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Freud’s Unconscious & Wilhelm Reich

Freud’s Unconscious & Wilhelm Reich

In 1952, an interview took place between Kurt R. Eissler M.D. (a psychoanalyst himself) representing Sigmund Freud’s archives, and Wilhelm Reich. The interview took place over the course of two days at the Organon in Rangely, Maine, on October 18th and 19th, 1952. Later, its full, transcribed text was published as the book Reich Speaks of Freud. The conversation began with the following question:
Dr. Eissler: Dr. Reich, the question I want to ask you is a very simple one. It is a very comprehensive question, but it is a simple one. I would like to know everything you know about Freud, everything you observed and everything you thought. Even if it is not based on a correct observation, the mere fact that you thought it about Freud would be so important for us to know.
Dr. Reich: That is quite a big order. I know a lot about Freud. I would like to start with a basic theoretical difference in the approach of psychoanalysis and my work, not to propagate my work, but to explain how I saw Freud.
The questions and answers continue in the book.  Reich’s answers are concise and condensed; the information in each paragraph can be elaborated and expanded over many pages. In one point, Reich said the following; “Freud was the Moses who never reached the promised land. His unconscious was only an idea, it’s not real. It was never real. You know where it becomes real?”
Dr. Eissler:  No.
Dr. Reich: In the twitchings which we get out of the organism in our work.   Do you know anything about that? You don’t?  The unconscious comes out in orgone therapy, in actions of the protoplasm. He didn’t reach that. I think he was a very eager physician, he wanted to cure people, but it didn’t work. It just didn’t work.  So you see, there were many reasons for Freud’s resignation.
For a psychiatrist, psychoanalyst, psychologist, a physician practicing a different specialty, or even for a lay person with an interested in psychology but not altogether familiar with Reich and his theories, these statements may look strange. How can the unconscious show itself in the twitching of muscles? The most submerged and most unknown component of mind elides in tendons? Any clinician who is unfamiliar with this concept would be baffled by this proposition. He might even take this statement as a sign of disturbed thinking. Sitting in on this interview, its entirely likely he would have thought Reich had gone off the deep end.
If a clinician shows patience and humility while struggling to comprehend Reich’s theories, however, a door will open up to him and a field that he was never aware of will become evident to him.  It will expand his vision and his knowledge. Such expansion will be extremely helpful to himself or herself, as well as to the broadest knowledge base of their profession. In the following pages, it is our goal to elaborate and make this concept accessible to the reader.
One of Freud’s major contributions to modern medicine was his emphasis on the power of the unconscious mind. So much of mental life is unconscious, he contended, extending far beyond the realm of awareness. Freud recognized that the treatment of neurotic symptoms would be made possible by rendering the unconscious meaning of the symptom conscious, lifting it into tangible detail, giving it form in words; informing it. And although the technique of making unconscious conscious was initially based on hypnosis, Freud later discovered the technique of free association. He persuaded his patients to speak freely and to bring up anything that came to their mind no matter how irrelevant it might initially seem. In practice, one idea inevitably was bringing up another idea, like the links of a chain connected to a great, unseen anchor. The chain of association eventually led to the unconscious meaning of the symptom. Freud contended that through the practice of unearthing the unconscious meaning of the symptom, the patient improved.  Later on, however, Freud himself realized that by unearthing the unconscious meaning of symptoms, the symptoms themselves would not always improve. Hence, Freud changed his intentional statement “the symptoms should improve” to the more doubtful“the symptoms may improve.”
As a pioneering physician, Freud had high hopes for his discovery of the unconscious and its effect in the treatment of neurosis. On an audio recording that exists in his museum in Vienna, Freud states that through his efforts he found that the unconscious mind opens the door in curing neurosis, and that he hoped that his discovery would serve curing patients who suffer from neurosis.  However, 70 years later the psychoanalysis that once promised a cure for neurosis has faded away.  In 1993, even Time magazine published an article with the shopworn headline “Is Freud Dead?”
In the November 29th, 1993 Time Magazine, there was an article titled, “Is Freud Dead”? By the end of the article, the author concludes that “psychoanalysis and all of it’s off shoots, may in final analysis, turn out to be no more reliable than countless other pseudosciences that once offered unsubstantiated answers or false solace.”
Reich viewed Freud’s discovery as a kernel of an idea that needed to be advanced. In The Function of the Orgasm, he writes the following.
Objectively seen, it was not a matter of competing with Freud, or of establishing a profession, but of advancing an enormous discovery.  At issue was more than the elaboration of known material; essentially, it was matter of discovering the biological basis of the libido theory through experimentation.  It was necessary to bear responsibility for a piece of the momentous knowledge which presented a direct challenge to a world of superficiality and formalism. It was necessary to be able to stand alone- which did not exactly foster popularity. It is clear today to many people working in this new psychological branch of medicine that character analytic theory of structure is the legitimate continuation of the theory of unconscious psychic life.
Returning to the earlier question of why do some patients improve after unconscious meaning of the symptoms is discovered and others do not: In the pursuit of finding an answer to this puzzle, Reich describes a patient that was referred to him by Freud. The patient was suffering with sexual impotence. He said that in the third year of psychoanalysis, he arrived at perfect reconstruction of the “primal scene”.
He was about 2 years old when it occurred.  His mother gave birth to a child.  From the adjacent room, he had been able to observe every detail of the delivery.  The impression of a large bloody hole between her legs became firmly ingrained in his mind.  On a conscious level, there remained only a sensation of an emptiness in his own genitals….  According to psychoanalytic knowledge of that time, I merely connected his inability to have an erection with the severely traumatic impression of the ‘castrated female genital.’  This was no doubt correct. However it wasn’t until a few years ago, that I began to pay special attention to, and to understand the feeling of emptiness in the genitals in my patients. It corresponded to the withdrawal of biological energy….  At that time, I incorrectly assessed the total personality of my patient.  He was a very quite, well mannered and well behaved, and did everything that was asked of him. He never got excited. In the course of three years of treatment, he never became angry or exercised criticism. Thus according to the prevailing concept, he was a fully integrated, adjusted character, with only one acute symptom, ‘Mono-symptomatic neurosis’.   I delivered a report on this case to the seminar on technique and was praised for the correct elucidation of the traumatic primal scene.  Theoretically, I had given complete explanation of the symptoms, the patient’s inability to have an erection.  Since the patient was industrious and orderly, adjusted to reality, as we used to say, it did not occur to any of us that it was precisely this emotional tranquility, this unshakable equanimity which formed the pathological characterological basis on which erective impotence could be maintained. The other analysts considered the analytic work that I had performed, complete and correct. For my part I left the meeting unsatisfied.  If everything was indeed just as it should be, why was there no change in the patient’s impotence. There must be something missing someplace, but none of us knew where. I terminated the analysis several months later- the patient had not been cured.  The imperturbability with which he bore it was as stoical as imperturbability with which he had accepted everything throughout the entire treatment. This patient impressed upon me the important character analytic concept of “affect block.” I had hit upon the far-reaching connection between the present day formation of the human character and emotional coldness and genital deadness.
In the example above, Reich describes a case in which the neurotic symptom did not improve even though its unconscious roots had been discovered and recognized by the patient.  He also states that for the first time he discovered the significance of pathologic character structure, in this case, the patient’s unemotional, cold and passive character was actually the basis of the illness. The neurotic symptom was manifesting itself upon this pathologic basis. The symptom remained unchanged because it was only a spike manifesting itself on the base of the character pathology.
Using treatment based on orgonomic theories and techniques, based on Reich’s own documented treatments, we give utmost importance to patient’s character, demeanor, movements, tone of their voice, and other manifestations of the character. We consider the voice inflection, how the patient says things, rather than “what he says.” Words can lie, but underlying attitude and character never lies.
The patient’s characterological appearance inevitably also reflects in his physical and somatic state. It appears in his voice and in his muscular flaccidity, or rigidity, and other physical characteristics. Dr. Reich, in The Function of the Orgasm, describes a case that elucidates the resolution of muscular and physical armor, which is counterpart of character armor.
In Copenhagen in 1933, I treated a man who offered considerable resistance to uncovering of his passive homosexual fantasies. This resistance was overtly expressed in the extremely stiff attitude of his throat and neck, (“stiff necked”).  A concentrated attack on his defense finally caused him to yield, though in an alarming way.  For three days, he was shaken by acute manifestation of vegetative shock.  The pallor of his face changed rapidly from white to yellow to blue. His skin was spotted and motley.  He experienced violent pains in the neck and back of the head.  His heartbeat was rapid and pounding. He had diarrhea, felt tired, and seemed to have lost control. I was uneasy. True, I had often seen similar symptoms, but never in such violent form. Something had happened here that, while somehow a legitimate part of the work, was not immediately intelligible. Affects had broken through somatically after the patient had relinquished his attitude of psychic defense. Apparently, the stiff neck, which emphasized austere masculinity, had bound vegetative energies which now broke loose in an uncontrolled and chaotic manner. A person with an ordered sexual economy is not capable of such a reaction. Only continuous inhibition and damming-up of biological energy can produce it. (The biological energy and sexual energy are of the same nature and merit.)  The musculature had served the function of inhibition. When the neck muscles relaxed, powerful impulses, as if unleashed from a taut coil, broke through.  The alternating pallor and flushing of the face could be nothing other than the flowing back and forth of body fluids, i.e., the contraction and dilation of the blood vessels. This fits in extremely well with my earlier described views on the functioning of biological energy[…] Sexual life energy can be bound by chronic muscular tension, anger and anxiety can also be blocked by muscular tension […]
Character armoring was now seen to be functionally identical with muscular hypertonia.  The concept of “Functional identity,” which I had to introduce, means nothing more than that muscular attitudes and character attitudes have the same function in the psychic mechanism: they can replace one another and can be influence by one another. Basically they cannot be separated. They are identical in their function […]
The loosening of the rigid muscular attitudes produced peculiar body sensations in the patients: involuntary trembling and twitching of the muscles, sensations of cold and hot, itching, the feeling of pins and needles, prickling sensations, the feeling of having the jitters, and somatic perceptions of anxiety, anger and pleasure.
In “The Orgasm Reflex and a Case History,” which has been considered previously with more detail in our journal, Reich writes that, “It is not that under certain circumstances, a memory brings about an affect, but that the concentration of vegetative excitation and its breakthrough, reproduces its remembrance.”
In other words, the release of affect that is contained by physical and somatic contractions reproduces the memories that once were connected and attached to it. Reich expanded that idea:
Freud continually stressed that in analysis, the analyst was dealing solely with derivatives of unconscious, that the unconscious was not really tangible.  This contention was correct, but not absolute, it pertained to the methods used at that time, by which the unconscious could be inferred only through derivatives, and could not be grasped in its actual form.  Today, we succeed in comprehending the unconscious not in its derivative, but in its reality, by directly attacking the binding of vegetative energy.
The interested reader who has followed this article up to now should grasp the depth of Reich’s short statement during his interview with Dr. Eissler when he acknowledged the importance of Freud’s discoveries, but used them as a guide to elucidate the actual, literally informed position of the unconcscious. “You know where it becomes real?” Reich asked. “In the twitching which we get out of the organism in our work.”

Posted in Biopathies & Psychiatric Orgone Therapy2 Comments

Kleptomania, a Case Discussion

Kleptomania, a Case Discussion

In 2007 a middle age woman came to see me.  She told me that she was feeling very tense, never could relax, she said she never felt happy.  She was feeling as if her head was exploding.  The bright point of her life was her young daughter.  She was well educated, nice and kind and compassionate towards her.  She was proud of her daughter and said that she was very supportive and appreciative of her.

She was an immigrant and came to the United States at age 18 years old.  Among other things she told me she said when she arrived to the United States, she was greeted by her brother and was living with her brother and brother’s wife.  She did not feel welcomed there by her sister in-law.  Her sister in-law was unhappy by her presence at their home and by different ways implied that she wished her to leave.  Under that circumstance she was introduced to a man by a relative.  She said that by the coaxing and encouragement of her relatives and pressure by different family members in spite of her reluctance and doubts she married him. Her marriage was significantly influenced by her desire to leave her brother’s home as soon as she could.  She described her marriage as an unhappy one and stated that her husband was unpredictable and was demanding, harsh, rude and insulting toward her and toward her parents and relatives.  She was feeling sad and angry with him and guilty because she could not make her parents happy as she wished to.  She felt helpless, alone and could not invite them to their home and make them proud of her.  She said she stayed in this marriage for the sake of her daughter.  She said that in front of her relatives and friends she often had to find excuses to justify her husband’s behavior.  Later on husband had a nervous breakdown and was unable to work.  This was another burden for her.  She now not only was trying to find an excuse to justify her husband’s behavior but also had to try to make up stories to pretend as if her husband was working to avoid relatives gossip.  She did not want to subject herself to the gossip of family and friends.  She herself, however, continued her school and progressed and found a job and eventually became an office manager and was earning a good salary.  She was supporting the home both financially and in other aspects of house affairs.

After giving this information to me, she then with some hesitation and trepidation said that she in order to relieve her tension and anxiety, leaves her home and goes shopping.  She said shopping gave her some relief.  Later in the session I found out that she had episodes of shoplifting as well and she felt deeply embarrassed and ashamed of this behavior.  She said that she picks up things that she often does not need.  Later on I found out that because of these habits she also had been arrested several times.  She was ordered by the Court to seek psychological treatment.  She also had attended certain classes and programs, recommended by the Court for this behavior.  She said that she was given fines and ordered to perform community service as punishment in lieu of detention and was ordered psychiatric treatment in the past for which she sought treatment and received suggestions and medications.  She had followed all these therapeutic suggestions but now she was again in trouble. I found out that now she again was under prosecution for shop lifting for the fourth time.  She was dreading the prospect of imprisonment but the possibility of imprisonment was high because of previous similar offenses.  She was a respectful woman, an office manager with a responsible job supervising many financial transactions and was respected in her community and in her church.  When she saw me in the first session, she already had an attorney.  In subsequent sessions I learned that she changed her attorney and eventually found an attorney and later on found another attorney and she was hoping that with consultation and retaining two attorneys she would have better chances to avoid imprisonment.  She was referred by the attorneys to see a psychologist who was familiar with court proceedings and necessary reports in such matters.  She paid a heavy price to her lawyers and psychologist for reports.

Her mental status examination during the initial visit was unremarkable for any thought disorder.  She was a middle aged woman properly and neatly dressed, age appropriately groomed and initially came across friendly and pleasant.  As the interview progressed she started to show some anxiety and had episodes of crying spells.  She wanted to know why in spite of her awareness of wrongness of stealing and legal consequences of it she was still unable to resist her impulse and had to face the embarrassment and dangers of such a behavior.

Before discussing the treatment and outcome of it in this particular patient, let us review some of the contemporary definitions, concepts and descriptions of this condition, which is called kleptomania.

Kleptomania in the diagnostic and statistical manual of psychiatry DSM IV is defined under the category of impulse control disorder.  Under the diagnostic features, the DSM IV defines kleptomania as follows:

“The essential feature of kleptomania is the recurrent failure to resist impulses to steal items even though the items are not needed for personal use or for the monitory value.  The individual experiences rising subjective sense of tension before the act and feels pleasure gratification or relief in committing the act.  The stealing is not committed to express anger or vengeance, is not done in response to a delusion or hallucination and is not better accounted for by conduct disorder, manic episode, or antisocial personality disorder.  The objects are stolen despite the fact that they are typically of little value to the individual who could have afforded to pay for them and often gives them away or discards them.  Occasionally the individual may hold the stolen objects or surreptitiously return them.  Although individuals with this disorder will generally avoid stealing when immediate arrest is probable, they usually do not preplan the act or fully take into account the chance of apprehension.  The stealing is done without assistance from or collaboration with others.  The individuals with kleptomania experience the impulse to steal as egodystonic and are aware that the act is wrong and senseless.  The person frequently fears apprehension and often feels depressed or guilty about the theft.  The disorder may cause legal, family, career and personal difficulties.  The kleptomania appears to be much more common in females.”

In the psychiatric text book 8th edition of Kaplan and Sandok, kleptomania is defined and described as; “The essential feature of kleptomania is a recurrent failure to resist impulses to steal objects not needed for personal use or for monitory value.  The objects taken are often given away and returned surreptitiously or kept hidden.  People with kleptomania usually have the money to pay for the objects they impulsively steal.  Like other impulse control disorders, kleptomania is characterized by mounting tension before the act, followed by gratification and easing of tension with or without guilt, remorse, or depression during the act.  The stealing is not planned and does not involve others.  Although the thefts do not occur when immediate arrest is probable, people with kleptomania do not always consider their chances of being apprehended, even though repeated arrest leads to pain and humiliation.  Those people may feel guilt and anxiety after the theft, but they do not feel anger or vengeance.  Furthermore, when the object stolen is the goal, the diagnosis is not kleptomania, in kleptomania the act of stealing is itself the goal.”

In psychiatry text books, the etiology of kleptomania, like many other psychiatric illnesses is described in a vague manner.  In the textbook of psychiatry it states:  “The symptoms of kleptomania tends to appear in times of significant stress, for example losses, separation and ending of important relationships.  Some psychoanalytic writers have stressed the expression of aggressive impulses in kleptomania, others have discerned libidinal aspects.  Those who focus on symbolism see meaning in the act itself, the objects stolen and the victim of the theft.  Kleptomania is often associated with other disturbances, such as mood disorder, obsessive compulsive disorder, and eating disorder.  It is frequently associated with bulimia nervosa, in some reports nearly 1/4 of patients with bulimia nervosa met the diagnostic criteria of kleptomania.”  Under the biological factors, the book states that brain disease and mental retardation have been associated with kleptomania, as they have with other disorders of impulse control.  Focal neurological aspects, cortical atrophy and enlarged lateral vesicles have been found in some patients.  Disturbances in monamine metabolism, particularly of seratonin have been postulated.

As one can see there is no meaningful description of the etiology of this illness in the textbooks of psychiatry and this is not only specific for kleptomania but many other psychiatric disorders.  This disorder is attributed to a wide variety of postulations.  However, this is not the case in Orgonomy and Reichian approach – We will discuss theories and treatment approach in Orgonomy later – for now I will return to describing the client who was suffering from kleptomania and inconsistencies in contemporary psychiatric theories.

The description of kleptomania in the DSM IV, as well as its description in psychiatric text books as the reader may recognize is vague.  In the DSM IV as well as in text books of psychiatry kleptomania is described as a recurrent failure to resist the impulse to steal items, even though the items are not needed for personal use or for monetary value.  The text book definition and description of it is also similar.  However, neither DSM IV nor psychiatric text books describe the origin of the impulse.  The text books and DSM IV descriptions do not say where and why this impulse appears in a person.  Science and scientific thinking dictates that every impulse must have an origin and must have energy attached to it.  Neither of these characteristics of an impulse has been dealt with in contemporary medicine, psychiatry or psychology.  The impulse is vaguely defined without description of its characteristics, qualities and its origin.  This shortcoming is not limited to the description of impulses in kleptomania, but it exists in all other psychiatric illnesses as well. Medicine, psychiatry and psychology have avoided dealing with energetic aspects of such impulses and source of its emergence.  From our point of view that is the reason why the pathologic process, the development of these illnesses are poorly understood and treatment of psychiatric illnesses has been hindered.  A recent article in the March 1st issue of New Yorker Magazine titled, “Head Case” by Lewis Menand pointed to disappointing results in psychiatric treatments, is an example of this hinderance.  A similar article titled, “The Assault on Freud” was also published in Time magazine November 29th, 1993 regarding disappointing results in psychoanalysis.  On the contrary, Orgonomy deals head on with the matters of impulse and energy.  Orgonomy considers these impulses, i.e.: impulse to steal as a secondary impulse or drive, the distortions of primary healthy impulses which is distorted because of armoring of the organism.  The theory which has been developed in Orgonomy is based on the experimental work of Dr. Reich and also based on clinical observations and treatment trials, which proves itself applicable in clinical work.  Our theoretical approach to these impulses is that the impulses originate from the core of the organism, which we regard to be autonomic ganglions in the center of the organism and propagates toward the periphery in a pulsetory manner.  As a consequence of persistent outer and environmental inhibitions against expression of natural primary impulses, sexual and aggressive impulses, mechanism of armoring sets in, which permanently prevents expressions of anger, rage, and sexual emotions.  The original healthy impulses then split and get distorted and manifest themselves with different neurotic and anti-social manifestations.  Schematically in Orgonomy this process is explained as the following schema (courtesy of the Wilhelm Reich Infant Trust):

Our treatment approach is based on these schemas.  Ideally the clinician who is conducting the treatment, will need to acquire the knowledge experience and skills of psychoanalytically oriented psychotherapy as well as psychiatric orgone therapy. In restoring the orderly flow of the energy in the organism, to loosening up and removing the armoring and establishing the organismic capacity to express primary and undistorted drives, the clinician finds himself working as an electrical engineer restoring the proper energy flow in the human organism.  The ideal psychiatric orgone therapy treatment is considered complete when the armoring is resolved and orderly flow of energy is restored in the body.  In such a case patients become capable of expressing primary unadulterated and undistorted impulses as he or she wishes to.  Parallel with it, the patient develops sexual potency, potency to love and have genital embrace, be affectionate and in the final stages of treatment develop full orgastic potency.  The patients who achieve such a level of health as Dr. Reich has described, attains qualities of Jesus Christ, incapable of lying and incapable of harming.

However, achieving such a level of health is not always possible.  In fact psychiatrists and clinicians conducting psychiatric orgone therapy rarely are able to resolve the armor of a patient which is heavily ingrained throughout their lives to achieve full orgastic potency.  We often have to content ourselves with resolution of armor to a certain extent.  By some resolution of armoring, the patient senses relief and some normality is brought to their lives.

The treatment of this patient started and progressed based on principles of psychiatric orgone therapy, with recognition that stealing impulse was a distortion of patient’s ability to express her primary impulse of anger, rage and sexual drives.  The treatment of this patient lasted one year with an average of one session every week.  In this vignette I do not intend to explain step by step the treatment process, which has been described in this journal by Dr. Reich with annotation and in other Orgonomy literature by Dr. Reich as well as by Dr. Herskowitz.  I only will mention some cardinal points and developments that happened during this treatment process.

I began the treatment of this patient from the most superficial and conspicuous feature of the patient, her facial expression as is customary in psychiatric orgone therapy.  Her excessive politeness and apologetic and pleasant appearance was the surface manifestation.  This was a feature that had been with her since childhood, she all her life was trying to please others, trying to avoid any confrontation, but at the same time this apologetic and agreeable mask was the mask that was hiding her anger, rage and sadness.  As treatment progressed the patient recognized this attitude, events in her life that caused this attitude were expressed by the patient.  She recognized her fear of expressing anger, which started from the relation with her own parents and later on with her brother’s wife and then with her husband.  She gained insight on her inability to express anger.  By the techniques specific to psychiatric orgone therapy her excessive pleasantness, politeness and appeasing attitude was uncovered from her facial expression.  She became able to express her anger and frustration toward different people including her husband that she all along was fearful of.  Attaining this ability and insight surprisingly translated itself to actions in her life and at her home.  She became capable of speaking up against her husband, she even threatened her husband to throw him out and divorce him and to her own surprise, the husband complied and suddenly changed his attitude.  She gained power that she all along longed for.  She also dared to talk about the oppressive environment that she grew up in since her teenage years.  By her ability to express her anger and speaking up against her husband a significant change happened in her life.  She became more relaxed and more expressive.  During this time with the help of her attorneys she completed her legal obligations properly and became free of legal threats.  She also lost the impulse to steal or commit other transgressions, such as frequent traffic violations that she used to do.  Several months later she was invited by her relatives to return to her country of origin.  She accepted the invitation and went to visit her relative.  For a while she kept contact with me and as of the last I knew about her, her condition was stable and she did not have impulses to steal.  She, while in treatment, told me with horror that she was assigned to attend programs and saw many people who were attendees of those programs for numerous times without improvement, becoming revolving doors in institutions.

This is one example of thousands, who suffer from such illnesses but because of a poor understanding of the illness by present day psychiatry and psychology, they remain poorly treated, constantly struggling with their impulse, which continues to seek reappearance and ruins their potential to live, work and love.  Dr. Herskowitz, in a speech he gave in commemoration of the 50th year of Dr. Wilhelm Reich’s death in Rangely Maine said: “I lived long enough to know that life is too short to be wasted with sickness.”

As described earlier we consider the psychiatric orgone therapy complete when armoring is widely resolved and the patient develops orgastic potency.  In the case, which was described, although some resolution of armoring took place, but because of the patient’s departure to her country of origin and interruption of the treatment process , armoring was not adequately resolved.  In such cases there is always the danger of reemergence of unhealthy and pathologic impulses as a consequence of redevelopment of the armor.  Therefore, we cannot in confidence claim a successful completion of treatment in this case.  Nevertheless, considering the educational value and theoretical discussion of it, its presentation was judged to be worthy.

Posted in Case Studies9 Comments

Annotation on Dr. Reich’s case: The Orgasm Reflex

Annotation on Dr. Reich’s case: The Orgasm Reflex

One of the essential books on Orgonomy and Psychiatric Orgone Therapy, is The Function of the Orgasm written by Dr. Reich in 1940 shortly after arriving in the United States.  It is a good, basic book for students of Orgonomy containing condensed valuable information.   In this book, Dr. Reich describes the gradual evolution of his theories starting from psychoanalysis when he was first a student of Freud, and his growth and evolution into character analysis.  He describes the development of the theory of character armoring, muscular armoring, and the development of vegetotherapy and psychiatric orgone therapy. In short, the book reveals the historical evolution of Dr. Reich’s theories and techniques.

In a section of this book, Dr. Reich elucidates the theory and technique of psychiatric orgone therapy, describing a patient that he treated with this approach. This case encompasses many clinical aspects that we may see during psychiatric orgone therapy in different patients. However, considering the fact that this one case encompasses many aspects of psychiatric orgone therapy, describing and analyzing it will be informative and interesting for the students of psychiatry and psychology who are not well acquainted with the theory and technique of psychiatric orgone therapy.  Excerpts from Dr. Reich’s book, The Function of the Orgasm, are printed below in block quotes followed by an annotation.

The Orgasm Reflex – A case History

To describe the direct release of sexual (vegetative) energies from the pathological muscular attitudes, I am choosing a patient in whom orgastic potency was established rapidly. I want to make it quite clear at the outset that this case does not claim to represent the great difficulties which are usually encountered in overcoming disturbances of the orgasm.


The clinical theories of Dr. Reich are based on 2 major theories.  Orgasm theory and the theory of armoring.  Orgasm theory is the continuation of the libido theory of Freud. Freud, in order to explain certain observations and phenomena in his patients, in children including new born children, had to assume the presence of a psychosexual energy that he named “libido energy”. Without such a hypothesis, these observed phenomenons could not be explained.  However, psychoanalysis, psychiatry and medicine in general have avoided dealing with these phenomena and moved away from the theory of libido.

Reich however did not flinch from facing such questions and phenomena and continued elaborating on libido theory realizing that the presence of a psychosexual energy is indispensable. He called it “orgone energy”.  Orgone energy, it’s expansion, contraction, and pulsation are mediated by the vegetative nervous system in the human organism. Therefore he equates it with vegetative energy. The second theory, the theory of armoring, explains the chronic physical and muscular contractions that happen in the process of containing the flow of this energy.  The vegetative energy becomes anchored and contained  in these contractions and encrustations.  Resolution of the muscular armoring brings a release of this vegetative energy.

A  twenty-seven-year old technician came to me because of his addiction to alcohol. He suffered from the fact that he had to give in almost everyday to the urge to become inebriated; he feared the complete ruin of his health and capacity for work.  When he was with his friends, he could do nothing against the temptation to get drunk. His marriage was a shambles. His wife was an extremely complicated hysteric who did not make life easy for him. It was immediately evident that the wretchedness of this marriage constituted an important motive for his escape into alcoholism. He further complained that he “did not feel life.” In spite of his unhappy marriage, he could not bring himself to form a liaison with another woman. he did not derive any pleasure from his work;  he performed it mechanically, listlessly, without any interest. He said that if it went on like this, he would soon “breakdown”. This condition had already lasted a number of years , and had become appreciably worse in the last months.

Conspicuous among his pathological traits was the fact that he was incapable of any aggression. He always felt compelled to be “nice and polite,” to agree with everything people said, even when they expressed opposite, mutually contradictory opinions. He suffered under the superficiality that ruled his life. he could not really and seriously devote himself to any cause, idea or work. He spent his leisure hours in cafes and restaurants, engaging in empty, meaningless chatter and exchanging stale witticisms. True, he sensed there was something pathological in his attitude; at the same time, he was not fully aware of the pathological meaning of these traits. He was suffering from the widespread illness, a misconstrued contact-less sociality, which becomes rigid compulsion and inwardly devastates many people.

The general impression given by this patient was marked by the uncertainty of his movements; the forced jauntiness of his walk made him appear somewhat awkward. The attitude of his body was not rigid; rather it expressed submission, as if he were continually on his guard. His facial expression was empty and without any particular distinguishing features. There was a slight shininess to the skin of his face; it was drawn tight and had the effect of a mask. His forehead appeared “flat.” His mouth gave the impression of being small and tight. It hardly moved in the act of speaking; his lips were narrow as if pressed together. His eyes were devoid of expression.


In psychiatric orgone therapy, we give the utmost importance to the patient’s demeanor, appearance, the way they walk, talk, and behave in general. Facial expressions, eye movement, etc.  These are all expressive of people’s attitudes that are reflective of their lifetime of experiences. In psychiatric orgone therapy, the most importance is given to the patients appearance and attitude in general, his character, physical and muscular attitude. This is in contrast with the psychoanalytic approach  or other psychological approaches which rely mostly on words and on “what patients express” through talking. As Reich says “words may lie, the attitude and character never lies.”  The reason Reich is describing the patient’s attitude and appearance in such detail is based on the above mentioned principles.

In spite of this obviously severe impairment of vegetative motility, one sensed a very lively, intelligent nature beneath the surface. It was doubtlessly this factor that enabled him to tackle his difficulties with great energy in therapy.

The ensuing treatment lasted six and one half months, with one session each day. I want to try to describe its most important stages.

At the very first session, I was faced with the question of whether I should first consider his psychic reserve or his very striking facial expression. I decided in favor of the latter, leaving it to the further course of the treatment as to when and in what form I would deal with his psychic reserve.


In psychiatric orgone therapy, we face the problem of  the resolution of armor. Armoring in general, consists of the sum total of attitudes, demeanor, as well as muscular attitudes, contractions, muscular tensions, expression of the eyes, etc. Armor consists of two counterparts.  Character armor which is functioning in the realm of psychology, and muscular and physical armor that is it’s counterpart in the physical realm.  The character armor is a reflection and an expression of physical armoring, therefore the resolution of the armor can be approached either by attacking the character and characterological specificities or directly approaching and resolving the muscular armor, of which the character armor is a  consequence, and in which it is anchored. Here Dr. Reich states that initially he was contemplating whether first to approach his character armor by exploring the patient’s psychic reserve, or his muscular and physical armor by approaching his facial attitude, the contour of his face, skin, the form of his mouth, etc. Reich decided in favor of the latter. Either approach in many cases leads to the resolution of armor.

Following the consistent description of the rigid attitudes of his mouth, a clonic twitching of his lips set in, weak at first but growing gradually stronger.. He was surprised by the involuntary nature of this twitching and defended himself against it. I told him to give in to every impulse.  Thereupon, his lips began to protrude and retract rhythmically and to hold the protruded position for several seconds as if in a tonic spasm. In the course of these movements, his face took on the unmistakable expression of an infant. The patient was startled, grew fearful, and asked me what this might lead to. I allayed his fears and asked him to continue to give in to every impulse and to tell me whenever he sensed the inhibition of an impulse.


In the process of psychiatric orgone therapy, we face muscular twitching , certain sensations in the muscle or the body that are often unfamiliar to the patient, usually not painful or discomforting, often pleasurable. However such unfamiliar movements and changes alarm and concern the patient.   At times, patients themselves are able to recognize its meaning.

During the following sessions, the various manifestations in his face became more and more distinct, and they gradually aroused the patient’s interest. This must have some special meaning, he said. What was very peculiar, however , was that he appeared not to be emotionally affected by these somatic manifestations; indeed, he was able to speak to me calmly following such a clonic or tonic excitation of his face. During one of the subsequent sessions, the twitching of his mouth increased to a suppressed crying. he also uttered sounds like the outbreak of a long-suppressed, painful sob. My insistence that he give in to every muscular impulse bore fruit.  The described activity of his face grew more complicated.


As described earlier, muscular contractions contain the anchored, suppressed feelings.  By that we mean the energy that is attached to the feeling which energizes the feelings. By gradual resolution of muscular armoring, the energy which is initially suppressed by the muscular  contraction is released, and the energy surfaces with it’s original form of feeling, concomitant with movements and fasciculation of the muscle which is an indication of the resolution of  the armor.  The affect is thus released, in this case by crying.

While his mouth became twisted into spasmodic crying,  this expression did not resolve itself into tears. To our surprise,it passed over into a distorted expression of anger. Strangely enough, however, the patient did not feel the slightest anger, though he knew quite well that it was anger.

When these muscular actions grew especially strong, making his face blue, he became apprehensive and restless. He repeatedly wanted to know where  this was leading and what was happening to him in these actions. I began now to draw his attention to the fact that his fear of an unexpected happening was entirely in keeping with his general character attitude, namely that he was dominated by a vague fear of the unforeseeable, of something that might suddenly overwhelm him.

Since I did not want to abandon the constant pursuit of somatic attitude once I had attacked it, I had first to ascertain how his muscular facial actions were related to the general defense attitude of his character. If the muscular rigidity had not been so distinct, I would have begun by working on the character defense as manifested in his reserve.

However I was now forced to conclude that there was obviously a split in the psychic conflict which dominated him. The defense function was performed at this time by his general psychic reserve, while that which he warded off, i.e., the vegetative excitation, was revealed in the muscle actions of his face. Fortunately, it occurred to me that not only the warded off affect but also the defense was represented  in his muscular attitude. The smallness and cramped attitude of his mouth could of course, be nothing other than the expression of it’s opposite, the protruding, twitching , crying mouth. I now proceeded to cary out the experiment of consistently destroying the defense forces, not from the psychic but from the muscular side.


Dr. Reich explains here that the muscular contractions and physical attitude represent hidden affects such as sadness, the urge to cry, etc. But it also represents it’s defense. It is the sum total of the forces that are warding off the impulse and the impulse that is trying to get liberated from the defensive attitudes.  For example, the smallness and cramped attitude of his mouth is an indication of him trying to suppress his feelings and is also indicative of the feelings that are trying to be expressed.  Reich also said that he proceeded to carry out the experiment, consistently destroying the defensive forces. Resolution of the defensive forces is essential in liberating the impulses that are embedded in the conflict.  Analyzing and detecting, or comprehending the impulse only will give an intellectual understanding of it while defensive forces are still operating.

Thus, I worked on all the muscular attitudes of his face which, I assumed, represented spasms, i.e., hypertonic defenses against the corresponding muscular actions. Several weeks passed before the actions of the musculature of his face and neck intensified into the following picture: the contracted attitude of his mouth first gave way to a clonic twitching and then became transformed into a protrusion of the lips. this protrusion resolved itself into crying, which, however , did not break out completely. In turn, the crying was replaced by an exceedingly strong reaction of anger on his face. His mouth became distorted, the musculature of his jaws became as stiff as a board, and he grit his teeth. In addition, there were other expressive movements. The patient sat half up on the couch, shook with anger, raised his fist as if he were going to strike a blow, without, however, following though. Then, out of breath, he sank back exhausted. The whole action dissolved into a whimpering kind of weeping. These actions expressed “impotent rage,” as is often experienced by children.


Here again Dr. Reich explains the significance of the patient’s attitudes and movements, and therapeutic acts gleaned from observation. The fact that the patient raised his hand but did not strike a blow is expressive of his inhibition, similarly he was not able to express the rage and instead his actions dissolved into whimpering weeping. These are a reflection of the defensive structure that is still operating in the patient.

When this attack had subsided, he spoke about it tranquilly, as if nothing had happened. It was clear that somewhere there was a break in the connection between his vegetative muscular excitation and the psychic perception of this excitation. Naturally , I continually discussed with him not only the sequences and the content of his muscular actions, but also the strange phenomenon of his psychic detachment from these actions. What was particularly striking to both of us was the fact that , in spite of his lack of emotional involvement, he had an immediate comprehension of the function and meaning of these episodes. I did not even have to interpret them to him. On the contrary, he surprised me again and again with elucidations that were immediately evident to him. I found this most gratifying. I recalled the many years of painstakingly work of interpreting symptoms, in the process of which the analyst inferred an anger or anxiety on the basis of associations or symptoms, then through months and years, tried, at least to some extent, to make the patient aware of it. How seldom and how ineffectively one succeeded in those days in arriving at anything more than an intellectual understanding.


Here Dr. Reich compares vegetotherapy and character analytic approach to a psychoanalytic approach, which he was once a student of.  Psychoanalysis relies on free association and words.  Reich indicates here that in psychoanalysis, the analyst had to interpret or assist the patient to comprehend the meaning of the symptoms, however since defensive structure persisted, the accompanying affect remained anchored and bound  in the muscular contractions, and the symptoms persisted and the result often was only an intellectual understanding of it.

The patients often comprehend the meaning of their muscular attitude when it is pointed out to them and it’s resolution starts. Once a patient of mine who had squinted eyes and was unable to open his eyes wide enough, when confronted with this feature, stated, “doctor, there must be a shit load of shame in me, I’m unable to open my eyes.”

Thus, I had good reason to be pleased that the patient had an immediate grasp of the meaning of his action, without any explanation on my part.

He knew that he was expressing an overwhelming anger which he had kept locked up in himself for decades. The emotional detachment subsided when an attack produced the memory of his older brother, who had very much dominated and mistreated him as a child.

He understood now without any promptings from me that he had at that time suppressed his anger against his brother, who had been his mother’s darling. To ward off this anger, he had adopted toward  his brother an agreeable and loving attitude , which was at violent odds with his true feelings. He had not wanted to incur his mother’s displeasure. The anger which had not been expressed at that time now rose up in his actions, as if unaffected by the intervening decades.

At this point we have to pause a moment and form a clear picture of the psychic situation with which we are dealing. Analysts who use the old technique of symptom interpretations know that they work with remembrances and have to leave it more or less to chance whether.

The corresponding remembrances of earlier experiences also emerge, and  the emerging experiences are actually those in which the strongest and, in terms of the patient’s future, the most important excitations were developed.

In vegetotherapy, on the other hand, the vegetative behavior necessarily produces the memory which was decisive for the development of the neurotic character trait.

It is known that the approach which proceeds solely on the basis of remembrances accomplishes this task to a very limited degree. in assessing the changes in a patient after years of this kind of treatment, one realizes that they are not worth the expenditure of so much time and energy. The patients in whom one succeeds in getting directly at the vegetative sexual energy bound in the musculature produce the affect before they know what affect they are dealing with. Furthermore, the memory of the experience which originally produced the affect automatically emerges without any effort.


The affect gets released before the memory of the corresponding event to which the affect is related to.  However the memory often emerges automatically, concomitant or soon after the release of the affect. Reich once said, that in fact today, our goal is the same as it was in psychoanalytic treatment,  to resurrect the earliest childhood memories, however, the approach is different.

An example of this would be our patients remembrance of the situation with his brother, who was preferred by the mother.   This fact cannot be overemphasized; it is as important as it is typical. It is not that under certain circumstances a memory brings about an affect, but that the concentration of a vegetative excitation and its breakthrough reproduces the remembrance.  Freud continually stressed that, in analysis, the analyst was dealing solely with “derivative of the unconscious,” that the unconscious was like “a thing in itself,” i.e., was not really tangible. This contention was correct, but not absolute. It pertained to the methods used at that time, by which the unconscious could be inferred only through its derivatives, and could not be grasped in its actual form. Today, we succeed in comprehending the unconscious not in its derivatives, but in its reality, by directly attacking the binding of vegetative energy.


Here Dr. Reich equates the vegetative energy as a tangible form of the unconscious that really exists in the body.

For instance, our patient did not deduce his hatred of his brother from vague associations having but little affect.  Rather he acted as he would have acted in the original situation, as he would have acted if his hatred of his brother had not been off set by the fear of losing his mother’s love. Moreover, we know that there are childhood experiences which have never become conscious. It became evident from the subsequent course of the analysis that, while the patient had always been intellectually conscious of his envy of his brother, he had no awareness of the extent and intensity of the rage he had actually mobilized in himself.


This again stresses the fact that remembering childhood or traumatic memories without experiencing the affect that is attached and bound to it, has very little therapeutic affect, perhaps only an intellectual understanding of it.

As we know, the effects of psychic experience are determined not by its content, but by the amount of vegetative energy which is mobilized by this experience. In the compulsion neurosis, for instance, even incest desires are sometimes conscious. We contend, however that they are “unconscious” because they have lost their emotional charge. And we have all had the experience that, using the conventional analytic method, it is not possible to make the compulsion neurotic conscious of the incest desire, except in the intellectual form. Frankly speaking, this means that the repression has not been eliminated. To illustrate, let us return to the further course of this treatment.

The more intense the muscular actions of the face became, the more the somatic excitation, still wholly cut off from psychic recognition, spread toward the chest and abdomen. Several weeks later, the patient reported that in the course of twitching in his chest, but especially when these twitching subsided, he sensed “currents” moving toward his lower abdomen. During this time, he left his wife with the intention of forming a liaison with another woman. However , it was revealed in the course of the following weeks that the intended liaison had not materialized. Initially , the patient was indifferent to this. Only after I had drawn his attention to it did he try , after venturing a number of seemingly plausible explanations, to take an interest in the matter. But it was quite evident that an inner prohibition prevented him from dealing with this problem in a really affective manner.  Since it is not customary in character-analytic work to deal with a subject, no matter how topical, unless the patient enters upon it of his own accord in a fully affective way, I postponed a discussion of this problem and continued to pursue the approach dictated by the spreading of his muscular actions.

The tonic spasm of the musculature spread to his chest and upper abdomen. In these attacks, it was as if an inner force lifted him up from the couch against his will and held him up. The muscles of his abdominal wall and chest were board like. It took some time before I understood why a further spreading downward of the excitation failed to occur. I had expected that the vegetative excitation would now spread from the abdomen to the pelvis, but this did not happen. Instead, there were strong, clonic twitchings of the musculature of the  legs, and a marked intensification of the patellar reflex. To my complete amazement, the patient told me that he experienced the twitching of his leg musculature in a highly agreeable way. Quite involuntarily, I was reminded of epileptic clonism, and my view was confirmed that in both the epileptic and epileptiform muscular contractions, we are dealing with the release of anxiety which can only be experienced in an agreeable, i.e., pleasurable manner. There were times in the treatment of this patient when I was uncertain whether or not I was confronted with a true epileptic. Superficially, at least, the patients’ attacks , which commenced tonically and occasionally subsided clonically , showed very little difference from epileptic seizure. I want to stress that , at this stage of the treatment, which had been in progress for roughly three months, the musculature of his head, chest and upper abdomen, as well as the musculature of his legs, particularly of his knees and upper thighs, had become mobile. His lower abdomen and pelvis were and remained immobile. The gap between his muscular actions and the patients’ perception of them also remained unchanged,. The patient knew about the attack. He was able to comprehend its significance, but he did not experience it emotionally. The main question continued to be: what caused this gap?  It became increasingly clear that the patient was resisting the comprehension of the whole in all of its parts. We both knew that he was very cautious. It was not only in his psychic attitude that this caution was expressed, nor in the fact that up to a certain point he was cooperative and adapted himself to the requirements of the work, and that when the work transgressed certain limits he somehow became unfriendly and cold.  This “caution” was also contained in his muscular activity; it was so to speak, doubly preserved.


Here again Dr. Reich describes the emotional condition and its anchoring in the somatic state as physical and muscular contractions.

He himself described and comprehended his situation as follows: he is a boy being pursued by a man who wants to beat him. While making this escape, he dodges to the side a number of times, glances apprehensively over his shoulder, and pulls in his buttocks, as if to put them out of  reach of the pursuer. In conventional analytic language, it would have been said that behind his fear of the blows, there is a fear of a homosexual attack. As a matter of fact, the patient had spent roughly a year in symptom interpretation analysis, during which his passive homosexuality had been continually interpreted. “In itself,” this interpretation had been correct.  From the point of view of our present knowledge, however, it is clear that it had been meaningless. There were too many factors in the patient which opposed a really affective comprehension of his homosexual attitude.  For example, his characterological caution and the muscular binding of his energy, which were still far from resolved.

Now I began to deal with his caution, not from the psychic side, as I am usually in the habit of doing in character analysis, but from the somatic side.

Annotation: Here Dr. Reich again mentions, the approach of psychiatric orgone therapy in two different ways.  The character analytic way, and the muscular/physical (vegetotherapy) way, attacking the muscular and physical contractions and spasms.

For instance, I pointed out again and again that, while it was true he revealed his anger in his muscular actions, he never followed through, never really struck with his clenched and raised first.


Earlier in the case Dr. Reich brought to the attention of the reader that while he was angry he raised his fist, but did not strike it down.

Several times, at the very moment the fist was about to strike the couch, his anger disappeared. From now on, I concentrated my effort on the blocking of the completion of the muscular action, always guided by the understanding that it was precisely his caution which he was expressing in this inhibition.  After consistently working on the defense against the muscular action for a number of sessions, the following episode from his fifth year of life suddenly occurred to him: as a small boy he had lived near a cliff, which dropped off precipitously to the sea.  One day, he was intensely involved in building a fire at the edge of the rocks; he was so immersed in his play that he was in danger of falling into the sea. His mother appeared in the doorway of their home, saw what he was doing, was frightened, and sought to draw him away from the cliff. She knew him to be a hyperactive child, and , precisely for this reason she was very much afraid. She lured him to her in a sweet voice, promising to give him candy. When he ran up to her, instead of keeping her promise, she gave him a terrible beating. This experience had made a deep impression on him, but now he understood it in connection with his defensive attitude toward women and the caution he demonstrated toward the treatment.

Yet this did not put and end to the matter. The caution continued. One day, in the interval between two attacks, he humorously told me that he was an enthusiastic trout fisherman. He gave me a very impressive description of the joys of trout fishing; he enacted the corresponding movements, describing how one catches sight of the trout and how one throws out the line. In the act of telling and demonstrating this to me, he had an enormously greedy, almost sadistic expression on his face. It struck me that , while he gave an exact description of the entire procedure, he omitted one detail, namely the moment at which the trout bites into the hook. I understood the connection, but saw that he was unaware of the omission. In conventional psychoanalysis, the analyst would have told him the connection or would have encouraged him to comprehend it himself. For me, however it was precisely this point that was of utmost importance, namely to find out why he had not described the actual catch, why he had omitted this detail. Roughly four weeks elapsed before the following took place: the twitching of various parts of his body lost more and more their spasmodic tonic character. The clonus also diminished and strange twitchings appeared in the abdomen. They were not new to me, for I had seen them in many other patients, but not in the connection in which they now revealed themselves. The upper part of his body jerked for ward , the middle of his abdomen remained still and the lower part of his body jerked toward the upper part. the entire response was an organic unitary movement.  There were sessions in which this movement was repeated continuously.Alternating with this jerking of his entire body, there were sensations of current in some part s of his body, particularly in his legs and abdomen, which he experienced as pleasurable. The attitude of his mouth and face changed a little. In one such attack, his face had the unmistakable expression of a fish. Without any prompting on my part, before I had drown his attention to it, the patient said “I feel like a primordial animal,” and shortly afterward, “I feel like a fish.” what did all this mean: Without having any inkling of it, without having worked out a connection through associations, the patient represented in the movements of his body and obviously hooked, flapping fish. Expressed in the language of the analytic interpretation, it would be said “he acted out” the caught trout. Everything about him expressed this: his mouth was spasmodically protruded, rigid, and distorted. His body jerked from the shoulders to the legs. His back was as stiff as a board. Not entirely intelligible in this phase was the fact that, with each jerk of his body, the patient for a time thrust his arms forward as if embracing someone. I no longer remember whether I drew the patient’s attention to the relationship between these actions and the story of the trout, or whether he grasped it of his own accord. But he very definitely felt the connection immediately and had not the slightest doubt that he represented the trout as well as the trout fisherman.

Naturally, the whole incident was directly related to his disappointments in his mother. From a certain point in childhood, she had neglected him, treated him badly, and often beaten him.  Quite often, he had expected something very nice or good from her, and had received the exact opposite. His caution became understandable now.  He did not trust anyone; he did not want to be caught. This was the deepest reason for his superficiality, his fear of surrendering, of assuming real responsibility, etc.  In the process of working through this connection, his personality underwent a conspicuous change. His superficiality disappeared; he became serious. The seriousness appeared very suddenly during one of the sessions.  The patient said  literally, “I don’t understand; everything has become so deadly serious all of a sudden.” Thus, he did not merely recall the serious emotional attitude he had had at a certain period of his childhood; he actually changed from being superficial to being serious. It became clear that his pathological relationship to women, i.e., his fear of forming a liaison with a woman, of giving himself to a woman, was connected with this anxiety which was rooted in his character and had become part of his structure. He was a man whom women found very attractive; strangely enough, he had made little use of this fact.


The behavior of the person becomes dictated by that distorted characterological structure which inhibits the expression of primary feelings, in this case distortion exhibited itself by superficiality without any depth in making relations. From now on, the somatic sensations of current increased visibly and rapidly.  First in the his abdomen, then also in his legs and upper body.

The defensive structure, the physical and characterological armoring, is falling apart and giving in to the understanding of his character.  Correspondingly, his muscular blocks and contractions are loosening up and vegetative currents are spreading from the head toward the abdomen and towards the pelvis, as expected in the process of psychiatric orgone therapy.

He described these sensations not only as currents, but also as voluptuous and “sweet.” This was especially the case when strong, lively, and rapid abdominal twitchings occurred.

Let us pause a moment to review the patient’s situation at this stage of the treatment.

The abdominal twitchings were nothing other than the expression of the fact that the tonic tension of the musculature of his abdominal wall was subsiding.  The entire reaction was like a reflex. When his abdomen was tapped lightly, the twitching was immediately evoked. After several twitchings, the abdominal wall was soft and could be pressed in deeply. Previously,  it had been extremely taut and displayed a phenomenon which, conditionally, I should like to call abdominal defense. This phenomenon exists in all neurotics, without exception, whenever they are told to breathe out fully and a slight pressure is applied to the abdominal wall approximately three centimeters below the end of the sternum. When this is done, there is either a strong resistance inside the abdomen or pain is experienced similar to that felt when pressure is exerted on the testicles. A glance at that the position of the abdominal contents and of the solar plexus shows us that, together with other phenomena still to be discussed, abdominal  tension has the function of enclosing the plexus. The abdominal wall exerts pressure on it. The same function is fulfilled by the tense and downward-extended diaphragm. This too is a typical symptom. A tonic contraction of the diaphragm is  discernible, without exception, in all individuals who are neurotic; it is expressed in a tendency to breathe out only in a shallow and interrupted manner. The diaphragm is raised in exhalation; the pressure on the organs below it, including the solar plexus, is diminished. Apparently, a freeing of the autonomic plexus from the pressure exerted upon it is dependent upon the relaxation of the diaphragm and the musculature of the abdominal wall. It is manifested in the appearance of a sensation like that experienced in the upper abdomen in swinging, in the decent of an elevator , and in falling. On the basis of my experiences, I have to assume that we are dealing here with an extremely important phenomenon. Almost all patients remember that as  children they held down and suppressed these sensations in the upper abdomen which are felt quite intensely in anger or anxiety. They learned to do this spontaneously by holding their breath and pulling in their abdomen.


In the treatment of patients with psychiatric orgone therapy, Reich has divided body structures to seven segments.  The segments are divided as ocular, oral, cervical, thoracic, diaphragmatic, abdominal and then pelvic.  The treatment usually starts with the point furthest from the genitals, from ocular, oral and cervical segments.  The diaphragmatic segment occupies the body region between the thoracic cavity superiorly and the abdominal cavity inferiorly.  The abdominal segment extends from below the diaphragm to the brim of the pelvis. (See “Emotional Armoring” by Dr. Morton Herskowitz)

The bio-psycho-sexual energy, orgone energy, that energizes the instincts which feelings draw their energy from, is vegetative in.  The vegetative nervous system, in the human organism, has a major role in producing and withdrawing the energy and in expanding and contracting the organism as a whole.  The lower part of the abdominal cavity is rich in vegetative (autonomic) ganglia, which are considered to be the center, the most condensed area with autonomic ganglia where the energy is emitted with pulsatory impulses.  Contraction of the abdominal walls by contracting the musculature and inhaling and holding the breath causes suppression of the solar plexus and resolution of the production of energy therefore abating the anxiety.

Knowledge of how pressure on the solar plexus develops is indispensable for an understanding of the further course of our patient’s treatment. What followed was definitely in agreement with the above assumption; indeed, it confirmed it. The more carefully I had the patient observe and describe the behavior of the musculature in the region of his upper abdomen, the more intense the jerking became, the more intense also became the sensations of currents following their cessation, and the more the wavelike, serpentine movements of the body spread. But his pelvis continued to remain, stiff, until I began to make the patient aware of the rigidity of his pelvic musculature. During the movements , the entire lower part of his body jerked forward. The pelvis, however, did not move by itself; it moved together with his hips and thighs. I asked the patient to pay attention to the inhibition which obstructed the separate movement of his pelvis. It took him about two weeks to thoroughly perceive the muscular block in his pelvis and to overcome the inhibition. He gradually learned to include his pelvis in the twitchings. Now , a previously unfamiliar sensation of current also appeared in his genitals. He had erections during the session and a strong urge to ejaculate. Thus, the jerkings of his pelvis, his upper body, and abdomen were the same as those which are produced and experienced in orgastic clonus.


In psychiatric orgone therapy, resolution of armor from the upper most segment of the body starts and gradually proceeds to the lower segments. Resolution of armor corresponds with the release of feelings and memories that are anchored in the contraction of those musculatures.  The resolution of armor in the pelvic area is the last and deepest segment that the therapist deals with;  Resolution of it, frees the orgasm reflex. The orgasm reflex constitutes the involuntary movement of the pelvis back and forth in the state of heightened sexual excitation which is beyond one’s voluntary control. Resolution of armor in this segment, becomes possible when psychiatric orgone therapy progresses to the stage that all other segments are free of armoring and pelvic armor is resolved, the treatment is considered to be successfully completed. Dr. Reich described the character emerging after such resolution of the armor as “incapable of lying, and having Jesus Christ qualities”.

From this point on, the work was concentrated on the patient’s behavior in the sexual act, which he was asked to describe precisely. This description exposed what is found not only in all neurotics, but in the overwhelming majority of all men and women: movement in the sexual act is artificially forced, without the person being aware of it. Usually, it is not the pelvis itself that moves, but the abdomen, pelvis, and upper thigh as one unit. This does not correspond to the natural vegetative movement of the pelvis in the sexual act; it is , on the contrary, an inhibition of the orgastic reflex. It is voluntary movement, as opposed to involuntary reflex action. Its function is to reduce or to wholly cut off the orgastic sensation of current in the genitals.

Proceeding on the basis of these experiences, I was now able to make rapid headway with the patient. It became evident that his pelvic floor was held in a state of chronic tension. It was this case that finally enabled me to understand an error which I had committed formerly. In my previous efforts to eliminate the orgastic inhibitions, I had , of course, treated the contraction of the pelvic floor  and had attempted to loosen it. However, I had been continually haunted by the impression that this was not enough, that the result was somehow incomplete. Now I understood that the pressure exerted upon the solar plexus from above by the diaphragm from the front by the abdominal wall and from below, by the contracted pelvic floor considerably reduced the abdominal cavity. I shall speak later about the significance of these findings with respect to the development and preservation of neurotic situations.

After a few more weeks, I succeeded in completely dissolving the patients muscular armor. The isolated abdominal twitchings decreased to the extent to which the sensations of current in the genitals increased. His emotional life grew more serious. In this connection, he remembered an experience from the time he was about two years old.

He was alone with his mother at a summer resort. it was a clear starry night. His mother was asleep and breathing deeply; outside he could hear the steady pounding of the waves on the beach. The mood he had felt then was the same deeply serious, somewhat sad and melancholy mood which he experienced now. We can say that he remembered one of the situations from earliest childhood in which he had still allowed himself to experience his vegetative (orgastic) longing.  Following the disappointment in his mother, which had occurred when he was five years old, he had begun to fight against the full expression of his vegetative energies and had become cold and superficial. In short, he had developed the character which he presented at the outset of the treatment.

Following the increase of the sensations of current in the genitals, the feeling of a “peculiar contact with the world” intensified. He assured me that there was a complete identity between the emotional seriousness which over came him now and the sensations which he had experienced as a small child with his mother, especially on that night. He described it as follow: “it is as if I were at one with the world. It is as if everything inside of me and outside of me were whirling. It is as if all stimuli emerged much slower , as in waves. It is like a protective husk around a child. It is incredible how I now sense the depth of the worlds.” There was no need for me to tell him; he grasped it spontaneously: the feeling of unity with the  mother is the same as the feeling of unity with nature.  The equating of mother and earth or universe takes on the deeper meaning when it is understood from the point of view of the vegetative harmony between self and world.

On one of the following days, the patient experienced a severe attack of anxiety. He jumped up, his mouth contorted  with pain; beads of perspiration covered his forehead; his musculature was as stiff as a board.  he hallucinated an animal, an ape.  in doing so, his hand had the bent attitude of an ape’s paw, and he uttered sounds from the depth of his chest, “as if without vocal cords,” he himself said afterward. It  was as if someone had come very close to him and threatened him.  Then, trance-like, he cried out, “Don’t be angry, I only want to suck.” The anxiety attack subsided, the patient grew calm again, and in subsequent sessions, we concentrated our work on this experience.  Among many other things, he remembered that at about the age of two (which was established by the fact that they had lived in a particular apartment at that time), he had seen Brehm’s Tierleben for the first time and had looked at a gorilla with great admiration and astonishment.  He was not aware of of having experienced the same anxiety then, but the anxiety that occurred in the session undoubtedly corresponded to that experience.

In spite of the fact that anxiety had not become manifest at that time, it had subsequently dominated his entire life. Now it had finally broken through. The gorilla represented his father, the threatening figure who wanted to obstruct his sucking. Thus his relationship to his mother had remained fixated at this level and had broken through right at the beginning of the treatment in the form of sucking movements of his mouth. But this did not become spontaneously intelligible to him until after his entire muscular armor had been dissolved. It was not necessary to spend five years searching for the early sucking experience on the basis of memory traces. In the treatment, He actually was an infant with the facial expression of an infant, and the anxieties he had experienced as an infant.

I can briefly summarize the remainder of the treatment. Following the dissolution of the two main fixations in the childhood situation, his disappointment in his mother and his fear of yielding, genital excitation increased rapidly. WIthin a few days, he met a pretty young woman, with whom he easily formed a friendship. After the second or third sexual act, he came to the treatment beaming and reported in complete amazement that his pelvis had moved  “so curiously by itself.”  From his detailed description it was apparent that he still had a slight inhibition at the moment of ejaculation.  However, since the pelvic movement had already been liberated, it required but little effort to eliminate this final inhibitory trace. It was a matter of not holding back at the moment of ejaculation, but of surrendering himself completely to the vegetative moments. He had not the slightest doubt that the twitching he had experience during the treatment had been nothing other than the suppressive vegetative orgastic movements of coitus. However as it was later shown, the orgasm reflex had not developed wholly free of disturbance. the orgastic contraction were still jerky. He was still very hesitant to allow his head to fall back, i.e., to assume the attitude of surrender. However, the patient soon overcame this resistance against a soft, coordinated course of the  movement. Following this,the final trace of his disturbance, which had not appeared so clearly before was resolved. The hard , Forceful form of the orgastic movements correspond to a psychic attitude which said, “a man is hard and unyielding; any form of surrender is feminine.”


The patient had a slight inhibition at the moment of ejaculation.  “it was a matter of not holding back at the moment of ejaculation, but of surrendering himself completely to the vegetative movement.”  This is an important concept that armored individuals have difficulty submitting to pleasurable currents.  The inability to ejaculate, or ejaculation that is without convulsion, are all secondary to patients inhibition and fear to surrender to the full sexual excitation.  These concepts are unfamiliar to contemporary medicine and psychiatry, some seventy years after publication of this book, still there is no explanation by psychiatrist or sexologists or contemporary medicine, why a person becomes incapable of ejaculating although they may be erectively potent.  But as the reader sees, blocking the feelings, blocking the pleasurable sensations, and the fear of submitting to pleasurable sexual sensations,  which is a consequence of armoring constitutes the core of many sexual dysfunctions.

Immediately following this realization, his infantile conflict with his father was resolved. On one hand, he felt sheltered and protected by his father. He knew that , no matter how difficult matters might be, it would always be possible to “retreat” to the parental home. At the same time, he strove to stand on his won feet and to be independent of his father. He looked upon his need to be protected as feminine, and he wanted to rid himself of it. Thus, the desire to be independent and the need for passive-feminine protection conflicted with one another. Both were contained in the form of the orgasm reflex. The resolution of the psychic conflict took place hand in hand with the elimination of the hard thrust-like form of the orgasm reflex, and its unmasking as a warding off of the genitals, surrendering movement. when he finally experienced surrender in the reflex, he was deeply baffled by it. “I would never have thought,” he said, “that a man can surrender, too. I had always regarded surrender as a characteristic of the female sex.  In this way, his own warded-off femininity was connected with the natural form of orgastic surrender, and thus disturbed the latter.


The last few paragraphs are referring to the patients memories from childhood, his recognition of his impression of his father as a threatening figure like a gorilla, and his fear to get closer to his mother because of that.  The memories that were broken though correspond with the psychoanalytic concept of the odipal complex, which is of central importance in psychoanalysis. The fixation of libidinal energy in different stages of child development, as a consequence of the traumatic effect of the environment is also a theoretically important and crucial matter in psychoanalysis. In orgonomy, the concept of libido energy is given utmost importance and is understood as the real energy concept that exists tangibly and anchors in the tissues and contractions of the tissues.  However in psychoanalysis in general, elaboration on the libido theory is avoided. Psychoanalysts do not know what to do with the concepts of Freud’s libido theory. They talk about libido theory not as a real energy or entity, but something  in abstract, not tangible, something metaphysical. That is why no technique has developed about loosening up or removing that libidinal fixation.  When theoretically it is needed for the explanation of many psychiatric illnesses, psychoanalysis resorts to the libido theory and it’s fixations, but then never consider it as a real energy and talk about it in abstract, hypothetical and unreal terms.  However, this case indicates how recognizing the psychosexual energy as a real energy as it is recognized in orgonomy, leads to clinically therapeutic results that otherwise are unattainable.

It is interesting to note how society’s double standard of morality was reflected and anchored in this patient’s structure. In customary social ideology, we also find that surrender is emotionally associated with femininity, and unyielding hardness is associated with masculinity. Accordingly, it is inconceivable that an independent person can give himself and that a person who does give himself can be independent.  Just as , on the basis of this false association, women protest against their femininity and want to be masculine, men rebel against their natural sexual rhythm out of fear of appearing feminine; and it is from this false assessment that the difference in the view of sexuality in man and in woman derives its seeming justification.


Here one can see how the principles of orgonomy which are applied in human psychology transcend psychology and enter into the realm of sociology and culture.

During the ensuing months, every change became integrated in the transformation of his personality.  While he did not deny himself an occasional social drink, he ceased to drink excessively. He made a suitable arrangement with his wife and formed a happy liaison with another woman.  Most important, he showed great interest and enthusiasm in a new job.

The superficiality of his character had completely disappeared. He was no longer capable of engaging in empty talk in cafes or of undertaking other things that did not have some objective interest.  I want to make it quite clear that it would not have occured to me to guide or to influence him morally. I myself was surprised by the spontaneous transformation of his personality. He became objective and serious. He grasped the basic concepts of sex-economy less on the basis of his treatment, which was of short duration, than spontaneously on the basis of his changed structure, the feeling of his body, i.e., on the basis of the vegetative motility he now experienced.

Over the course of the next four years, the patient showed considerable improvement in the integration of his personality, in his capacity for happiness, and in the rational management of difficult situations.

I have now been practicing the technique of vegetotherapy for six years with students and patients and can see that is provides great advantages for the treatment of character neuroses.  The results are better than they were previously, and the duration of the treatments are shorter. A number of physicians and teachers have already learned to use character-analytic vegetotherapy.

Posted in Biopathies & Psychiatric Orgone Therapy, Case Studies4 Comments

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Wilhelm Reich – Founder of Orgone Therapy

Annals of The Institute for Orgonomic Science (December, 2015)

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