Diagnosing a male hysteric: Don Juan-type

The aim of this paper is to provide a clinical account of a male hysteric, Don Juan-type, taken from the early stages of treatment. The patient presented with a relationship problem but there soon emerged a form of compulsive sexuality or hypersexuality in his love relations that became a central feature of the clinical picture. This hypersexuality expressed itself in a compulsive need to stage, or to stage-manage, interpersonal scenaria of a sexual or sexualised nature. These scenaria, which were repeated in different variations and with different personnel, are seen by the author as a dramatisation of the primal scene with the patient taking up the position of the oedipal father. Explanations for the disappearance of male hysteria are given, including a new theory which claims that an imbalance in psychoanalytic theory itself led to the feminisation of hysteria. This critique allows certain forms of hypersexuality in men to be promoted as a form of hysteria, the most common example being Don Juanism-a form of compulsive sexuality that encompasses normative, conversion and character features. The paper also examines the male hysteric's developmental agenda. What the patient's compulsive sexual tableaux exposed was that he had never faced a separation that was not a triangular experience. This meant that his separations were experienced as two developmental agonies telescoped into one-separation (pre-oedipal) and exclusion (early oedipal). This combination, the author suggests, is so frightening in a particular group of men as to explain the choice of hysteria as opposed to some other choice of neurosis.