The Sexual Life Of The Child Part 11

In conclusion, I will report a case which proves that when children are inclined to s.e.xual practices, they will find sufficient opportunity, even in the absence of coeducation. This was the case of a boy of eight and a girl of seven years, who stripped quite naked and got into bed together; from the fact that spots of blood were found on the bed-clothing, it appeared that very definite s.e.xual malpractice had taken place. The girl's s.e.xual history was followed up for three years after this. She showed herself much inclined to make s.e.xual advances towards adults, pressing herself up against them in a way which innocent persons interpreted as manifesting the caressive inclinations of the child.

Having given this ill.u.s.trative case, I must not omit to state that similar incidents may, of course, occur from time to time in connexion with the coeducation of children. But we must avoid the error of attributing to external chance-influences, such as coeducation, occurrences which are dependent upon the very nature of human beings; for such things happen whatever method of education be adopted.

Naturally, the difference between the s.e.xes must not be ignored; but in children the existence of s.e.xual differentiation must not be incessantly and anxiously emphasised. Brothers and sisters, when they have reached a certain age, should certainly not be placed naked together in a bath.

But this is to be avoided, not for fear lest thereby s.e.xual excitement might result in the children, but because to do so would be in opposition to the customs of our time, and it is precisely by such contrasts with generally accepted customs, that the attention of children is aroused. Further, we may approve of the fact that in consequence of the movement for child-protection (_Kinderschutz_), the misuse of children in various ways--in the theatre, for example--has undergone a notable diminution. But in this matter also, the decisive factor is not exclusively the interest of s.e.xual morality, but rather the rights of the children themselves. The same consideration applies, in part, to an earlier movement. In France, in the year 1848, the appearance of children on the stage was legally prohibited, one reason alleged for this enactment being the moral dangers resulting from the mixing of the s.e.xes in such conditions, but reference was also made more particularly to the need for the better protection of the physical and mental powers of the children.[138]

I come now to the description of certain other mental influences necessary for the child. A very important point is that we should use our utmost endeavours to divert the child from the s.e.xual impulse. The more the awakening of this impulse threatens to force itself upon the child's attention, the more necessary is it to bring into play the measured activity of other faculties and interests. We think here as much of methods of aesthetic culture, reading, and the theatre, as of bodily sports and games. At the same time, it must be our aim to cultivate the general strength of the will, since this is needed alike for the control of the s.e.xual impulse, and for the overcoming of other temptations and pa.s.sions. The general moral education of the child, the formation of its character, and the encouragement of a pursuit of ideal aims, are all also of the greatest possible importance in relation to s.e.xual education. Nothing is better adapted to ensure personal happiness and a high moral standard, than the inculcation of idealism, which must on no account be confused with aloofness from the everyday affairs of the world.

By many persons, an especial stress is laid upon the value of religious education, for the purpose of directing in proper paths the s.e.xual life of the child, and of giving help in the mastery of its temptations. But notwithstanding the fact that I value most highly a _genuinely_ religious education, I feel that for the purposes just mentioned we cannot place much reliance upon _that which in our schools of to-day pa.s.ses by the name of religious education_. I have been personally acquainted with too many persons brought up on "strictly religious"

lines, adherents of the most diverse creeds, but chiefly Protestants, Catholics, and Jews, whose religious education has been of remarkably little use to them in this respect. Among children, I have known some who m.a.s.t.u.r.b.a.t.ed immoderately, and yet their progress in their religious studies was extraordinary. I have known of serious epidemics of masturbation, in some cases of mutual masturbation, in boarding-schools in which the day's work was always begun with prayers and hymns. Quite recently, another case has been reported to me, of a so-called exemplary school, where the educational methods had a strong religious trend, and yet seduction to mutual masturbation played a great part. In spite of these experiences, I do not dispute the fact that even in a.s.sociation with the modern methods of religious instruction--but not always in consequence of these--many have been withheld from masturbatory and other s.e.xual acts. These cases fall into three groups. The first group consists of cases in which the s.e.xual impulse is very weak, so that very little is requisite to prevent the occurrence of s.e.xual practices. To the second group belong the cases of those who are kept in check by the fear of G.o.d's anger, which will be visited, they are taught in their lessons on religion, upon all unrighteous acts. The third group is comprised of those rare natures who are really profoundly inspired by religious ethical sentiments, and in whom even the ordinary unpractical methods of religious instruction have not been able to inhibit the development of genuinely religious feelings. These three groups may readily be recognised among adults as well as among children. But when I compare the number of the children and young persons making up these three groups with the number of those to whom religious instruction has been quite useless, I feel justified in a certain scepticism. I do not pretend to a.s.sert that those who have received religious instruction have become more immoral than the others; but I am certainly ent.i.tled to contest the a.s.sertion that religious instruction induces a loftier s.e.xual morality. Indeed, a further limitation is needed here, and one to the discredit of religious instruction. A portion, even, of those persons comprising the exceptional cases just enumerated, have not thereby attained to spiritual peace. Tormented, and at times almost mastered, by the s.e.xual impulse, they struggle unceasingly under the influence of terror lest they should commit a deadly sin by yielding to this impulse. The mental condition[139] of such persons--I speak chiefly of young men--is in some cases such that a doctor may well doubt if he be not justified in advising them to indulge in illegitimate s.e.xual intercourse. I have myself never given such advice in these cases, nor do I intend to give it in similar cases in the future. I refrain from doing so on ethical grounds, which I have discussed in great detail in connexion with the s.e.xual question in my work on Medical Ethics.[140]

The physician has no right to advise his patient to the performance of an act which is regarded by the latter as a deadly sin. But all the more because I have felt unable to give such advice, do I feel it my duty to insist here upon the seamy side of the education by which this state of mind is induced.

My view that what is commonly called religious education does not as a rule help the subject to master the s.e.xual impulse, has been forced upon me by the numerous confessions entrusted to me by persons who have received such an education. Very recently, I was shown a diary in which a young man, obviously very religious and pious, to whom G.o.d was the source of all hope, and who thanked G.o.d for His grace on every page, refers again and again to the fact that he has found himself unable to overcome the lower forms of sensuality. He writes: "In resisting this powerful sensual impulse, religion was of some help, but unfortunately not very much. When I was only twelve years of age, the impulse towards the lower forms of sensuality made its appearance, and speedily attained great intensity. Again and again I believed myself to be strong enough to withstand it, only to pa.s.s from a weak and inefficient resistance, to a profound fall." And later he writes: "But the lower sensuality persisted, however much and however often I resisted it. My imagination continually produced the horrible pictures. And though in desperate rage I clenched my teeth to drive them away, they always left traces in my soul, and from time to time I fell. How I have struggled, how I have fought! How often with tears have I sought G.o.d's protection and help, praising G.o.d with holy zeal and faith. In my room I knelt, praying for grace and strength. I write this, not for self-glorification, but to show you, dear reader, how terrible, how gigantic is the struggle for virtue."

Notwithstanding all that I have written, I do not for a moment dispute the fact that a religious education may effect admirable results, both in respect of s.e.xual matters, and of others. _Indeed, I am firmly convinced of this._ But the religious education competent to do this does not consist merely of learning Bible texts by heart; nor is its chief aim the inculcation of precepts which are to-day impossible of fulfilment--as the child sees at every turn in the conduct of the members of its own environment. I refer to the religious education which has an internal reality, and arises spontaneously out of the demands of morality. I do not mean the sort of education which regards it as almost a disgrace that we come naked into the world; not the religious education which regards man as soiled by the fact that he is born from his mother's womb; nor that which considers every s.e.xual act as essentially sinful, and asceticism as man's salvation. It is not religious education of such a kind that will have any good effect in the matter of s.e.xual education; but that religious education only which is in complete accord with our ideas of morality, and which is based, not so much upon the historical and material contents of the Bible, as upon the internal and everlasting truths of religion.

The s.e.xual dangers of the Bible have often been pointed out. But this work would be incomplete, if I omitted making a fresh reference to the matter. In the Bible, s.e.xual processes are repeatedly mentioned. In the mind of the child a conflict inevitably arises when, on the one hand, he finds that everything of a s.e.xual nature is diligently concealed from him, and, on the other, in the Holy Book which is put before him as the basis of his moral instruction, he finds that so much attention is paid to s.e.xual things. It is not the actual accounts of s.e.xual things in the Bible which const.i.tute the danger, but the contrast between the plain speaking of the Bible in these matters, and the general affectation of secrecy outside its pages. An additional point of importance is the fact that in the Bible s.e.xual topics are handled in a way which is by no means always delicate. I may recall the frequency with which the idea of the _wh.o.r.e_ is employed for purposes of comparison; and I may refer also to the occasional use of strongly erotic language, as, for example, in the Song of Solomon. A further danger lies in the fact that the Bible contains descriptions of customs which are no longer in harmony with modern ideas; it suffices to mention the accounts of polygamy in the Old Testament. Unless the distinction between what is historical and what is truly religious is carefully explained to the child, the latter's moral ideas will very readily become confused.

In this connexion, I must also refer to the Catholic confessional, about which of late years a good deal has been written. I may recall the disquisitions on the moral teaching of Liguori. The father confessors have to read books in which are discussed the questions of casuistry with which they have to deal, in order to learn what authoritative decisions have been given regarding the concrete cases on which they are asked to pa.s.s judgment. In these books, s.e.xual misconduct plays a leading part. This is also true of the confessional manuals written to a.s.sist the penitents in the discovery of their sins, in which s.e.xual errors also find a place. Opinions as to the wisdom of giving such manuals to penitents are certainly very divergent. When we read the authoritative decisions, for the use of confessors, p.r.o.nounced by Catholic theologians upon s.e.xual faults, we are sometimes astonished at the practical insight displayed in these decisions; the opinions expressed must, indeed, often appear dubious to the strict moralist, and yet they are occasionally marvellously well adapted to the practical requirements of the case. In many instances, however, even this cannot be admitted; and however right from the practical point of view the decisions may sometimes be, we must not overlook the dangers of the confessional. Cases have been personally known to me in which, at the confessional, penitents have been cross-questioned in such a way about s.e.xual details that unfavourable consequences were, in my opinion, extremely likely to ensue. This statement applies with equal force to the case of children, who have to go to confession as soon as they arrive at the "age of reason."[141] No one will dispute the a.s.sertion that the father-confessors gather much experience in the exercise of their profession, and that most of them possess sufficient tact to avoid asking improper questions. But to a.s.sert this of all of them would be to rush to the other extreme; and for the same reason that in the latter part of this chapter I shall express myself as opposed, at any rate in part, to s.e.xual instruction in schools, do I think that to ask such questions of children as are sometimes asked in confession, may in certain circ.u.mstances lead to very undesirable results. When the child penitent describes to the confessor s.e.xual faults (masturbation, &c.), however well intentioned the words of the confessor may be, it is impossible that they should be so individually adapted as is really necessary in such cases; and the detailed discussion of these matters which sometimes follows is open to grave objection. In what I have just said, it is far from my intention to attack one of the sacraments of the Catholic Church; but the matter is one to which it was necessary to allude, and I will merely add that the error must be avoided of taking as a basis for criticism much that is written with a party bias against the Catholic Church, and much also of the mockery of the confessional which abounds in erotic literature. For example, when Michelet[142]

a.s.serts that, in matters concerning love and the s.e.xual life, a French girl of fifteen is as far advanced as an English girl of eighteen, and when he refers this to the effect of a Catholic education in accelerating the process of human development, it is necessary to observe that these far-reaching generalisations are not supported by any jot of proof.

In the earlier parts of this chapter, I have discussed certain questions belonging to the psychical sphere in their bearings upon s.e.xual education. I have now to refer to two specialised methods of treatment: first of all, the one which has initiated the whole of the newer psychotherapy, namely, hypnotism; and, secondly, the psycho-a.n.a.lytic method. Hypnotism has been employed against all kinds of s.e.xual processes, both in adults and in children. As far as children are concerned, it is masturbation, in especial, for the prevention of which hypnotic suggestion has been tried. When the child is old enough to be hypnotised, good results will occasionally be obtained; but in many other cases the desired end can unquestionably be attained without the induction of the hypnotic state, either by suggestion in the waking state, or else by the other methods to be described in the present chapter.

Here are brief notes of a case in which hypnotic suggestion was employed with beneficial results.

CASE 17.--X., a boy eleven years of age, was diligent at school. For some time past he had withdrawn from the companionship of all his school-fellows, and his parents had noticed that he was continually in the company of a schoolgirl two years older than himself. He availed himself of every opportunity to play with this girl. When they sat together at table, it was noticed that they endeavoured to secure physical contact by bringing their knees together. In addition, they were often seen kissing one another. It was obvious that the two had a mutual inclination each for the other. If anyone gave the boy a present of money, he shared it with the girl. The two wrote letters to one another, and some of these letters fell into the parents' hands.

Thereafter the two were watched, so that this exchange of letters became impossible. At first, the matter was not regarded seriously; on the contrary, the two were teased about it, especially the boy. The latter became very unhappy, and for a time it was believed that the intimacy had been broken off. In reality, the rupture was apparent merely, and was simulated to escape the teasing. In secret, they continued to meet.

Whereas regarding the girl few details were at my disposal, I had a good deal of information about the boy. It was astonishing how many excuses he made to deceive his relatives. Sometimes he was supposed to be writing his home-lessons, sometimes to be at a gymnastic lesson or at church, when in reality he was with his girl friend. It had been observed before that the boy occasionally played with his genital organs. Since a complete separation from the girl gave rise in the boy to a state of profound depression, followed by his paying attentions to a somewhat older girl living in his house, his parents now sought my advice. The boy proved to be extremely susceptible to hypnotism and to hypnotic suggestion, and it was remarkable how rapidly a complete change in his demeanour was effected. Since then I have seen the boy occasionally, the last time being when he was about fifteen and a half years of age. There had been no return of the s.e.xual tendencies previously observed. Quite recently, indeed, he had been known to m.a.s.t.u.r.b.a.t.e occasionally; and it was for this reason that he was again brought to consult me. But for four years previously, notwithstanding the fact that he had been very carefully watched, no improper conduct had been detected. Undoubtedly, the recent practice of masturbation would have escaped notice, had not the parents been made very anxious by the earlier experiences. No special treatment was now undertaken, since it appeared that there was nothing more amiss than is observed in average boys of his age; symptoms which in most cases disappear spontaneously, and without treatment.

A short account must also be given here of the method of Breuer and Freud, or the psycho-a.n.a.lytic method. It is true that this method is applicable to adults only, but its aim is to relieve the ill effects of s.e.xual experiences during childhood. I have before pointed out that in Freud's view four neuroses always result from previous s.e.xual experiences; and two of these, hysteria and compulsion-neuroses (_Zw.a.n.gsneurose_) are considered by him to depend upon s.e.xual experiences during childhood. Freud, who originally worked out this method in co-operation with Breuer, but subsequently further developed it by himself, a.s.sumes that the hysterical symptoms which result from the noxious influences of s.e.xual experiences during childhood, are always permanently allayed if we succeed in making the subject once more actively conscious of them, and enable the emotions thereby again aroused in the mind of the patient to obtain an efficient outlet (_sie zum abreagieren zu bringen_). If we are able, either with or without the aid of hypnotism, to reawaken the effect which was originally experienced as a result of the s.e.xual trauma, the hysterical symptoms will be permanently relieved. Originally, he endeavoured to reawaken the memory of the s.e.xual trauma by means of the induction of profound hypnosis. Later, however, he was able to do this, without the aid of hypnotism, by conversing with the patient, and by awaking his memory by means of questions. This method, to which formerly Freud gave the name of the cathartic method, but which is now generally known as the psycho-a.n.a.lytic method, has to some extent been further developed by Freud's pupils. Freud's view is that by means of psycho-a.n.a.lysis he is enabled, from the sphere of the unconscious, or rather of the subconscious, to restore to the supra-consciousness the lost s.e.xual experiences of childhood or of later life; and by this means to effect a permanent cure of the most diverse diseases. No detailed criticism of this method of treatment will here be attempted, but my views on the matter will to some extent have become apparent from what has been said in earlier parts of this book. The value of Freud's work appears to me to consist chiefly in this, that he has insisted more definitely than other writers upon the reality of subconscious processes. But I believe that the general s.e.xual etiology which he a.s.sumes to exist can from no point of view be regarded as sound, even with the limitation which he later imposed upon his own doctrine, namely, that it is not the s.e.xual experience itself, but the reaction against this experience, which is etiologically significant. Recently, I have several times tried to treat by the psycho-a.n.a.lytic method some of the cases for which that method is supposed to be suitable, and as a result of my experience I have been forced more and more to the conclusion that, notwithstanding all the other advantages of the psycho-a.n.a.lytic method, _the importance of the factor of s.e.xual experiences in the causation of disease has been greatly over-estimated by Freud_. Moreover, I believe that the cures effected by Freud (as to the permanence of which, in view of the insufficiency of the published materials, no decisive opinion can as yet be given), are explicable in another way. A large proportion of the good results are certainly fully explicable as the results of suggestion. The patient's confidence in his physician, and the fact that the treatment requires much time and patience, are two such powerful factors of suggestion, that provisionally it is necessary to regard it as possible that suggestion explains the whole matter.

There are, of course, many other psychological influences to which attention must also be directed. One of the most important of these is the avoidance of psychical contagion. A boy who is s.e.xually premature, or in whom some other striking s.e.xual manifestations have occurred, may exercise an extremely harmful influence upon other children. We must endeavour to remove such a boy from the companionship of others, and in this country this often can be effected through the instrumentality of the Law of Guardianship (_Fursorgegesetz_). But it will by no means always be easy to find the guilty person. It is extremely common for such an abnormal child to set the tone for the others; and such a child may be making remarkable progress in study, although its s.e.xual and moral level is a very low one. A number of other measures will be inferred from what has been said in the section on etiology. These are social rather than medical problems. We must avoid letting children have the chance of seeing others engaged in s.e.xual intercourse; they must not live in too close and intimate an a.s.sociation with other children; they must not grow up in the society of prost.i.tutes; children who are past infancy should not share a common bed. As regards school-life, it is supposed to be a matter of great importance that there should be separate closets for the two s.e.xes. I am myself doubtful if this last matter is one of much moment.

In any case, we can interfere for the special protection of children who have been exposed to peculiar risks, and have for this reason been led astray s.e.xually. I have seen children who have been taught s.e.xual misconduct, either by a nursemaid or by other children, and have practised such misconduct for a time; but in whom a complete cure has resulted from separation from the seducer. In some cases, of course, it will be necessary to do more than this, and to subject the child to some special treatment; and in rare instances, in which the sphere of the s.e.xual is already markedly developed, it may be necessary that this treatment should be inst.i.tutional. But such cases are certainly very uncommon. A matter of importance is that the parents or other persons responsible for the care and guidance of the child, should understand the psychical management of children; for example, that they should not fall into the common error of regarding the love-affairs of children as a joke, and that they should not, by this att.i.tude, actually encourage the children in their course of conduct.

One part of s.e.xual education is made up by the question of the purposive s.e.xual enlightenment of children--a matter much discussed at the present day. I have shown, on page 8, that this question is not, as many suppose, a new one. Those who have written on the subject of s.e.xual enlightenment use this term with somewhat various meanings. As regards the extension of the term, it may be applied to either (or both) of two fields, which we may term the objective and the subjective aspects of the s.e.xual life. To the objective side belong the physiological processes by means of which is effected the reproduction of organisms, whether plants, animals, or human beings. In explanation of these it is necessary to describe the reproductive organs, and the processes of conjugation, fertilisation, and fructification, as they have long been customarily taught in the botany cla.s.s; and the nourishment of the nursing infant from the breast of the mother may also be described. To the subjective side, belong the relationships of the s.e.xual processes to the individual organism, the good and the bad effects of the s.e.xual impulse, &c. In this connexion, reference will be made to the dangers of masturbation, s.e.xual excesses, pregnancy, venereal infection, and so on.

By many writers, these two fields are not distinguished each from the other with sufficient clearness. The question, whether children should be taught about the methods of reproduction in plants, animals, and human beings, must not be confused with the question whether they should be taught about masturbation or the venereal diseases. It is possible to teach children that self-abuse is a harmful practice, without giving them any account of the physiological processes of reproduction; and, conversely, these processes may be described, without any special reference to the bearings of the matter on the individual life. Of course, the two fields are interconnected; and some writers suggest that in teaching children and young persons a proper respect for the genital organs, such teaching should be based upon a knowledge of the subsequent function of these organs in the work of reproduction. The individual processes cannot at once be referred to one field or the other; involuntary s.e.xual o.r.g.a.s.m, menstruation, the p.u.b.eral development, inasmuch as they exhibit both a subjective and an objective aspect, belong to both fields. This is also true of the s.e.xual act itself, in connexion with which, moreover, the princ.i.p.al difficulties of s.e.xual enlightenment arise.

Having thus considered the general significance of s.e.xual enlightenment, we have next to ask what are the grounds on which such enlightenment is thought to be desirable. These will have become partly apparent from what has been said regarding the importance of the s.e.xual life of the child; but this does not exhaust the matter, for the s.e.xual enlightenment of the child may also comprise instruction concerning the entire subsequent development of the s.e.xual life. The reasons for s.e.xual enlightenment may be cla.s.sified under various heads; the chief of these are reasons of health, of social life, of law, morality, education, and the intellectual development.

To consider first the matter of intellectual development, we have here to think, not so much of a limitation of the intellectual growth in consequence of the s.e.xual thoughts of the child, as of the fact that instruction in the nature of s.e.xual processes, at least as far as the objective field is concerned, promotes the general culture. The degree to which even adults are ignorant about such matters, is hardly credible. There are persons who believe that every egg laid by a hen will develop into a chicken if incubated by the mother, or if kept for the proper time in an artificial incubator; there are persons who do not know what the hard roe and soft roe of fishes are, who do not understand the nature of the sp.a.w.ning process, and are, in fact, quite uninstructed concerning the process of reproduction in fishes. I have conversed with adults who did not know wherein a wether differs from a ram, or a bullock from a bull; and who were even ignorant, as regards great groups of the animal kingdom, whether they reproduced their kind by means of eggs or living young. But on such matters as these, every cultured person should be sufficiently informed, and should not be capable of being shamed by the superior knowledge of an uneducated child from the country. On one occasion, I even saw a married woman, actually twenty-eight years of age, who had been examined by a gynecologist, and for whom the latter had recommended the operative division of the hymen; but the lady confused this operation with ooph.o.r.ectomy, and it was by no means an easy matter to make her understand the difference between the two. It will readily be understood that every grown man and woman ought ultimately to be fully informed concerning all such matters. In part, such instruction will take place at school, and more especially in the case of processes in the vegetable and lower animal world; these things will be explained in connexion with instruction in natural history and biology. But information about the human reproductive organs cannot be given in the school, unless to children of a considerable age; for these matters, direct personal instruction at home is more suitable.

Apart from the demands of general culture there are other reasons why s.e.xual enlightenment is desirable. These chiefly concern the subjective aspects of the s.e.xual life, whilst the objective processes serve princ.i.p.ally for preparatory instruction.

First of all, grounds of health have to be considered. It may be desirable to enlighten the child regarding the dangers of masturbation, those of ordinary illegitimate s.e.xual intercourse, and those of s.e.xual excesses. No detailed discussion of these points is here necessary, since they have been dealt with before at considerable length, especially on p. 180 _et seq._ Here I will merely point out that this aspect of enlightenment affects the entire future of the child and the family it will one day have. The first consideration here is the danger of venereal infection, and it is this danger, in close a.s.sociation with the other prophylactic efforts of our time, which has given rise to the recent movement in favour of s.e.xual enlightenment. In this connexion the dangers may be explained that threaten the male from gonorrhoeal infection, not only in his own person, but also in the persons of his future wife and children. The wife may be infected by the husband, and the visual powers of the new-born child may also be endangered.

Ophthalmia of the new-born, which often leads to blindness, commonly depends upon conjunctival infection received during the act of parturition. Syphilis was referred to on p. 192. Here it may be added that still-births and abortion and miscarriage may result from syphilitic infection either of the mother or of the embryo. Or the child may be born alive, but suffering from syphilitic infection. Even when no actual infection of the offspring results, syphilis favours the occurrence of a general degeneration of the progeny. If we desire to safeguard human beings against such dangers as these, we shall feel it necessary to enlighten them before it is too late; and in view of the fact that from a single act of intercourse infection may result by which the health may be permanently injured, such enlightenment is no less necessary for girls than for boys.

I need not describe the dangers to health resulting from masturbation and s.e.xual excesses, for these have previously been considered in detail; but it is necessary to allude to the exaggerated statements which are sometimes encountered regarding the dangers of masturbation, especially in popular works on the subject, so that the physician may be on his guard about this matter. A child who during and after the act of masturbation has a keen sense of wrong-doing, and consequently suffers much from self-reproach, may, if the fear is superadded of having done serious permanent injury to health, be affected with grave hypochondriacal manifestations. Many instances of this have come under my notice, in young men and young women of sixteen or thereabouts. Even when the practice of masturbation has long been discontinued, and the patient is quite grown up, such symptoms may arise, owing to the persistence of the fear of disastrous results, and the auto-suggestive influence of this fear. Nowhere is more tact required by the physician than in his dealings with those who m.a.s.t.u.r.b.a.t.e or have m.a.s.t.u.r.b.a.t.ed.

There is even a real danger that a moral lecture may cause a shock to the system; in the case of some young men it may sometimes be better to acquiesce in masturbation, rather than to alarm them by talking about the disastrous consequences of the indulgence. I refer to those unfortunate creatures who suffer from severe hyperaesthesia of the s.e.xual impulse, and who for social reasons are not in a position to satisfy the impulse in any other way than by masturbation, or who refrain from illicit intercourse in the well-grounded fear of venereal infection. The physician who has seen a number of such cases, who has learned how they continually relapse into the practice of masturbation, notwithstanding all their good resolutions and their conviction that masturbation is at once dangerous and immoral, will be likely to feel that it is better, not indeed to recommend masturbation, but from time to time tacitly to permit it. To do in these cases what it is well to do in certain others, namely, to describe the bad effects of masturbation, may give rise to grave conditions of depression, and even to suicide. Certainly, in such cases, we must carefully avoid alarming the patients too seriously about the consequences of masturbation.

In undertaking the s.e.xual enlightenment of the child, those phenomena of the s.e.xual life should not be forgotten which are shown by experience to arouse in the ripening child, now curiosity, and now anxiety--and the chief among these are involuntary s.e.xual o.r.g.a.s.m and menstruation.

Imagine the state of mind of the girl who has never heard a word about menstruation, and awakens one morning with blood flowing from the genital organs; or that of the boy, who has his first nocturnal seminal emission, without having received any information as to its significance. Similar considerations apply to some of the other signs of p.u.b.erty; and especially to the growth of the pubic hair, which has made many a child extremely anxious. Although, by the time this age is reached, a child has commonly been sufficiently informed about these things by his playfellows, we meet with instances in which nothing of the kind has occurred.

Hitherto I have been considering the hygienic grounds for effecting s.e.xual enlightenment; but there are also important ethical reasons for such enlightenment. It is not possible in our life to speak the truth always and unconditionally; but this fact does not give us the right to lie to children without good cause. Especially dangerous is it to relate to children fables about the stork or the cabbage-garden, at a time when they have long been enlightened about s.e.x from other sources. I recall the case of a girl seven years of age, whose mother was still in the habit of telling her that babies were brought by the storks; but this child was accustomed to join with other girls and boys in playing at "father, mother, and midwife," wherein they displayed a comparatively exact knowledge of the processes of reproduction and birth. We are not surprised when a woman tells us that as a child her confidence in her mother was seriously shaken from the moment when she was enlightened by others concerning the s.e.xual life, and she recognised that what her mother had told her about the matter was quite untrue. I do not mean to imply that stories of the stork and cabbage-garden variety are to be altogether excluded. It would be as reasonable to prohibit all kinds of fairy tales. Some tell us that we should tell children fairy stories only so long as they regard the whole of life as a fairy tale. But in view of the vivid imagination of childhood, no such sharp distinction is practicable. Let the reader recall his own childhood. Does the child regard the fairy tale as a lie, even after he has began to doubt if the world of fairy stories has any actual existence? Certainly not.

Similarly with regard to the stork fable. I consider that the complete suppression of this fable, unless we replace it with some like poetical fancy, can do nothing but harm to the child's nature. All that we must ask is that such a story shall not for too long be put before the child as fact. When the child's development has gone far enough, it will be well to dispense with the stork story. This is suggested by considerations both of prudence and of morals, and the like considerations urge us to describe to the child, tactfully and at the proper time, the true nature of the reproductive processes.

Such a course is desirable, if merely for the reason that when a child is s.e.xually enlightened by other children, this is usually effected in so coa.r.s.e a manner as very readily to undermine the bases of respect for the s.e.xual life of humanity. A child who has been instructed regarding this grave and important matter by his parents and in a proper manner, is in a position to reject offers of a coa.r.s.e method of enlightenment; but by the customary--too long customary--plan, as far as children are concerned, of altogether ignoring the s.e.xual life, children are deprived of the power of repelling obscene methods of enlightenment.

The legal dangers to which reference was made on p. 201 _et seq._ are additional reasons for undertaking the s.e.xual enlightenment of the child. I pointed out that, in certain circ.u.mstances, a boy of thirteen who undertook s.e.xual practices with a girl of twelve was committing a punishable offence. But s.e.xual enlightenment is desirable, not merely for those of this age, but also for those who are somewhat older. A large number of people are completely ignorant of our penal code in these relationships. I recall the case of a s.e.xually perverse young man of twenty who on a number of occasions performed the following acts with boys of about thirteen years of age. He would go to a public bath, induce a boy of thirteen or so to enter his dressing cubicle, and, as if in joke, tie the boy's hands together. In reality, as he did this, he experienced s.e.xual excitement to the point of e.j.a.c.u.l.a.t.i.o.n. This latter occurred especially when he touched the boy's body--not his genital organs. He had absolutely no idea that such acts were punishable with imprisonment, in accordance with the third paragraph of Section 176 of the Criminal Code; and it gave him a terrible shock when I explained to him that he had rendered himself liable to imprisonment. Some persons even believe that they may handle children's genital organs, for the purpose of exciting themselves s.e.xually, without rendering themselves liable to punishment. It is obvious that on these grounds also enlightenment on s.e.xual matters may be extremely desirable.

Finally, there are certain social and economic reasons for s.e.xual enlightenment. These reasons are closely connected with those bearing upon health, but they may in part be separated from the latter. No one will deny that illegitimate s.e.xual intercourse may entail grave social consequences. For women these dangers are much greater than they are for men; but for men, even, they are by no means inconsiderable. As far as women are concerned, the danger of extra-marital impregnation occupies the first place. The importance of this of course varies greatly in various regions and in different social strata. In the servant-cla.s.s in the country, for instance, pre-marital s.e.xual intercourse, and even pre-marital motherhood, is far from having the seriousness which attaches to these things among the old peasant families firmly rooted to the soil. Among the servant-cla.s.s in towns, the matter has a more serious aspect than among the same cla.s.s in the country. On the other hand, in many artistic circles in the Metropolis, pre-marital intercourse, even on the part of women, is regarded far more indifferently than in other strata of society. None the less, for a girl of the upper ranks, extra-marital pregnancy is for the most part tantamount to social annihilation. Even here exceptions occur, and we shall find good families of the aristocracy and the upper bourgeoisie in which a woman who has given birth to an illegitimate child, or even one who is manifestly a cocotte, will be socially recognised, provided she has attained some great position, such as that of a great artist, for instance. In such cases we may even find that women who on other occasions are unable adequately to express their hatred and contempt for prost.i.tutes and similar unfortunate beings, will yet be proud of their friendship with such a woman, and will boast of it in public. But such opportunities of social recovery are open to very few; most women of the upper cla.s.ses sink rapidly and far in the social scale as soon as it is publicly known that they have experience of illegitimate intercourse.

For this reason, such consequences must be taken into the reckoning. The objection need not be raised that the s.e.xual enlightenment would not safeguard a girl, since, when she gives herself to a man, a girl knows well enough that children are the result of s.e.xual intercourse. The objection is unsound, if we only have a right understanding of what we mean by s.e.xual enlightenment, and if at the same time we do not neglect the general s.e.xual education. Enlightenment should not be limited to merely making the person concerned aware of the consequences of s.e.xual acts; it should, as it were, become ingrained in the flesh and blood, so as to influence the actions, even unconsciously. A girl brought up in this way will defend herself instinctively against the wiles of a seducer. But only by such an education, by one which is not confined to the mere imparting of information, can we produce in the girl greater powers of self-protection and a more enduring self-consciousness, and so save her from the far too common fate of behaving like a stupid unripe creature, and believing all the a.s.severations of the first man who makes love to her--a.s.severations which the man himself, in the moment of pa.s.sion, very probably believes. Let me, then, repeat that all that appertains to the s.e.xual enlightenment must became part of the flesh and blood of the subject; only from this can we expect good results, whereas a s.e.xual education which consists merely in the acquirement of information, is altogether valueless. But by a true s.e.xual enlightenment, in the sense above defined, it is probable that many a girl may be safeguarded from prost.i.tution; and many a child, boys as well as girls, may be better protected against the attempts of paedophiles. And these considerations apply, not merely to childhood, but also to subsequent life--especially as regards girls. How many girls enter upon marriage quite ignorant and altogether inexperienced. They commit themselves to the keeping of a man of whom they know hardly anything at all. The parents are often satisfied with the most meagre information. It is considered improper to ask for detailed information regarding the husband's past life, and hence it often happens that a girl is delivered up to an unscrupulous man suffering from venereal infection, simply because she has never been adequately informed regarding the serious step she is undertaking, regarding the completely new mode of life upon which she is so suddenly entering. We thus see that there are ample grounds for explaining to a girl in good time precisely what she will undertake in entering the married state.

A question of importance is at what _age_ the s.e.xual enlightenment can most wisely be effected. Some advise that enlightenment should begin with our answers to the first questions the child propounds upon the subject; others contend that it is better to wait till it is somewhat older than this. There is truth in both these views; but the matter and manner of our communications must be appropriate to the age of the child with which we are dealing. When a young man is being sent to the university, it is wise to instruct him concerning the dangers of venereal infection; but to inform him that human beings come into the world as the result of an act of s.e.xual intercourse would be altogether superfluous. Conversely, if a child asks its parents where its little brother has come from, we do not need to say anything about syphilis and gonorrhoea; but none the less we can give such a child an account suitable for one of its age of the way in which human beings come into the world. Speaking generally, it may be said that the biology and physiology of reproduction--that is to say, the objective processes--may be described at a comparatively early age; but that cautions regarding masturbation should not, _in average cases_, be given before the age of thirteen or fourteen; and that instruction about the risks of venereal infection should be deferred until even later than this. In the case of boys, in so far as enlightenment in the school is concerned, information about venereal infection may, for practical reasons, best be given about the time the boys are preparing to leave for a higher school. In the case of girls, for whom a caution against risks of impregnation and against prost.i.tution are especially in question, we have also, as far as s.e.xual enlightenment in the school is under consideration, to recommend the time when they are about to leave school. But if we prefer that s.e.xual enlightenment, or at any rate a part of such enlightenment, should be effected at home rather than in the school (a course which I regard as essentially preferable), it will be impossible to lay down a fixed rule as to the age at which this should take place. To a lively girl of twelve or thirteen years, a great deal can be said far better by the mother, than can be said to a girl considerably older, say at fifteen, by the school physician, schoolmaster, or schoolmistress.

Speaking generally, in the case of girls, the enlightenment may well begin at a somewhat earlier age than in the case of boys--at any rate as regards the subjective processes of the s.e.xual life.

On the whole, it may be regarded as definitely established that the child may well receive information about the objective processes at a very early age, and this long before the time commonly regarded as marking the commencement of p.u.b.erty. But as regards the subjective processes, it is better that there should be some delay. It may, indeed, be asked whether it would not be preferable that in the case also of the subjective processes, the child should be instructed before they actually make their appearance in the child's own consciousness, to render possible the adoption on the child's part of a more objective att.i.tude towards these phenomena. But in reality such a course offers no advantages. The child is quite unable to understand the dangers of the s.e.xual life, as long as it has no actual experience of s.e.xual feelings.

For this reason, it is better to accept the view of those who contend that, as far as the subjective processes of the s.e.xual life are concerned, we should wait till near the end of the second period of childhood before beginning the enlightenment. But we must not forget what has previously been pointed out, that the p.u.b.eral development may begin at a time when nothing of the sort is apparent to the eye of the observer; and we must also bear in mind that the first seminal emission and the first menstruation are by no means so important, as marks of the p.u.b.eral development, as is commonly believed. For the fulfilment of the aims of the s.e.xual enlightenment, however, it does not so much matter when the first physical manifestations of the p.u.b.eral development make their appearance, but when the first s.e.xual feelings and sentiments, which must be distinguished from the unconscious and purely physical symptoms, are experienced. The important matter is, not whether follicles have already matured in the ovary, but what influence such a process has exercised upon the mental life of the child. For this reason, in our study of the individual case, we must have some knowledge of the psyche of the child with which we are concerned.

A matter also within the scope of our subject is the question by whom the s.e.xual enlightenment may best be effected. This question is connected with the questions for what reason and at what age enlightenment should take place. As regards these points, it lies between the school and the home. Some writers contend that so far as possible every thing, others, that, at any rate, a great deal, should be imparted at school. The latter view is also my own.

In so far as the enlightenment has to do with purely biological processes, and especially in so far as it relates to processes in the vegetable and lower animal world, it can be effected in the school, and in the first years of the second period of childhood; but of course the giving of such instruction at school does not prevent a father who goes out walking with his son, or a mother with her daughter, from seizing opportunities of giving information about the s.e.xual processes of plant-life. At school, education regarding such biological processes will form a part of the lessons in botany and zoology; or will be imparted in the cla.s.s on general biology, if such a cla.s.s exists.

Instruction in hygiene, such as is often advised, has little to do with the matters we are now considering; and at any rate could merely involve an elementary account of such processes. The school may even be the best place for s.e.xual enlightenment regarding the s.e.xual life of human beings, at least in the case of the older pupils. There is no adequate reason for objecting to boys about to leave school being warned by a schoolmaster or a physician about the dangers of venereal disease; and at the same time a plea may be put forward against the view that it is inc.u.mbent upon every young man to prove his strength by the maximum indulgence in s.e.xual intercourse.

But the matter is very different as regards the enlightenment concerning the subjective processes of the s.e.xual life of those who are still quite young. It is impossible to approve of the suggestion that a girl of twelve or a boy of fourteen should receive instruction in school as to the dangers of masturbation. Enlightenment of this sort must be given in a purely individual manner, and for this reason the school is here out of the question. It may be objected to this that we now and again encounter a schoolmaster who is able to establish between himself and his pupils a relationship of complete personal confidence, and that such a man is just as well able as the father to instruct his boys about these matters; _mutatis mutandis_, the same considerations apply to the exceptional schoolmistress as compared with the mother. But although it must be admitted that such cases really exist, they are--and this is no fault of master or mistress--such rare exceptions, that it is out of the question to base upon their existence a general rule that enlightenment upon these particular points should be given in the school.

Enlightenment regarding the earliest manifestations of the s.e.xual life, whether about the feelings or about the peripheral processes, demands such a degree of individualisation, that a schoolmaster or a schoolmistress, who has to teach from thirty to fifty pupils at once, or even a larger number than this, is quite unable to undertake anything of the kind. Such enlightenment can be properly effected only by an individual confidant, and by one who makes the fullest possible allowance for the child's own individuality. Such a confidant is most suitable, if only for the reason that enlightenment on these questions can best be effected, above all in the case of little children, as far as possible in response to spontaneous inquiries, or at least when an opportunity is afforded by some chance occurrence. The express manufacture of an opportunity, such as would be necessary in the school, might entail very unfortunate consequences; and even if, in response to a wide demand of our day, instruction in hygiene is given in school, either by a schoolmaster or a medical man, the antic.i.p.ation of such topics might have undesirable results. In the German Medical Congress of the year 1908, it was evident that even the advocates of hygienic instruction in the school were not all prepared to answer with an unqualified affirmative the question whether the school was the best place for effecting s.e.xual enlightenment; and a resolution proposed by Scheyer was adopted, to the effect "that this Congress considers that the question of the school taking part in the work of s.e.xual enlightenment is one which it would at present be premature to discuss."

Those who are inclined to a.s.sume to-day that we have left the older authorities far in the rear, would do well sometimes to study the works they despise. Basedow in his _Elementarbuch fur die Jugend und fur ihre Lehrer und Freunde_ (_Handbook for Young Persons, their Teachers, and their Friends_), gives some ideas as to how a mother may best enlighten her children regarding s.e.x-differences. Looking at a chest of drawers, one of the children says to the mother that the purpose of clothing is to protect the body from cold and heat, and to cover the private parts.

The mother replies that the last-named use of clothing is indeed very important, and that it is very naughty to allow these parts of the body to be seen, unless in cases of the greatest need. But the child goes on to say that an additional use of clothing is to help us to know one person from another, and to distinguish the female s.e.x from the male; and her little brother remarks that he knows of no difference between the s.e.xes other than that shown by the clothing: "If I were dressed like my sister, I should be a girl." "No, no, my child," answers the mother, "as time goes on, a girl's form becomes very different from that of a young man. In men, a beard grows; but not in women. Men cannot give birth to a child, nor can they suckle a child; they can only procreate children, or become fathers. For this reason, even from the time they are born, their bodies are different from those of little girls. And not only are their bodies different; their inclinations are different also; &c. &c." Although we may be disinclined to accept everything that Basedow and other early educationalists have said about such matters, none the less, in these old writings the modern educationalist will find much that is suggestive.

Of late years, now that the school physician has gained a higher position, the suggestion is sometimes made that it is by him that the s.e.xual enlightenment may best be undertaken. As far as children of a fair age are concerned, and in the matter of imparting warnings against the dangers of venereal infection, I share this view. But as regards enlightenment as to the personal s.e.xual life in the case of a child of thirteen or so, I am compelled to differ. My reasons will be obvious from what has been said before. The princ.i.p.al reason is that the enlightenment ought to be effected by someone who enjoys the child's personal confidence. Undoubtedly there are certain school physicians who fulfil this condition; and to such persons this task may, of course, be entrusted. The very fact that they enjoy the children's confidence suffices to show that they possess certain special qualifications for such a task, and further, that they have the faculty of coming to a real understanding with children. But the fact that a man is appointed to the position of school physician, does not by itself prove that he possesses to an adequate degree the fine perceptions and the tact that are needed in effecting the s.e.xual enlightenment; nor does it prove that he is the person best fitted to enlighten the children with whom he has to deal.

In this difficult matter, we cannot be too careful in formulating any general rule. The person who is to effect the s.e.xual enlightenment must possess, not merely a theoretical knowledge of the processes of s.e.x, but also the faculty of making these processes intelligible at the right moment and in the right way. But how is the school physician or the schoolmaster to know, in individual cases, the degree to which the s.e.xual life has developed? _He must have definitely abandoned the old view that either the child's age in years or the external physical signs of p.u.b.erty can be regarded as indicating with any degree of precision the progress of psychos.e.xual p.u.b.erty._ But since this latter, the psychos.e.xual development, should most often guide us in the choice of the right moment for effecting the s.e.xual enlightenment, we are compelled to depend upon an individual consideration of the child, such as will be possible only to a person who is fully in its confidence. We learn from everyday experience that even very near relatives, if they have failed to penetrate the child's intimate psyche, may have utterly erroneous conceptions of its mental life. They completely ignore the extent to which the s.e.xual imaginative activity has already developed; they know nothing as to whether the originally obscure sensibility of the child has now become focussed in a particular direction, so that its feelings are stimulated by definite individuals; they are ignorant of the degree to which the child's genital organs have become subject to the peripheral changes characteristic of s.e.x. In the fourth chapter of this work I have discussed the wide individual differences which children exhibit in these various respects; and a mere reference to the matter here should suffice to show that the most careful and detailed individual examination of the child-soul is indispensable, and that the observance of a mechanical routine in the process of s.e.xual enlightenment would be even worse than no enlightenment at all.

It is a question of great importance, who, outside the school, is the person best fitted to undertake the s.e.xual enlightenment; and I have repeatedly expressed my preference for the selection of the mother. But a mother who is unable to superintend the general education of her children, because she is compelled to spend most of her time away from home engaged in earning a livelihood, is not fitted to undertake the s.e.xual enlightenment of her children; equally unfitted for this is the mother who leaves the education of her children in the hands of hired a.s.sistants, whilst herself occupied in attending public meetings, perhaps on behalf of the woman's movement, of the education of children, of the promotion of the s.e.xual enlightenment, of rational dress, or the like, whilst her children at home are abandoned to moral corruption; and the same considerations apply to the mother whose nights are so much occupied in dancing and feasting, that the greater part of her days have to be spent in bed. Fortunately, however, there are many mothers who have very different conceptions of their duties to home and children. We find such mothers very often among the cla.s.s of skilled artisans, but also among the cultured middle cla.s.s,[143] although among these latter the desire to ape the manners of the so-called upper cla.s.ses is unfortunately far too general. I have seen cases in which the mother was still the confidant of her sons after they had entered the period of early manhood; and thus I have known a mother who in the case of a son of sixteen and even of eighteen years, was in a position to allay the grave anxiety awakened by the first occurrence of nocturnal emissions.

But where the mother is not the confidant, some other person must take this place, as, for instance, a governess or a near relative. In the case of boys, the father is often the person best able to undertake the s.e.xual enlightenment; or it may be a physician who enjoys the lad's confidence, and especially a family physician in the old and excellent sense of the term; in other cases it may be an elder brother, or an old family friend. Much good in such cases may be done by a friend, older, indeed, than the child who is to receive enlightenment; and yet not so much older as to make the child feel that a mutual understanding is hardly possible. In any case, next to the possession of a cultivated intelligence by the person who undertakes to effect the s.e.xual enlightenment, the point of greatest importance is that this latter person should receive the full confidence of the child. Only when the child has such perfect trust, will it accept as true what it is told, and not suspect that, as has so often been the case, it is being put off with hypocritical phrases--for children recognise the hypocritical character of much of what they are told about s.e.xual matters at an age far earlier than most elders are willing to believe. But another reason why the person who undertakes the enlightenment must be one who has the child's fullest confidence, is that in that case only can the child be expected to be absolutely straightforward. A very frequent mistake in dealing with children is to mistrust them needlessly. Let us suppose that a child has been discovered to m.a.s.t.u.r.b.a.t.e, and that it is spoken to very earnestly in order to break it off the habit. I have known cases in which, although everything pointed to the fact that the child had abandoned its bad habit, yet, when it denied masturbating any longer, it was accused of lying. A child will naturally never give its confidence again to one who has once unjustly reproached it in this manner. On the other hand, a child is far more likely to acknowledge its faults to one in whom it has perfect confidence. The child's confidence can be gained only by an individual confidant. In the presence of such a confidant, a child loses all sense of false shame, and this is an indispensable precondition for effecting a really valuable enlightenment. Where no individual is forthcoming who fulfils the requirements just specified, it is usually better to dispense with the enlightenment; and above all, in this matter, a mechanical routine must be avoided.

I will now briefly report a case in which a younger brother made a confidant of his elder brother, and will show how unwise it would be to lay down any general rule as to who is the person best fitted to undertake the s.e.xual enlightenment of a child.

CASE 18.--One day a student of medicine came to me to ask my advice about his younger brother, a lad of thirteen. This latter, an intelligent boy, was attending the upper third cla.s.s of the higher school. The boy confessed to his brother that he m.a.s.t.u.r.b.a.t.ed to excess, and that he found that scenes of cruelty especially aroused s.e.xual stimulation. I asked the student to bring his young brother to see me, and the latter made on me a very favourable impression, especially in the matter of his frankness. He spoke to me quite openly, and attended most carefully to all my advice. I explained to him truthfully that his future was endangered, not only by the masturbation, but also by the perverse ideas; I told him that the danger of a combination of masturbation with perverse ideas was especially serious; and I a.s.sured him that he was still at an age when it remained possible for him to develop into a normal man. Some years later, I saw the young man once more. His subsequent development had been excellent, and he was almost free from perverse s.e.xual sensibility.

In this case it would have been utterly wrong to insist on the lad's being enlightened by his father, his mother, his guardian, or his schoolmaster. The