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Despite the many studies of perversion that have been undertaken since Freud's masterly essay (1905), there is still much about the subject that is unknown. Freud's statement that 'neurosis is the negative of perversion' proved incomplete, and he later modified it (Freud, 1915), (1919), (1927), (1940). It revealed the importance of infantile sexuality in perverse behaviour, as is the case with neuroses, where, because of anxiety, the ego utilizes defences that are more or less adequate but the suffering and unhappiness still persist. In perversions, on the other hand, the defences are fixated to the sensation of pleasure because the ego accepts the infantile sexual components and the repression of others. Freud and other authors have stressed the great importance of the Oedipus conflict and castration anxiety in perversions because of the frequent occurrence in such patients of persistent anxiety, strong sensations of danger in relation to the sexual act, fantasies of vaginal castration and of damage to the penis during the sexual act. The perversions were increasingly studied, as were the neuroses and psychotic mechanisms. These studies stressed the characteristics of the ego–superego defence system or those of the instinctual life (sexuality and aggressiveness) as being dependent upon biological-constitutional and environmental factors.
Some of the most important discoveries that have contributed to the psychoanalytic theory of perversions are: identification in homosexuality with the parent of the opposite sex as being dependent on oral conflicts predisposing to the reversed Oedipus in the phallic stage; negation of castration in male exhibitionism; defensive reinforcement in the sadism and masochism of individuals with a strong death instinct; intense aggressiveness projected on to objects and turned against the self in sadomasochistic perversions; scopophilia produced by erotization and aggressiveness in looking due to trauma and primary scene fantasies;