Content Warning: Portnoy’s Complaint depicts antisemitism and an attempted rape.

The novel begins with a description of Portnoy’s Complaint, a medical disorder named after Alexander Portnoy. Those with Portnoy’s Complaint find that their extreme (often perverse) sexual desires are at war with their ethical and altruistic impulses. The description is written by the protagonist’s psychoanalyst, Dr. Spielvogel.

In a session with his therapist, Alex Portnoy describes how his mother is “so deeply embedded in [his] consciousness” (5) that when he was in school, he believed that all his teachers were actually his mother in disguise. He was so convinced that his mother had the magic power to transform into other adults and was always evaluating him that he became very honest and intelligent. His father is a perpetually constipated, self-loathing, Jewish insurance salesman who wants his son to achieve the success that he never could. Though he tries to take pride in his work, his customers don’t respect him. Alex believes that, like “so many Jewish men of his generation” (7), his father serves his mother, his sister, and—in particular—Alex himself. Alex remembers playing catch with his father and being disappointed with his father’s complete lack of sporting ability, but he was unable to express that disappointment to him.