Etiological Factors in a Case of Male Perversion

Perversion is an imprecise term used loosely to designate sexual variance. Although sexual perversion is viewed as deviant behavior, there are a number of sexual activities of a nongenital nature which are considered normal or at least not representative of significant psychopathology. Anna Freud1 stated that perverse behavior in an adult signifies that primacy of the genitals has not been established or, as a consequence of regression, has not been maintained. In Three Essays on Infantile Sexuality,2 Freud theorized that the perversion is the negative of the neurosis. While this view predates Freud's structural theory, and does not incorporate an evolved theory of defense, it does suggest that sexual perversion can be viewed as equivalent to neurotic symptoms and can be analyzed on this basis. In A Child is Being Beaten,4 Freud presented his hypothesis which related sexual perversions to the Oedipus complex. Freud concluded that perversions in men derived from an Oepidal phase in which an incestuous attachment to the father is paramount. Freud, however, did not dismiss the possibility that pregenital fixations could contribute to the evolution of sexual perversion. In the Schreiber case, Freud stated that individuals who have not “freed themselves completely from the stage of narcissism” are exposed to the danger that some “unusually intense wave of libido, finding no other outlet, may lead to a sexualization of their social instincts and so undo the sublimations that they had achieved in the course of their development.”3 Kohut5 proposed that specific, circumscribed disturbances in the narcissistic realm are usually the motive behind the evolution of sexual perversions. In this formulation, perversion is viewed as the sexualization of pathological, narcissistic constellations.

Thus, while no widely accepted theory of perversion is available, theorists are of the opinion that Oedipal and preOedipal phase-specific disturbances can be incriminated. In the case to be p