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Psychiatric Times. Vol. 29 No. 12
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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.

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