Int J Psychoanal 2003; 84:1043–1059 PSYCHOANALYTICAL PSYCHOTHERAPY

Diagnosing a male hysteric: Don Juan-type

TREVOR LUBBE
36 Cartsens Street, Tamboerskloof, Cape Town 8001, South Africa — tlubbe@yahoo.com
(Final version accepted 23 October 2002)

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from
the early stages of treatment. The patient presented with a relationship problem but there soon
emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central
feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or
to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were
repeated in different variations and with different personnel, are seen by the author as a dramatisation
of the primal scene with the patient taking up the position of the oedipal father. Explanations for the
disappearance of male hysteria are given, including a new theory which claims that an imbalance
in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain
forms of hypersexuality in men to be promoted as a form of hysteria, the most common example
being Don Juanism—a form of compulsive sexuality that encompasses normative, conversion and
character features. The paper also examines the male hysteric’s developmental agenda. What the
patient’s compulsive sexual tableaux exposed was that he had never faced a separation that was not a
triangular experience. This meant that his separations were experienced as two developmental agonies
telescoped into one—separation (pre-oedipal) and exclusion (early oedipal). This combination, the
author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as
opposed to some other choice of neurosis.

Keywords: male hysteria, gendering of hysteria, Don Juanism, compulsive sexuality, primal
scene, triangulation of separation dynamics

Theoretical introduction
Although male hysteria rarely features nowadays in our diagnostic thinking it has not altogether
disappeared from the psychoanalytic nomenclature—nor is it entirely absent from current
psychoanalytic writings. The male hysteric is as old as psychoanalysis itself (Freud, 1886) hence
it is good news that there are new and striking ways of talking psychoanalytically about male
hysteria today (Bollas, 2000; Mitchell, 2000).
The reasons for the decline of hysterics generally have been well documented (Laplanche et
al., 1974; Satow, 1979; Micale, 1995; Mitchell, 2000) notwithstanding their surprise appearance
in the consulting rooms of New York’s Park Avenue or the Latin Quarter in Paris. These include
the following interrelating factors: the virtual disappearance of frank conversion symptoms in
the patient population; reŽ nements and additions in diagnostic categorisation (psychosomatic
illness, Hysterical Personality Disorder, Borderline Personality Disorder, ME, Post-Traumatic
Stress Disorder, Dissociative Identity Disorder); the intrinsic plasticity of hysteria which allows
endless nosological variation; historical and social developments that supersede symptoms from
one era rendering them normative.
However, a new theory on the disappearance of hysterics has emerged which identiŽ es
an imbalance in psychoanalytic theory itself (Mitchell, 1986, 2000; Showalter, 1993). Mitchell
(2000, p. 127) claims that, after its initial promotion as a cause célèbre, male hysteria became

©2003 Institute of Psychoanalysis

1044 TREVOR LUBBE

masked in psychoanalytic theory and practice through feminising its symptoms. This gendering
of hysteria as female resulted in the diagnosis in men becoming less common. Analysts like
Ferenczi, for example, were not unusual in regarding war as providing a veritable ‘museum’ of
male hysterics. Yet it was not long before the general medical fraternity shrank from diagnosing
male veterans of war as hysteric, irrespective of their conversion symptoms, and especially if
sexual determinates were theorised. Hence the vanishing of hysteria as a diagnosis in both men
and women, both inside and outside psychoanalysis.
This critique, striking though it appears in its claims, nonetheless opens the door to a
reclaiming of the male hysteric in a number of ways. For example, the critique claims that while
male and female hysterics might share the same conversion and phobic outlets for their repressed
sexuality there is a discrepancy in psychoanalytic accounts of how men and women enact these
choices of neuroses. Intense longings for ideal love, capriciousness, seductiveness, sexual
deviousness, promiscuity, sexual jealousy, sexualisation and sexual acting out appear largely
in the descriptions of the female hysteric, while in men these manifestations have been deŽ ned
as the ‘negative’ of the neuroses—crypto-perversions. Alternatively, they are blended into
normative behaviour (la petite hysterie). In other words, exaggerated ‘femininity’ is hysterical
but exaggerated ‘masculinity’ is not.
This critique suggests that the relationship between hysteria and sexuality in men is more
complex.1 While in the male hysteric repression remains the primary mechanism, it is possible
to view failures in repression as producing a type of hypersexuality or compulsive sexuality that
has an hysterical component. The most frequently cited example of this exaggerated masculine
type is, of course, Don Juan. Don Juan is the serial seducer and rejecter of women trapped in the
performance factor of his sexual conquests, especially at the daredevil level. Different aspects
of Don Juanism have been emphasised in the psychoanalytic literature. Flugel (1934, p. 108)
related the countless disappointments in Don Juan to his search for an ideal that no one can live
up to. Fenichel (1946, p. 243) commented on the narcissism inherent in Don Juan’s attempts,
through his conquests, to provide proof that he can excite a woman. Mitchell (2000, p. 260)
linked Don Juan’s compulsive sexuality to his compulsion to make others jealous. Jealousy is
a strong feature of sibling rivalry and Mitchell makes a compelling case for privileging sibling
rivalry dynamics in the aetiology of hysteria, male and female. Speaking about the displacement
of erotic conquest Freud observed that ‘Every collector is a substitute for a Don Juan Tenorio
and so too is the mountaineer, the sportsman, and such people’ (1895, p. 209). Young-Bruehl
(1996, p. 228) pointed out that ultra-masculine activities like gun collecting and belonging to
paramilitary organisations are often diagnosed as ‘anti-social’ when, in fact, they have a basis in
hysteria. So, from the collector to the inveterate  irt who perspires and blushes involuntarily at
every overture he makes, to the hardened philanderer whose interest is solely in overcoming the
resistance of an unwilling woman, Don Juanism can be viewed as a form of male hysteria that
encompasses normative, conversion and character features. This is not an argument for a new
form of hysteria in men but merely recognises an old form obscured by an imbalance in theory.

Case introduction and presentation

A young man of 38, whom I shall call Mr S, was referred for problems with his girlfriend (Ms
B) of eight years standing. We arranged two initial interviews and when he arrived he seemed
very edgy. He began by telling me that years ago when his previous relationship broke up he had
collapsed emotionally and physically and had to be rescued by family members who  ew to the

1
As would be the relationship between perversion and female sexuality.
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1045

part of the country he was living in at the time to bring him ‘home’. He literally could not do
anything for himself for weeks and had to be nursed by his sister and mother. He went on to say
that his current relationship was in an impasse, and that he was experiencing some of the same
panicky feelings that had come up previously.
The reason for this was that his girlfriend, Ms B, had been dropping hints all year long,
but was now speaking quite openly, about when they should get engaged. Mr S had reacted by
asking her to decorate his apartment, which he unashamedly confessed was to buy time and to
keep her distracted for a few months.
He then went into a long list of reasons why he felt Ms B might be the wrong person for
him. This catalogue, which came out in one long stream, took up the rest of the session, and
while he started off by trying to balance things with her good points—she was a very affectionate
person who ‘had the look of caring in her eyes’; she was loyal, always neatly groomed and
dressed; she wore nice perfume and was independent and had her own career—he soon had
only negatives on his list. The thrust of his complaint, as far as could be made out, was that life
with his partner had become dull—she never had anything new or interesting to say; she never
initiated anything. ‘We just sit around like two old fogies who have been married for twenty
years.’ After half an hour, as I listened, I began to wonder to myself what advice he had received
from his friends. Hearing his lament I thought, how could anyone not resist saying to him, ‘Well,
if the picture is so overwhelmingly negative, why not move on?’ Near the end of the meeting
Mr S went quiet and looked at me in such a way as to suggest this must be the conclusion I
had come to myself. Dramatically he leaped up and  ed the consulting room, not to return for
his following appointment and not cancelling in advance. He did not respond to my bill until a
month or so later when I telephoned him.
Then two months later he contacted me again and said he needed to come back. The
problems with his girlfriend had worsened. He arrived and spoke about there being more
open discussion now about marriage and dates and he just couldn’t bear it. He felt extremely
pressurised and felt his girlfriend was holding a sword over his head. He couldn’t bear to be
near her at times. He wanted her to leave him alone. ‘She’s only interested in a wedding and in
having children and that will mean the end of me.’ This sense of persecution dominated the early
sessions. He acknowledged that he should be happy but said that he felt defeated and weak. After
one incident in which he was being particularly spoiling of wedding talk Ms B turned around
and told him she was going home and that he could telephone her when he was in a better mood.
When she left Mr S  ew into a panic. He immediately lost any warm feelings towards her; he
withdrew and said spitefully to himself, ‘She’ll have to use a syringe to suck any warmth out
of me’. In hearing this sequence I better understood his  ight from the Ž rst interview—he  ed
at the point of realising that intrinsic to the idea of marriage or any committed relationship lay
experiences of individuation, separation and loss.

History
Mr S was the youngest of two children—he had an older sister. His parents divorced when he was
5 years old and they moved to two different parts of the same city. However, before the divorce
there was a turbulent period where the parents united and separated several times and Mr S
himself moved frequently between the parents. He claimed this was bewildering as it placed him
in a position of divided loyalty and of not knowing who to believe. The reasons for the divorce
were given as the father’s womanising and his long periods away from home due to work.
His father was a successful businessman and was described as a powerful, larger than life
Ž gure, charming and very seductive, yet cruel, controlling and manipulative. He reported very
1046 TREVOR LUBBE

few early memories and claimed he had no ‘concept’ of a father during his earlier years. His
memories came mainly from middle childhood and they were all humiliating and traumatic.
Once, when he was 6 years old, he had hidden some matches down the side of the car seat. His
father, who had probably observed this, questioned him about whether he had been playing with
matches—which he denied. His father then dug out the matches and humiliatingly faced him
with his lie. There were other excruciating examples down the years but the Ž nal humiliation
came at the age of 19 when Mr S was in his father’s employment, running one of his small
businesses. In six months he had made a great success of this venture. Out of the blue one day his
father called him into his ofŽ ce and, in front of other staff members, started criticising his work.
He said he felt completely stripped of his achievements and once again humiliated. He decided
to leave and went to live in another town where he started up a small business of his own which
became very successful. This is where he met his Ž rst girlfriend, the one who left him two years
later and caused his collapse.
Other comments about his father: he had given Mr S some sexual advice when he was
growing up. ‘Don’t let a woman get into your blood because you’ll need a syringe to get her
out’; ‘There’s no such thing as a woman who can’t be satisŽ ed—there’s only something wrong
with the man’s performance.’ About his sexual history Mr S reported he was a compulsive
masturbator during his early teens. During his Ž rst sexual experience at 17 he stopped himself
from climaxing so as to sustain an erection throughout. He claimed to have taught himself all the
correct techniques of how to bring a woman to orgasm as a safeguard against penile failure. He
added that he cannot let a woman touch his penis if it is  accid and that he frequently keeps his
underpants on during intercourse to prevent this. He reported, too, his feelings of dread when
his partner, Ms B, masturbates. He feels a failure and that she is preferring herself to him.
Mr S’s mother was described as a warm, loving, totally dependable person. She always
took care to make everything seem Ž ne. She supported him, took his side and always provided
for him whenever he needed anything. For example, he claimed she bought a house next door to
his school so he could enjoy lunchtimes at home. He lived with his mother up until the age of 19
when his sister began visiting the house with her small children. He reported feeling displaced by
these children at this time, not being ‘number one’ in his mother’s eyes, so he decided to move out.
He also spoke of recollections and reports from his infancy that were to become extremely
relevant. His mother used to kiss him a lot—on the nose and between his eyes. She soothed
him through touching and always had a loving look in her eyes. He had three dummies, one for
his mouth and two for either hand so that he could tickle his face. Mr S also recalled his nappy
changes—the careful way all the necessities were laid out by mother. The changes he described
as lovely experiences; plasticky, tingling, warm sensations that started in his genital area and
spread over his whole body. He elaborated, ‘I used to look at nappies constantly. At age 5 I used
to put one on just to have that sensation. Even as an older child, if I walked into a shop that sold
nappies I’d get that sensation’. Both the dummies and the nappies were discussed as sensual
substitutes for mother.
Other less idealised details about his mother surfaced over time and with prompting from
me. When Mr S was 15 his mother remarried and she moved to another town with her new
husband, and Mr S was placed in a boarding school. He reported getting along well with this man
but he described this as a desperate time. When he became a boarder he insisted on having his dog
brought to the school fence every afternoon by a domestic worker who was still resident in his
mother’s home. Six months later his mother and stepfather returned and took up residence in
his mother’s former home and Mr S reverted to being a day pupil. He promptly retrained his dog
to bite anyone other than himself who tried to give it orders.
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1047

In his appearance Mr S is a slight young man, boyish, with open, appealing looks. He enters
with a slight bow on small nervous steps and has a self-effacing, somewhat effeminate air. As far as
his work goes, Mr S has built up and owns his own very successful import/export-related business.

Initial sessions
Mr S commenced with twice-weekly sessions but this was soon extended to three times a week.
At the start I focused on the obvious themes: his fear of being taken over and exploited by his
objects and how this related to his father, but also his strong desire to be nursed by a loving,
caring object—the mother and Ms B. This split I also took up in his general relationships by
showing him how, when they were based on fear, he struggled to access more loving and trusting
feelings in himself. This did not prevent him at the start from continuing with his grumbling
about Ms B. He complained about always being the one who initiated sex. ‘She doesn’t realise
it’s like food for me—I have to have it!’ he said. Even when he was tired and wasn’t interested in
sex he blamed her nonetheless for not coming forward. I would listen carefully and when these
complaints began to sound like he was free of con ict in the matter I would say something like,
‘You are stretching your complaint now—it must be that you’re anxious for an opportunity to
reveal your more loving and affectionate side’. This would make him tearful. After one session
where I had spoken to him in this way he returned to the following session with a dream from
which he had awoken crying. He dreamed that he had Ž ve cats and that he was trying desperately
to keep them in the house. Someone had left a door open and he was anxious and upset they
would escape. I realised something of the complexity of his predicament. If he allowed himself
too freely to develop loving feelings towards his object he would be committing himself. Then
he would have to face terrible fears about holding on to the object. Yet, if he treated his objects
too indifferently or with too much disdain then he ran the risk that they would leave, or escape,
causing a collapse. Readers will recognise in this something of the predicament facing the
borderline individual, hence the ongoing debate amongst clinicians comparing the hysteric with
the borderline (Green, 1997).
Of course, I had no way of knowing that the situation was still more complex. It soon emerged
that Mr S was having a parallel relationship with an ex-employee (Ms Z) which had been going
on for several years. This news was followed by a further revelation that he frequently visited an
exclusive brothel for sex at all hours of the day or night. In addition, he referred to a history of casual
sexual encounters and during the Ž rst February of his therapy he made mention, in passing, of
arranging to have Ž ve Valentine’s Day bouquets fashioned and couriered to all corners of the city.

First six months of treatment

I would like to mention at this point that during these opening months Mr S would sometimes not
turn up for sessions. There would be no message and no reference to the missed session when he
next appeared. Following these absences he always felt a stranger to me and once or twice I was
pulled up by a sickening feeling that he might be seeing another therapist in tandem with seeing
me. This feeling lessened markedly in the tenth week when he reported occasions following his
sessions when he experienced a ‘warm feeling’ inside—which caused him immediately to rush off
to visit a prostitute. I felt my reaction, in part, re ected his capacity for living in independent worlds.
In week fourteen Mr S was furious with Ms B for consulting a psychologist on a personal
matter. He punished her by  irting with a new female staff member at work after checking Ž rst
whether she wore a wedding ring. When I suggested this was a retaliation his eyes widened in
amazement and he said, ‘Actually, I’m not a jealous person. I once told Ms B that she could
1048 TREVOR LUBBE

have a lover but I must be able to watch’. Then he spoke of a shopping trip with Ms B in which
she had mentioned an engagement ring and asked him what he thought. He was  ummoxed and
said it was ridiculous to spend so much on a ring. She agreed but added that she would be quite
happy with a small stone or even an antique ring. He then jumped in and said he had another idea.
This idea was that he knew of someone who could get a diamond, maybe from a client who was
leaving the country, and who wanted hard currency. They could get it for half the price and then
it wouldn’t lose its value so easily.
I suggested that Ms B’s mention of an engagement ring had surprised him but that, instead
of expressing his concerns to her, he risked devaluing the whole meaning of an engagement ring.
‘Do you think so?’ he said. ‘I suppose I do conduct a business approach to everything. But you
know my business is different from other businesses. Every cent I make goes straight into the
business which then immediately generates more income. I don’t even draw a proper salary, you
know, and don’t even drive a decent car.’
I agreed this approach had something of general value in it—but I said his problem
seemed to be that he couldn’t Ž nd a way, especially when he was so angry with Ms B, of
reinvesting his good feelings back into the relationship. Then I said straightforwardly, but
with some humour, that he should think very carefully about applying his business approach
to buying an engagement ring because, while he might imagine this would bring him value
for money in the short term, in the long term he was sure to end up with diminishing returns.
To my surprise he looked quite touched by this piece of advice. ‘I know what you mean’, he
said. As we approached the end of the session, however, he mused aloud about how often he
played with the idea of changing his car. He liked to visit showrooms and test-drive all the
latest models. He could afford every one of them but he never purchased one. The dealers
must be thoroughly sick of him. ‘I’ve test-driven all the latest BMWs, you know, every
single one!’ he said. ‘What a thing to put yourself through!’ I replied. ‘And what a relief it
must have been that I gave you a piece of advice without your having to extract it from me.’
Of course, I was aware of an underside to his car comments, namely, that he also saw my
offer of advice as a sales pitch that he was interested in trying out, but probably not buying in
to. I believe that, countertransferentially, my offering this kind of advice, something I would not
ordinarily do, was an enactment of a helpful father/son dynamic that had gone badly wrong for
Mr S. His father was very seductive, and then rejecting, and though he was touched by my offer
he was probably very suspicious of it. This dynamic would be played out in later sessions but as
a reversal—through his risky behaviour he would solicit parental concern from me only then to
reject it. A more worrying aspect to me of my being ‘helpful’ at this point, however, was that it
suggested I had been persuaded that Mr S’s relationship might succeed despite his unfaithfulness
and secret sexual life—in other words, it appeared that I had been complicit in his modus vivendi
(Brenman, 1985).
After the session I gave more thought to Mr S’s difŽ culties in choosing what or who he
wants; that he is incapable of deciding on his object of desire and how this has been described
as a classic hysterical symptom (Kohon, 1986). This was probably another contributing factor
to my momentary anxiety that he was capable of seeing another therapist without my knowing.
In the transference my position of therapist in the Ž rst year was denied in favour of having
an indulgent ‘mother’ listener. This changed when his reports became more sexually explicit
with the clear intention of impressing me as the father. When I interpreted this I noticed that
he then developed a dislike of my interrupting him once he had begun an account of one of his
escapades—he insisted on Ž nishing Ž rst before I was allowed to comment. Again, I took this up
as his anxiety that, like the father, I would cut short his presentation when his aim was to show
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1049

me what a good performer he was. Later, I interpreted his need to Ž nish Ž rst as his preference
for a masturbatory mode of performance—no dialogue, but getting his version out Ž rst and only
then leaving the stage clear for the other.
There then followed two further sessions centred around the engagement ring. Mr S
had gone ahead (ignoring my advice) and looked at rings in a second-hand shop—a Russian
white. The colour was good with only one blemish but there was no certiŽ cate. ‘I’ve started
to learn all about diamonds’, he reported enthusiastically. I asked why he needed to do that.
‘Because it’s important to me; it must have a value to me as well. It has to be equal—all
parties have to be happy.’ I replied, ‘So all along your main worry has been that this
engagement programme is mainly for Ms B and not for you’. ‘Exactly!’ he said. This was a
Thursday session. Then, following the weekend, he mentioned on the Monday that there was
something that had happened, but he couldn’t bring himself to speak about it. Society would
not approve and I would not approve either, and he thought he would not be able to face me
if he told me. What he’d like to be able to do is to tell me and then erase it immediately.

The Ž rst sexual tableau

On the next Monday Mr S arrived wearing dark glasses and a heavy coat. He asked me for a
pen as he needed to gather his thoughts. He said he wanted to tell me what had happened at the
weekend but was scared I would change my opinion of him. ‘If I were to listen to such a story I’d
think the other person was crazy. I’m also scared that if I tell you I won’t be able to come back.
‘It started on Thursday last week. I spoke to Ms Z [the ex-employee] at work and she said
she’d like to meet up, so I got excited and phoned and booked an hotel room for that afternoon.
When I called her later at the ofŽ ce to tell her about the booking she said something had come
up and that she couldn’t make it. I was irritated and decided to keep the booking anyway and get
a prostitute. I phoned the hotel and changed the booking to the evening, and I went to this escort
agency and looked over the girls and booked one for 8.30pm. But when I left I felt so excited
that I went back inside. She undressed me and bathed me and one thing led to another—but in
the middle of it I thought of Ms B and I phoned her and said I’d booked the hotel for the evening
and told her to come at 8.00pm. I thought I’d surprise her with a threesome.
‘When I left the agency I bought some roses and champagne and some candles and decided
to get the engagement ring on appro. and give it to her during the course of the evening. Then
suddenly I had the idea of getting a male prostitute too, so I rang another escort agency and
booked one for about 9.30. I thought if Ms B arrived at about 8.00 we could relax and have
a drink Ž rst. Well, it all went off as planned—Ms B was very pleased with the  owers and
the champagne and I told her about what I’d planned and she seemed Ž ne with it. At 8.30 the
girl arrived and she took off her top and kissed Ms B and they were kissing and getting into
it and I was watching, and the girl had oral sex with Ms B, too. I put the ring on the bedside
table and was planning to give her the ring when she climaxed, but with all the excitement I
missed the opportunity. The guy arrived at 9.30 and the girl got dressed and left. He tried to
have sex with Ms B too, but he lost his erection a few times. He didn’t stay long and he left
and I ran a bath and put candles in the bathroom, and I gave Ms B the ring when we were
in the bath. She was delighted and she kept looking at the ring and stroking it on her Ž nger.
We decided to stay over for the night, and we were close and loving through the night.’ He
Ž nished his story and then peered at me expectantly and observed that I had a frown on my face.
‘Goodness me!’ I said. ‘Yes, I’ve been listening very carefully. You certainly proved me
wrong about one thing—that you’re not a jealous person!’ He looked surprised and I regretted my
note of sarcasm and quickly changed tack. ‘But thank you’, I said. ‘Thank you, it’s been helpful,
1050 TREVOR LUBBE

because I don’t think I fully realised just how difŽ cult this whole ring situation was for you. All
you wanted to do, it seems, was to present Ms B with an engagement ring but look at what you
had to put yourself through in order to accomplish this.’ Mr S looked sad and said he was relieved
he had told me. He had promised himself there was no point to coming to therapy if he held
things back. I said it was a good thing he could get it off his chest, because whilst everything had
gone off as planned he was obviously concerned that something crazy had happened.
Mr S was concerned about my reaction to his story—that I would not be impressed but
disgusted. My sarcasm revealed that I had been shocked, perhaps especially by Ms B’s complicity
in this tableau. I felt I had been kept in the dark and then, through projective identiŽ cation, had
been invited to play a part in a primal-scene phantasy gone mad. Mr S clearly felt some shame
in recounting his story, however, I felt his main concern was that I might catch a glimpse of his
modus vivendi, that is, his attempt to pretend that this eroticised psychodrama was the real thing
and that it presented ‘no problems’ in the face of a potential catastrophe for his relationship.

The end and the aftermath of Ms B

Three months later Mr S and Ms B Ž nally broke up. She had been away on a work trip and in his
usual way he’d entertained other women during her absence. When she returned she was reluctant
to engage with him in sex and he needled and needled her until she gave in, but told him she didn’t
like it ‘his way’. Then they had a row in which she refused to give way to his demands. During the
Ž ght he reported he saw the ‘look of caring’ go out of her eyes and he immediately panicked and
phoned his mother to get her to smooth things over with Ms B. She stood her ground, however, but
the crunch came when he discovered an email sent to her by a man she had met on her last trip. Only
later did she have the opportunity to explain the innocence of the email, but for Mr S he had peered
into the abyss. He sprang into action and insisted she move her belongings out of his apartment.
In the weeks that followed, alongside the fury and accusations of betrayal directed at Ms
B, the frantic visits to prostitutes, the attempts to seduce other women (with some success),
there were questions cropping up in Mr S’s mind—questions about his treatment of Ms B over
the years. He noticed her paintings still stacked up against his living-room wall. He had never
bothered to put them up. He cried and searched himself for when last he had said something nice
to her or bought something for her. She had kept faith with him all these years.
Then he developed panicky feelings. His palms became sweaty; he was short of breath; he
developed a pain in his side and a strange metallic taste appeared in his mouth. He couldn’t bear to
see Ms B, it would kill him, so he avoided her phobically and called her ‘it’ when referring to her in
the sessions. His phobic armour suggested that his symptoms were expressing an anxiety hysteria.
However, he responded well to my interpretations about how his rage helped to conceal
his fears of being left to die and, in a very short time, his phobia lessened and he went to visit
Ms B to apologise. She spoke frankly to him about his controlling behaviour and his endless
demands which had made her feel he could not survive without her. She brought up, much to his
chagrin, the hotel room scenario and said that she had not liked that at all. He responded well.
He apologised and agreed he’d been a ‘total shit’. He re ected later, ‘I really enjoyed being the
other me’—meaning a more emotionally engaged version of himself. Then he sobbed bitterly in
the session and I said it was such a relief in him to be united with these feelings in himself.

The arrival of Ms L
The situation moved quite rapidly at this point and I felt I had to keep up with developments.
Intermittently Mr S experienced a desperate sense of being alone. ‘There is no one to
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1051

“claim” me’, he cried. At the same time he began socialising more actively and this seemed
to suit him. He befriended several people from his golf club and this led to many enjoyable
weekends dancing and socialising. He also  irted a great deal with younger woman but was
shocked by their pragmatism—by their wish to enjoy themselves without strings attached.
In cases where he found the door closed to his charms, he persisted, and was capable of
converting these contacts into sisterly arrangements—he would offer lifts to social events
in exchange for companionship. Yet his vulnerability to other men encroaching on his
‘territory’ remained high and drew from him extreme responses. Typically, he would wander
off but as soon as another man expressed an interest in his ‘date’ he would rush back to
elbow them out. I commented that he seemed less interested in meeting someone new than
in preventing his ‘date’ from enjoying herself. Eventually, though, as part of this crowd, he
met someone new—a young woman, Ms L, whom he liked and who seemed attracted to him.
Soon another stage-managed scenario was in the ofŽ ng, this time at Mr S’s home. He
rushed out to buy  owers to Ž ll all the rooms, spent a great deal of money on new bedding
and cushions, stocked up the refrigerator and food cupboards and had special seafood  own in
from the coast. While on the surface his intention was to seduce, the compulsiveness of these
arrangements shone through.
After several ‘dates’ he reported evangelically, ‘She speaks to me, she’s got something
to say and I don’t have to do all the work. And I Ž nd myself listening to her—it’s remarkable!
And we laugh together. I’m frank with her—I say things and I’m not overconcerned about her
reaction. We were dancing and interacting with others on the dance  oor, yet when we are alone
I’m looking into her eyes—it’s so freeing and I feel so appreciative’. When reporting about their
sex he said, ‘I can’t understand it, we held hands while making love—it was lovely. I want to cry
when climaxing—it’s not from a sense of loss … it’s … it’s … I can’t explain it!’
Though encouraging, this honeymoon situation continued for about three weeks until some
anxieties of an adolescent nature began appearing: ‘Starting again is so nerve-racking—what if
she compares me to other men?’; ‘What if I become clingy again?’; ‘What if she suddenly goes off
course—what if she says, “cheers”?’ Then he suddenly began complaining about Ms L’s sexual
stamina and that she had bitten him on the shoulder during sex and he was most put out by this.
Without a trace of irony he crowed, ‘I need a more balanced person—I’ll take Ms B back any day!’
In the next session Mr S’s insecure feelings surfaced more openly. He brought a dream in
which he was entering a large hospital ward where there were rows of beds. Prostitutes were
operating there. He went inside but said to himself, ‘I don’t want to do this’. There were no
faces to be recognised, only a row of vaginas. He woke up thinking of Ms B and feeling drawn
towards her—towards a security zone of reliability and security, he said. He had gone round to
her house that evening but she was out and he convinced himself she was seeing ‘that man’. He
went home feeling awful and put himself to bed. The following day he woke up feeling anxious
and immediately contrived to plunge both himself and Ms L into an AIDS scare. He suggested
they get themselves tested immediately. He decided not to pass through a GP service and so, by
some method unknown to me, he organised a direct service through a laboratory and they both
went for blood tests.
I felt alarmed when another tableau presented itself around the test results. He bought in
some food, a platter and some Ž zzy drinks; he made a Ž re, set up candles, and the plan was that they
would open their test results together. That evening they hesitated before opening the envelopes,
having a discussion Ž rst about what they would do if either of them had tested positive. Ms L said
conŽ dently that she had an ‘impeccable’ history of safety when it came to sex. Mr S, of course,
could not claim the same for himself. He opened his envelope Ž rst and scanned to Ž nd a negative
1052 TREVOR LUBBE

result, which he announced with relief. Ms L then opened her envelope, but read her results from the
bottom up, which took longer and she looked terriŽ ed, said Mr S. He watched her closely and felt
sorry for her. She was also negative and there was also great relief. I felt like twisting his head off.
Near the end of the session Mr S, perhaps sensing my feelings, became interested to know
my response to this psychodrama. At Ž rst, the feeling I had was that he wanted me to commend
him on a job well done but he stared at my notebook and said he liked the fact that I wrote down
his dreams because it meant I was taking him seriously. I took him back to the dream and said he
had been dicing with death in that dream (coitus with prostitutes) but had pulled himself away
in fear, and woke up searching for security from Ms B—whose absence he automatically took
as her being with another man. This remained his worst fear, I said, of being excluded and left
to die alone, and his only way of dealing with this fear was to pull someone else (Ms L) into his
panic by making her dice with death. He looked peeved and reminded me it could have been a
total disaster. I agreed and said, ‘You mean like a joint suicide?’ He shook his head in amazement
and disbelief. I said there was no longer any point in his denying his spiteful jealousy—it was
therefore not far-fetched to suggest that, when it came to women, if he felt he couldn’t have them,
no one else should be allowed to have them either.

Discussion
At this juncture there are several themes that could be gathered together and considered from a
theoretical angle. First, it could be claimed that all Mr S is seeking is to secure the unalloyed love
of every woman he meets and tries to seduce. However, his shuf ing back and forth between
partners, unable to choose—like he did between his divorcing parents—re ects a frantic search
for the ideal object that no one satisŽ es. This is not due to ambivalence, as Kohon (1986, p. 379)
points out, but ‘divalence’—it is about not being able to change over from one object to another.
In the realm of the unattainable, therefore, all Mr S’s women are but a series of vaginas that are
exchangeable. They are part-objects and not subjects even though he expects them to treat him as
a subject. As we can observe, Mr S has barely achieved a separation from his biological mother
and the story of his relationship with Ms B highlights how he converts his partner into a twenty-
four-hour-a-day life-support ‘mother’ in order that he may launch himself into the world under
the illusion of being an independent and sexually mature man. However, in any independent
relationship he might establish he soon recapitulates the same separation problem plus his
genitalised defensive solution—that is, the need for additional sexual substitutes as a means of
dealing with any separation or loss that might crop up as part of his principal relationship.
In the separation-individuation domain we can repeatedly observe how Mr S eroticises the
absent object (see Bollas, 2000). Any awareness of the object’s absence or separateness raises
the alarm and this awareness is immediately denied through turning to an external object for sex
(see Brenman, 1985). For instance, at the end of his early sessions, after having received some
understanding from me, Mr S had to rush off to a prostitute for sex. The hospital ward dream,
however, drew attention to the fact that the absent object is not only eroticised but ‘genitalised’—
this is an important distinction that I shall be taking up later. In addition, the dream also reveals
the Ž rst signs of concern about the damage being done (hospital beds) to himself and his objects
through this type of genitalisation, as well as the inclination to seek refuge with an object that is
warm, safe and soothing.
This brings us to the meaning of the sexual tableaux. Mr S must have what he wants
whatever the cost and whatever the risk. The HIV crisis and the murderous jealousy towards
rivals illustrate the link between sex and death in the hysteric that several writers have mentioned
(Britton, 1999a; Bollas, 2000). Mr S appears driven by the phantasy that what goes on in the
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1053

parental bedroom will rob him of his life-support system, leading to his inevitable destruction. His
destruction is threatened not by castration fears, which are circumvented, but by a combustible
combination of separation and exclusion fears. In the stage-managed sexual scenarios—whether
explicitly or implicitly triangular—this phantasy is enacted as a means of mastering these fears
with himself as the natural victor. Only by introducing potential rivals, as Mr S did in the hotel
suite, and then vanquishing them can he achieve the kind of security he is seeking—which he
can tell exists by looking into the eyes of the object and seeing only himself re ected there. The
point is that if these defensive manoeuvres fail then the only alternative is for the object and the
self to achieve a lasting union through a kind of Wagnerian romantic death (Britton, 1999b). The
other option, of course, is a depressive collapse in the face of negotiating an oedipal outcome.
Rank (1929) described the compulsive philandering of Don Juan as an attempt to eliminate all
rivals and take total possession of the primal mother. On one occasion Mr S tried to befriend one
of his prostitutes by inviting her to his home and paying for a whole evening. He claimed she
was a ‘better class’ of prostitute but I interpreted that his aim was to take sole possession of her
by disposing of her other clients.

The gathering of the transference

When Mr S and Ms L decided to ‘cool’ things between them Mr S went though a shaky few weeks.
In one session he came in saying things were not going well. He looked up suddenly and asked,
‘Have you painted this room? I haven’t noticed the warm colour before’. He went on to describe
a miserable weekend in which he had tried going out to cheer himself up but to no avail. After an
evening out he had invited himself to a new female friend’s home and asked if he could stay over.
She was taken by surprise and began to make up the couch. ‘My goodness, no!’ he exclaimed.
‘I can’t have the couch!’ So he took off his shoes and slipped into her bed and fell deeply asleep.
The next morning he woke up crying with the following dream. ‘I was imprisoned for
having allegedly murdered someone. I had escaped twice and had been rearrested and had been
brought into this big room, not a court as such, but an ofŽ cial-type room. All the faces were
blurred and I stood up and said this was not fair, that this had not been proved, life wasn’t fair.
Someone said, “But you’ve stabbed someone to death with a pen”. Still, my whole feeling was
life wasn’t fair but I knew I had to accept what I’d done. Just then—and this was very clear—a
big hand came to rest on my little hand and I felt reassured but I knew at the same time that he
couldn’t get me off the charge.’ Mr S said he recognised the hand as that of his father’s with his
long, broad Ž ngers, well manicured—though the man was a younger man.
To the pen he associated a Ž ght he had got into at school with a rival—he was sent to the
headmaster for caning. He thought it was unfair and unjust to be beaten, and totally humiliating.
Neither parent had ever laid a hand on him. He vowed then never to submit to a caning again if
he should Ž nd himself in a similar situation.
I said that the image in the dream of the father’s reassuring hand was the Ž rst positive
image in connection with his father to have come up so far in his therapy. He agreed. I linked
this to his comments at the start of the session about my warm room and to the warm feeling
he’d experienced following his early sessions. These were the Ž rst positive feelings, I said, he’d
been able to express so far about me—a younger helpful Ž gure, perhaps. I mentioned also his
previous comments about my note-taking and this being something positive. The pen in the
dream then, I suggested, represented quite different feelings towards me—murderous feelings.
He accepted this without argument. I said the dream also indicated what a difference it would
make if he could accept his longing for a man’s help, especially since his problems were so
tied with women, but that when a man came forward to help him he couldn’t stop himself
1054 TREVOR LUBBE

viewing such a man as a dangerous rival who was out to humiliate him or stab him in the back.
The banishment of a father from Mr S’s adult life was most striking. Certainly in oedipal
terms his father was an extremely dangerous Ž gure and so his victory would have to be total.
Because of this, the only identiŽ cation open to him at this time was an hysterical (mimetic)
identiŽ cation which we can observe in how Mr S follows quite literally in his father’s footsteps,
not only with respect to his sexual advice but in relation to his alleged womanising. In this way
he could maintain a link to his father and yet triumph over him compulsively. This produced
initially a split-transference—on the one hand, he needed to defeat me and render me impotent
in interfering with his modus vivendi. On the other hand, like a little boy, he wanted my help,
approval and encouragement for his attempts to do his best, even in the realm of love relations.
Countertransferentially this drew from me a number of split responses. For instance, my
sarcastic ‘joke’ about his claim not to be a jealous person during the Ž rst sexual tableau not only
re ected my shock but also my sense of helplessness in the face of Mr S’s sexual acting out.
Similarly, my alarm over the AIDS tests results scenario and my suggestion that it was a ‘joint
suicide’ represented both my fear and concern over a fatal outcome as well as my wish to shock
the patient into recognising this. My inclination to strangle the patient, too, for his treatment of
Ms L, and women generally, re ected my anger and frustration with his messy sexuality. Yet
his discoveries of hitherto unknown feelings of tenderness, appreciation and joy were genuine
and they convinced me that a developmental approach to his problems was justiŽ ed. This split
transference had to be carefully monitored, however, because I had to be mindful of how the
presentation of the little boy might be a decoy for compulsive triumphing over the object. The
negative side of the split came more to the fore during the Ž rst year of treatment and only in
the second year were the longings for admiration and love from a father/therapist able to be
approached in the transference in a way he could accept without fear or denial.

The ‘married woman’

As we drew towards the end of the Ž rst year of treatment, and towards a break, Mr S seemed
more settled, more productive at work, and able to spend more time alone at home. Soon,
however, the sessions began to feel lifeless and my suspicions were soon conŽ rmed when in one
session he announced there was a ‘married woman’ on the scene. He had met her at a restaurant
where he and his friends had joined another table through lack of space. He spoke about his
mental attraction to someone more mature, someone who doesn’t play games, and who spoke
openly about problems in her marriage, including a lack of chemistry with her husband. My heart
sank as a measure of concern about the safety of everyone.
In no time at all the scene in the hotel room was set before us again. Compulsively, it was the
same hotel but this time a different suite was chosen and Mr S set about arranging the scene. The
 owers, the candles, the champagne and the oysters took up their customary positions but on this
occasion there was something artful, even ironic about Mr S’s description of these preparations.
He agreed he was in ‘planning’ mode, as he put it, but he said if it worked ninety per cent he would
be satisŽ ed. ‘But this is not a fantasy’, he told me icily towards the end of the session. ‘It’s going to
happen.’ I said it sounded like he was going ahead only to see if I would try to stop him. He laughed.
‘Don’t be silly—that’s shrinky-shrinky stuff.’ I said I did not believe this was shrinky-shrinky
stuff. I believed that with his careful arrangements he wanted to show to me, and presumably to
the other man in the picture (the husband), that only he could be in sole possession of Mrs M.
He came to the next session in lively spirits, jokingly enquiring whether I was on good
form today. I said he was mocking me because he was nervous about his victory over me and
wasn’t sure what to expect. He reported that Mrs M had been impressed by his arrangements,
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1055

especially his attention to detail. This had touched him, he said, because he had hunted all
morning for a special spoon for the caviar! I said he was angry and disappointed with me for not
showing the same enthusiasm for his arrangements.
This comment caused him to lose his initial liveliness and he went on to give an account
of the evening’s events, the sexual details of which were reported less salaciously than usual. He
mentioned that when Mrs M started rubbing herself he was amazed not to Ž nd this threatening,
and he recognised that his own masturbation didn’t make him a bad lover. He said there was
anxiety only when Mrs M had to leave to meet her husband. During their encounter she had also
mentioned that there were good things about her marriage and times when she wanted it to work.
He heard himself exclaim out loud, ‘Who’s going to control the parameters here?’ She laughed
and this shook him because he had been serious. I again addressed his modus vivendi by agreeing
that he would indeed have been serious, because in his planning mode he was trying to make it
look like everything was Ž ne and under control when simultaneously he was aware the situation
was completely unstable.
Within a week or so his anxieties mounted. He said, ‘There’s no stability in this … all the
cloak and dagger stuff … I’ve been seeing her at these odd times during the day … it doesn’t
feel safe. How did I get into this? It will be a repeat of Ms B. What if the husband turns up?
My mind says its dangerous but I can’t stop myself—I’m like a drug addict’. Shortly after this
session Mr S resolved to end things with Mrs M. He came to a session in a smart suit carrying a
letter he intended to deliver to her personally. Of course, by going in person he secretly hoped to
be dissuaded, but this backŽ red. Later, he reported her response when she opened her front door,
which had infuriated him—‘How theatrical!’

Discussion and conclusion

I have described the point at which my work with Mr S had uncovered his speciŽ c developmental
deŽ cit associated with a premature genitalisation of separation-individuation con icts in infancy
and childhood. In adulthood this produced a type of hypersexuality focused on triangular
situations (explicit or implicit) reminiscent of primal-scene dynamics belonging to the early
stages of the Oedipus complex (O’Shaugnessy, 1989). This was a defence against an amalgam of
separation (pre-oedipal) pain and exclusion (early oedipal) pain. These dynamics were beginning
to be expressed in the transference. While in some men this convergence of pains might produce
sexual acting out that appears normative, in Mr S’s case I think it Ž ts both descriptively and
dynamically the diagnostic criteria of male hysteria, Don Juan-type.
Of the Don Juan-type male, Fenichel claimed that he ‘had not passed the archaic prestages
of love’ (1946, p. 243)—which would include, I am suggesting in this paper, the prestages of the
Oedipus complex with respect to the development of love relations. Mr S’s seductive approach
to women appeared to have little or no background in adolescent sexual experimentation or
romantic liaisons. He claimed that only by drinking beer could he ask a girl to dance and that he
studiously avoided all situations where he might compete for a girl’s attention.
In describing the type of early experience that might beget a male hysterical object relationship,
Brenman (1985) recounts the situation of a mother who is overwhelmed by her circumstances and
who unconsciously conveys to her son a sense of impending catastrophe. Yet consciously, through
overattentiveness, overprotectiveness and lots of sensual stimulation, she offers herself not as a
mental object but as a sensual object to make the child believe that there are no problems and that
everything is perfectly Ž ne. As Brenman concludes, this is a model that encourages the denial of
psychic reality and the use of an external object to avoid catastrophic anxieties and emotions—the
hysteric’s modus vivendi.
1056 TREVOR LUBBE

This model explains why Mr S is so vulnerable to panic, notwithstanding his mother’s

overattentive caring of him during childhood. I believe her caring was more likely to be in
the nature of a ‘set piece’ than in providing emotional processing—and it is these ‘set pieces’,
being as they are so reminiscent in Ms S’s memory of the careful way his mother had laid out
all the ‘necessities’ for his caring (especially during feeding and nappy changing), that, through
genitalisation, were being enacted in his stage-managed sexual tableaux. His main interest in
these scenes was in becoming swept up by the object’s physical and sensual qualities—with her
neat appearance, her smell, her manners, her style of breathing whilst asleep, and so on—aspects
that clearly belong to the infantile bodily relationship with the mother. It was these aspects of the
mother as a physical life-support system that, through genitalisation, were given the appearance
of mature sexuality where, in fact, they re ected a defensive organisation against acute separation
and abandonment anxieties. Ironically, premature genitalisation meant that Mr S lived in constant
fear of his penis not being able to perform its normal intercourse function (Joseph, 1997).
Throughout this phase of therapy I found it useful to put pressure on this modus vivendi by
interpreting to Mr S how he was often aware of something going wrong in his love relations, or
having the potential to go wrong, even though he was carrying on as if everything was Ž ne.
But how do we explain such acute anxiety where the patient is not borderline psychotic? Klein
suggested that the male hysteric of the Don Juan-type treated women like food—his genitality had
become imbued with a devouring oral quality which was his earlier solution to fears of loss: ‘He
becomes like someone who expects a famine and is hoarding up food’ (1939, p. 5). This captures
something of Mr S’s desperation: ‘She doesn’t realise it’s like food for me—I have to have it!’
Rupprecht-Schampera (1995, p. 469) also highlights the interaction of oedipal and pre-
oedipal factors when considering aetiology in hysteria since neither alone provide a uniŽ ed cause
of all its forms, mild or malignant. He proposes that in the male hysteric there is a premature
genitalisation of the mother–child relationship which is implemented by the child as a means
of achieving a separation (p. 465). This paper places the emphasis on the other side—on the
mother’s overinvolvement and overstimulation. Either way, the result is a type of triangulation of
separation dynamics that Britton describes as lying at the root of an ‘hysterical solution’ (1999a,
p. 9). That is, in separations, as a condition of the object’s absence, the subject automatically
infers a relationship between the object and another object.
This helps to explain what happens to Mr S when his objects leave him. For Mr S the object
never simply leaves—it leaves for another, whether this is a sibling or the father. In facing separations
Mr S is therefore presented with a double threat—dyadic separation and triadic exclusion.
We see further evidence of this in Mr S’s very Ž rst complaint about Ms B. When she talked
about marriage he experienced her as choosing ‘something else’ over him (‘She’s only interested
in a wedding and in having children and that will mean the end of me’). When she enquired about
an engagement ring, too, this was experienced in the same way, hence he ‘gets in on the act’ (Britton,
1999a, p. 9) by making himself an expert on diamonds. Her masturbation, too, he felt as her choosing
her own body over him, so be becomes an expert on female orgasm and how to mastermind it.
Similarly, when his sister’s children appeared in the mother’s doorway he felt immediately
displaced. His claim not to be jealous turned out to be an extraordinary denial. Every separation
was undergone as a primal-scene experience belonging to the early stages of the Oedipus complex.
With his latest affair with Mrs M he has Ž nally arrived at the triangular situation that most
resembles the parental bedroom. Here we can identify his defensive enactment most clearly as
a reversal of the primal scene—his uniting with the ‘mother’ is dependent upon replacing the
‘father’ and inserting himself in his position. He is again ‘getting in on the act’ but I would like to
emphasise that there are clear developmental motives as well as repetition-compulsion elements
 DIAGNOSING A MALE HYSTERIC: DON JUAN-TYPE 1057

in these stage-managed scenaria. In his own sexual development Mr S is still negotiating the
task of combining the tender and the sensual with the sexual, and of forming his own masculine
identity. His sexual dramatisations, therefore, are both an acting out of his terror of a genital
relationship between the parents as well as a rolling out of opportunities for getting beyond this
prestage of the Oedipus complex.
This would require many further hours of psychotherapy, which led us eventually to
recognising a deep sense of loneliness underlying Mr S’s relationships. Predictably, this resulted
in a depressive collapse and Mr S withdrew himself almost entirely from the world to avoid
emotional involvement. ‘I’ll have to put myself into a monastery’, he declared. He did not
become psychotic or stop attending his sessions but this heralded a period of asceticism in his
life. Asceticism is the negative of compulsive sexuality but in the hysteric they may coexist or
rotate as alternative ‘ways of living’ (Fenichel, 1946; Bollas, 2000).

Acknowledgement: I wish to thank Jennifer Allen for her scrupulous editorial help; to the Melanie Klein Trust
and the Wellcome Trust and Library I owe similar thanks for their friendly access to archival material.

Translations of summary
Diagnose eines Hysterikers: Don Juan Typ. Das Ziel dieses Artikels ist es, eine klinische Darstellung eines
Hysterikers vom Don Juan Typ in den frühen Stadien der Behandlung vorzustellen. Der Patient präsentierte sich
mit einem Beziehungsproblem, aber sehr bald trat eine Art der zwanghaften Sexualität oder Hypersexualität in
seinen Liebesbeziehungen zu Tage, die ein zentraler Aspekt des klinischen Bildes wurde. Diese Hypersexualität
drückte sich in einem zwanghaften Bedürfnis aus, sexuelle oder sexualisierte Szenarien darzustellen oder
darstellen zu lassen. Diese Szenarien, die in verschiedenen Variationen und mit verschiedenen Darstellern
wiederholt wurden, werden vom Autor als eine Dramatisierung der Urszene verstanden, wobei der Patient
die Position des ödipalen Vaters einnahm. Es werden Erklärungen für das Verschwinden der männlichen
Hysterie gegeben, einschliesslich einer neuen Theorie, die behauptet, dass ein Ungleichgewicht in der
psychoanalytischen Theorie selbst zur Feminisierung der Hysterie führte. Diese kritische Perspektive macht
es möglich, gewisse Formen der Hypersexualität bei Männern als eine Form der Hysterie zu verstehen. Das
gängigste Beispiel ist der Don Juanismus – eine Form der zwanghaften Sexualität, die Bezüge zum Normativen,
zur Konversion und zum Charakter enthält. Der Artikel setzt sich auch mit der Entwicklung des Hysterikers
auseinander . Die zwanghaften sexuellen Darstellungen ließen erkennen, dass er nie mit einer einer Trennung
konfrontiert war, die nicht ein trianguläres Erlebnis war. Das bedeutete, dass er Trennung als zwei verschiedene
Entwicklungskatastrophen erlebte, die in eine ineinandergeschoben wurden: Trennung (präödipal) und
Ausgeschlossensein (früh ödipal). Diese Verbindung, so vermutet der Autor, ist für eine bestimmte Gruppe
von Männern so furchterregend, dass sie die Wahl der Hysterie anstatt einer anderen Neurosenform erklärt.

Diagnóstico de un histérico donjuanesco. La Ž nalidad del presente artículo es ofrecer una descripción clínica de
un histérico donjuanesco, en las etapas iniciales del tratamiento. El paciente presentaba aparentemente problemas
de relación, pero pronto surgió una forma de sexualidad compulsiva o hipersexualidad en sus relaciones amorosas,
que vino a ser el rasgo central del cuadro clínico. Esta hipersexualidad se expresó en una necesidad compulsiva de
protagonizar escenas, o dirigir esceniŽ caciones, de naturaleza sexual o sexualizada. Estas escenas, que se repitieron
con diferentes variaciones y personas diferentes, son consideradas por el autor como una dramatización de la escena
primaria, tomando el paciente el rol del padre edípico. El autor presenta varias hipotesis acerca de la desaparicion
de la histeria masculina, incluyendo una teoría nueva que sostiene que un cierto desequilibrio en la misma teoría
psicoanalítica ha conducido a la feminización de la histeria. Esta crítica permite entender determinadas formas de
la hipersexualidad en los hombres como modalidades histéricas, siendo el ejemplo mas comun el donjuanismo,
una forma de sexualidad compulsiva que abarca rasgos normales de conversión y de carácter. El autor también
examina los estados de desarrollo del histérico. Lo que las conductas sexuales compulsivas del paciente pusieron de
maniŽ esto fue que nunca había afrontado una separación que no fuera una experiencia triangular. Esto signiŽ caría
que sus separaciones las experimentaba como dos formas de agonía condensadas [telescoped] en una—la separación
(pre-edípica) y la exclusión (edípico inicial). Tal combinación, sugiere el autor, es tan aterradora para un grupo
determinado de hombres como para explicar la elección de la histeria, en contraposición a otra elección de neurosis.
1058 TREVOR LUBBE

Diagnostic d’une hystérie masculine : le donjuanisme. L’objectif de cet article est d’apporter un témoignage
clinique à partir des premières étapes du traitement d’un patient hystérique, de type « Don Juan ». Le patient
s’est présenté comme ayant des difŽ cultés relationnelles mais il est apparu rapidement une forme de sexualité
compulsive ou hypersexualité dans ses relations amoureuses qui est devenue l’aspect central du tableau clinique.
Cette hypersexualité se manifestait dans le besoin compulsif de jouer, ou de mettre en scène, des scénario
interpersonnels de nature sexuelle ou sexualisée. Ces scénario, répétés selon diverses variantes et avec des
personnes différentes, sont considérés par l’auteur comme une théâtralisation de la scène primitive, le patient
prenant la position du père oedipien. L’auteur avance des hypothèses sur la disparition de l’hystérie masculine,
notamment une nouvelle théorie, selon laquelle un certain déséquilibre dans la théorie psychanalytiqueelle-même
a conduit à la féminisation de l’hystérie. Cette critique permet de promouvoir certains aspects d’hypersexualité
chez l’homme comme des formes d’hystérie, l’illustration la plus connue étant celle du donjuanisme : une forme
de sexualité compulsive qui englobe des aspects normaux, des aspects de caractère, et des aspects de conversion
(conversifs). L’auteur se penche également sur les stades du développement de l’homme hystérique. Ce que
les conduites sexuelles compulsives de ce patient montraient, c’est qu’il n’avait jamais été confronté à une
séparation qui ne soit pas une expérience triangulaire. Ceci signiŽ ait que ses séparations étaient vécues comme
deux angoisses fusionnant en une seule – séparation (pré-oedipienne) et exclusion (oedipienne précoce). L’auteur
suggère que cette association est tellement terrorisante pour un groupe particulier d’hommes qu’elle rend compte
du choix de l’hystérie en opposition à d’autres choix de névrose.

Diagnosi di un isterico: il dongiovannismo. Lo scopo di questo lavoro è dare la descrizione clinica, ricavata
dalle prime fasi della cura, di un paziente isterico affetto da dongiovannismo. Il paziente si presentò inizialmente
con un problema relazionale, ma presto emerse una forma di sessualità compulsiva, o ipersessualità nei rapporti
amorosi, che divenne la caratteristica fondamentale del quadro clinico. Questa ipersessualità si esprimeva nel
bisogno compulsivo di mettere in scena, o dirigere, scenari interpersonali di natura sessuale o sessualizzata.
Questi scenari, che erano ripetuti con diverse variazioni e con personaggi diversi, sono visti dall’autore come
una drammatizzazione della scena primaria con il paziente che assume la posizione del padre edipico. L’autore
propone delle spiegazioni sulla scomparsa dell’isteria maschile, compresa una nuova teoria secondo la quale uno
squilibrio della teoria psicoanalitica stessa ha portato alla femminilizzazione dell’isteria. Questa critica fa sì che
certe forme di ipersessualità maschile siano promosse al rango d’isteria, e l’esempio più comune è quello del
dongiovannismo, una forma di sessualità compulsiva che racchiude caratteristiche normative, di conversione e di
carattere. L’articolo esamina inoltre l’agenda evolutiva dell’isterico. Il quadro sessuale compulsivo del paziente
presentava il fatto che egli non aveva mai affrontato una separazione che non fosse un’esperienza triangolare.
Ciò voleva dire che le sue separazioni erano sperimentate come due angosce evolutive condensate in una: la
separazione (pre edipica) e l’esclusione (edipica precoce). Questa combinazione, suggerisce l’autore, fa talmente
paura a un gruppo particolare di uomini da spiegare la scelta dell’isteria in contrapposizione ad un’ altra scelta
di nevrosi.

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