Priapism

On the unconscious fantasy of erection

Abstract

A case of psychogenic priapism is described. The patient awakens several times during the night with a disturbing erection which he experiences as a rigidity of the whole body. The constipation and the hemorrhoids which afflict the patient lessen when priapism increases. The dreams from which he awakens without anxiety and with priapism show the unconscious defense phantasies against a persecuting object expressed by the symptom. On the three levels, pre-oedipical, early oedipical and oedipical proper-which he autor relates to the there phases of instinctive evolution described by Paula Heimann: the oral organization, the polimorphus stage and the anal organization - the persecuting object has its own structure each time. In the face of the bad breast, there arises - in relation with Lewin‟s oral triad - a three-fold dread. The dread of swallowing poison and being emptied by diarrhea (through association with his younger brother‟s typhoid fever when he was a suckling). The erection, as a consequence of its valvular function, closes the conduit and prevents from the aggressive enuresis as well as from being emptied. The dread of being swallowed is equivalent, through the phallus-body equation, to the dread of falling into an abyss. The erection, symbolised by a giroscope, annuls the gravitational force. The dread of sleeping against which priapism acts as an awakener. In the face of the combined couple, there arises the fear of being petrified by the phallic mother like Medusa as well as the fear of the earthquake througt the explosive mixture of the primal scene (in association with the father‟s death due to a cerebral hemorrhage during intercourse). The erected phallus symbolises the mother phallus stolen from the phallic mother against whom he defends himself with the apotropaeic exhibition of the fetish, thus repeating the phantasy reflected in the Perseus myth. The rigidity of the erection expresses the unconscious phantasy of rendering the combined couple immobile such as in catatonia. In the face of the father‟s penis, the frustrating object of the Primal scene, there arise the fear of the Influencing Machine, which breaks loose the homosexual libido and masturbation. The prapism by de-congesting the anus interrupts the stream of the ominous Machine and controls the father‟s penis. Many of the dream symbols and phantasies which nourish the patient‟s inclination towards chemistry, are analogous to those of alchemy. The possession of the father‟s penis is the secret through which he obtains the “materia prima” to realize the “chemical wedding” between the masculine and femenine sustances, urine and faeces, inside the “hermetic receptacle” which is the priapic penis, in order to obtain the “philosophical stone”, the idealized breast, symbolised in one dream by the cautchuc tree with its valuable latex milk. Priapism autoplastically materializes fecundation,, pregnancy and parturition, thus expressing the rebirth phantasy equivalent to the return to the womb, a phantasy which is implicit in the relation with the idealized object. The symptom substitutes sleeping as an intrauterine state and the patient continues “dreaming” with his body. The hysterical materialization is a manifestation of the primary process in the corporal scheme. The pregenital libido is displaced and condensed in the penis, which ultimately symbolises the breast. In view of the analogy to Perseus, the hero who defeats the monster, the Oedipus myth in considered. Oedipus is a symbol of erecion. The myth is the exegesis of the symbol, that is to say, the unconscious phantasies expressed in the erection are ilustrated in the Oedipus myth. The encounter with Layo at the Trifurcation is the incorporation of the father‟s penis belonging to the mother. When he thus gets hold the Sphinx‟s secret, he can strike her dumb, repress the image of the phallic mother and commit incest with Jocasta. The theree typical dreams - death of a loved person, an examination, and that one of nakedness with immobilization - described by Freud express the Oedipus conflict: the situation in the face of Layo, the Sphinx and Jocasta. The sexual act, in as much as it expresses the unconscious phantasy of a return to the mother‟s womb, simultaneously expresses the defense phantasies against the anxieties inherent to such a return. This case offers the chance of studying some aspects of the problem of conversion hysteria. The author‟s hypothesis is that the materialization of the mother phallus would be valid for every conversion hysteria since the bisexual phantasy which according to Freud exists at the bottom of this neurosis means, in terms of object relation, the relation with the mother phallus which satisfies both the phantasy with the mother‟s breast and the father‟s penis. The first “materialization” of the mother phallus takes place in the transitional phenomenon described by Winnicott. It is when the child emerges from the schizoid position, from the hallucination of the idealized breast, that he starts to elaborate illusions upon a real object, the transitional object. It now one only real object which articulates the schizoid mechanism — idealization and denial — wherefore the schizoid splitting becomes repression. The unconscious phantasy expressed in the materialization of the mother phallus, is simultaneously the expression of a defense mechanism, repression, due to the screen function of the fetish. The relation between splitting, repression, denial and the pre-oedipic, early oedipic, oedipic proper situations respectively, shows the genetic continuity of the defense mechanisms and therefore the evolution of the reality sense as the dialectic between unconscious phantasy and the evolutionary factor.