The psychoneuroses and their treatment by psychotherapy / Translated by Smith Ely Jelliffe.

  • Dejerine, J. (Jules), 1849-1917.
Date:
1913
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Licence: In copyright

Credit: The psychoneuroses and their treatment by psychotherapy / Translated by Smith Ely Jelliffe. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    A certain number of classes of patients seem to us to be established, each one presenting several special indications. The first category consists of the chaste, who, by one of the mechan- isms which we have already studied, have become afflicted by sexual phobias, and imagine themselves attacked by an impotence which they have never experienced. These patients, although their situation seems so illogical, are extremely numerous. Their condition usually arises from a conflict which exists in them between the sexual instincts which make themselves felt, and certain scruples which make them consider not only the thing itself but even the idea as shameful and blameworthy. Being obsessed with sexual phobia on the one hand, these patients, on the other hand, by reason of the multiplicity of sexual representations which throng their mind, frequently experience repeated seminal losses. If the patient under consideration is old enough, after having re- assured him, one ought to advise him to marry. In marriage, as a matter of fact, the sexual excitement may be satisfied and quieted down without raising any scruples. On the other hand, it is very comforting for the sexual phobic to feel himself in the presence of a partner whom he knows, or at least believes, to be very ignorant concerning matters of the sexual life, and incapable of judging weaknesses which under these conditions, however, one might almost say never occur. If, for reasons of position or youth, marriage is impossible or must be too indefinitely postponed, the task of the physician becomes much more delicate. The question will naturally be raised whether one is right under such circumstances to advise a young man to avail himself of professional amours. From the point of view of pure morality it is quite certain that such conduct could not be defended. But what we also believe is this, that, still remaining within the medical domain, such indications would only offer dangers of various kinds. Suppose even that it was a choice of running one or the other risk, there would be not the slightest doubt that one would eventually find the patient uneasy and overcome with scruples, reproaching himself over the act which he had committed and which he considers degrading and immoral. He would once more become chaste, but chaste through dis- gust, and not through principle. His moral condition, on the contrary, would be in no way improved. On the other hand, if it is usual for the sexual imagination of the chaste to be singularly exaggerated, it is also true that, more especially on account of their being capable of very definite images, the imagination of the initiated chaste is passionate in the extreme. What then is to be done? It would seem to us that the best way to act, in connection with such a patient, is to make him thoroughly understand all the phenomena which concern the sexual life, and to let him know that the disturbances which he feels result from errors of interpretation, and that, as a matter of fact, he is experiencing per- fectly natural physiological phenomena, over which he has no need to 22