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A middle-aged, white male patient had a brief episode of moderately severe, sharp, spasmodic pain in the glans area, which tended to localize around the external urethral meatus and was unaffected by urination or intercourse. Urological consultation failed to establish an organic cause for the symptom nor could any functional basis be elicited, and after two to three days the pain subsided spontaneously.
Several months later, the patient went on a holiday with his wife to a part of the country where he had grown up. He had a reunion with his college roomates, who had all enjoyed greater success in their respective careers than he had, and hence were much wealthier than he was or could ever expect to be.
In the first session after his return from this vacation, he related that, while he was at a dinner party with his roommates and their wives, he found himself contrasting his life style adversely with theirs, felt uncomfortable, and then noted a sudden pain in his penis similar to that described above, which again remained for a few days without evidence of any physical etiology. He could not understand why the pain would recur under such conditions, but when the interpretation was made that he may have been responding to the disparities of money and achievement that existed between him and his roommates in a phallic narcissistic fashion—that is, feeling humiliated because his penis might be smaller than theirs and wanting his to grow and become larger—he had the following associations.
He mentioned that on the same trip, after visiting his roommates, he had stopped off in New York where he attended the play “Equus” by Peter Shaffer, which contains a nude scene involving a young man and woman. He recalled paying very close attention to the male actor's flaccid penis; he thought it appeared much lengthier from certain angles than from others, and concluded that it was definitely bigger than his and wished that he were as well-endowed. Subsequently, he was relieved to lea