At the beginning of our talks Patricia would become extremely guarded whenever I attempted to open any discussion of a personal nature. She had come for help with the express conviction that I, the doctor, should find a quick and easy solution to her periods of acute anxiety: drugs, a sea voyage, anything that did not entail looking inward, taking responsibility for her condition. This evasiveness, this desire to find easy solutions, is characteristic of all forms of frigidity in women, but it is sometimes extremely pronounced in the type of frigidity this patient suffered from.

However, as Patricia developed confidence and trust in me, the real facts gradually emerged. She had been married for ten years and had two children, six and eight. Her husband was socially prominent, financially successful, and (as I saw for myself later, when I had a few discussions with him) strikingly handsome, a slender, tall, dark-haired man with a gentle and charming manner.

During her entire marriage this patient had never had, she finally told me, “one solid hour of happiness.” From the very beginning she had quarreled with her husband, and the domestic strife, at least on her part, had become truly bitter after the birth of their first son. She had felt that her husband was becoming increasingly cruel, selfish, demanding, and insensitive to her needs. She had believed that he was trying to impose his will on her in any and all situations and that it was an absolute necessity to struggle against this domination. “I felt as if he would shatter my integrity if I didn’t put up a fight,” she told me. “It was as though he wished to have me as a slave, nothing less; it was either he or I.”

The quarrels were generally over the most trifling matters, and though her husband almost invariably tried to make up within a few hours, she would rebuff him, and consequently bitter feelings would often endure for a week or more at a time. These battles of will, or power struggles, would terminate only, it became evident, when she had felt that he had been sufficiently punished for his transgressions, though she confessed that by the time she was ready to forgive him she had often forgotten what the original quarrel had been all about.

She felt, too (still felt and always had), that her husband was extremely critical of her and that he never really gave her full approval for anything. She believed that he did not like the way she dressed, the way she conducted herself socially, or the way she managed the children. When I asked her just how he expressed his disapproval of her, to give me an example, she could not think of anything specific and concluded lamely: “Well, he usually praises me to my face, but I can tell by his expression that he doesn’t mean it.”

Later, in the areas she had specifically mentioned, I checked with her husband on his attitudes. He told me that he had felt at the beginning and still felt that his wife dressed beautifully and that she was absolutely perfect at any kind of social function. “She has a really remarkable gift for conversation of any kind with practically any person,” he said. On the other hand, he had sometimes felt that she tended to be too permissive with the children and that she worried about them excessively. However, he had learned early that he could not help her in this matter and only prayed that the children would have no adverse effects from her tendency to pamper them. I should like to report that, as she recovered, Patricia gradually became aware of the fact that this “critical” attitude she had ascribed to her husband was almost entirely a product of her personal problem.

Another powerful conviction she possessed was that her husband did not really love her. She felt that he was mainly interested in exploiting her, both for his “selfish” sexual needs and to advance his business. At the beginning of their marriage her husband had entered his father’s engineering firm and at once had been faced with the necessity of doing a great deal of entertaining. His wife, he soon found out, was an excellent hostess and he came to depend on her gracious parties mightily. His dependency on her collaboration she at once took for exploitation and even extended that to mean: “He doesn’t love me; he merely finds me a convenience. Any other presentable woman would suit him as well.” There was another twist to this irrational conviction, though it was more hidden and did not emerge until quite late in the treatment. Her feelings might be expressed in these words: “He didn’t succeed on his own; I made him what he is, even if I never get the credit for it.” Imagine, with an underlying feeling of this kind, how much chance for survival any tender feelings toward her husband might have.

As the sessions continued and Mrs. Agnew gained more and more confidence, she began to feel freer about discussing her sexual life. She at length confessed that she had never experienced any sexual pleasure in her entire life, neither before nor after her marriage. At no point, could she recall, had she ever masturbated or attempted to do so, even in early childhood. Kissing or being stroked gave her no sensations whatsoever. From the beginning, intercourse had been distasteful and often painful, though sometimes she took a slight satisfaction from the obvious pleasure her husband obtained from orgasm.

The actual sexual life of this couple had been at a virtual standstill for nearly eight years. Intercourse occurred, at most, at three-month intervals. It was never spontaneous. The husband was required to make an appointment for a “date” several days before actual intercourse. His wife would acquiesce to such a tryst only after she had refused him several times and had accumulated a great deal of guilt for so doing.

From the moment she made the appointment she would become anxious, and this would increase to the point where she was filled with actual dread. Often she would be forced to break the appointment and postpone it. As the time for the intercourse approached she would also experience feelings of rage, repeat to herself over and over, “Why must I, why must I?” In preparing for the act itself (putting her diaphragm in, inserting the jelly), she would linger for as much as an hour while her husband waited. She often found that her vaginal muscles contracted to such a degree that the insertion of the diaphragm was painful and difficult to accomplish.