PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICE
VOLUME 12, #2, SUMMER, 1975
ORGONE THERAPY: A CASE PRESENTATION
CHARLES KONIA
Spring Hill Farm, Easton, Pa. 18042
The purpose of this paper is to acquaint the
interested psychiatrist with the principles and
practice of orgone therapy. The scope of this
paper does not permit a detailed exposition of the
methodology. The reader is referred to the refer-
ence list for a more thorough understanding of
the therapy. According to Wilhelm Reich (1948,
1949) upon whose work the therapy is based,
neurotic symptoms are maintained by a stasis of
biological energy (orgone energy, in Reich's
terminology) in the organism. This formula-
tion, in turn, goes back to Freud's libido theory
(1959 a, b). Under conditions of health, energy
is periodically discharged in the sexual orgasm,
so that it does not back up into neurotic
symptoms or behavior. In emotionally disturbed
individuals, such discharge is blocked by armor,
which is both characterological (psychic defense
mechanisms) and biophysical (muscular ten-
sion, bodily rigidity).
The capacity for complete discharge of energy
in the orgasm is called orgastic potency. Its es-
tablishment is the goal of orgone therapy. Reich
demonstrated clinically that orgastic potency is
the single most effective criterion in the treat-
ment of emotional disorders since it: 1) is the
only sure means of preventing relapse into pre-
genitality and symptom formation by providing
a natural discharge of excess energy through the
genital embrace; and 2) presumes the greatest
degree of restructuring of the individual not only
sexually, but in every aspect of functioning,
including the capacity to work and think ration-
ally.
The fundamental difference between orgone
therapy and other forms of psychiatric therapy is
the use of direct work on the patient's body in
order to eliminate muscular armor and increase
mobility. In many instances this remains the
most effective manner of reaching emotions that
are held in muscular tensions. This is done in
conjunction with analysis of character defenses.
192
When armor is loosened, there is a release of
blocked emotion (anger, sadness, fear, sexuali-
ty) which has been held back by the armor; with
emotional letting-go, energy flows more freely
through the organism and can be more readily
discharged in the orgasm. A crucial objective in
therapy is to allow the organism to tolerate the
rise in energy level obtained by the dissolution of
the armor. This is especially important when the
final pelvic armoring is removed, at which time a
sudden increase in energy occurs.
As Baker (1967) states,
Therapy is not simply a matter of 'working' on muscle
spasm or producing dramatic emotional outbursts. The
efforts of the organism to express itself must be carefully
watched and the organism must be assisted in that expres-
sion by overcoming the obstacles which present them-
selves. Resistances are recognized and eliminated by re-
leasing muscle spasm, increasing push through it, reveal-
ing character defenses, overcoming ignorance, and pre-
senting problems in understandable perspective. Thus the
organism gradually unburdens itself of its restrictions and
expresses its buried emotions from superficial to deep,
until basic repressions that involve the Oedipus conflict
are met and overcome.
I have selected this case because it represents a
clear, uncomplicated picture of Orgone therapy.
ANAMNESIS
The patient was a 25 year old single white
school teacher who came to therapy because she
wanted to settle down and stop running from
herself. The aspect of her behavior that she
found most disturbing was her relationships with
men. She had a history of repeated unsatisfying,
short-lived sexual experiences. In general she
chose men who treated her abusively, often to
the point of physical punishment. She was en-
tirely unable to protect or extricate herself from
these situations which invariably ended with her
being jilted.
She married a Negro drug addict musician and
 ORGONE THERAPY: A CASE PRESENTATION
went to California with him. While there she
made several short attempts at psychotherapy,
including a series of five LSD sessions. When
her husband died of a heroin overdose, she felt
somehow responsible. Returning to the east, she
gradually became fed up with her behavior and
decided to get herself straightened out.
When I first saw her she was about 25 pounds
overweight. Typically she ate when depressed or
anxious, following a disappointing love affair.
She was unable to be alone for any length of
time, requiring the constant reassurance of
someone near. She was frigid and was able to
have only minimal genital sensations through
oral genital foreplay. This was often accom-
panied by masochistic fantasies of being forced
to submit sexually, or imagining that she herself
had a penis.
Past History
The patient was an only child. Her memories
of her father are few; however there were two
distinct screen memories that she recalled. The
first was of being chased under her bed by her
father after she cut her mother's dresses with a
pair of scissors and then not being punished by
him; this left her with a definite feeling of sexual
excitement. The second occurred just prior to his
death, when she was eight. At that time she had
inadvertently seen him naked, and she inter-
preted his death as a punishment. Immediately
following his death she began overeating to the
point of becoming obese. In addition, she be-
came spiteful towards her mother until she was
totally out of her control, and had to be restrained
by a maternal uncle. She related this behavior to
being angry with her mother for not remarrying
and bringing another father into the home. At the
same time, her behavior produced a fear that her
mother would also leave her, and she turned into
a "good little girl."
Biophysical Examination
The patient tended to be soft-spoken and
seductive. When frightened, her facial expres-
sion became indifferent or calm. She was of
average height and heavily built. Aside from her
obesity, which was mainly centered in her legs,
thighs and abdomen, the most prominent feature
was her mouth, which seemed to be stuck with a
tremendous emotional charge behind it. The ex-
193
pression varied between a smirk, disgust, indif-
ference or boredom, depending on her mood.
Her face appeared tense and bloated. Her eyes
were frightened and slightly bulging, but were
lively and expressive.
TREATMENT
The Ocular and Oral Segments.* I began by
focusing on her indifferent facial expression,
which I felt concealed her most superficial layer
of rage. She admitted that behind her indiffer-
ence she was afraid of showing her anger and felt
that she would get "kicked in the face" if she
ever revealed her true feelings. At the same time,
I worked on her facial tension by having her
make faces. This made her frightened and she
recalled her inability to express her anger to-
wards her mother's helplessness and lack of un-
derstanding. When she behaved spitefully, her
mother's favorite phrase was '' what did I ever do
to deserve you?" This made the patient feel
frustrated and worthless, but she invariably got
even with her mother by becoming even more
spiteful.
Gradually when her face lost some of its
bloated appearance, and looked somewhat more
expressive, her distrust of men began surfacing.
She admitted not knowing how to be herself with
someone who was not as bad off and ' 'crazy'' as
she was. She was afraid that any other kind of
man would find out what she was really like, and
have nothing to do with her. Therefore the surest
way to avoid rejection was to submit sexually
and become a "receptacle."
Discussion of this material was soon followed
by a sneer and she was able to express a few brief
angry shouts. However her anger soon became
stuck in her chest and she became dyspneic. I
prodded her trapezius muscle to mobilize this
anger and that produced more angry faces and
shouting. She was greatly pleased with this out-
burst but immediately became frightened and
had the urgent feeling of having to do something
more. I interpreted this as a fear of incurring my
disapproval by not being a good patient, and
related it to pleasing men out of fear. She left
with a serious look on her face. In the following
sessions she entered feeling angry with me for
what I had said last time, but knew that I was
* Muscular armor occurs in seven segments, perpendicu-
lar to the long axis of the body: ocular, oral, cervical,
thoracic, diaphragmatic, abdominal, and pelvic.
194 CHARLES KONIA
correct. As she became somewhat more trusting,
she stated that I was the only man that she didn't
have to please. I took this declaration with a
grain of salt, since I knew that she was still
unable to show emotions, especially anger, fully
in her eyes. I therefore went back to mobilizing
her eyes by having her roll them and express
fear. Gradually they became less proptotic. Then
with pressure on the masseters, she was able to
show anger in her eyes while shouting "Stop
it!" She looked as if she could stab me. This was
the strongest anger that she had expressed, and
following this her face appeared more open. She
began asserting herself in her daily life.
When she began to enjoy making angry faces,
and became somewhat contactless with herself, I
knew that a layer had been worked through and
waited to see what would happen next.* I didn't
have to wait long. In the next session she had a
lost look in her eyes, and reported that her weight
had been steadily increasing. Her distrust be-
came intensified. Expressing rage in her face
beyond a certain threshold produced a great deal
of fear; she turned her head away so that I would
not see her angry looks. I again mobilized her
terror by having her look startled with her eyes.
This produced the strongest fear she had ever
known. She cried and felt afraid of being alone.
When I saw her in the next session her face had
regained that typical swollen, bloated appear-
ance that she had when I first saw her, and she
reported that she had eaten voraciously all week.
She looked intermittently confused, lonely,
frightened, and angry. During the session I kept
after her tendency to please me, and related it to
her fear of being abandoned, pointing out that
any display of anger means desertion. Mobiliz-
ing fear from her eyes at this time was fairly
easy. Rolling her eyes, she would scream in
panic for entire sessions at a time. This was often
accompanied by crying and an expression of
1
Layering refers to the stratification of the armor. In
general, the surface corresponds to more recent (superficial)
emotional material, while deeper layers correspond to older
historical material. There are certain indications that a given
layer has been worked through. One is the fact that the patient
does not offer resistance to expressing the emotion in ques-
tion, but on the contrary, appears to enjoy it. Another is
following the sense of contact with oneself that occurs with
the dissolution of a given layer of armor, the patient often
reverts to a state of contactlessness. This appears when the
emotional push from within is counterbalanced by an equal
force of resistance against its expression.
sadness in the lower part of her face. Intensifica-
tion of her fear made it necessary for her to block
off her deeper emotions from her throat. Squeez-
ing a towel (which often helps relieve a spastic
throat) partially helped to mobilize the throat
block, but then her tongue interfered.2
At this time, in spite of her fears, she termi-
nated an unsatisfying relationship with a boy-
friend. She began to assert herself with men, and
to feel that she had some rights in a relationship.
In therapy she became somewhat brazen and
decided she was not going to please me by show-
ing feelings, unless she genuinely felt them.
At this time I attempted mobilization of her
oral rage, by pressure on the masseters, but this
proved to be premature. She became distrustful
again, and looked at me as if I were going to
leave her. I therefore went back to her eyes and
had her express more fear alternating with anger.
This brought out murderous thoughts and feel-
ings directed at me, but this made her feel guilty.
As she became able to tolerate her fear, her
throat spontaneously became mobilized and she
began making deep frightened sounds. At this
time her fear was so intense that she had to touch
me to convince herself that I was still in the
room. She recalled that her mother could not
tolerate any display of anger, and felt at those
times as if she were actually going crazy.
Now her deep oral rage, in the form of biting
became accessible. She growled, moved her jaw
with a biting motion and felt like killing. This
was the strongest anger that she had felt thus far.
It took the form of a blinding rage towards her
mother for being so controlling and hypocritical
and this was followed by quivering of her lips for
the first time.
The Abdominal Segment: In the next session
she reported the following dream: Her father is
sick, and her mother is preventing her from see-
ing him. She recalled that at the time of her
father's death she was never told that her father
had died, only that he was sick and went away.
This made it possible for her to deny the reality
of his death and years afterward she still
searched for him. At this time, mobilizing fear
from her eyes brought out her deep fear of aban-
donment. She felt terror and wanted to scream
out "Daddy don't leave me," but could not.
This gave into deep sobbing. She began feeling
2
The tongue is functionally part of the cervical segment
which includes the throat.
 ORGONE THERAPY: A CASE PRESENTATION
her mourning over her father's death.
In her daily life she began to tolerate being
alone for longer periods of time, and in therapy
she came in touch with the intense rage in her
abdomen (where most of her fat was centered).
This rage, in turn, intensified fears of abandon-
ment. She became "scared stiff" and screamed
out in panic. This alternated with more abdomi-
nal rage which finally ended in strong abdominal
cramps. She recalled a time just prior to her
father's death, when she had accidently seen him
naked. She felt somehow responsible for his
death since this image was frightening and pro-
hibited. It was immediately after his death that
she began to overeat.
Deeper mobilization of her fear of abandon-
ment produced dyspnea accompanied by a fear
of dying, and she began to quiver in her arms and
chest. She identified this fear as a punishment for
having killed her father. Then followed very
strong rage towards me which she also felt down
to her abdomen. She looked hatefully at me and
shouted "I hate you!" She compared me to her
father and stated that she loved me, but that I
didn't love her, and would leave her just as her
father had done. This outburst was followed,
during the next week, by a moderate amount of
weight loss from her abdominal area. This
weight loss intensified her terror, and strong
frightened shouting poured out of her for long
periods of time.3 This resulted in sensations in
her pelvis and thighs, although her genital was
bypassed.
Then followed deep sadness at her father's
death. She felt a deep longing for him, accom-
panied by an emptiness in her stomach, and
described having fantasies of her father being in
her abdomen. She felt strong reluctance to face
her sadness since this made her feel vulnerable.
She also began having genital sensations for the
first time in her life, but was afraid to tell me, for
fear of being discharged as cured. I reassured her
that this was not the case, and that she was only
beginning to have genital feelings. There was
still a lot of work to be done.
As she began to trust me more, the spasm in
her lower abdomen gradually began to yield and
3
Excessive fat can be looked upon as a form of armoring.
The fat soaks up energy (1 gm. fat equals 9 calories as
compared to 1 gm. protein equals 4 calories) and also acts as
a protection against stimuli. It interferes greatly with
therapy. Behind it is a great deal of anxiety.
195
she began experiencing an almost unbearable
longing for her father. She cried out uncontrolla-
bly, "Daddy, why did you leave me, why did
you have to die?" Further expression of this
longing from her lower abdomen produced
strong anxiety in her perineum. At this time she
developed a fear of getting appendicitis and dy-
ing. She felt this would be a punishment for
having sexual feelings for her father. The long-
ing for her father gradually developed into fan-
tasies of swallowing him both through her va-
gina and orally.
End Stage: The Pelvic Segment: I then gently
massaged her jaw. This produced very strong
biting from her mouth, accompanied by squeez-
ing of her pelvic floor. She expressed a very
strong rage in her pelvis and thighs, as if she
were biting with her vagina. Following this she
felt intense genital longing, and felt that her
vagina wanted to be filled with a penis. During
the session breathing produced a pelvic retrac-
tion on expiration (preorgastic sensations).4
In the following session jaw mobilization re-
sulted in very powerful clonisms, which ter-
rified her. I knew that once her jaw finally gave,
she would quickly develop the orgasm reflex
provided that she did not clamp down in another
segment.5 I was not wrong. Within a few min-
utes the reflex appeared. This at first terrified
her, and she cried out of fear. But then very
strong surges of sexual excitement overcame
her, and she cried "I can feel! It's wonderful!"
Her jaw looked open, and her whole face ap-
peared to have completely lost its tension, taking
on a seriousness and depth that was not there
previously. She felt very alive and sexual.
During the last few sessions I focused on
completely eliminating the biting from her
mouth and vagina. During one session her
pleasurable pelvic sensations became blocked.
This led to a violent explosive anger at everyone,
including me. She shouted and kicked and hit.
4
Preorgastic anxiety arises when genitality is being re-
established and sexual impulses, no longer blocked, reach
the genital. Because the patient cannot tolerate them, con-
traction occurs, often manifested as pelvic retraction on
expiration.
5
The orgasm reflex refers to "the unitary involuntary
contraction and expansion of the total organism seen during
respiration if energy flow is uninhibited. Also seen at the
acme of the sexual act, suppressed in most humans."
(Baker, 1967).
196 CHARLES KONIA
"I want to be well! I don't want therapy any-
more!"
As she gave up her attachment to me, she
slowly relinquished her Oedipal ties to her
father. She became capable of staying open sex-
ually and achieving genital gratification. Cor-
respondingly, her relationships with men
changed. She began to select men, not out of
neurotic motives or fantasies, but on the basis of
whether or not they provided genuine satisfac-
tion of her needs. Therapy lasted 215 sessions.
DISCUSSION
A precise understanding of the structure of the
armor, both from a characterological as well as a
biophysical standpoint, which presumes an ac-
curate biopsychiatric diagnosis, is essential for
the successful treatment of any patient. Since the
major armoring of this patient was in the pelvic
segment with the secondary source of armor in
the oral segment, this patient was an hysteric
with an oral unsatisfied block.6 Her pelvic ar-
moring was manifested by the fact that a primary
aspect of her neurotic character was a constant
push toward genital contact with simultaneous
running from her sexual feelings because of anx-
iety (Fenichel, 1945). The end result was that
she was left chronically unsatisfied.
Complicating her basic structure was her se-
vere pre-genital (oral) block. Her mouth was
genitalized and served as a substitute to fulfill her
sexual desires. Unlike the simple hysteric who
runs at the first sign of a sexual encounter and/or
sexual feelings, this patient would cling tenaci-
ously to any man with whom she became in-
volved. During the course of therapy, constant
mobilization of her oral block was therefore es-
sential. Prior to loosening up a deeper level of
armoring, the therapist repeatedly had to return
to the oral segment and release the particular
emotion that was being held.7
In attempting to understand the treatment of
this patient it will be helpful to follow logically,
step by step, the layering of the armor from the
6
A block, which is functionally identical with muscular
armoring of an erogenous zone, is of two types: repressed or
unsatisfied. In the repressed, armoring is more complete and
no impulses are allowed through a given erogenous zone. In
the unsatisfied type, strivings are felt and impulses get
through the block, but the zone cannot yield sufficiently to
fulfill needs (therefore we have over-eating, over-drinking,
over-talking, none of them with any satisfaction.)
most superficial to the deepest expressions.
Psychologically one traces the layering from the
patient's most superficial character traits through
the deeper emotions which underlie the Freudian
unconscious (secondary drives, Reich) to the
successful resolution of the Oedipal conflict
(Fenichel, 1945).) From the biophysical aspect
one passes through the segmental layering of the
armoring, from the most superficial features in
the upper segments (eyes, facial expressions,
etc.) down through the cervical, thoracic, dia-
phragmatic, abdominal, and finally into the pel-
vic segment where the Oedipal conflict is
thoroughly dealt with.
The skillfulness of the therapist depends on
his being able to perceive which aspect of the
armor is closest to the surface and therefore
requires his immediate attention. To begin with,
this patient's glib, indifferent facial expression
covered the most superficial layer of her fear of
showing feelings. She would get "kicked in the
face" if she did. Expressing this fear brought out
her spiteful anger, primarily directed at her
mother for controlling her and interfering with
her life. Exposing this anger immediately
brought out a deeper layer, her present-day dis-
trust of men based on a fear of rejection by them.
This fear made her behave like a nice, sweet little
girl, and turned her into a "receptacle" to be
used by any man. Working through this distrust
brought out sneers and other angry faces. This
anger in turn, revealed a deeper fear of aban-
donment on an oral dependent level directed
toward her mother. "Don't leave me the way
Daddy did" is what she felt at this point. Until
now the primary focus of attention was in her
first and second segment (the ocular and oral),
but as her emotions became deeper, she began to
block in her throat. Facing her fear of maternal
abandonment brought out angry biting, ex-
pressing her rage at being deserted by the
mother. It was at this time that the patient first
had fleeting oral-genital sensations with quiver-
ing of the lips. This rage was followed by deeper
fear of abandonment by the father, which slowly
gave way to profound rage toward him, and
therefore towards all men. She felt the source of
7
The importance of an open ocular segment which under-
lies the contactful experiencing of every emotional expres-
sion cannot be over-emphasized. In this patient this segment
was not heavily armored and therefore was able to be
mobilized as the lower segments opened up.
 ORGONE THERAPY: A CASE PRESENTATION
this rage primarily in the upper part of the ab-
dominal segment. Expression of this hatred was
followed by a deeper fear of longing (fear of
being hurt) which began from her lower abdo-
men. This fear was based on her feeling that her
father would leave her if she expressed any feel-
ing toward him. This was followed by a pro-
found sorrow and longing (localized in the lower
part of her abdomen) for her father. Correspond-
ingly, she began to lose weight (gave up the
incorporated father in her abdomen) which was
followed by sensations in her pelvis and thighs.
This gradually produced preorgastic sensations,
and the crystallization of the incest wish and
castration anxiety (sexual taboo for longing for
her father and the revival of her fear of punish-
ment for seeing him naked). This in turn gave
way to very powerful biting from her mouth and
vagina based on her impulse to bite off and
swallow her father's penis. Finally came the
197
total mobilization of her jaw: her organism gave
in with clonisms of the jaw and pelvis which led
to the orgasm reflex and orgasm anxiety (fear of
dying). Tolerating these feelings soon produced
strong feelings of genital excitation and the es-
tablishment of genitality.
REFERENCES
BAKER, E. F.Man in the trap, New York: MacMillan, 1967.
FENICHEL, O. The psychoanalitic theory of the neurosis.
New York: Norton, 1945.
FREUD, S. Sexuality in the aetiology of the neurosis, Col-
lected Papers, Vol. I. New York: Basic Books Inc., 1959
(a).
FREUD, S. Further remarks on the defense neuro-psychosis,
Collected papers. Vol. 1. New York: Basic Books, Inc.,
1959 (b).
REICH, W. Function of the orgasm. Orgone Institute Press,
1948.
REICH, W. Character analysis. Orgone Institute Press,
1949.