Primal Scene and Sexual Perversion

Before discussing the unconscious meaning of sexual perversion and the possible elements of what might be called a 'perverse' structure I should like to delimit the clinical concept of such a structure as opposed to a neurotic or a psychotic one. This presents some difficulty since a perverse organization cannot necessarily be deduced from, or defined simply in terms of, the incidence of deviant sexual behaviour. Sexual aberrations occur in people with differing psychic structure and the same sexual act may have a significantly different meaning and function according to the personality. Nor may such a structure be said to include people whose sexual relations or whose masturbation is regularly accompanied by what might be termed perverse fantasy, since this is in no way specific and might be considered by many to be the prerogative of the neurotic. In contradistinction, the individual whose sex life is expressed mainly through manifest and organized perversion usually displays a singularly impoverished fantasy life. This may mean that his inner object world allows him to imagine sexual relations solely from one limited perspective (Sachs, 1923). In addition, his ego structure is such that he usually feels compelled to carry into immediate action most of what he imagines. On the whole he has little erotic freedom, whether in act or fantasy. Nor may we include in the category of a stable perverse organization those patients, often of hysterical structure, who have engaged in incidental homosexual adventures, nor the obsessional analysands who recount perverse phases such as fetishist or anal erotic experiments. These have a qualitatively different meaning and function. The erotic expression of the sexual deviant is an essential feature of his psychic stability and much of his life revolves around it. A similar qualitative distinction is to be made for people whose ego and object relations are predominantly psychotic. Such individuals sometimes seek out ho