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In most of the work dealing with sexual perversion an attempt has been made to differentiate between the perverse structures of the neuroses and the psychoses. Early writings concentrated upon instinctual development, but subsequently attention was shifted to the functions of the ego. It is, however, difficult to describe a perverse structure common to all the patients suffering from sexual anomalies which we find in clinical work. Classically, every individual who cannot have an orgasm without an anomaly in his choice of object, or without distorting the sexual act, is considered sexually perverse, sexual aberration being the necessary or sufficient condition of gratification. Observations show that there are many cases which do not come within this strict definition, some because, although they are able to have normal sexual intercourse, they prefer an abnormal sexual act, others because they experience their perversions more in imagination than in reality, which brings them within the category of neurotic patients. Despite the variety of structures which must be borne in mind, we believe we have been able to discover a constant feature in the object relationships of these patients.
i.In all the categories we have in mind, the patients keep a certain distance between themselves and the object which is unconsciously sc cathected that they escape a constantly underlying fear but nevertheless maintain a certain possibility of erotic gratification.
ii.They succeed in eroticizing just those mechanisms of the ego which permit them to maintain this particular object relationship.
Eroticization of defence mechanisms or of anxiety with the consequent possibility of orgasm is the specific characteristic of sexual perverts, whereas in neurotics this eroticization, even when it exists, is never recognized as such by the ego and in no case leads to orgasm.
A few preliminary remarks appear to us to be necessary at this point:
i.Let us remember that perversion is never a liberat