The whole subject of sex has too long been shrouded in mystery and fear-fear nourished by ignorance and misunderstanding. Other fears of mankind have been dispelled by understanding. We have learned that many diseases are caused by bacteria and viruses and not evil spirits. Consequently we no longer feel an irrational terror of disease but try to control it by isolation, inoculation, and chemotherapy. If sexual matters were similarly understood and openly considered by all, the sexual fears and conflicts so prevalent in our civilization would disappear.
Perhaps the greatest obstacle to universally healthy sexual attitudes is the fact that although many parents realize the value of sex education they feel inadequate and ill prepared to offer guidance to their children. They are still addicted with inhibitions, embarrassment, and a feeling that sex is unclean. As a result the child gathers independently a distorted, unhealthy collection of misinformation and misinterpretations.
Logically there is no reason why the psycho-sexual development of the individual should be regarded in a different light from other bodily functions. At each stage of development certain manifestations appear for which the child should be prepared. He is more harmed by anxiety and fear of things he doesn’t understand in regard to sex than by possible premature indulgence.
The injudicious handling of sex curiosity in young children may have lasting effects. Many of the barriers that prevent a normal, healthy response in adolescents toward members of the opposite sex have their origin in such early encounters. A deep-seated fear of sex may lead to repressions that make the young girl or boy shrink within a shell of reserve that they cannot explain Years of maladjustment and unhappiness may result from a few moments of mismanagement.
The most effective safeguard against the development of sex conflict ill adolescence is a campaign of sound sex education for both parents and children, the guiding principle for parents should be honesty and an air of casual frankness. It is not necessary to attempt a full discussion of biology in one sitting, for such earnestness and overemphasis is as extreme as complete refusal to discuss the topic.
In answer to the child’s questions about other things it is not customary to sit down and give him a full lecture on each subject. A simple, honest answer to his question is all that is needed, and although the original question may be followed by others for elaboration, the subject is soon dropped and the youthful mind follows its natural course to other things. The child’s interest may appear first in questions about his own origin and if the answers are supplied without emotional display or concern the child accepts them matter-of-factually. These suggestions may seem obvious to us but it is amazing how many of the children who come under observation at the clinic are totally ignorant of the scientific fundamentals of sex.
Individual Problems Complicated
Various types of emotional reactions, only a few of which have been discussed, are usually operative in producing the symptoms exhibited by a given individual.
This is well illustrated by the following case report:
The patient was a young man in college, who came to the psychiatrist with the following complaints. For four years he has tried in vain “to get control of himself” and has become thoroughly discouraged and about “at the end of his rope.” He has had mastoid, sinus, and tonsil infections which he thinks have affected his mind. For the last three years he has been intensely unhappy and has made no friends, because “people despise him.” He says that he is a physical coward and is “mentally tortured by bad habits.” Ideas run through his head so that he cannot sleep. At times he has felt that people were reading his thoughts and watching him on the street; and occasionally he believes he is going insane and has resolved to commit suicide.
This young man’s childhood was unhappy, owing both to unfortunate neighborhood conditions and to the incompatibility of his parents. During most of their married life his parents were kept together more by financial and religious considerations than by any regard for each other. Finally, the father decided that the only way out of the difficulty was to break up the home.
Unable to talk it over reasonably with the patient’s mother, and in order to avoid a painful scene, he sent the family to another city, where he had arranged a home for them. He also provided that the mother receive a certain sum of money each month for the support of herself and the two boys. At this point the father dropped out of the picture, as he went to another state to reestablish himself in business.
The boy’s early social contacts were unfortunate. He had several prolonged illnesses, which affected him physically to such an extent that for a time he was unable to compete with other boys in physical things. Moving into a new community made this doubly hard. He was bullied unmercifully by other boys. Finally, he came under the domination of a boy who was living in the same apartment house, a boy somewhat older, rather stupid, but well developed physically.
The latter assumed a sort of protective attitude toward the patient. It was from this boy that the patient had his first sex instruction. He was taught to masturbate and at the same time told that it would hurt him physically. He confessed his first experience to his mother, who was horrified and shocked. She told him that this was only a confirmation of her belief that he took after his father in his Weaknesses. She told him that his father had always been sensual and impressed the boy with her disgust for masturbation and with her conviction that it was a great sin.
He made a resolution to stop, broke the resolution, made another, and with each attempt became more and more convinced that he was unable to combat this evil. He felt that he must conquer it in order to prove to himself and his mother that he was not a weak character, sinful by nature, etc. It became to him a sort of symbol of his whole struggle against the idea of evil. If he could conquer this thing, it would mean that he could conquer the weakness he had inherited from his father, he would regain the respect and affection of his mother and be able to compete with his younger brother for her regard.
His idea about masturbation added to his difficulties with other boys. He felt that not only was he physically handicapped by the illnesses which he had had and his subsequent awkwardness but also that he was not equal morally to the other boys in his group. He heard from some of them that one could always tell a masturbator by the pimples on his face and the inability to look a man in the eye. He became even more self-conscious and developed a fear that his habit would be discovered. As a result, he avoided meeting other boys and stayed at home a great deal, neglecting physical exercise and recreation.
About this time there were in the neighborhood several bullies. They were quick to recognize the patient’s attitude, and on one or two occasions waylaid him on the way from school, challenging him to fight. He was frightened and ran. On the only occasion when he did put up a light because he could not get away, he was severely beaten up by the two boys. This convinced him that he was a physical coward and added to his already growing disgust with himself.
In his university courses, this boy had shown an uncanny ability to pick out bits of information which tended to confirm certain things which worried him. He learned something of the biological theory of heredity and was strengthened in the belief that he had inherited his father’s weakness of character. He learned something of scientific determinism, interpreting it to mean that man is in no way a free agent, and that it is impossible to develop one’s will power if one does not already have it.
He heard of the evils of the so-called “inferiority complex” and having found a word under which he could sum up his problems, he was more than ever impressed by the magnitude of them Although he made good grades, success in this was of little value to him, in fact, to act as a compensation for the other failures. He therefore lost interest and began to neglect his studies. Above all things he needed that recognition, friendship, social contact, which his own feelings prevented him from getting.
It was found at the outset that any simple explanation and advice would not be’ of any value to the patient. He had ahead had such explanations from various competent faculty advisers. What was required was a thorough emotional reeducation. It is obvious from the account of the patient’s life that his problems were deep-seated and involved such fundamental relations as that of the patient toward his family, toward religion, and toward the problem of sex. The patient was unusually intelligent and cooperative throughout the procedure. He was seen at least three or four times every week; and although there have been times when he showed great depression; on the whole his progress has been marked.
At present this boy is handling the family situation well. He is no longer irritable, quarrelsome, and reclusive at home. He has been able to make several valuable acquaintances on the campus. He is now quite able to apply himself consistently to his work, and his grades have improved. He has chosen a profession and, even though he is not yet ready to enter his professional training, he is exceedingly interested in it and had done a great deal of outside reading on related subjects. He has solved the sex problem satisfactorily and is not masturbating or doing any unusual amount of fantasizing about sex, things. He no longer believes himself a coward.
The Logical Result
With such histories it is impossible to escape the conclusion that the resultant mental condition is the logical and inevitable outgrowth of learned methods of behavior, that these methods with variations probably would have been adopted by almost anyone subject to similar situations, and that the final symptoms which appear to be so abnormal are essentially the reactions found in every normal person under certain circumstances.
These things hold true not only for the simple types of cases described above but for most of the other mental illnesses. Thus the patient with dementia praecox lives in a dream so deep that it shuts him off from all contact with reality. He derives his satisfaction from imaginary companions, activities, and achievements. This is precisely the same method used by child and adult when they daydream gratification they have been unable to derive from reality.
The dementia praecox patient behaves like a child in getting pleasure from the infantile activities which the adult has so outgrown that they seem senseless and disgusting. This finds an exact parallel in the normal adult who, when meeting an obstacle which he is unable to overcome, exhibits childish temper or drops the work to indulge in play.