One can picture a man entering his sexual life and making decisions about contraception. He is prepared by his early sexual and family experiences, and is under a yoke of expectation from both himself and others. He may be able to accept and assimilate such forces, or he may not be able to cope, using such defences as denial, splitting or internalized depression.
In our everyday work with patients, doctors will discover that the aggressive, pleasure-seeking stud is a rare beast, but if they can listen to the hidden feelings, doctors will find a more complex human being. Although he may have times of uncontrolled pleasure, they will be interspersed with upsurges of longing for safety and loving, and the problems brought by the need to be in control.
When in a stable pair bond, decisions about limiting his family will seldom be based on his personal needs alone. He will worry about his partner, and such concern is to be welcomed, but at other times it may be necessary to help him to pay more attention to his own needs. Such necessary concern for the emotional life of both partners may lead to a move from one contraceptive method to another until one is found that feels right.