ABSTRACT
Herbert is a 35-year-old man of Central European origin who has been living in Spain since he was 11 years old. He is tall, blond, with a ragged complexion, and his physical appearance could be pleasant if he were more careful with his grooming and personal toilet. He consulted around four years ago because he was unable to reach a sexual climax. He had previously consulted several specialists who had found no relevant cause as far as a somatic disorder was concerned, and they suggested he should look for psychotherapeutic assistance. Since the age of 20 he has experienced the need to urinate frequently, and he complains of a more or less permanent itching sensation in his urethra. These disorders come to their height during sexual intercourse, in such a way that the more excited he gets, the stronger the itching sensation becomes and the greater the need to urinate, which prevents him from obtaining any kind of satisfaction when ejaculation occurs. He also complains of "nerves in his stomach", has trouble digesting, and frequently suffers from diarrhoea. There is also a serious tendency towards bulimia. He often feels depressed, irascible, on the verge of blowing up, and it is then that he thinks of suicide. He is afraid of himself and that one day his impulses could lead him to losing control and carrying his thoughts through into action. 76During adolescence there were several episodes of attempted suicide through the intake of pharmacological substances, although he always sought help immediately afterwards. On one occasion the apparent cause was a romantic disillusion. He was frequently beset by the idea that he could die, which led him to a psychoanalytic therapy that lasted for six years and which he terminated a short time ago. The reason was, according to him, that he had not benefited from it, even though he admitted that it had allowed him to get by.
