Understanding Perversion in Clinical Practice

Structure and Strategy in the Psyche

Fiona Ross

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429923548
• Edition: 1
• Topic: Psychology
• Subtopic: Cognitive Neuroscience & Neuropsychology
• Index: Psychology

Understanding Perversion in Clinical Practice is a volume in the eagerly anticipated clinical practice monograph series from the Society of Analytical Psychology. Aimed primarily at trainees on the psychotherapy and psychodynamic counselling courses, those compact editions will be invaluable to all who wish to learn the basics of major psychoanalytic theories from an integrated viewpoint. The authors are Jungian analysts trained at the SAP, highly experienced in both theory and practice. Perversion is a concept that defies simplistic classification. This monograph provides a comprehensive study of the nature of perversion and the therapeutic relationship needed for treatment. Case studies are used throughout to illustrate aspects of perversion and notable psychoanalytic theories are detailed for greater understanding of what perversion is and how it can be treated. Female perversion is explored in a separate chapter as the symptoms and underlying reasons are quite different from those in male perversion.This is a helpful and succinct exploration of perversion in its numerous manifestations that provides a firm foundation in the subject.

Chapter One

The Character of Perversion

Psychotherapy is about ‘the space between’. It is not just about the patient and certainly not just about the psychotherapist but it is about what happens between them. But psychotherapy focuses on another space between that is particularly important in the treatment of the perverse patient. This second space is between what the patient actually does and his experience. The first space is interpsychic and is crossed backwards and forwards again and again, by interactions between the couple in the consulting room. The second is an intrapsychic space and the dark hiding place of meaning.

It can be extremely difficult to understand the connection between the perverse behavioural symptomatology described by a patient in his relationships with others and the typically charming exterior and the engaging manner he initially displays towards his psychotherapist.

It might be useful to think of patients driving to psychotherapy in their own vehicle. We would easily recognise those with bumps and scratches inflicted through their trafficking in the world and with a little more skill we would diagnose a bent axle or a cracked chassis. It is not so unusual for a new patient to drive to therapy in a heavily armoured tank. We see the armour-plating and know there is a long hard battle ahead but at least we have sight of what we, and the patient, are up against. When the perverse patient comes, he comes in his submarine and the only part he allows into the consulting room is the periscope. This periscope is alert, responsive and adept at engagement, so we may feel optimistic about forming a good therapeutic alliance. The trouble is that we will have engaged with a part that does not represent the whole. In fact the periscope is nothing like the submarine. Usually periscopes communicate with their submarines through an arrangement of carefully placed mirrors. In the case of the perverse person there is a complicated system of distorting mirrors designed to misinform and to deceive. The deception is not only endemic to the internal system but also designed to confuse communications between the inner and the outer world.

Definitions

Louise Kaplan usefully describes a perversion as a mental or psychological strategy. The aim of the strategy is to deceive and to mislead (Kaplan 1991:9). Chapter 2 will expand on this essentially deceptive quality of perversion that confuses the onlooker as to the underlying meaning of behaviour. On the surface there might appear to be something neat and recognisable about perversions. This is particularly so because they are behavioural and can be classified.

The Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition (American Psychiatric Association, 1994) classifies perversions according to their specific behavioural manifestations. Here they are named Paraphilias (para = deviant, philia = attraction). Below are those listed with my own brief summary of characteristics. Readers are advised to consult DSM-IV for a definitive psychiatric description:

Exhibitionism: exposure of the genitals to a stranger, with or without masturbation, usually with the conscious desire to shock or sexually arouse the other.

Fetishism: sexual interest in nonliving objects, commonly women’s clothing, particularly underwear and footwear. Tactile or sensory contact (e.g. smelling) with the object or use of the object by a sexual partner may be necessary for sexual satisfaction.

Frotteurism: rubbing the genital against a non-consenting person, usually in a crowded place. Also fondling of a woman’s genitals or breasts.

Paedophilia: sexual activity, with or without intercourse, with a pre-pubescent child.

Sexual Masochism: acts that involve suffering or humiliation perpetrated either by oneself or a sexual partner. They include bondage, whipping, cutting, sexual servitude, oxygen deprivation (hypoxyphilia).

Sexual Sadism: deriving sexual satisfaction from the psychological or physical suffering of the other.

Transvestic Fetishism: sexual excitement through cross-dressing, usually with masturbation.

Voyeurism: secretly watching people undressing, naked, or engaged in sexual activity.

Examples of Paraphilias Not Categorised: telephone scatologia (obscene phone calls), necrophilia (corpses), partialism (exclusive focus on part of body), zoophilia (animals), coprophilia (sexual arousal dependant on excremental activity of some sort) klismaphilia (enemas), and urophilia (urine).

Specific expressions of perverse desire may change with the evolution of society. Stalking, for example, is now regarded as a dangerous infringement of individual rights and could be categorised as a perversion. Development in technology has opened up new channels for the communication of pornographic material, and for the seduction of minors through internet chat rooms.

Perhaps there is only one underlying perversion, which expresses itself in a variety of behavioural outcomes. If that were so, we would be looking at a syndrome or cluster of characteristics indicating a particular organisation of psychic structure, protected by a defensive system. We could begin to understand this structure and its defences by looking at some of the characteristic themes associated with sexually perverse acts. Sandwiching the word ‘perversion’ between ‘sexually’ and ‘acts’ suggests a comprehensive model linking the instinctual, the emotional and the behavioural. I will present the characteristic themes which appear within a perverse system and then return to them individually and in combination showing how the system is established and how it functions to preserve the integrity of the self.

Characteristics of Perversion

Anxiety is a bubbling undercurrent lapping at ego weaknesses and at other vulnerable structures in the troubled psyche. If perversion has taken over, the anxiety ceases to express itself through communicable neurotic symptoms that the psychotherapist might receive as the patient’s way of showing distress and asking for help. When the rigidity of a perverse solution cuts in, the patient’s presentation of his difficulties can seem strange, different, encapsulated, inaccessible and often meaningless. Connected with anxiety is the psychic conflict, which becomes embodied and is expressed in acting out. The threat to psychic equilibrium leads to a compulsion to act as a substitute for the internal processes of remembering and reflecting. If the patient cannot bear to remember or to reflect, the only way to resurrect deeply disturbing material may be to act out. At least this gives an indication of the distress the patient suffers even if the acting out may itself be destructive or retaliatory. In the case of perversion, acting out usually involves a crossing of the body barrier: it is an intrusive relationship with the body of another person. When the patient is in a heightened state of anxiety, perverse acting out can restore a feeling of self-esteem. Bodily action becomes the psychic regulator. There is a compulsion to alleviate anxiety by distracting the psyche so it focuses on short-term goals that offer excitement and relief.

In the perverse act there is a denial of difference. There is a denial of generally accepted boundaries of age, position, part/whole, and of opposites. This is an undifferentiated world of psychic shit (Chasseguet-Smirgel 1985:128).

The Core Complex is at the heart of perversion. (Glasser 1979:278). This is the addictive push-pull movement of attraction-repulsion: a craving for closeness or merger with the loved object, which, when acted upon, leads to an experience of terror at being overwhelmed or devoured. Although present in other pathologies, in sexual perversion the intense feelings, including aggression, have become eroticised.

Splitting and part-object relating characterise a world of fantasy imposed upon an unwilling other. There is little sense of the wholeness of a two-person relationship. (Stoller 1986:x) refers to the dehumanised, unloving aspects of human behaviour that emphasise anatomical more than interpersonal gratification.

Idealisation of part objects and idealisation of the pre-pubescent self. The well-known figure of Peter Pan could be seen as J. M. Barrie’s idealised pre-pubescent image of himself. Pre-genital sexuality in perverse adults results from a fixation at a premature stage of psychosexual development rather than regression from full genital sexuality to an earlier stage.

Humiliation and Retaliatory Triumph. The perverse act is characterised by overwhelming hostility and aggression. Some understanding of the retaliatory dynamic may be found in the tragic case of the paedophilic murder of a nine-year-old boy some years ago. When previously in Wormwood Scrubs, one of the killers, Timothy Morss, had attended group therapy sessions for sex offenders. In one such session he outlined his favourite fantasy. He wanted to “pluck a blond boy, aged between eight and thirteen, from the street, take him somewhere quiet, bugger him, strangle him and then dispose of his body”. (Campbell, Elliott and Bowcott 1996:6) This was a man who had himself been sexually abused as a child. It has the quality of reversal of opposites - the humiliated child becomes the persecuting adult.

How do these themes come together in perversion? For Stoller perverse behaviour is that which seeks to harm or dehumanise (Stoller 1986:211-12). McDougall defines perverse acts as those “in which an individual (1) imposes personal wishes and conditions on someone who does not wish to be included in the perverse individual’s sexual scenario (as in the case of rape, voyeurism, and exhibitionism); or (2) seduces a non-responsible individual (such as a child or a mentally disturbed adult)” (McDougall 1995: 177). According to Cassell’s English Dictionary perversion is “The act of perverting; a misinterpretation, misapplication, or corruption; the act of forsaking one’s religion; sexual derangement.” This suggests cognitive, behavioural, spiritual and sexual aspects to perversion. There is a strong sense of wrongness in this definition: a moral or even legal wrongness. How do we understand this wrongness in psychoanalytic terms? The most useful concept I have found to contain this and other facets of perversion is that of deception. This will be the focus of Chapter 2.

Returning to the characteristics of perversion and their interrelationship, anxiety heads the list. Because it is an ‘undercurrent’ in the unconscious, it is also a driving force that moves the ego to action. The intensity of the anxiety is so severe that there is a call for an immediate solution to alleviate the suffering of the self. This anxiety fuels a perverse syndrome of addiction and somatisation with risk taking and sometimes criminal behaviour in the outer world. The perverse act allows the patient to escape temporarily from his anxiety and therefore from the need for further perverse action until the level of anxiety begins to rise again. So the patient may appear to be presenting with an episodic disturbance, whereas he could more usefully be seen as taken up by a perverse cycle in which anxiety builds to a critical point and is then dispelled by action. The cycle affords immediate, but short term, protection from the experience of deep depressive anxieties and grave feelings of loss. The action circumvents conflict in that the anxiety does not lead the patient into contemplation of his inner world but turns outwards and drives the ego to act. The experience of anxiety is so unbearable that the patient turns away from his inner world to find an immediate solution to the suffering of the self. It is this urgency that causes the ego to become linked to action rather than neurosis, although it does not in itself explain why such action is perverse.

Not only is the individual locked within an endless cycle but he is also fixated at an earlier stage of development. For Freud all sexual aberration resulted from fixations and traumas in childhood. Jung might have associated such behaviour with fixation on an extroverted attitude without inner reflection or an adjustment only to the demands of the external. “An individual who adjusts himself to it is admittedly conforming to the style of his environment, but together with his whole surrounding he is in an abnormal situation with respect to the universally valid laws of life” (Jung 1963:335).

Here Jung is describing a drivenness, a need to find a solution in the outer world even if this upsets the balance of the psyche and deprives the inner world of the ability to reflect and find inner meaning in outer action. So preoccupying and obsessive is this solution finding in perverse behaviour that many men placed in Grendon Prison for sex offences against children saw sex offending as their true occupation rather than their stated job or profession. This preoccupation with behaviour confirms the extent to which, in the psychic sense, perversion is about staying still and not about development and change. Freud described the work of psychoanalysis as “Remembering, repeating and working through” (Freud 1924:147). This he considered to be the opposite of acting out, in which the patient avoids remembering anything that is forgotten or repressed but alternatively acts it out from his unconscious. The patient repeats without knowing. This dismissal of the value of acting out was challenged by Greenacre, who described acting out as a form of remembering rather than its opposite (Greenacre 1950). Limentani distinguished three fairly well defined groups of acting out: 1. Acting out as an expression of the individual’s fantasy life. This may lead to an act which is difficult to understand but can be understood if the motivation is allowed into consciousness. 2. Acting out geared to finding a solution to internal conflicts. Limentani sees this type of behaviour disorder as oedipal in origin and as typical of many sexual offenders and of cases of compulsive taking and driving away. 3. Acting out as a form of communication with the analyst (including messages that the patient wishes to solve his psychic conflicts through anti-social behaviour). All three types of behaviour are within the range of a patient who frequently resorts to perverse solutions (Limentani 1966:74).

Acting out always involves denial. It denies the expression of parts of the self, which might allow for reflection and it denies the experience of psychic pain by diversionary behaviour. Chasseguet-Smirgel goes much further in describing the omnipotence of this denial as almost a total denial of reality. “It is a fatherless universe submitted to the total abolition of the limits between the objects and even between the molecules, a universe which has become totally malleable, a fatherless universe where the subject confers upon himself the creator’s powers, the subjects having abolished all genital procreation in favour of anal production” (Chasseguet-Smirgel 1985:122).

Such denial is a turning away from reality testing. Klein describes the developmental importance of reality testing in seeing that internal objects are safe by good experiences with outer objects. Inner reality is tested by outer reality. With every positive experience the child’s good inner objects become more firmly established. When the depressive position arises, the ego is forced to develop methods of defence, including manic defences that are essentially directed against the ‘pining’ for the loved object (Klein 1975:344).

In perversion the denial involves a distortion of what is whole and separate, what is different and the same. There is a oneness of process and content that Jung might see as a return to the mentality of participation mystique; a reliving of the infantile non...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• About the Author
• Preface to the Series
• Introduction
• Chapter One The Character of Perversion
• ChapterTwo Deception
• Chapter Three The Trickster
• Chapter Four Female Perversion
• Chapter Five Assessment
• Chapter Six The Psychotherapeutic Relationship
• References