Has the new feminism of the last decade stirred up age-old fears of female power, which exist in both men and women?
Since sexual-role expectations differ from culture to culture, from generation to generation, it is more useful to ask which sex has what kind of power over the other, in which culture, at what historical time, and in precisely what way? Is it acknowledged and accepted or covert and hidden? We know that when there is rapid change, many re-adjustments are necessary, which cause anxiety.
In historical periods, where sex roles were static and fixed, there was less individual choice, less ambiguity, a more stable equilibrium than we now have. Most women feared male power and bowed to it or played along with it. Many still do. The new effort to establish more equality between the sexes is beginning to destroy the old, patriarchal “balance of power” and there is more overt competition between them; many men fear the new assertion of women!
Much has been written about man’s fear of the castrating bitch with the “dentate” vagina, but little attention has been paid to woman’s fear of her own sexual power, her fear of “being castrating” rather than just castrated. This is reinforced by cultural prohibitions against female assertion as “unfeminine” resulting in inhibitions that unduly restrict the lives of many women. Examples from social anthropology and mythology will be used to illustrate how men learned to use their physical power to combat their fear of magical female power.
Clinical Examples of “Dread of Female”
1) A man with a very seductive, critical, ambitious mother was deprived of any tenderness and sent away to prep school at an early age. He developed an aggressive facade and had premature business success which brought him into sudden competition with brilliant men. He was fairly active sexually before marriage but was impotent with aggressive older women. He married a petite, charming, child-bride who was still very much under the influence of her mother’s strict prohibitions against sexuality. In order to discourage masturbation, the mother had warned that her genitals would get too large and no man would want her. (An example of a mother fearing her daughter’s sexual power.) Any seductive behavior was forbidden and the girl was deeply ashamed of any sexual excitement. After five years of marriage she still expected to be wooed, was not overtly responsive emotionally, and kept her husband in pursuit. Their sexual life was quite satisfactory until she became pregnant. He had been reluctant to have children as he felt he had to “mother” her and did not want to share her. He found himself repulsed at her pregnancy and could not make love to her for fear of “hurting” her. Rage and revulsion over his own mother’s body overcame him and he withdrew totally. The wife felt abandoned, unloved, and retaliated by giving all her attention to her children, whereupon he developed a peptic ulcer.
2) A second man with a seductive, smothering, indulgent mother was overpraised as a little prince, his penis admired openly, and he was exposed to his mother nude in the bathroom up to the age of five. When he explored his fear of the female genitals in analysis, he realized that he thought the mother’s genital area was a huge, black hole based on fleeting glances at the pubic area with its hair, making it appear monstrous. His life-long preoccupation about his “small” genitals stemmed from these early bathroom scenes where he also had seen his father nude. His father was hostile and undermining so penis size became symbolic of male competition.
3) A third man who was at first impotent and then premature, likened the vagina to a high, black cave in which he would surely be lost, “swallowed up,” as he had felt as a child by his overwhelming mother. It is interesting that all three of these men had hostile but seductive mothers and were the only son, so they got the full brunt of their mothers’ sexual preoccupations. None of the mothers had good marriages; all had contempt and hatred for their husbands and focussed on their sons.
4) A fourth example was seen in the husband of a woman who had a phobia of penetration and still had an intact, tight hymen after eight years of marriage. She had fears of male violence and especially of pregnancy, as well as a sexually prudish mother who never had let the father touch her after the patient’s birth. She had never been able to tolerate a pelvic examination but kept a fantasy of having no vagina. It took a great deal of therapy to work through this in the course of which I interviewed the husband to find out why he seemed so tolerant. They had erotic lovemaking by manual manipulation without penetration. He put up with this limited sexual life patiently because of his fear of upsetting a woman or of hurting her. This was traced back to his fear of a tyranical mother and grandmother. He also had a peptic ulcer at the height of his frustrated need for affection. He also contributed to this by infantilizing his wife; he would not let her drive because it was dangerous, kept all money matters from her as “too complicated,” and acted as her managerial agent when she had no such need. All of this increased her feelings of childishness and helplessness and made him feel strong and indispensable. Again, one sees the marked ambivalence to women, a fear of upsetting them, a caution and timidity that passed for gentleness but also was very controlling. It covered his deep craving for intimacy and love.
I also have innumerable examples of situations in which the husband refused intercourse almost entirely after the birth of the first child, saying either that the wife preferred the child to him, that she only wanted him for impregnation, or that she was no longer attractive since she had become a mother and thus, unconsciously, taboo for sex.
Increasing knowledge about sexual function has enabled many people to be more natural and at home with their bodies and that of the other. Many couples, or one member of a pair, come for treatment because they cannot use the new information available. Their unconscious fears are still there, similar to the fears expressed overtly in the ancient myths quoted earlier. Sexual expertise is increasingly necessary for self-esteem and people come more willingly for therapy. Especially, if they have children to whom they are committed, there is often a strong motivation to work out sexual problems within the marriage.
A Case of Marital Dysfunction Where Both Feared Female Power
The following case was selected as typical of a bright, young couple with children, who wanted treatment to preserve their marriage. Both had tremendous sexual fears which were largely hidden early in the marriage but as these became exposed the fear each had of the deadly effect of female sexual power began to enhance the fear of the other; they fought and withdrew from each other until they reached a therapeutic impasse. Both had mothers whom they hated and feared; they had strong sexual inhibitions, being virgins at marriage, were attracted to each other by lively intellectual interests but also by the fact that each felt the other to be “sexually safe.”
The wife knew she was not sexually attracted to her future husband but liked his “emotional calmness” seeing it as “strong and silent,” a respite from her fears of male brutality, unaware that the facade covered emotional withdrawal. She was so phobic about facing the outer world alone after the protection of home and then of a dormitory, that she sought refuge in marriage and immersed herself in years of childbearing. This distracted her from growing marital problems and when she became restless and dissatisfied her husband encouraged her to return to get her Ph.D. She was grateful for this help but it exposed her to new people and new ideas, forced her to become more self-assertive and played a role in disturbing the previous marital equilibrium, which was essentially one of emotional and sexual uninvolvement.
The wife was the first to come for treatment, complaining of sexual frustration with her passive, sexually disinterested husband. She was an exceedingly bright, intense, articulate woman, who had gradually become aware of her sexual inhibitions and the fact that she was non-orgastic. After reading Masters and Johnson, she tried to get her husband interested but he refused to read or to try anything new. He had obviously been more comfortable with her early sexual reluctance and responded to her new sexual demands with premature ejaculation, a symptom he had not had before. He said he could not see why a woman would want orgasm and that he preferred to masturbate “to get it over.” She felt she had fulfilled herself as a mother, was beginning to work professionally but could not find herself as a woman.
The last was the reason for her concern with orgasm. She had grown up with a fear of all aggression due to the frightening parental battles she had to watch. The protected position she adopted was that of the “good, quiet” girl who hid all of her feelings. Outside the home, in a safe structured situation like school or camp, she was a dynamic leader, energetic, assertive, creative and competent. She feared and hated her mother who was a very narcissistic, domineering woman, who tried to control every detail of her life. She dreamed of her mother as a clawing, ugly huge cat which she tried to lock in a bathroom because it was going to push her down a flight of stairs. It is easy to see how she developed fear of female power “monstrous” in proportions. Her self image as a fat, ugly adolescent added to her low feminine self-esteem. Overeating reflected her sense of maternal deprivation and led to her feeling of being a devouring female.
The father was a much warmer person and the patient was his favorite child as they shared many intellectual interests which he encouraged. However she could never trust him because he had unpredictable rages, mainly aimed against the mother but they terrified the patient. The father was also furious with the mother’s control but could not stand up to her effectively, giving the patient contempt and distrust of men. There was a gold star inlaid in the floor of the foyer of her parents’ home and she had a repeated fantasy of falling downstairs into it, being fragmented and broken into pieces. She later associated this with her fear of orgasm that might also split her apart.
When her father was affectionate, he was too rough and she developed a dislike of having him touch her even when he was adoring. In therapy she realized that she pushed her husband away with the same disgust, which helped to explain her physical revulsion to him. Part of this was worked out early in treatment; her need to control all feeling was connected with early family life and she finally became orgastic. When she tried to get her husband to enjoy sex with her in a more spontaneous way, he was very threatened and showed signs of deep-seated fears of female genitals, which he denied. When she had a full orgasm in his presence, terror showed on his face, he gagged, had coughing spasms or vomited. He seemed unable to enjoy touching her body as though it were poisonous and particularly avoided the vaginal area, conceiving it as “swampy, smelly,” a dangerous place where one might lose one’s penis — deep, primitive dread of female sexual power. This not only made her feel repulsive but as though she had turned into the castrating bitch her mother was. She became enraged at his tentative, furtive sexual advances. He would get her sexually aroused and then turn away, leaving her hungry, humiliated, feeling dirty and lewd for wanting more. She wanted a man who was more sure of himself, more masterful, to help her feel feminine. To have to teach or encourage a man made her feel she was being used as a whore. She became terrified of her sexual greed; it seemed unending as though she could never make up for lost time, never have enough to get even for her years of deprivation. She felt like an insatiable monster, a Lillith who seduces men in their sleep, a sphinx who strangles, a succubus who drained men of their virility, a Medea who could murder .
The patient felt desperate and futile. At this point I interviewed the husband and found him looking bland and smiling, ready to admit that his chief goal in life was to keep emotional calm at any price, not to upset the boat or even make any waves. He realized he had learned to keep distance from women because his mother was an overwhelming, smothering, demanding person whom he handled by passivity and avoidance. He was utterly unaware of any hostility toward women, wife or mother, although it was quite discernible in the interview. He agreed to treatment not through real interest or curiosity but because he was afraid of losing his wife. He was at first unproductive, relying on prodding from the analyst as he had from his wife. Later, when both patients had given permission for their analysts to exchange data, I found out the following from his analyst: The husband had entered treatment complaining of no close relationships, knowing that he couldn’t share feelings, was “dead” with his wife, remote with his children, and quite depressed.
Despite his good professional facade and ability to be successful and assertive there, he knew that he feared violence and controversy. This was parallel to his wife’s fears of violence and quarreling. He had no relationship with either parent, his father being largely absent and his mother very controlling. When he saw his brother do battle with her, he would get upset and leave the house. He was claustrophobic as a child about getting caught in gates, trapped in dark places. He had a fantasy of being tied to a stake with wild dogs biting his penis. He was able to associate this with his fear of excited women who seemed wild, and had “vagina dentata.” He took no risks, feared sexual failure, and focussed on placating his wife. Both feared sexual freedom as violent and destructive. He feared castration by women and she feared she would be castrating, especially as her fear of men decreased and she became more assertive. When he became premature, her worst fears were justified. Each played into the other’s fears and they began to polarize. As she became more sexually demanding, he relied on her sexual activity to “turn him on” but paid for this via her increasing contempt. As his fear of her grew, he became more sexually passive, seeking strength through withdrawal, trying to defeat woman’s sexual need to save his masculine integrity. The wife felt it was her fault; she had frightened him away with her new sexual prowess. His passive-aggressive withdrawal forced her into being more assertive, and taking over administrative roles and child discipline, which they both feared due to experiences with their own domineering mothers. This is an example of the unconscious tendency toward self-fulfilling prophecies.
The solution of this therapeutic impasse involved the use of four-way sessions (both patients and both analysts together) during a period of special stress. In this setting it was possible for all to observe his masochistic, “saintly facade,” his passive-aggressive “forgetting” and his pleasure in withholding until he drove her “up the wall.” This increased her guilty rage until she felt like a shrew and began to act like one, being “bitchy” and provocative. With the protection of his analyst he was able to be overtly angry at her, which was not only revealing but reassured her that he was not a “saint,” thus she became less guilty. He was astounded when she began to talk about her phobias in front of him, he had thought she was so strong nothing could intimidate her. He began to feel compassion for her depression and saw how he drove her into it by dampening any show of emotion or liveliness on her part. Her anger and passion no longer frightened him, he could listen and begin to understand. They both became less afraid of overt hostility; they both saw him as less weak and her as less powerful.
As communication became more open and honest, they both had dreams in the same week which summarized what they had learned about their fears. She dreamed of being trapped in a brothel but escaped and ran home to her husband; the old dread of being lewd because of her sexual wishes was gone and she was ready to try to work things out with her husband. He dreamed of walking down a road alone with two pyramids of barbed wire looming ahead. He associated these with his wife’s elbows when she was crossing them over her breasts to keep him away. He realized he did want tenderness and affection, not just masturbation and isolation. He admitted that face to face contact scared him as he confused passion with rage. This opened the way for him to become more sexually assertive and she became less demanding. Four-way sessions were stopped and they returned to finish their own individual analyses. As he overcame his revulsion of female genitals and castration by female power, they could be physically closer. She no longer felt like or acted like a bitch in bed and learned to separate hostile aggression that was related to fear of rejection by the male from normal assertiveness. She began to feel both more feminine and more able to be effective at work. With such a dovetailing of neurotic anxieties about both sex and aggression, leading to a breakdown of communication and a vicious circle of polarization between activity and passivity, the introduction of an unusual modality, the four-way sessions, seemed necessary to break the impasse.
The New Male Impotence
Another example of the increased fear of female power is shown in new patterns of impotence. In the past, impotence was seen more often in older married men who had lost interest in their wives and who often recovered their confidence with younger women who were new and more exciting. The newly freed young women tend to be more demanding and less accommodating, exerting a new type of pressure on men for performance. Virginity is now something to get away from rather than to preserve; women seek and expect orgastic release. Widespread acceptance of premarital sex among social equals has replaced past social attitudes that offered ideological rationales for sexual moratoria or sexual abstinence for a period as young people matured in different ways and at various ages (Erikson 1968). Without a widespread sociological study, there is no way of knowing whether there may be an increased reporting of sexual symptoms because of the new cultural openness. There are also changes in the structure and manifestations of neurotic phenomena. Complaints of impotence and frigidity have a new “ring” a different “aura;” they take new forms and are precipitated by new social circumstances. There is less sense of humiliation about sexual inhibitions; both sexes tend to see them as “more human than otherwise”. They also have higher expectations from treatment, whether it be individual therapy or one of the new modalities such as couple or sexual therapy. In order to understand the negative effect of the sexually freer new woman on some men, we need to return to the anxiety about women’s sexuality that exists in such men. As described above, many men have a deep-seated fear of female power built on their early dependency on mothers, who were often controlling, overwhelming, and/or seductive in a way that crippled the growing boy’s sense of and mastery of his masculine identity. A weak or distant father played a role also but this is not our concern here. Such boys may cover their fear of female domination by a show of pseudo-independence, a reaction formation of male chauvinism or a brittle facade of male domination. They may have an inordinate stake in demonstrating mastery over the female in order to reinforce a shaky sense of masculine identity and are thus very vulnerable to the self-assertive woman. The new feminism then plays into their deepest fears. The male may react with withdrawal, passive sabotage, excessive criticism of the woman or with specific sexual symptoms such as impotence or premature ejaculation while still in his twenties, after having originally been potent.
It stimulated me to look at the effects of feminism on men. The increasing sexual interest and activity of women can be very encouraging and exciting to many men, especially healthy ones who prefer cooperation to passive acquiescence. The “liberated” woman can use her new freedom and new data about sexual physiology, and the broad spectrum of sexual behavior to be open and interested in her partner’s approach, sensitive to his needs and his fears just as she hopes he will be sensitive to hers. On the other hand, she may use her new information about sex to demand multiple orgasm, to make the man feel inadequate if she is not complete satisfied, to put the burden of proof on him (Turkel 1976). In the past men measured their sexual adequacy by their performance not by her response. Some women are getting even by reversing the emphasis, as though saying, “if you are so sexually potent, prove it to me.” This may turn on some aggressive men but turn off others.
Needs for sexual and emotional satisfaction should be given equal respect between the two sexes as well as between individuals, but the new egalitarianism can be misused for the sake of power needs, competitiveness, or hostility. Recent studies of sexual development and behavior indicate that maleness is more difficult for nature to create in the fetus and newborn but also more difficult to maintain in the adult as shown by the large numbers of male sexual deviants. Some of this is biological; the male must have an erection to perform while the female may be passive or hidden in her response. When men were expected to take the initiative and were in control of timing, they had a chance to be ready and could then stimulate the woman to follow them into successful intercourse, hopefully for both to enjoy. When women take the initiative, men with self-doubt often experience this as a “command performance” and either block, withhold, become negativistic or simply “wilt.” They do not want to be used as a stud, to appease and gratify a woman’s narcissistic needs, to be used as a “sex object.” Here again, their complaint is similar to the familiar one seen so often in women. Many men are very dependent on woman’s approval and tenderness, although they often do not know it or will not admit it. Thus the demanding, seemingly insatiable woman has them in her power, can render them impotent. If she uses her independence to show men up or make them feel unneeded, again she has reversed the tables and the war between the sexes goes on in a new form. We get more and more proof that both sexes are vulnerable to rejection and performance anxiety. If the archaic domination-submission pattern is to go, it must be replaced by cooperation and mutual respect.
I want to give some specific examples from the current social scene that highlight the sexual imbalance:
1) High-school students are subjected to peer pressure for sexual performance before many are ready. With intercourse starting at 13-14 years, those who develop slowly or who are shy and anxious, are at a tremendous disadvantage. The old restrictions gave them more time to grow, a moratorium and a privacy now unavailable. Young adults used to be able to take pride in waiting for the right partner and right time to start sex; now they must hide their virginity and inexperience, not because it is forbidden but because it is expected too soon, at least for some. Excessive inhibition was one burden; pressure to perform prematurely is another.
2) Colleges that were segregated by sex and now adding small numbers of the other sex are running into unforeseen difficulties. The transition from token to full integration is most difficult. A few women on a men’s campus seems to be less troublesome; the girls enjoy being sought after and often have the wisdom to be discriminating. A few boys on a women’s campus are apt to feel tremendous pressure; they cannot satisfy the sexual and emotional demands of eager, hungry girls and may recoil into loneliness, impotence, or homosexuality. Other young men, apparently more secure, come to dominate the classrooms and take over the positions of authority. This, in turn, threatens the feminists on campus who feel robbed of rulership and their chance to experience autonomy without competition from males. Some become more militant and embrace lesbianism for the sake of solidarity, especially if they feel left out in the race to attract the few men available. There is too much pressure to find lasting partnerships, not enough time to play around and experiment. Some educators look back on the old days of weekend visits and mixers, which were more open ended, did not force premature pairing, allowed five days respite for study and thought, and see some of the good functions of those old habits. This may be a passing phenomenon on the way to full coeducation, where sexual pressures are not so focussed, but, in any event, it illustrates how disruptive to individual development, premature undue focus on sexual performance can be.
3) Some “swinging” young couples in their twenties have learned to use sex as bait and frequency rather than quality of performance as a measuring rod, thus increasing impersonality and the competitiveness. Sex can be used for the sake of power, to avoid intimacy or commitment, to cover up dependency, to avoid responsibility and growth. Some girls boast of the number of men they have captured, enslaved, and then outdistanced so that the young men became impotent. This is a dramatic reversal of an overt pattern, it used to be men that mainly collected scalps. This dehumanization of sex had led to use of drugs and pornography to “turn on” disillusioned or apathetic young people. Some suffer from confusion as to sexual and personal identity; some escape into the anonimity of unisex, some into the asceticism of Eastern mystical philosophy as respite.
4) Singles bars also have a new atmosphere; they not only serve as rendezvous for the lonely person on the make or wanting companionship, but are full of overt, hostile, sexual competition. Many women, tired of waiting to be pursued, are now pursuing men, taking them home, having a sexual encounter, where they size up the man and if he cannot have sex every half hour all night, send him home feeling defeated and deprived of warmth or tenderness. The man feels used and discarded, complains of his wish for friendliness and comraderie as well as sex and decries the new impersonality, usually attributed to men in the past.
The following is an example of a man who was late in starting to try sex, was impotent in college when he began, overcame his difficulties while in therapy in graduate school, only to have them return when he was faced with a very responsive, sexually hungry woman who surprised and frightened him by taking the initiative for intercourse the first night they met. His mother had been a very beautiful, narcissistic woman who had contempt for her husband and treated her son as a little prince, indulging him, praising him excessively, and grooming him to fulfill her social and intellectual ambitions. She kept him with her for comfort, did not make any efforts to help him make friends among peers so that he felt alienated and awkward later in school. When he could not be the popular success she wanted she became hostile, belittling, and very controlling. He became negativistic, seclusive, asocial, and obese. She then deserted the family, leaving him lonely and enraged, blaming himself for her leaving as he had not satisfied her. This was the background for his early impotence. He feared sexual rejection and failure, became passive with women, and focussed on professional training.
When first in therapy, he could only get an erection with fellatio; it made him feel in control. “You can’t move but I can force you to bow to me.” Fellatio made him feel powerful and covered his anxiety. As he improved with therapy; he was only impotent at the very beginning of a new relationship, for weeks at first and then only the first time or two. He had many affairs, getting more sadistic as he became more competent, but stayed free from intimacy. As he recaptured the buried yearning for closeness with mother, he became consciously lonely, stopped his promiscuity, and looked for a closer more enduring relationship. He felt ready to “give in” when he met the responsive woman who took the initiative. Her apparent lack of hostility and open friendliness decreased his suspicions but her readiness for sex frightened him. He realized that he had used hypersexuality and sadism to keep control and feared that with her he would lose the “upper hand.” Her always being ready and taking the initiative at times, had made him feel secure in being wanted at first but then made him fear she could outlast him and he might fail to satisfy her. She was not overtly demanding but with his past, he felt pressured and anxious. He felt it would be humiliating to ever say “no, not now” or “that’s enough for now.” He once asked “Is there ever a time when you don’t want sex?” She answered, “Yes, when I’m sick and don’t feel well.” He was astonished and said “these insatiable women will eat a man alive.” This was early in their relationship when both were feeling sexually deprived and hungry, but it illustrates the danger that an overtly eager woman may precipitate old potency problems.
Another man with a very domineering mother and an absent father had a dream that he could unscrew his penis and put it on the mantle, where he could reach it anytime and put it back on. Thus, he could have intercourse when he wanted it, not when the woman demanded it. Another avoidance technique is masturbation which may be used to escape from the woman, to avoid impotence, to show her that he is not dependent and does not need her. Here desire is confused with dependency needs. A man who puts great stake in his “cocksmanship,” a Don Juan, unaware of his fear of intimacy, who uses sexual exploits to continually prove his male competence, may be very vulnerable to the possibility of failure. When such a man runs into the sexually free and/or demanding woman, he may become terrified that he cannot keep up with her. After having sex with her in the evening, he turns her down in the morning, goes into the toilet and masturbates, comforting himself with the thought “my penis is my own.” None of these fears of female domination are new but the new female assertiveness has played into the age-old fears of man, he cannot hide his fears as well, they are more apt to be exposed.
Other examples of phobic avoidance and retreat from women, come from my professional women, who come for treatment because of their fears of assertion. Many originally used their husbands as mentors; the man felt useful as in a Pygmalion role and the woman felt more secure with male backing. However, the day comes when the woman must go out more on her own and win her own battles; her husband is often threatened in spite of the fact that he originally encouraged her. In several cases where the woman made a clearcut leap ahead, got tenure in a university or a new, better-paying job, the man would suddenly become impotent. In some cases this was transitory, especially if the woman was able to understand the reaction rather than resent it and encouraged the man to feel he was still valued and wanted. Other men who are too fearful or even paranoid about women turn on their wives, retaliate with affairs or desertion, unable to understand the concept of equality.
One such man, who needed and refused treatment said “If you (his wife) have financial freedom and a world of your own you will undoubtedly want sexual freedom too.” He resorted to an affair while she did not.
Therapeutic Considerations
The core problem is that of the man who has great stake in mastery of the woman because of his fears of her domination over him. He cannot accept equality because if he loses the sense of mastery, he feels mastered, emasculated. The humiliation of this is so great that he either cannot accept therapy at all or needs a nonthreatening male therapist who can encourage rather than confront him. Thus he will refuse to go for sex therapy or even couple therapy as they represent open exposure. I have seen many such men in consultation and when I can reach them I try to get them into individual therapy using the concept that if their wives used treatment to grow and feel stronger, why should they not have the same advantage. Some go on to group therapy, but individual one-to-one work was necessary at a point of despair, shame, and humiliation. Many of those who respond well to the new sex therapies are not so sick, not so vulnerable to humiliation and exposure, better motivated to cooperate with their partners, more able to accept encouragement and re-education than the more recalcitrant cases I have cited.
Many psychoanalytically oriented therapists have worked with impotent men, who were referred from sex therapy centers either because they had no partners or who could not face the team approach. Sexual histories were taken but then behavior therapy, modified desensitization or biofeedback approaches were used to overcome phobic inhibitions. A large percentage overcome the symptom of impotence within three months but if the patient is discharged, the symptom often recurs. Many patients produce spontaneously dramatic dreams and memories and the underlying character disorder emerges. Prolonged therapeutic follow-up is necessary in as many as 75% of the cases to maintain improvement.
The values of the new sex and couple therapy are obvious for those who are able to respond. Those with deep phobias and strong fears of intimacy may either refuse to go or will regress afterwards. For these, individual depth therapy is the ultimate recourse; it is private, personal, empathetically related to the needs of greatly inhibited, fearful people.
Each analyst sees a different patient population, according to his or her own interests and techniques. We see new trends, a shift in complaints which is relevant but may not be proven statistically. Social change is both inevitable and desirable but the more rapid it is, the more it causes anxiety. Since people often fail to anticipate the negative effects of increased freedom, we as therapists must be resourceful and flexible to meet new needs. A wide variety of approaches is useful so that patients have a choice but we need to formulate our own criteria as to what kind of therapy is best for which patient—they often cannot choose wisely and will fall for the newest, most publicized or most expedient method, even though it does not suit them. Some who dread exposure do not come to us at all. This is particularly true of men who put such stake in their sexual prowess and worldly power in order to hide their fear of dependency and female power that any admission of need for help is seen as weakness and an intolerable narcissistic wound.
References:
Moultont, R. (1977). The Fear of Female Power. J. Amer. Acad. Psychoanal., 5:499-519