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DR. FREEDMAN CLEARLY DOCUMENTED and has explicated the dynamic issues in the perversion and has traced its genetic development. Such patients usually present strong preoedipal character outlines, which ordinarily resist psychotherapeutic treatment. Most cases of major perversion that come to psychoanalysis have much longer and stormier therapies with much more limited gains, if not outright failures.
In this instance, not only did the patient show developmental growth as a result of his psychoanalytic treatment, but a six-year follow-up seems to suggest that there has actually been a consolidation of these gains. Dr. Freedman addresses himself to this knotty question of his patient's uncommon plasticity and capacity for growth, attributing it to the fact that he had attained a normal phallic-oedipal level of development before a series of repeated and intense traumata evoked unusually strong castration anxiety, resulting in a regression to preoedipal positions in which his adult character and pathological perversion were grounded.
Dr. Freedman goes on to suggest that we may be able to distinguish those cases of perversion which are analyzable