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The literature on the four perversions discussed is confusing and often contradictory; the approach is piecemeal, focusing on the genital behavior rather than on the total personality and complete psychodynamics. Long-term analytic study and treatment, using a holistic approach, permitted a better understanding of a series of eight patients and resulted in the giving up of their perverse sexual activity.
The early parental attitudes could not be causally related to the development of the perversion except in a non-specific sense. The mothers of these patients were recalled ambivalently as having been domineering and manipulative as well as loving and protective, with inconsistency or conflict between these attitudes. The father was seen as either ineffective and passive or strong and awesome, but distant. Both parents were felt generally to have shown a lack of emotional expressiveness and overt warmth. The childhood activity which became the perversion was initially a habitual, non-sexual behavior, one that provided the child with the greatest degree of relatedness to the parents in an otherwise conflictual, rejective, or emotionally cold atmosphere. It did not seem to be related to any libidinal strivings, either pregenital or oedipal. The sex of the parent concerned was less significant than the degree of acceptance and warmth derived. The behavior then became compulsive as basic anxiety and conflict between repressed and expressed anxiety-relieving attitudes developed in the child. It became sexualized during early adolescence, in the course of the maturative changes of that period.