John J had only recently turned twenty-eight. He became my patient on a cold winter night because of some things that were disturbing him. His face was expressionless as he told me this, looking down at his shoes. He was engaged to a woman he had been with for some time, but when he went away on business, he liked to get drunk and have sex with different women. He thought he should probably stop, he said, wringing his hands. He didn’t know why he did it. He and his fiancée had been together for a few years, and she was a nice girl. He didn’t want to hurt her.