Dr. Mary O. Hawkins has remarked that in the masturbation fantasies of adolescents can be found the fundamental elements of their neuroses, but that one does not usually hear these fantasies until treatment is almost completed. Perhaps the same is true of forepleasure fantasies and activities in adults. Greenson indicates that the analyst learns from these fantasies not only the fate of the infantile instinctual components and their relation to end pleasure, genitality, and orgasm, but also the various defensive maneuvers in operation against the instinctual drives. Forepleasure activities vary tremendously but if they lead to satisfying mutual orgasms Greenson considers them normal. He discusses briefly a number of pathological patterns of forepleasure, nicely illustrated with case material, and concludes that frequently forepleasure activities are used to enact a fantasy which has the purpose of denying or counteracting some frightening aspect of sexuality. The fantasy distracts from the sexual act, and the greater the amount of fantasy the less the object and the self are cathected.