Paternal dominance exactly the opposite type of history has been recorded in five cases of men referred for treatment of secondary impotence when therapy. His fears for sexual performance and, for that matter, almost any measure of performance were overwhelming.

His discussions in therapy were mixtures of praise and damnation for his father. His consistently hopeless personal comparisons with presumed levels of paternal performance were indeed sad to behold.

There have been five examples of one-parent family imbalance (permanent absence of either father or mother from the home). Retrospectively, the histories essentially join those of the composite reports of maternal or paternal dominance.

Therefore, there seems little relevance in further illustration. It really matters little whether parental dominance is achieved by force of personality, with the opposite partner continuing in the home as a second class citizen, or is irrevocably established by absence of one partner from the home on a permanent or semi permanent basis (professional demands, divorce, death, etc.).

Unopposed maternal or paternal dominance, regardless of how created, can destroy any susceptible young man's confidence in his masculinity. With maternal dominance, the paternal role can be painted so gray and meaningless that there is little positive male adult patterning available for an impressionable teenager.

Unopposed paternal dominance:
May create such a concept of overwhelming masculinity for an impressionable teenager that it is impossible for him to match his ego strength with the paternal image enshrined by his fantasy.

With too little or too much masculinity as a pattern, he becomes increasingly sensitive to any suggestion of personal inadequacy.

Failure of performance, any performance, may be over whelming in its implications.

The beleaguered male frequently extrapolates real or presumed social and professional pressures into demands for performance. As his anxieties increase, he becomes progressively more unstable emotionally, is quite easily distracted, and complains of feeling chronically tired in a well-recognized behavior pattern.

Finally, some occasion of sexual demand finds him unable to respond effectively. For any sexually oriented, personally secure man there is always tomorrow.

But for the insecure, pressured male, it is the end of the line.

All else fades into the background as he focuses on this new failure. Is this the final evidence of loss of his masculinity? Fears of performance, regardless of original psychosocial focus, are rapidly transferred to sexual concern be cause it is so easy to remove sexual functioning from its natural physiological context.

Religious orthodoxy provided the same handicap to the secondarily impotent male as that emphasized in the discussion of the primarily impotent man. Twenty-six instances of secondary impotence directly related to religious orthodoxy have been identified among 213 men referred for secondary impotence.

To a significant degree, the histories of primarily and secondarily impotent men are almost parallel when religious orthodoxy has major etiological influence. Six of 32 cases of primary impotence were at least sensitized to sexual dysfunction by their religious backgrounds.

The histories of the 6 men with primary impotence and the 26 referred for treatment of secondary impotence show remarkable parallels with the exception that there must be at least one instance of successful coitus in the history of the secondarily impotent men.

The 26 cases of religious orthodoxy divide into 6 Jewish; 11 Catholic; 4 fundamentalist Protestant; and 5 mixed marriages in which both husband and wife, although professing different religious beliefs, were gravely influenced by rigid controls of religious orthodoxy during their formative years.

The symptoms of secondary impotence frequently do not appear for the first hundred or even thousand exposures to sexual function.

A significant exception is established when reviewing the histories of these 26 men. Severity of religious orthodoxy places pathological stress on any initial coital process. For the relatively non susceptible male, regardless of the sexual handicap of theo logical rigidity, this tension-filled opportunity usually is met without failure at sexual functioning, or if there is failure, repetitive sexual exposure during the honeymoon provides ample opportunity for successful completion.

There are, however, a number of susceptible men who do not follow the usual male pattern of successful consummation of marriage. These are the individuals who may develop symptoms of primary or secondary impotence.

Erection influence by religious orthodoxy, the symptoms of secondary impotence develop through two well-identified response patterns.

The first pattern divides into two specific forms:

1. Infrequent success in the first coital opportunity usually followed, despite this initial success, by failure in the first few weeks or months of the marriage.

2. most frequent, erective failure usually underscored during the first sexual opportunity provided by the honeymoon and continuing despite virginally frantic efforts to accomplish consummation.

For some ill-defined reason a successful vaginal penetration is recorded in the first month or six weeks of marriage; occasionally this is followed by a few more uneventful sexual experiences, but soon fears of performance assume unopposed dominance and, thereafter, the male is essentially impotent.

In the second pattern, at least six months and frequently many years will pass without consummation of the marriage. Then in some unexplained manner, vaginal penetration finally is accomplished and there is wild celebration, but the future is indeed dark.

There usually is a brief period of time (a week to a year at the most) in which sexual function continues alternatively encouraged by a success and depressed by a failure. Fears of performance fight for dominance, but so does the sexually stimulative warmth of a partner.

Effective sexual functioning assumes an off-again, on-again cyclic pattern. This cycling of sexual dysfunction is castrating in itself. The untoward effects are essentially as damaging as if the marriage had continued unconsummated.

The pattern of occasionally successful sexual functioning followed by inexplicable erective failure produces a loss of masculine security and abject humiliation for the untutored, apprehensive, sexually immature male, and creates a high level of frustration and loss of both social and personal security for the female partner.