PsychiatricTimes Members: Login | Register

|     

PsychiatricTimes SearchMedica Medline Drugs

Powered by SearchMedica

 
Risk Assessment
News
Current Issues
Blogs
Special Reports
CME
Conferences
Resources
Careers
Multimedia
About Us
 

Home » Blogs » Couch in Crisis

Psychiatric Times. Vol. 29 No. 12
Pages: 1  2  
Next
COMMENTARY 

Penis Size: A Consideration of Fantasy and Reality (With Only a Few Puns)

By Lawrence D. Blum, MD | December 11, 2012
Dr Blum is a psychiatrist and psychoanalyst in private practice in Philadelphia and in Cherry Hill, NJ. He is on the faculty of the Psychoanalytic Center of Philadelphia and is Clinical Assistant Professor of Psychiatry at the University of Pennsylvania in Philadelphia.

Penis size, a topic that is often spoken about only in whispers or jokes, merits serious discussion. Not only do many men have a great deal of concern about it, but since this concern and the psychodynamic means for understanding it are seldom discussed in professional training, few psychiatrists, psychologists, and other therapists are prepared to help their male patients deal with their worries about this subject. Over the years, I’ve observed that most of my male patients have worried that their penises were “smaller than average” or “too small.”

How should we understand this challenge to statistical common sense? And why do men think women are concerned about their size?

Human concern about the penis is old and universal. Artifacts from around the world feature human forms with exaggerated genitalia. Little boys in all cultures get accustomed to touching themselves early, and if possible, often. Freud was both right and wrong about penis envy. Does it exist? Yes. In women? Occasionally. In men? Almost always. Men worry that some other guy is bigger, and that women care. Men develop fascinations with cigars, pens, cars, trains, baseball bats, knives, guns, and sausages, but not usually with frisbees, soup, pillows, or suitcases. They exhibit themselves and hide themselves, and they make endless anxious locker-room jokes. Men want to be bigger and at the same time often fear being bigger, sensing it to be dangerous. This makes realistic understanding of size surprisingly difficult.

Much of the thought and feeling on this subject is infused with concerns from childhood. In the child’s mind, and therefore on some level in the adult’s, bigger is always better. In Westerns, the bad guy is always older, dressed in darker (non-innocent) clothing, tall in the saddle, and always has a beard or moustache. He is powerful, the father, the antagonist of the beardless youth who tries to win the woman that the older man wrongly holds hostage. I have yet to meet a male patient who didn’t bring forth some present-day version of this perpetual struggle to be as big as his dad; big instead of his dad; bigger than, and with all the advantages of, his dad (or grandfather, uncle, or whomever the most primary male was). Sometimes these strivings are subtle, sometimes they are blatant, and often they are disguised by submissiveness or self-defeat. Frequently they show up as anxiety about attaining the privileges of the adult male, such as having sex, holding a good job, or earning a promotion.

Children make their best efforts, using the means at their disposal (such as fantasy) to right the terrible injustice of being little. They are envious, imperious, and wishful, even as they are also kind and loving. Smart as they are, they have little sense of reality. Plotting to get what the adults have—their partners, money, big bodies and big penises—they expect others to be up to the same tricks as they are. They know from their own fantasy schemes to get the goods from the big adults that it’s dangerous to be big and to have the treasure, because then you are a target. Just as in the Westerns, someone may be gunning for you. So they play defense as well as offense and protect their own precious possessions.

Pages: 1  2  
Next
 

Join the Conversation

Want to join the conversation? If you're a healthcare professional, we'd like to hear your comments. Just sign in or register today to become part of our growing, online community.






 
TOPIC INDEX

Addiction Medicine
Alzheimer Disease
Anxiety Disorders
ADHD
Bipolar Disorder
Child & Adolescent Psychiatry
Dementia
Depression
DSM-5
Geriatric Psychiatry

 

Health Care Reform
Major Depressive
Disorder
OCD
Personality Disorders
Schizoaffective Disorder
Schizophrenia
Sleep Disorders
Somatoform Disorders
All Topics

 


 
FROM PHYSICIANS PRACTICE
Primary Care Can't Thrive Without Nurse Practitioners
Courtney H. Lyder, ND,  May 17, 2013
With a projected shortfall of primary-care physicians, it's time for alternate solutions to patient care. Nurse practitioners are one logical remedy.
VWhat Physicians Can Learn from the Allscripts EHR Lawsuit
Marisa Torrieri,  May 16, 2013
Lawsuit prompts question: What should physicians do to ensure they end up with a great EHR instead of buyer’s remorse?
Eight Ways ICD-9 Will Still Matter to Medical Practices
Brenda Edwards, CPC,  May 15, 2013
What should your medical practice do with your ICD-9-CM book after October 1, 2014? Keep it.
Seven Ways Technology Can Speed Up Patient Collections
Cheyenne Brinson,  May 15, 2013
Failing to adopt widely available billing and collections technology can cost medical practices big. Here's how to do it right.
Four Reasons Private Medical Practice is Becoming Extinct
Carol Stryker,  May 15, 2013
It’s becoming increasingly difficult for private medical practices to thrive. Here’s what’s driving the trend toward consolidation.
 

 

 
MOST POPULAR
  • Most Popular
  • Most Emailed
  • Most Recent
  • Developmental Psychopathology Comes of Age
  • Grief and Depression: The Sages Knew the Difference
  • The Moral Struggles of Practicing Psychiatrists
  • Update on Mental Health Benefits and Substance Use Disorder Services Under the Affordable Care Act
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Developmental Psychopathology Comes of Age
  • Psychiatry and the Myth of “Medicalization”
  • Synthetic Cathinones: Signs, Symptoms, and Treatment
  • Journey of the Traumatized Hero: Kerouac’s On the Road and Gandhi’s Railroad Ride
  • Eco-Psychiatry: Why We Need to Keep the Environment in Mind
  • DSM-5: Where Do We Go From Here?
  • Suicidal Behavior: A Separate Diagnosis
  • New Insight Into the Neurobiology of Depression
  • Cultural Psychiatry and the 'No-Chicken' Doctor
Click here to subscribe to our newsletter
 
COMMENTS
  • Most Commented
  • Most Recent
  • Psychiatry and the Myth of “Medicalization”
  • Grief and Depression: The Sages Knew the Difference
  • Is it Time for a Treatment Manual to Complement DSM-5?
  • Diagnosis and its Discontents: The DSM Debate Continues
  • Lamotrigine for Major Depressive Disorder Is Inappropriate
  • Psychiatry and the Myth of “Medicalization”
  • Parity Laws: Powerful Weapon—or Pipe Dream?
  • The Moral Struggles of Practicing Psychiatrists
  • DSM-5 Won’t Solve the Overdiagnosis Problem—But Clinicians Can
  • NIMH vs DSM 5: No One Wins, Patients Lose
Click here to subscribe to our newsletter


 
CAREER CENTER

  •   Featured Jobs  
  •    Resources   
  • Psychiatry and Nurse Practitioner Opportunities
  • Associate Medical Director - Psychiatrist Delray Beach, Florida
  • Retiring Child Psychiatrist Seeks Replacement August 2010 or Before
  • Chairperson, Dept of Psychiatry Needed
  • FT Staff Psychiatrist - Excellent Benefits
  • BC Adult and Child Psychiatrits - PT and FT Positions Available
  • Managing Risks When Practicing in Three-Party Care Settings
  • 12 Tips for Making Your Practice Greener
  • Keys to Avoiding Malpractice: Standard of Care in Psychiatric Practice
  • Take This Job and Shove It
  • Merging Administrative and Academic Careers in Psychiatry


CancerNetwork | ConsultantLive | Diagnostic Imaging | Musculoskeletal Network | OBGYN.net | PediatricsConsultantLive |
Physicians Practice | Psychiatric Times | SearchMedica | Medical Resources

© 1996 - 2013 UBM Medica LLC, a UBM company
Privacy Statement - Terms of Service - Advertising Information - Editorial Policy Statement - UBM Medica Network Privacy Policy