Unmastered Masturbation Conflict
<< Excerpt from the Analysis of a Prepuberty Boy >>
Robert A. Furman, M.D.<sup>1

1</sup> Assistant Clinical Professor of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, Ohio.
Training Analyst, The Cleveland Psychoanalytic Institute.
Director, Cleveland Center for Research in Child Development.

In Masturbation from infancy to senescence, pp. 223-229. NY: International University Press, 1975

In the terminology favored by Kestenberg (1967), pre-puberty commences with the appearance of secondary sexual characteristics and puberty, for the male, when mature spermatazoa are present in the semen. The first emission, which does not contain mature sperm, occurs some time in the middle of the prepubertal period of development.

In the course of analytic work with prepubertal boys aged 11 to 16, I have been struck by the difficulty encountered in obtaining adequate reports or descriptions of the onset of emissions, much less an understanding of their meaning. With one boy who was in analysis from 11 through 15, his emissions did not begin until he had completed his analytic work, leaving me with the impression, which could not be substantiated, that his emissions were delayed by his analysis because of a resistance to discuss some aspect of this phase of his development.

I have also been impressed by what has seemed to be the soundness of the concept of the “inner genital phases” of development as postulated by Kestenberg (1968) which has proven helpful in the analyses of adults. But in my work with the mothers of young children, in the rare analysis I do with children in the preoedipal phases of development as well as in the analyses of prepuberty boys, I have not been able to obtain the confirmation I have sought regarding the inner genital phases.

A recent analytic experience afforded the opportunity to observe prepubertal development focused on the first emission and accompanied by what seemed to be a conflict over inner genital sensations. In addition, some understanding emerged as to why this particular period of development may be difficult to observe in analysis.

Frank’s analysis started when he was 10 and a half and entering the fifth grade, and was terminated a few years ago when he was in the ninth grade and 14 and a half. The parents’ presenting complaint was his learning problem. He was unable to complete any school assignments on his own and had for years been able to do a minimal amount of work only with tutoring and with his mother’s extensive assistance. Although polite, courteous, and acceptable to adults, he had no friends as his strange, hyperactive, hyperexcited behavior seemed unacceptable to his peers. He was enuretic, a sleepwalker, and had set one serious fire three years earlier.

He had first come to my professional attention at age four when the mother sought help for his day and night wetting. An uneven home situation, which was denied by the mother at that point, made direct work with him unfeasible, and the mother was referred for weekly work geared toward establishing controls and order in the home and to helping her become aware of and deal better with her denial. The work was successful in many ways. The day wetting ceased, night wetting became intermittent, and Frank was able to cope through kindergarten and first grade. The mother’s weekly sessions were tapered off and stopped during kindergarten. Frank’s condition deteriorated greatly when he was in second grade. He was diagnosed as psychotic by the school psychologist and excluded from most of the school day. His work was partially maintained by daily tutoring, but the fire setting brought the mother back for further consultation.

I learned at this time that Frank’s deterioration had coincided with a miscarriage by the mother, which he had observed, the significance of which she had totally denied. She was able, with support, to discuss this with him, and his strangeness in school subsided sufficiently for him to resume full attendance, though still with tutoring, by the third grade. But of greater significance was the fact that the family became convinced that his need for intensive treatment was sufficiently compelling for them to agree to establish the further controls at home which I felt were a necessary prerequisite for analytic work. After I became convinced of their ability to fulfill this commitment, there was about a year’s delay before analytic time became available.

The initial analytic work focused on Frank’s out-of-control, exhibitionistic behavior, which the parents had never reported, and his inability to form meaningful peer relations. This led us to infrequent but repeated primal scene exposures, recurrent observations of the breast feeding of a series of younger siblings, as well as the effects on him of prolonged periods of overstimulation by his father. We were faced from the outset by Frank’s constant passive excitement and his predominant defense of converting it into exhibitionistic activity. The father’s excitement with him had been but thinly veiled, and Frank was most troubled by his awareness of the recurrent incestuous seductions to which he had been exposed. Because of the unusual nature of the father’s difficulty, unusual in the overtness with which it had often appeared, vague passive excitement and negative oedipal wishes had to be worked through over and over in the analysis, to a degree not usual in the analysis of a prepuberty child. Frank felt under enormous pressure to understand and master these aspects of his development. He was sustained in this work by the accurate awareness of his mother’s respectful and appropriate concern for him, as, with external support, she became increasingly able to mother and protect him effectively.

By the time Frank was 13 and a half, after three years of analysis, he had experienced a great improvement of which he was keenly aware and most appreciative. He was by then a consistent B to C student, working completely independently, and had a well-balanced maturity which was earning him the friends he had so desired. To our surprise and his delight, his analysis had revealed that behind distressing neurotic aversions to things musical or athletic lay gifts in both areas that he had begun to utilize. In late fall, as we were working on different aspects of his remaining reading difficulty and its relation to a temporary difficulty in reading music, there was a sudden and unusual change in the character of his hours.

Although Frank had often drawn with crayon or pencil as we worked, his productions had always been nonrepresentational designs or even collage-type pictures. These had been made as if he had been doodling, and the content of his art efforts had never had much value for our analytic work. Rather abruptly, he began to draw helicopters and became preoccupied with them, focusing on their detail for an entire hour and resuming the drawing at the next session. He had no particular interest in airplanes, which made this change all the more surprising. I felt at first that we had just come to a new resistence, but the extent of his preoccupation indicated there was much more to it than that. What was striking was that no matter how much detail was added to his helicopter in terms of weapon systems or more and more elaborate living quarters, the drawings were never just right, never satisfactory. This preoccupation continued for about a month. We were aware only that he was trying to communicate something that he was feeling that did not seem just right. Then the interest stopped almost as abruptly as it had started.

Within a few days Frank told me he thought his emissions had started, but it was striking how uncertain he was. We both knew that he was eager for this maturational step to occur, and were puzzled about what had actually happened. It was a topic he was reluctant to pursue, although he readily accepted the observation that perhaps the helicopter drawings were an attempt to deal outside of himself with new sexual feelings he had perceived inside his body. This was his typical response to an interpretation he felt to be correct. I explained further that perhaps his emissions were truly beginning but as yet had not the strength they would develop in time. The subject definitely disappeared from the analysis some three weeks before we were forced to focus on some realistically distressing apprehensions about his father’s health.

Just before the Christmas holiday, Frank had to be informed that his father had a serious cardiac illness that could prove fatal in the matter of a few years. He took the news with a mixture of stoicism and sadness, but was concerned lest he deny it, as “playing pretend with bad news” had been the mechanism that had caused him the most difficulty. On return from the Christman holiday, he brought me up to date on his father’s current status and his struggles to manage it, which had been partially successful. He then announced with finality and assurance that his emissions had started. At this point our focus on this maturational step was in regard to its relation to the current unfortunate external situation with his father, and it was not possible to understand the meaning to him of his emissions from the purely internal point of view.

The months that followed showed Frank able to become more independent, to integrate his analytic work better despite his appropriate and feelingful concern for his father. But this maturation seemed more a continuation of what had been transpiring during the year than a response to the onset of his emissions. In late spring, he was working on his masturbation problem and had just gained some control through the insight that he masturbated actively to discharge an excitement that would otherwise have led to exhibitionistic impulses. He was aware these impulses were the result of passive excitement he experienced in his hours, as if I were exhibiting myself to him. The transference origin of these feelings was familiar to us.

It was in conjunction with this bit of analytic work that he went back to discuss the beginning of his emissions. He said there had been a period of time, right after the helicopter drawing had stopped, when he had first reported emissions, when without any warning a small amount of sticky substance would emerge from his penis, often when he was reading. This spontaneous, uncontrolled though infrequent occurrence had been most distressing to him. At that time, he was unable to produce emission by masturbating. He was greatly relieved when, during the Christmas holiday, his masturbatory efforts were rewarded with a full emission which he could make occur when he wished. He was specific in describing a change in the volume of the ejaculate, but what was most important to him was that at the point of discharge he could “feel it coming,” which had not been true at first.

Discussion

It seemed possible at this point to have some thoughts about just what had occurred in the fall. The helicopter period must have been a reflection of vague new feelings arising that had their origin in internal developmental changes, primarily centered in the prostate. The secretion Frank could not control must have been from the prostate, the result of maturation whose stirrings he had tried to convey by means of the helicopter drawings. Once this prostatic activity had become manifest externally, the need ceased for the helicopter drawings which had been attempting to portray outside of himself what was going on internally. The relief provided him by the achievement of full ejaculation was one of control over the formerly uncontrollable but also one of active discharge of an otherwise passively experienced excitement which he felt to be feminine in nature.

He was aided in his awareness of these inside feelings as feminine because of his familiarity with the defenses he employed. These had been used previously when his femininity had been aroused by stimulation from outside. He had always said that when his father exhibited himself to him it made him feel “like a girl.” He had elucidated his active masturbation as a defense against such feelings arising in the transference when he spontaneously returned to the period of his prostatic emissions, which he had also attempted to control by actively masturbating.

It might be noted here that there was no significant change in the pattern of his masturbation fantasies with the onset of his emissions beyond what was to him an embarrassing increase in the intensity of his feelings.

It seems possible that observations in the analysis of the developmental period of the first emission may be complicated on two scores. First, most boys await their first emission as proof of and reassurance about their masculinity. If the first emissions are previewed by sensations which are felt to be primarily feminine in nature, this can understandably be both so confusing and distressing as to preclude their discussion until after full emissions actually begin, at which time there is little inclination to look back on the period that preceded them. It was clear in Frank’s analysis that in this period of his development the feelings he experienced had been unusually difficult to communicate in words, even though he always had been very successful in expressing himself verbally in his analysis. Second, it is likely that his difficulties in describing these inner genital feelings were due not only to their vague nature, but also to their origin in preverbal experiences of a passive or feminine character, that is, early bodily sensations resulting from his mother’s ministrations. If this holds for Frank, I would expect it to be valid for other boys as well.

REFERENCES
   Kestenberg, J. (1967), Phases of adolescence with suggestions for a correlation of psychic and hormonal organizations. Part I: Antecedents of adolescent organizations in childhood. J. Amer. Acad. Child Psychiat., 6:426-463.
   Kestenberg, J. (1968), Outside and inside, male and female. J. Amer. Psychoanal. Assn., 16:457-520.

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