The curious case of patient N.

‘the vain cock’

Reader discretion advised: some parts of this correspondence may appear vulgar to the vulgar reader.

The narrator believes this correspondence in psychoanalytic literature to be one of the most bizarre unsolved cases today; psychologists from different fields and schools have offered, over the years, numerous analyses and commentary.

The most insightful of these remain the words present in this correspondence which the esteemed psychologist, Professor S. Furarasson, shared with his one time student and protégé, Dr. Suhbski.

Dr. M. Suhbski was the first psychotherapist to treat Patient N., and this was his last correspondence with Professor S. Furarasson before his death at the age of 92. The professor spent a lifetime in psychotherapy where he treated dozens of patients and trained many therapists, including Dr. M. Suhbski and Dr. P. Phaqmiaard, who in turn, have published extensively and contributed to the development of the field.

Dr. Pliez Phaqmiaard was the last therapist to treat Patient N. before he ceased seeking treatment altogether. Her disciples, along with Dr. M. Suhbski’s, have asked that we submit this case into the public domain so that other psychotherapists and lay persons alike, may further enrich the discipline through their critiques and ensuing debates.

This document shows the three letters of this historical case.

The narrator is an avid reader of psychology. However, as an amateur psychologist, he claims no particular knowledge in the field and encourages the reader to form his own opinion.

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In memory of Professor S. Furarasson.

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7th March_______

Dear Professor Furarasson

As you well know my dear professor, the work of the psychotherapist is never truly over. Even with the resolution of the patient’s symptoms, the scars that remain with the therapist are often gruesome and require a great deal of therapy and self-analysis themselves.

My heaviest burden is Patient N. who I’ve treated for seven years now. I confess to you good sir, that many a time I have fantasized of throwing the box of tissues at his face, banging on the armchair and shouting ‘fuck this shit’ as he so often does to me. It seems to me now that accepting him was one of the biggest mistakes of my professional career, and if not for his mother, a family acquaintance, I never would have.

N. was initially brought by his mother due to poor academic and professional performance which consequently, led to difficulty maintaining a job. However, when we started therapy, he didn’t seem a bit concerned in regard to his professional life. His chief complaint was: ‘I haven’t been laid in ages man! It’s coz em bitches think I’m a mama’s boy…’ He admitted several times later that he was in fact, a virgin.

I diagnosed him with body dysmorphic disorder, general anxiety, and mild depression which was unresponsive to antidepressants. He was a heavy smoker and occasional drinker although he didn’t particularly seem to enjoy any of them. His nihilistic tendencies, utter demotivation and bleak outlook towards life made his treatment ardent and his recovery extremely slow.

Summary of patient history:

N. was the first born son to a middle class family; his father, was a moderately successful dentist, and his mother was a school teacher. His mother was in a bitter war with her mother in-law who didn’t bless her son’s marriage. When not busy bickering with her mother in law, she would vent her anger on N., who would then run to his grandmother for protection. This continued till his grandmother’s death when he was ten.

Since then, he was exposed to the strong oedipal forces of his mother; she constantly smothered him, followed his every move, befriended all his schoolmates, and was a frequent eyesore at school. She used to complain that his teachers were not disciplining her son well enough, and at other times she would complain that they were too harsh, picking on him to humiliate her.

His situation was made worse by his father who would beat him up with belts, broom sticks, and the occasional slipper whenever his school grades were under average (very often), and whenever he was caught smoking, skipping school or chasing girls after class (often as well). Teasing and sexual harassment on the street, were N.’s only means of communicating with the opposite sex under the watch of his puritanical parents; the rest was frequent masturbation which drove his parents into a frenzy whenever he spent more than five minutes on his own.

At school he was short and skinny; he wore his straight hair effeminately and only grew very sparse facial hair in his late twenties. The most common beating game was the countdown: it consisted of a group of boys (anywhere from three to fifteen) counting from one to ten, and at ten, N. would receive a rapid succession of random punches, kicks and slaps; he always had the option of trying to run away, although he realized, eventually, that this triggered a sort of primitive hunting mechanism in the other boys, so when they inevitably caught him, the beatings ended up becoming much more sadistic. Therefore, he dropped the fleeing defense in favor of the curling and squealing one. Other forms of less frequent humiliation included sticking chewing gum in his long hair and on his desk, stealing his lunch, allowance, and books; once a boy from another class even managed to defecate in his schoolbag.

His aunt and grandparents (from his mother’s side), on the other hand, lavished him with gifts, trips abroad, and a very good weekly allowance; they even bought him a brand new car at a time when all his friends walked to school or took the bus. There was constant conflict between N.’s parents and his grandparents over their intrusion in disciplining their son, although very few serious steps were taken towards stopping it.

Thus N.’s genital psychosexual developmental stage coincided with constant emasculation and psychological castration from his mother, accompanied by regular beatings and threat of physical assault from his bigger, more masculine classmates.

Fortunately, we had a breakthrough around two years ago when he finally (after five years) took my advice of doing exercise and going to the gym. I told him it didn’t matter whether it was aerobics, competitive sport or even martial arts. I reasoned it would improve his body image, boost his confidence, and decrease the length and intensity of his bouts of depression.

He chose bodybuilding and took it up seriously and after a month he was content, stopped smoking and drinking, and even secured a decent job as a _______at ______ so I naturally believed the treatment was working perfectly. A few sessions later, he confessed that he was in a relationship with a female coworker named D. who goes to the gym and works for him as a________.

To this day, I don’t know for certain if he joined the gym after finding out she goes there, or if it was by chance that he met her there after taking my advice; every time we approach that topic we run into strong resistance. I believe he took up bodybuilding to overcome his deep feelings of shame and sexual inadequacy from the increasing unrequited erections he was having for D., his new object of desire.

His reasoning was well-founded as his relation with D. started to develop rapidly with the growth of his muscles. The incidence of sexual intercourse with his new partner reached a staggering seven times per day (not including non-penetrative sex) at the peak of his hypermasculine muscular growth phase.

The bizarre and sudden nature of his disorder occurred at the a time when he was at his peak musculature and sexual potency. A year ago marked the beginning of this peculiar condition.

This is a verbatim transcription of the recording from the session when he first talked about it.

N: (After 10 minutes of complete silence) so…what are we gonna talk about this time? Talk, talk, talk, that’s all you fuckin’ guys do is talk!

DrS: I see you are upset about something.

N: Upset? Oh you ain’t seen upset, oh no, don’t let me get started on upset now doc!

DrS: OK, what do you think we can do together to help you feel less upset?

N: Get my prick up for starters!

DrS: You’ve been having erectile dysfunction?

N: Jeez this guy! I tell him I can’t get hard and he translates it into geek talk! Yeah! I have erectile fuckin’dysfunction! OK? Happy? Here’s my doctors report, I’d already told the fucker nothin’ is wrong with my dick, after a gazillion tests and scans that cost a fortune he then says it’s not organic blah blah because I still have morning wood…I was pfff shithead?…what I just say?

DrS: (reading the report for a few minutes) yes, you are right. Your physical checkup is clean.

N: I know there’s nothing wrong with it, I just keep getting hard in the wrong places at the wrong time.

DrS: how do you mean?

N: I’ve been getting these raging boners at the gym when I work out.

DrS: hmmmm…

N: Don’t…Don’t you say it! If you fuckin’ say I’m gay, I swear to God…

DrS: I wasn’t thinking of that …but are you?

N: You motherfucker (indiscriminate noise)…you… (furniture moving around and more noise in the room)

DrS: OK, calm down now (heavy breathing and movement around the room)…take it easy…you don’t want me to call in Paul again and keep the door open… remember? It’s you who asks for privacy to talk…

N: (heavy breathing then silence)

DrS: Your girlfriend D., does she still go to your same gym?

N: Yeah? So? You think I haven’t tried it with her there? One minute I’m pushing iron and hung as a horse, next minute we’re butt naked tryna do it and I’m Mr. Limp Dick over here!

DrS: hmmm…maybe you need privacy and can’t perform in public?

N: It ain’t that doc…it ain’t that… before we did it private, public, cars, parks, upside down and whatever…I too thought maybe I was getting shy or somethin’…so I asked Manuel, the janitor to give me the keys to the cleaning room, he’s my neighbor…we tried it in there like a million times…nothing.

DrS: hmmm…how about in the morning? Have you tried intercourse during those morning erections?

N: Doesn’t work either…the moment I wake up and realize I’m hard and get started I go limp again…you gotta do somethin’ for me doc! She’ll leave me for one of em’ gym guys…I fuckin’ know it!

DrS: I’ll tell you what N…. I’ve treated many cases of ED before but your case is…atypical…in the meanwhile we’ll need to gather more data… I’ll ask the gym for permission to keep a hidden camera where you work out, and you keep a diary writing every time you get an erection, the duration, the intensity and anything happening around you at the moment.

N: (unintelligible blowing sounds)…yeah yeah…

DrS: well…I’m afraid today’s session is over… I’ll see you same time next week…

Your expert opinion and guidance is most urgently needed. I have attached the patient’s full personal history, video footage from the gym and contents of his diary. I hope this will aid you in uncovering the aetiology of his disorder and guide you to a treatment plan that will unburden him of his affliction.

Your faithful student.

Dr M. Suhbski

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March 23rd_____________

Dear Dr. Suhbski

I’m glad, as always, to receive from you my dearest and hear such praise of your skill and diligence. Your practise has a reputation surpassed by a very few, and the many compliments I still receive for being your mentor, pleasant as they are, reflect your genius not mine. The numerous academic citations stand as proof to the high esteem in which the scientific community holds your work.

As you mentioned, therapy takes a toll on us all. The therapist’s eye is privy to the dark, deep abyss of the unconscious human psyche, a darkness we often find ourselves sharing with the patient. Like you, I’ve long envied my patients apathy and carelessness. However, I’m quickly reminded of the price they pay for escaping their responsibilities and moral obligations.

I’d like to apologize for my late reply. I have spent the last few weeks extensively reading your patient’s personal history, neglecting my sleep, and drinking far too much coffee.

What struck me most was the patient’s physical transformation, he must have gained his own weight in muscle!

The few quotes that interested me and stood out from the rest were : ‘I was a sissy my whole life till I joined the gym’, ‘my mother didn’t want me to join when I was in high school saying it’ll make me shorter than I already am ’.

And: ‘haha! Everyone thought she’s waaay out of my league, all my friends are jealous coz all of them are broke skinny ass pussies who can’t get laid’.

From her photo I concur the she is a very attractive young woman who wouldn’t under normal circumstances, be interested in N.

From these quotes, we can confirm your hypothesis that he indeed took bodybuilding to overcome his inferiority complex, and as you mentioned, to get D.’s attention in which he was successful.

In my analysis, I find that as his relationship with his partner improved, and the incidence of intercourse increased, his shame of being a sissy, fear of castration and being beaten decreased. This same shame and fear had maintained his delicate EBM (erectile balance mechanism) all these years, they were key components, oxygen and water, so to speak, accompanying every erection N. has had so far; thus as his confidence peaked and he moved into an ever more dominant position in his relationship with D., the whole raison d’être of his erections disappeared for the first time in his life.

Meanwhile, the unfulfilled sexual desires of D. due to lack of intercourse, for the first time in her life, were causing her, unconsciously, to stare longer at the crotches of the other bodybuilders who frequented the gym, this in turn triggered the shame and fear cues leading to N.’s raging boners while working out.

I confess to you my dear doctor that I haven’t treated such an intriguing case throughout my long years of psychotherapy; however, I will recommend this trial treatment, which if successful, will dispel any doubts as to the accuracy of our diagnosis.

It appears to me that the only viable treatment at this stage of his disorder, which might cure him of his affliction and save his relationship, is for him to quit the gym and let himself slowly revert to his original effeminate and inadequate self. This will damage his newfound confidence and bring back the shame and fear that maintained his erections so far.

I realize how radical this may seem, but in the absence of any success of pharmaceutical or physiological treatments, I’m afraid desperate times call for desperate measures.

I’m looking forward to hearing from you in regards to this treatment plan.

Your teacher and friend

Professor S. Furarasson

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28th Feb______

Dear Professor Furarasson

The treatment was indeed as radical as you anticipated and even harder to administer. N. was very reluctant to leave the gym and revert to the same physical and psychological condition that led him to seek help. I felt much discomfort causing additional misery to him.

I admit to having doubts as to the efficacy of the treatment, but was amazed that the patient gradually started having erections with his receding masculinity and muscle bulk. The duration and intensity of his erections were back to normal as his fear and shame were back to their high (baseline) levels again.

I continued my followup, and his relationship with D. seemed to have been improving until one night he called my home phone number and said it was an emergency.

He came in shirtless, slightly bruised and said that D. had beaten him and kicked him out of his apartment. He was crying and pulling chunks of his long hair in his hands.

‘she told me ‘‘i want a real man, not a mama’s boy, get the fuck out of my life!’’…i don’t know what to do doc…i wanna kill myself…she fucked all of the guys in the gym! even Manuel! for God’s sake doc! sweet old Manuel!… she said at least he’s a man!’

I tried to hold him longer at home and calm him down, but he ran out. I called the police who went back to his apartment, asked around the neighbourhood, nothing. He vanished.

After a few months of looking around and asking about him I finally gave up; a year had passed without hearing anything about him so I assumed the worst.

I then received a letter from Dr. Pliez Phaqmiaard regarding a peculiar case of priapism. She thought it too similar to my case with N. to be a mere coincidence, and her description of her patient matched mine except for his body size and name, which we assumed, he changed after he’d moved out.

I bought a ticket and took the long flight across the Atlantic to see for myself. After a cup of coffee and pleasantries, Dr. Phaqmiaard and I visited the gym where her patient works out

I saw a couple of bodybuilders near the main desk and asked if they knew N., they didn’t know anyone by that name so I used A., the new name he uses with his new therapist. Their eyes flashed and said ‘Oh you mean el elefante?’.

I muttered ‘el elefante?’. I was a bit confused as I thought of the slender young man l saw last time and reasoned that this must be someone else.

‘Oh he really is that big now Dr. Suhbski…I mean all of him not just…’ Dr. Phaqmiaard then said.

‘El elefante is the biggest, meanest, and most ripped God in town, legend has it that when he bench presses 450 lbs, you can see his thing pulsating, getting ripped with the rest of him!’ said one of the bodybuilders.

The other bodybuilder took us into the main hall which was full of gym equipment. Around a bench, I saw a crowd of about thirty people, all from the gym, standing in a circle. Then I heard deep grunting sounds between counts:

‘THREE! HHMMMF… FOUR! You can do it! HHHHHMMMMFF !… FIVE!…’

I moved a bit closer in between the crowd and it was indeed N. lying on the bench with a giant barbell and his spotter standing behind him counting. I told Dr. Phaqmiaard that it was indeed my patient, she was all eyes and didn’t seem to hear me.

From the murmuring crowd I overheard ‘el elefante!’, ‘he’s pressing 500 lbs today!’, ‘that thing could kill!’ among other things I need not write here. The man was indeed enormous, and after seeing the rest of him, I understood the fitting name they had given him.

It seems that the traumatic nature of his breakup where he was beaten and kicked out of his apartment, exposed him to an overdose, so to speak, of fear and shame. This overdose appears to me, to have damaged his EBM causing his erections to go into overdrive.

Dr. Phaqmiaard says he is in a vicious cycle of impressing members of the gym, starting relations in which he unable to perform sexually, he gets rejected shortly thereafter, feels more shame, tries to compensate in the gym and impress someone else, and the cycle repeats. Once he runs out of options in one gym, he goes to the next. His therapist has coined the term as PGPI syndrome (promiscuous gym priapism with impotence) to describe his affliction.

She says that only cigarette smoking and alcohol which temporarily inflate his ego relieve him of his condition for a while.

I sometimes stay awake at night wondering if we did more damage to this young man than his parents, school bullies and girlfriends combined. The sight of his ungodly pulsating organ is now a recurrent nightmare I live with; my wife has in vain tried to comfort me during those nights.

Maybe we ought to have let God do his thing and nature take her course without our scientific theories?… Forgive me professor it seems that I’m rambling… I haven’t slept in days…

Respectfully yours

Dr. M. Suhbski

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Notes by the narrator:

Professor Furarason, as I’m told by his family, died about ten days after reading this letter. It was during the same time that the case became public with hordes of curious people chasing patient N. around gyms. El elefante became a household name.

The professor’s family describe his last days as angry, bitter and feverish. He barely ate or drank anything other than coffee and whisky.

Two days before he died, he attacked father B., a family friend, with a golf club after the latter had told him ‘…It is God’s will that these things come and go, but man with his science interferes and sadly my dear professor…it sometimes doesn’t go his way… I hear they call the poor soul el elefante with spectators chasing him wherever he goes…’

The professor put down his glass of whisky and took the club swinging and shouting ‘This is God’s will father, my staff that will split your spine into two! It will be the last good thing I do before I die! Come back you slimy imbecile! Leave me at him! God’s will is not done!…’

It took all three sons and daughter to subdue him. The priest was taken to hospital unconscious with a fractured skull and ruptured spleen.

On the day the professor died, he quietly locked himself in his study and doused himself, the library and entire room with kerosene. His maid woken from her sleep by the fumes, failed to open the door and called for help. After finally breaking down the door, they found the man dead, soaked with kerosene, with a lighter in his hand.

The ivory lighter was a gift given by his protege Dr. Suhbski for his ninetieth birthday, on it was carved ‘in lucem scientam’.

The coroner report later confirmed death from a heart attack. ‘He poured enough kerosene to burn the whole estate to the ground had it not been for the faulty lighter’ the police investigator said.

The public have long forgotten the case with the disappearance of patient N. while Dr. P. Phaqmiaard and Dr. M. Suhbski have since retired from science and academia. I’m told by their disciples that they are still in touch and meet for the occasional cup of coffee.

These letters today dear reader, are all that remain of their legacy, of the curious case of el elefante.


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