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In this paper we explore themes that emerge in psychoanalytic work with couples, particularly in those couples presenting with sexual problems, from the more ‘ordinary’ difficulties of anxiety about being intimate to the more pathological manifestations in perversion. We examine how unresolved conflict in the internal world, especially in relation to the internal couple, can lead to difficulties in the capacity for intimate relating. We suggest that intrusive projective identification and the use of ‘defensive sameness’ and ‘defensive difference’ serve as defences against intimacy. These defences function to obliterate the reality of the other and it is in this sense that we use the term perversion. Finally, we comment on the difficulties for the therapist who may feel drawn into a perverse arena when working with couples with sexual problems.
To illustrate these themes, we offer an interpretation of the film sex, lies and videotape (Soderbergh 1989). In this film we can observe a set of characters demonstrating the range of these difficulties, with the advantage that we do not encounter any problems about confidentiality.
sex, lies and videotape presents us with four main characters, all of whom have a relationship with each other. The film witnesses the different kinds of couples they form, ranging from the marriage between John and Ann to the more transient liaison between Graham and Cynthia. John is an upwardly mobile lawyer who has just become a partner in his firm. He is married to Ann, and they have a beautiful home in a comfortable middle-class American suburb. As the film opens, we see that he is engaged in a torrid affair with Cynthia, his wife's sister.
Ann is beautiful. She gave up work upon marrying and now occupies herself with looking after her husband and their home. She is obsessive about housework and sees a therapist with whom she talks about guilt and anxiety that the world will be overrun with garbage. She has lost interest in sex but realizes in d