silly, out of control,” Randy admitted. He was referring to spontaneous erections and a recent incident of night wetting. I wondered whether his penis acted this way in response to feelings and thoughts which Randy did not allow himself to know. This led to associations of shooting and killing, of being enclosed and crushed, and, most important, to Randy’s beginning awareness that feelings, thoughts, and bodily sensations belonged together.

Randy could not conceive of feelings other than in terms of being surprised and overwhelmed. He was unable to anticipate his anger or excitement or to recognize them in their initial stages. They always took him by surprise at full strength. To ward off his own fright, he often overtook others by surprise attack or imparted to them his anxiety through his behavior. In time we could relate Randy’s attitude to feelings to his overwhelming impressions of both parents’ nudity and, even more, to his unexpected exposures to their sexual intercourse. Further, Randy had, from his second year on, been the target of both parents’ violently aggressive outbursts. At these times Randy felt that their whole bodies were suddenly overwhelmed and were overwhelming him. To Randy, these outbursts paralleled the sexual scenes, day or night, particularly as the parents treated them in like manner. They did not consider their behavior unusual and were unaware of its effect on Randy. They never talked about it with him, denied, isolated, and repressed its occurrence, and conveyed their expectation that he show no response. Randy identified with them. Sudden overwhelming involving the whole body, rather than integration and mastery, was the norm. For defensive purposes, it seemed safer to be the uncontrolled penis than to feel helpless to control it. Needless to say, the family’s pattern of living—full of sudden decisions, changes of plans, and forever surprised by unanticipated events, extended the lack of mastery to all areas and made it impossible for Randy to feel that any aspect of life could come within one’s control.

His own anal and urethral experiences also contributed to Randy’s defensive pattern. His sudden outbursts were often accompanied by “making a mess,” e.g., strewing paper, cards, crayons. His angry tirades could be likened to “outpourings,” sometimes with actual spitting. When these forms were linked to loss of bowel and urine control, Randy was gradually able to reconstruct and recall his many second-year experiences with explosive diarrhoea and, somewhat later, his attempts at retention of urine in order to preserve his precious “penis-plug.” He remembered sadly that he never succeeded in retaining, “Suddenly the piss was out.” At such times, mother was furious with Randy and cleaned him roughly, in a way that hurt. Both passive and active strivings were thus gratified and formed a basis for his later attitude to his penis and to relationships at the phallic level.

Randy’s Masturbation Fantasies

Randy’s harsh guilt feelings were prominent from the start. He was a “bad boy,” and in spite of many defensive maneuvers he always felt that everything that went wrong was ultimately his fault — one of the few things on which he was in agreement with his family. Much of the first analytic year was taken up with his “bad, mad, sad” feelings and related to his unmastered second-year experiences. At that time, following his sister’s birth, his mother had emotionally withdrawn, gone to work and left Randy in the care of a succession of sometimes sadistic sitters. Some of Randy’s extreme guilt could be traced to primitive unintegrated introjections of the demanding, punishing adults, augmented by his own oral and anal aggression. Even during this early analytic period, however, Randy’s phallic preoccupations were much in evidence, particularly in the form of his widespread touching inhibitions and of his “crazy shows,” i.e., his excited aggressive outbursts, to which he subjected his captive onlookers. As defense interpretations freed his perception and motility for learning and neutral activities, we also began to trace his outbursts to times when Randy felt left out from the “goings on,” such as ordinary class noise, or when he had felt himself to be the passive watcher of someone’s superior appearance or performance. In an extreme example, Randy once rushed into the office in high-pitched excitement, stripped, jumped up and down wildly, uttering disconnected phrases: “Ram it in my mouth; push it in my behind; baby, baby.” Eventually he pushed at me and kicked at the walls. I told him that something must have surprised and scared him very much so that now he needed to try to surprise and scare me. It turned out that he had fleetingly met my husband on entering the building. This unexpected encounter had aroused overwhelming excitement and anger, displaced from his many encounters with his nude exhibitionistic father, to whom he never reacted at the time but simply appeared not to notice.

Interpretation of the defenses of isolation, turning passive into active, displacement, and introjection helped to decrease the bodily discharge as verbal contents increased. From these I first reconstructed a primal scene experience. Randy confirmed this by repeatedly walking on his knees from office to bathroom. Pointing up to the sink, he said, “That’s how high the sink was.” We could date this experience to the end of his second year when he had apparently wandered from his room to get a drink and observed the parents. His impressions, interlinked with his daily life at the time, were of mother overawed by the view of father’s penis and sadistically penetrated with his urine.

After some 18 months of treatment, Randy was much more master of himself. His compulsions were far less pervasive, he found pleasure and comfort in academic work and art activities, and needed to exercise less control over every aspect of his environment. The start of public school, however, increased the stresses and intensified his difficulties. During the early morning hours, Randy no longer compulsively masturbated, but was “doing nothing and thinking nothing.” His trouble started with getting dressed, which he could not complete without provoking his parents’ forceful intervention. His long walks to and from school were taken up with excitedly watching the boys’ fights and, often enough, with taking part in them. For the first time it was possible to point out to him that his provocative behavior with the parents and peers contained acted-out fantasies that belonged to the warded-off masturbation activity during his lonely mornings in bed.

Randy’s awareness of sensations in his penis increased, along with some recognition of his “waiting trouble,” that is, his enormous anxiety when he had to be alone, unable or forbidden to interrupt the activities of others to assure himself of their full attention. In a transference reaction around a brief vacation, we learned more about his “Asking-for-it trouble.” His provocative behavior had been described by the parents as “asking for it,” meaning, asking for retaliatory attack. Randy explained that his provocative fights belonged to his waiting trouble and contained both a question and an answer: “I am asking for what you were doing when you are away, and I am answering it with the excited fighting because that’s what I think you were doing.” Our work on this led to a period early in Randy’s third year when he was preoccupied with understanding sexual differences and wanted to command his mother’s love either by being a penisless girl like his little sister or a man with a huge penis like his father. His wetting symptom at that time expressed both wishes and was later displaced to his obsessional dressing symptom with which he frequently provoked the mother’s excited-rough handling of his body, similar to her earlier cleaning of him after he had wet. Suddenly, Randy recalled that he had always been on all fours when he wet on the floor. The next session had to take place in the lobby, “the wrong room,” for Randy refused to enter the office and slammed the door on me in a rage, threatening to lock me out. I suggested that he had at one time entered the wrong room in his home, had interrupted his parents’ intercourse and been locked out by his raging father. This must have scared him so terribly that he had to forget it and to make himself feel safe by raging at me.

The reconstruction was later confirmed both by Randy and his parents. At the time of the session in the wrong room, however, Randy responded to my interpretation by repeating over and over, “It could be and it couldn’t be, it could be and it couldn’t be.” This made it possible to link his recent severe doubting compulsion to his attempts to ward off the overwhelming anxiety he had experienced as his parents’ witness and intruder —a helpless little boy, unloved, unwanted, and at the mercy of inner and outer danger. Randy responded with a marked change in symptomatology. For the first time, he became phobic. He missed the next session and was too scared to go to school. We learned later that this repeated an earlier phobic period at about three and a half years which had followed this primal scene and preceded the onset of his obsessional neurosis.

When Randy returned after his phobic day, he was extremely guilty. He felt so bad that he was sure everything would be taken away from him, he would never be liked, and the worst part was that he lied about the bad things he did, acting innocent instead. Several aspects of his guilt could be understood. It was not so much his daily misbehavior and shortcomings for which he berated himself, as his warded-off masturbation activity and fantasies. Further, the great guilt he carried represented an identification with his parents and also contained his reproaches. “They did what they shouldn’t do. They lied about it and acted innocent. They should not have excited and punished me.” As Randy clung to his guilt, however, we began to see that it also gave him power over people and events, warding off feelings of helplessness. One day the light went off in our office. Randy was sure it was his fault because he had been jumping. I reassured him, explained a recent faulty wire connection, and turned the light back on. Randy was furious that he had not known about this and had no control over it. Furtively, he rubbed himself against the switch to turn it off again, proclaiming, “See, it is my fault.” At another time he was guiltily convinced that his turtle had died because of his deficient care. There was no real evidence for this, but he insisted. When I interpreted that perhaps he felt safer being guilty than being little and helpless, he cried out in sad despair, “And it didn’t even ask my permission.”

Shortly afterwards I prepared Randy for a cancelled session. He imagined that on that day “You and your husband and the whole family will climb on top of each other and there’ll be a big boom and the whole house will fall down.” When I wondered about this scary idea, Randy got down on all fours and said calmly, “It has to do with the story of Mommy and Daddy of long ago. Daddy was behind and on top of Mommy. She was looking crazy, rocking back and forth on all fours, and she liked it. Daddy was sticking his big penis in, then pulling and pulling over and over again to get it out, but it was stuck and when he finally got it out the penis came off. And I was glad.” His anxiety caught up with him the next morning when he waited for his parents to get up: “I was so scared, it felt I might be there alone forever, and in the end I dashed out and had a crazy outburst and then Daddy came out and put me in my room.” Now Randy could begin to see the connection between his “waiting trouble” and masturbation, and understand his fantasies in terms of his identification with both parents in intercourse. Additional memories enabled us to date his witnessing of intercourse a tergo to the age of about two and a half years. It predated the later occasion when he interrupted the parents and incurred the father’s wrath, but it formed the core of his masturbation fantasies.

In the months following, Randy’s masculine and feminine strivings manifested themselves in the context of positive and negative oedipal wishes. Opposite instinctual impulses were no longer intermingled, but gained dominance alternately and sometimes served to ward off one another. His wish to be a woman was more accessible. It showed itself in his “creep” feelings, a part of his provocations of bigger boys. He could finally allow himself to experience them in his sessions when they occurred in response to my talking—my words were the penetrating, exciting needle he hoped to have administered by my doctor-husband. Although Randy had not had unusual medical experiences, the occasional injections, the earlier habitual rectal temperatures, his sadomasochistic concept of intercourse, and the piercing quality of his parents’ angry yells had coalesced into this image. Later Randy hoped to provoke my husband’s direct intervention by being noisy in the sessions and by grabbing and touching objects on the way to our office. He wanted to bring about the attack to avoid a surprise. My husband might jump out at him and send him away because my husband was selfish and did not want to share me. Randy occasionally forgot his things in the office. They were intended as peace offerings and to prevent my husband from taking Randy’s more precious things. Randy took care never to put up drawings he considered good, and he made sure that he would not behave too well. There should be no visible cause for my husband’s envy or jealousy. Gradually Randy saw his feminine wishes as a defense against his fear of and aggression to the father figure and as an identification with the castrating woman. Isolated moments of anxiety overwhelmed him at this time, e.g., when a man appeared at the door to deliver a parcel, or when his doctor was to treat his plantar wart, or when he was praised for doing well and asserting himself positively. Randy was equally afraid, however, of his loving feelings for women, which he always warded off with a regressive sadistic-exhibitionistic excitement or bossy controlling. When he for the first time bought me a gift with his own money, he was in acute anxiety and behaved nastily for days until he finally handed it to me, blurting out, “I was afraid I would get too excited and love you too much and would want to give you my penis” —as he had given mother his precious bowel movements, and as he had thought father gave her his penis to make a baby.

When Randy began to enter the latency period, he had grown into a handsome, sturdy, well-coordinated boy. His harsh new superego clashed with his persisting instinctual pressures, which led to new symptom formation. By the time he was eight years old he had developed a serious learning inhibition. Characteristically, it manifested itself in rebellious refusal to do his assignments and to participate in class work and was well rationalized by his insisting, with some justification, that he had no need of school because he already knew the prescribed syllabus. At times he behaved so badly that he was sent home from school and threatened with expulsion. Randy frequently refused to go to school. His phobic response to learning had spread to school itself. Because he assiduously avoided discussing his problem in the analysis, I told him that I suspected his school trouble was a displacement from a treatment trouble. He did indeed now occasionally have difficulty in coming to his sessions, but for the most part he just turned away from me and tried to spend his sessions in the closet reading books. He was quite chagrined when he found himself incapable of concentrating on his reading, but was forced repeatedly to jump up, sway around drunkenly, and laugh hysterically as he repeated an innocuous word over and over as though it had an excited hidden meaning. We recognized his old defense against spontaneous erections and anxiety-arousing fantasies. We learned that when Randy had tried to work, his phallic excitement took him by surprise. For this reason, he had progressively restricted his learning activities and even school attendance. But now it had caught up with him and interrupted his favorite pastime, reading. “Reading has become greeding,” Randy commented, “stuffing things in to stop things from coming out.” Randy was familiar with this defense from our earlier work on his oral aggression. He also had new strict masturbation rules: “No regular kid my age does it more than once or twice a year.” The accompanying fantasies were unconscious. After some work Randy realized their content: He would jump on me from behind, bring me down on all fours and penetrate me sadistically. The passive and feminine aspects of the fantasy were in part gratified by the punishments and ostracism he incurred from others for his bad behavior and by the self-debasement that he had brought upon himself. Working through of the transference in relation to the past helped to resolve the symptom, but his continuing struggle with masturbation manifested itself in a behavior pattern. He would repeatedly “turn over a new leaf” and do well until a mishap or failure started the path downhill, replete with hopelessness, guilt, and regression to defiance. “I don’t care, I’ll make things bad on purpose.”

In many ways it was not surprising that Randy’s severe earlier conflicts should still cause him difficulty after almost four years of treatment and should require repeated working through. Yet, maintaining his latency and dealing with the realities of life appeared to be so difficult for him that other factors seemed to be at work.

Some Factors Affecting Randy’s Ability to Master and Modify Instinctual Drives

The analytic material pointed up clearly certain weaknesses within Randy. The different parts of his personality tended to interact so as to produce tension and disharmony more readily than balanced integration and adaptation. His instinctual drives retained a good deal of their infantile intensity and urgency. Fusion of libido and aggression lagged developmentally. In spite of great gains in all areas, his ego was often inadequate to the task of dealing with internal pressures and external demands. Although age-adequate defenses played a more prominent part, the earlier isolation, denial, externalization, displacement, and projection were still used under stress. Randy’s tolerance for anxiety at all levels was low. Neutralization and sublimation were much in evidence, but had by no means reached a sufficient degree of secondary autonomy. His means of healthy mastery were limited and his frustration tolerance was poor. Randy had always been plagued by very low self-esteem except for an occasional narcissistic overestimation of his intellect. His superego precursors had been exceedingly harsh. His new postoedipal superego was patterned on the earlier precursors, inadequately integrated and burdened with parental guilt. Although he never exposed himself to bodily harm, his excessive guilt and disgust with himself forced him into behavior injurious to his self-interest and calculated to deprive him of love, pleasure, and success. At other times he warded off the demands of conscience through externalization.

This personality picture undoubtedly contributed to Randy’s continuing stress. In time it became evident, however, that Randy’s internal struggles were also closely related to current experiences in his family life. Work on this area helped us to understand better how and why Randy found refuge in his neurosis. Randy’s masturbation conflict was one of the focal points of his difficulty and proved an avenue toward analytic understanding.

His daily life, whether the routines of getting ready for school, completing his chores, or partaking in a family outing, was time and again invaded by instinctual contents, sometimes with regressive admixtures, so that he had to resort to distorting defensive measures and failed in his adaptation to reality. At first, we could trace this constant excess of excitement and aggression to his narcissistic refusal to renounce his exclusive oedipal wishes, both with the mother and with the therapist. When I pointed this out to Randy he became extremely upset and started the next session by running away and making me feel that he might get lost. I interpreted his turning passive into active. We learned that he could conceive of giving up only as a total loss of the love object and of the self. Randy’s material now centered in turn on each developmental phase with its experiences of loss for him — the weaning at the time his sister was born, the elimination products “thrown away” by his mother, the fears of castration. Each stage also had its attendant separations from the mother. This working through was undoubtedly of some real value, but the relative ease with which Randy participated in the analysis made me suspect that he concentrated on old instinctual contents to ward off a painful reality. I told him as much. Soon an occasion arose when I learned from Randy’s mother that she had forgotten to pick him up at an agreed place, and he had finally wandered home alone. She felt badly, but had not shared her feeling with Randy or apologized to him. Randy had not reported this incident, as indeed he never reported anything that would justly blame his mother. When I confronted him with it and sympathized, he minimized the incident and brusquely told me that, “After all a mother has to have other things on her mind too. A boy my age is perfectly capable of getting home on his own. It’s no crime to forget something. Only a stupid crybaby would make a fuss.” It was with much difficulty that I could even begin to help him see his identification with a mother who rationalizes her own mistake and shifts the blame to the child for feeling helpless, unloved, and angry. It was striking that Randy, who could act so aggressively to his mother and berate her unrealistically, could not allow himself to accord her justifiable blame. Instead, he warded off his reactions and despised himself for them. One day the mother responded to Randy’s tease with total loss of control and threw a can opener at him. He hid away the can opener and hid himself in his room. In his next session he directed excited aggressive behavior at me, then suddenly became terrified of me when he noticed a bandage on my wrist. His associations led to new memories of earlier experiences of his mother’s menstruation and his fear of her apparently damaged genitals, but he bypassed mother’s recent attack on him. We had repeated occasions to observe that Randy used instinctual contents to ward off recognition of his mother’s periodic withdrawal of cathexis and of her frightening aggressive outbursts. It was safer to be excited and suffer from the unrealistic fear of the female genitals than to feel helpless in the face of his mother throwing a real can opener. Randy sometimes warded off his fear of mother by displacing it onto women teachers and the therapist. Often, too, his excited provocations of his mother were calculated to bring about her loss of control before she could surprise him when he was unprepared.

Another factor also contributed to Randy’s difficulty in renouncing his instinctual demands on his mother. He knew since his second year that, “I can always make her mad,” i.e., he could not assure himself of her continued love but he could always succeed in gaining her attention by involving her in an excited aggressive interplay. Tender love was not unknown to Randy with his mother, but because it had never been maintained for long, he felt it was a most vulnerable state, leaving him open to unpredictable loss and hurt. When he had found himself rejected and left as a baby and toddler he had directed his love to things and to bodily products. Later he would use masturbation as a solace until his warded-off anger invaded his fantasies to such an extent that he experienced his masturbation as a danger and a just cause for being rejected both by himself and by others.

Incidents with his mother similar to the one described above were not new. During Randy’s earlier years they had been a regular part of his daily life, albeit obscured by the parents’ unawareness of their behavior and by Randy’s own neurosis, which presented insuperable obstacles to any reasonable educational management. Since the beginning of Randy’s analysis the parents had gained considerable insight and tried to control their difficulties. Randy for his part improved greatly and could respond more age-adequately. The father succeeded sufficiently in modifying his reactions toward Randy. The mother did not.

Randy’s incestuous regressive excitement served to assure him of the continuity of his relationship with his mother, to ward off feelings of helplessness in the face of realistic danger from her, and to comfort himself at times of excessive stress. By also taking over the mother’s conveyed guilt, Randy protected his necessary idealization of her and afforded himself a measure of at least imaginary control. Needless to say, he paid a price in terms of ongoing unmasterable inner conflict and behavior problems. This caused him considerable unhappiness, but also assured the continuation of treatment which he utilized as a protection. Randy’s relation with his father was generally much more age-adequate and trusting, but his repeated preoccupation with incestuous impulses interfered with adaptive identifications and neutral competition, and intensified his castration anxiety and guilt.

Randy is still in the midst of working on these difficulties. He has made considerable strides in coping with them and, at nine years of age, latency maturation is his ally.

The analytic material shows the extent to which Randy’s current psychic responses are genetically related to past experiences in the mother-child relationship, when only pathological solutions appeared open to him. It is difficult to determine to what extent these neurotic tendencies are perpetuated by the long-standing weaknesses of Randy’s personality make-up and to what extent they are re-enforced by the circumstances of his present life.

Summary

An attempt was made to highlight some aspects of a young boy’s masturbation conflict as it revealed itself in the analytic material and changed during the course of four years of daily treatment. Two specific defenses, the genetic origins of the masturbation fantasies, and the effect of the mother-child relation on the masturbation conflict were selected to illustrate the work and to present the understanding gained from it. It was hoped that these excerpts from a lengthy analysis might throw some light on the varying roles of masturbation in one child’s life and on his ego’s changing patterns of dealing with it.

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