BOOK REVIEW : Sex Holds Clues to Mysteries of the Mind : THE PORNOGRAPHER’S GRIEF AND OTHER TALES OF HUMAN SEXUALITY <i> by Joseph Glenmullen</i> ; HarperCollins $28, 248 pages

The theme of these 10 case studies from the files of Dr. Joseph Glenmullen, a Harvard Medical School psychiatrist, are variations on an observation made by Anna Freud in 1981. She noted that the world her celebrated father had explored seethed with sexual repression but that, the sexual revolution notwithstanding, sexuality is still intensely private and remains the key to understanding personality disorders.

Glenmullen has set himself an ambitious task. Looking back over a century of changing sexual mores that includes the sexual free-for-all of the ‘60s and today’s perhaps AIDS-inspired conservatism, he has sought paradigmatic cases to explain sexual dysfunctions in their contemporary guise.

Glenmullen’s tales reveal the analyst at work, slowly excavating the terrain of the patients’ memories until hidden events and relationships emerge to explain the predicament. As the title reveals, these events are inevitably sexual.

Although the events may be sexual, the sexual element is usually a screen for something else. In the title story, for instance, “The Pornographer’s Grief,” we meet Scott, an MBA with a good job and a girlfriend who complains that he can’t feel anything. His emotional numbness is preventing the relationship from growing.

Eventually Scott reveals that he takes walks several nights a week to a seedy neighborhood, where he visits a porno shop and buys and reads the much-handled magazines. His problem is addiction, and pornography is the substance he abuses. The therapist’s job then is to find the source of the addiction.

Glenmullen points out that addictive behavior is not important in and of itself but is a clue to uncovering the childhood trauma that triggered it in the first place. This is, of course, the same trauma that is making him numb and preventing him from having a satisfying emotional relationship.

The most complex and ultimately satisfying story in this collection, “Traumatic Juxtapositions,” begins with a couple coming to therapy. The wife has had a nervous breakdown after witnessing a fight between two strangers in a convenience store. Noting that the wife’s sustained malaise seemed out of proportion to the triggering incident, Glenmullen probes to find deeper causes: the kind of childhood horrors we are getting used to confronting in the news. (To reveal more would be unfair).

Glenmullen’s tales, addressing problems ranging from bulimia to sex between therapists and patients, are as relevant to our own time and place as Freud’s story of Dora was to 19th-Century Vienna. His message, in case it was missed in the tales, is writ large in the postscript: “Sex as Metaphor.”

Where Freud found sex at the root of all psychiatric troubles, Glenmullen sees sex as a clue that can be used to find that root.

Ever since Oliver Sacks began recounting his experiences as a neurologist, collected medical case studies have become a popular genre. But it is not as easy as it looks. Sacks specializes in recounting unique and often bizarre instances of brain injury, leaving unforgettable images in his reader’s mind. But Glenmullen has chosen to disguise his patients by homogenizing many cases into bland stereotypes.

“The Pornographer’s Grief” is interesting if not compelling reading. No single patient elicits our compassion. Perhaps this is the result of making composite stories.

Glenmullen’s real success is his vivid description of what it is like to be a therapist. He demonstrates the delicate and decisive role played by a psychiatrist who is reluctant to prescribe drugs but is sometimes obliged to, and who, in his willingness to wait for what may be a very long time for a satisfying result, shows that healing is an art as well as a science.