Departing from Freud's distinction between actual neuroses, characterized by psychic inadequacy and masturbation, and neuropsychoses of defense, with their appropriate psychic activity and psychic mechanisms of defense, the author investigates a particular kind of adult patient whose major sexual activity is masturbation. These patients usually come to analysis with a broad spectrum of depressive, anxious and inhibited, and sometimes addictive symptoms. They complain about a dissatisfactory life—and soon enough the analysis itself becomes dissatisfying, at least for the analyst, as it runs into a standstill. The hours are impressive for their flatness, and the analysand cannot make creative use of the analyst's interventions; soon everything seems to have been said, but nothing has changed.

Particularly noticeable is that there are few signs of anxiety or curiosity expressed by the patient in sessions, and there is a lack of seduction and responsiveness to seduction in the lives of these patients.