A Contribution to the Problems of Female Sexuality1

Some four or five years ago a case was referred to me by the Department of Gynaecology of the hospital where I was then psychotherapist. It had been impossible to overcome the patient's fear of a vaginal examination, which had been attempted by several doctors at different times. That was the reason for her referral.

She had been married for ten years, yet her marriage had never been consummated because of her anxiety, which she had tried in vain to conquer. I shall later give some more details about her, as I found her story especially illuminating. Here I should like to report, first of all, that her case unexpectedly proved to be the first of a long series of similar ones, though the time which had elapsed in each case since marriage varied from two months to many years. I cannot go here into the method of treatment I had to evolve when faced with a constant demand to treat cases which obviously could not be put on a psychiatric waiting list. It is sufficient to say that psycho-analytical understanding helped me to deal successfully with the great majority of these patients. It should be added that, although the number of interviews had to be limited, I was in no case content to see the patient merely until consummation had been achieved. In most cases it was possible to help her to a satisfactory, or at least partly satisfactory, marital relationship. Where patients wished for and achieved pregnancy, they were seen throughout that time and during the puerperium, as it was assumed that women who had denied their femininity so strongly would need support in their adjustment to their maternal rôle. At the same time, this was regarded as a preventive measure which might protect the new-born from undergoing a similar fate.

The patient mentioned at the outset was a pleasant, tall and well-built woman of 39 who had, after much hesitation, decided to seek help since she wanted a child. Her own mother had died in giving birth to her and she had heard about her m