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What is the matter with this young man? And what has been going on, and not going on, in his therapy in so far as this report of his hundred and twentieth session by his therapist reflects that? Would that we had his report as well!
The first question is easier to answer than the second. At 26, his masculinity remains blighted - ‘went to a boys' school, underachieved … present work as a civil service clerk -again an underachievement of his capabilities … afraid of an adult sexual relationship, although craves this but is completely panicked at the idea … appears rather effeminate but is heterosexually inclined … not managed to negotiate any real form of independent existence … asked for a therapist close to home’. As for his choosing his therapist because ‘he was hoping to avoid an aggressive and intrusive relationship’ as he experienced with two previous male doctors, I do not agree. Among other reasons, of course, he chose her, or rather chose to stay with her for the 2%z years since referral, and ‘very quickly became exceedingly attached’, because it has allowed him to be intimately involved with a woman who is safe, who makes no sexual demands and who, unlike the two brisk male doctors previously, requires no serious masculinity from him.
I will come back to this issue in examining the material of the session. Meanwhile I would remark on the therapist's emphasis (or phantasy) in the extracts quoted from her preamble to the session itself, on the potency which is so unrealised. ‘He has had no complete sexual experience, having been very hurtfully rejected at 17 by a girlfriend’. Who hasn't been and who allows, let alone swallows such an explanation? Again, there will be more to say about countertransference in the session itself.
As to why his masculinity is blighted, there is a gigantic theme in the case which goes quite unmentioned in the session. It is present in the explanatory preamble, but embedded, and far from leaping out of the page. So unelaborated is it t