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February 12, 1952. THE PROBLEM OF SEX DIFFERENCE FOR A THREE AND A HALF-YEAR-OLD CHILD. Z. Alexander Aarons, M.D.
A boy of three and a half developed the symptoms, six weeks after the birth of a sister, of holding his penis throughout the day for a two week period, and of having nightmares. The boy was bright, outgoing, and had been very curious about his parents' genitals. He was once permitted to pull his father's penis. During his mother's confinement, while playing with two older boys, he wet himself and was very humiliated.
Treatment consisted of several interpretations to the effect that he was afraid of losing his penis, or having it hurt, of a great deal of reassurance, and was soon followed by the disappearance of the symptom. Subsequently he became aggressive toward his mother, resentful of the baby, and closer to his father. During this period he refused to wear pants, and wanted to wear dresses. This alternated with possessiveness toward the mother and play which might indicate a wish to rival his father.
Dr. Margaret Mahler stated that the treatment of this case was analytically oriented therapy rather than child analysis; although this type of therapy might alleviate symptoms, it would not affect basically the child's personality. A clue to the boy's choice of symptom, she believed, was the unusual fact that the boy had been permitted to pull his father's penis. The symptom, she said, might represent a defense against his passive wishes toward his father, and this was confirmed in his subsequent wish to wear dresses. She emphasized that this type of therapy was of value in treating incipient symptoms in preschool children. Dr. Bela Mittelmann suggested that the symptoms might be derived from problems concerning child bearing, and the boy's wish to have a child.