When alone with his girlfriend, a man panics because he suddenly begins to think of strangling her.
Ted, a single man in his fifties, was out on a date. The evening consisted of dinner and a movie, and then they finally ended up at the woman’s apartment. They became engaged in some light amorous activity. Ted’s date was apparently quite loquacious, as he explained to me, “She talked a blue streak all night.”
At one point when they were in bed, Ted was suddenly gripped by the thought that he wanted to strangle her. This is called an intrusive thought—one that seems to appear out of the clear blue sky and cannot be voluntarily put out of one’s mind. This kind of thought then becomes obsessive.
No matter how he tried, it was a thought Ted couldn’t shake. And he was startled by it, especially since he had also experienced the same kind of thought on a previous date with another woman. This previous experience lasted only a split second and he thought no more about it. What startled him on this date was having the thought again, even though he was with a different woman. Further, the more he tried to erase the “strangling” thought, the less he was able to. He then became frightened—alarmed, actually—and excused himself and fled.
Based on the symptom code of one (the wish), two (the anger), and three (the who), we would guess that Ted:
1. had his wish blocked;
2. got angry about it; and,
3. didn’t realize he was angry at someone in particular—a who.
Ted was never able to have a relationship because, as he said, he would get “bored with everyone.” He was a successful businessman who was also always in arguments with employees as well as clients. However, he did very well for those same people, largely because he was efficient, as well as generous, especially in doling out bonuses.
But he was an impatient person and, along with his impatience, he was insensitive to others. In contrast, he wanted others to be patient, tolerant, and sensitive with him. He said he loved it when others would focus on him and also appreciated opportunities to talk about himself. He was also quite interested in his appearance and would spend undue amounts of time in front of the mirror, checking to see whether he was looking as good as he wanted to.
Ted was sexually obsessed. He was always thinking about sexual things that, as he explained, “Would turn me on.” As a matter of fact, he would be happiest when looking for sexual things to think about that would, indeed, turn him on. And the looking for such things meant doing a lot of fantasizing and thinking and choosing certain women to think about that did, in fact, excite him. As far as he was concerned, his main problem was then finding a safe place to masturbate after he was turned on. And this kind of search for such places took place each day of the week.
At night he would masturbate in bed and that would satisfy the kind of activity required to get him to sleep. It was his daytime activities that were really problematic for him, but he hit upon something that he felt most people hadn’t even thought about. You see, Ted’s business took him out of the office each day for meetings with clients and potential clients. He was a stationery distributor—all kinds of stationery supplies (staplers, paper, clips, pens, etc.). That was his occupation. His private preoccupation, however, was finding public places that had bathrooms. He needed these places during the day because, when he would deliberately try to excite himself with sexual thoughts, he would want, and need, to masturbate. The question was, where to do it?
And this was his brainstorm. Hotels! In Manhattan, there are many, many hotels all over the place—especially in mid-town. And every hotel has a public bathroom in the main hotel lobby. And it worked. Wherever he was in Manhattan, he would find a hotel, locate the bathroom, and masturbate in one of the stalls. Then, when finished, he would go on his way to his next meeting.
This sort of activity was happening all of his adult life, at least for the past twenty-five years. Yes—twenty-five years! Did such activity affect his life generally and his dating activity specifically? The answer is a resounding yes. It kept him single because he was constantly gratifying himself and so he didn’t really have the motivation to connect with anyone in any significant way. That is, his compulsive masturbation was really a substitute for a relationship, and it kept him single for all his adult life. The masturbation was a relationship of self to self. This man was essentially in love with his penis—meaning essentially that he was in love with himself. Of course he always dated, but his girlfriends really constituted affairs he was having outside of his primary relationship, and this primary relationship was his relationship with himself, or rather, with his penis.
The most immediate question, however, was: Did this symptom of his masturbation connect in any way to his symptom of the strangling fear? The upshot was that he had two symptoms. The acute one was his strangling fear, but the chronic one was his compulsive masturbation. And it was pretty clear that the acute strangling fear would be the easiest one to cure. The masturbation symptom, however, would probably require some extensive therapy work.
Ted said that when his date would talk about him, he felt good, and that he tolerated the conversation very well. The problem for him was when his date would talk about everything else except him. Then he would become bored, impatient, and uninvolved. Usually, after such a date, he would mimic those moments when his date was talking about anything except him by repeating to himself: “Talk, talk, talk.”
The bottom line was that if he was the one who didn’t leave the relationship, then his partner would. His partner inevitably figured out that he simply could not, or would not, talk about anything except himself.
Ted’s symptom can now be unfolded by the symptom code:
One: The wish was for his date to stop talking about others. This was an indirect wish so that the symptom of the intrusive thought of strangling her frightened him, thus increasing his tension.
Two: Feeling deprived of his ego gratification—that he wasn’t being focused on—made him angry, but he didn’t realize it.
Three: The person toward whom he was angry—the who—was his date.
Now, Ted’s symptom can be more easily understood.
First of all, the thought of strangling his date did not literally mean he wanted to end her life, even though that particular thought actually did panic him. What the intrusive strangling thought signified was that he was simply angry at her. She wasn’t talking about him and this was making him impatient—a synonym for anger—that he didn’t recognize. He recognized the impatience, but not the anger. Again: “Talk, talk, talk,” is how he put it. “She wouldn’t talk about me!”
Thus, his symptom is really his basic wish, gratified, even though it is gratified in this neurotic way. That is, thinking of strangling her is equal to shutting her up. This means that at least the noise she was making (talking about others which he considered to be noise), would go away so that the possibility of the focus shifting to him would increase. And that’s all it means. He was never in any danger of strangling her and she was never in any danger of being strangled. “Talk about me, stupid,” is what he really wanted to say, and if he had said it, he never would have had the strangling symptom.
Point Four—the to do—was for him to continue to realize that he was always trying to have everyone focus on him, and that he needed to keep in mind that he was getting angry whenever this was not the case.
The one, two, three of symptom cure required knowing:
2. That Ted was angry; and,
3. That the person—the who—toward whom he was angry was his date.
The point here was for him to be involved in a doing thing which would satisfy the fourth condition of being in a doing place, that is, in front of the line. Even talking to someone about his need to focus solely on himself qualifies as a to do, an in front of the line achievement.
Once Ted realized all of it, his strangling thought vanished, but his compulsive masturbation prevailed. And Ted wanted to know about it. Why was he always, all his life, “so sexed up?” as he put it. The answer was that it was all about his need to aggrandize himself—to make himself bigger, better, stronger, handsomer, greater, and, finally, both heroic and generous. And all of his masturbatory fantasies—all the sex stories he thought about—were all about him in a position of power. They were never violent. The main story line of the fantasies had to do with the woman needing him, wanting him, beseeching him, and then needing to see his penis—which he said was his pride and joy “because it’s big, real big.” The big deal for him was when, in his fantasy, the woman would plead to see it and then when he generously permitted her to “go get it,” she, in a moment of loss of control, would thankfully grip it in both hands. When the woman gripped his penis that way in his fantasy, he would invariably climax.
When I told him that a case could be made that his fantasy of her grip on his penis was the equivalent to his fantasy of his grip on his date’s neck—the strangling thought that frightened him so—he gasped and said, “Oh, my God, I see what you mean. But what does it mean?” What it meant was that his fantasy of strangling by gripping her neck was his attempt to get her to talk only about him. At the same time, it was an attempt to recreate a gripping of something phallic (his penis) that possibly represented his wish for her to talk about him so that his anger toward her could be transformed into a loving, even sexual, moment because she would be talking only about him. Her talking about him in reality would be the same as his fantasy in which the woman needs him desperately. Of course, his desperation concerned his relentless need to be aggrandized—to be great.