copulate, may be suddenly overcome with the idea that he
will fail, or by some other thought which paralyzes erection and
renders coitus impossible. The remembrance of such a failure and the
distress and shame attached to it, even efforts to produce erection
indirectly for another attempt, constitute further causes of
inhibition of the cerebro-spinal activity; they temporarily extinguish
the sexual appetite, and prevent by their interference the automatic
mechanism of erection which they strive to produce. The greater the
fear of failure, the more the psychic impotence increases. This
phenomenon may be limited to a certain woman, but it is more often
general. Sometimes an incomplete erection is produced, which is
insufficient.

This condition, which depends on auto-suggestion, is best treated by
hypnotic suggestion. The sentiment of impotence powerfully depresses a
man, and the depression increases his impotence. This condition often,
however, disappears by itself.

A special variety of psychic impotence is that in which erection takes
place, but the idea of ejaculation predominates so much that it
paralyzes the voluptuous sensations, and causes ejaculation to occur
without pleasure, or even erection to cease.

Impotence may occur at the first coitus, or may come on gradually. It
is often produced suddenly at the time of marriage in persons who
have hitherto been very capable, even in Don Juans. Men may have
normal erections and pollutions, but these may be stopped by
counter-suggestions at each attempt at coitus. Habitual masturbation
may in some cases contribute to produce impotence, but we must not
generalize from such cases, nor construct a dogma from them, for
continence may also be a cause of impotence.

All these details, which are combined in all kinds of ways with other
sexual troubles, but which are also produced alone in men who are
otherwise normal, throw much light on the relation of the momentary
mental state of man to his sexual appetite and the accomplishment of
coitus.

I do not know under what heading the following case should be placed:

A young man of steady habits, and normal sexual appetite, had
always abstained from sexual connection and masturbation. He
only had emissions during sleep. The latter were accompanied by
erotic dreams, but never produced an orgasm, while disagreeable
sensations occurred on waking. He married for love a woman in
whom the hymen was resis