One wintry Friday morning, I opened my consulting room door to find a nervous young man looking up at me. Short, rather rotund, with thick glasses, Samuel nervously held out a clammy hand for me to shake. He was wearing a duffle coat and scarf, and reminded me of a lost and forlorn-looking Paddington Bear. Perhaps in his late twenties or early thirties, he looked anxious and upset, as though he would rather be anywhere else than here.
Without removing his coat or scarf, Samuel perched nervously on the edge of his seat and looked to me for guidance as to what to do next. I invited him to begin by telling me a little bit about himself. I learnt that Samuel worked in IT, and that he still lived at home with his parents. He had an older sister who was married and lived on the other side of the country. I asked Samuel what had brought him to therapy. He looked away and nervously pushed his glasses further up his nose – a gesture that I noticed he made every time he felt uncomfortable. Blushing deeply and stammering, Samuel told me that he seemed to have trouble with women; he said that he was very shy and never seemed to know what to say to them. Asking him about his previous relationships, I learnt that Samuel had never had a girlfriend, and was still a virgin. He had found himself in bed with a woman a couple of times, but on both occasions, he said, he had not been able to get an erection. As he told me this, he looked down at his feet in shame, twisting his watch nervously on his wrist.
I told Samuel how brave I thought he was, coming to seek help for this. I said that I imagined it must have taken a great deal of courage to talk to a complete stranger in this way, particularly one who happened to be a woman. I reflected that, perhaps, as we worked together, he might find that he learnt how to form a relationship – albeit a platonic one – with a woman, a template he could then use outside of the therapy room. A look of abject terror flitted across Samuel’s face. I reassured him that he had already taken the hardest step by talking to me openly and honestly about the difficulties he was facing.
Samuel and I began our work together by looking at his family history. His parents were from a working-class background, and had worked hard to give their children a comfortable upbringing. Samuel said that he had happy memories of his childhood, although he was always a very shy child. His sister was ten years older than him, and the two of them were not close. His parents had tried for years to have a second child, and so when Samuel finally came along he was seen as a little miracle. However, he was born with a heart defect, which meant that for the first few years of his life, he was in and out of hospital on a regular basis. His mother wrapped him in cotton wool, rarely letting him out of her sight to play with other children, and warning him away from any activity that she saw as risky, such as climbing trees or getting into play fights. When I asked Samuel about his father, I got the impression of quite a weak man, who in many ways was subservient to his wife. She seemed to be the one who was in charge in the relationship.
As a boy, Samuel was quite small for his age. He described himself as an unattractive teenager, with acne and thick glasses, which often led to him being teased and bullied by boys and girls alike. Feeling ashamed that he was unable to stand up for himself, he did not tell his parents about these experiences and instead buried himself in homework and computer games after school. When the time came for him to go to university, it seemed a natural choice for him to study Information Technology. He considered the idea of applying to universities in the north of the country, but his mother told him he would never be able to look after himself, and he was soon persuaded to study in London and live at home.
Mixing mainly with the boys on his course, he found the girls at university intimidating and unpredictable. Sometimes he would go to parties where drunk girls would flirt with him. He did not know how to deal with this and would get into a highly anxious state. On one occasion, a girl had taken the initiative, grabbed his hand and led him into the bedroom. As she kissed him and undid his trousers, he felt his panic and anxiety rise. His penis, however, did not. He described how she had fumbled with it and coaxed it, but to no avail; it remained flaccid and unresponsive. The girl laughed at him, shrugged, said she guessed he’d had too much to drink and wandered off – no doubt, he said, to find someone else who was more of a man than he.
Samuel was mortified and ashamed about this experience. It remained with him the next time he found himself interested in a girl. Betsy was on his course, and asked him for help with her work. Flattered that someone seemed to value him, Samuel struck up an awkward friendship with her. One day, towards the end of term, when they were working together on some coursework in his room, Betsy led him to the bed and began to kiss him. Samuel felt the familiar sense of panic. He immediately thought back to the incident at the party, and was sure the same thing was going to happen again. Sure enough, as Betsy began to touch his penis, he was aware that it was not responding as it should. He willed himself to get an erection, but the more he focused on his penis, the more it seemed to shrink. When Betsy took him in her mouth in an attempt to encourage him, he pulled away sharply, embarrassed and ashamed. Betsy looked mortified, and hurriedly stood up and gathered her things together. She stammered, ‘I – I’m really sorry, I thought you liked me, but obviously I got it completely wrong!’ Unable to speak through sheer embarrassment, Samuel watched helplessly as Betsy left the room. With both of them unsure how to put things right, their friendship swiftly disintegrated. Samuel was devastated and blamed his penis for once again screwing up his life.
After university, Samuel found a job in IT in the area of London where he lived, so he saw no particular reason to move away from his parents’ house. He studiously avoided situations where he might have to socialise with women, and continued his teenage habit of coming home from work and playing computer games. His mother continued to cook his dinner, and wash and iron his clothes, and to all intents and purposes, he continued to live his teenage life.
It seemed to me that this was a relatively comfortable existence for Samuel. In many ways, he didn’t have to grow up and face the responsibilities of adulthood. I was curious, therefore, about what it was that had brought him to therapy at this point in time. He said that he had begun to realise that at some point he would like a family of his own, and that if he were to do this, he would need to overcome his fear of women and address his sexual problems.
It was clear to me that the root of Samuel’s problems lay in his relationship with his mother, and to some extent the blueprint for manhood that he had from his father. Samuel’s mother seemed to want to keep him as her little baby, even though he was 29 years old. She had waited a long time to have him, she’d had to protect him as a small, sickly child, and she had gone on protecting and mollycoddling him right up to the present day. When Samuel had attempted to fly the nest by applying to universities in a different part of the country, she had quickly ensured that he stayed at home by making him believe that he would be unable to survive without her. Samuel had never seen his father stand up to his mother about anything, and therefore had no model for developing and defending his own point of view. Like his father, he quietly acquiesced and followed his mother’s wishes.
Much of the work that I undertook with Samuel over the next year revolved around building his confidence as a man. It was important that he and I built up an equal relationship, and not one in which I told Samuel what to do, the way that his mother always had. I had to rein in my naturally bossy tendencies so that Samuel could learn to think for himself.
Together, Samuel and I began to devise a series of experiments that would help him to increase his confidence around women. We brainstormed about all the different situations in which he had the potential to speak to women on a daily basis. These ranged from paying for his lunch in the office canteen to talking to some of the female colleagues in his team at work. I asked Samuel to rate each situation by the degree of anxiety he thought it would provoke in him. Beginning with the scenarios that Samuel saw as having the least potential to make him anxious, he took at least one opportunity each week to challenge his belief that he could not talk to women. At first, this proved difficult