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An earlier report (Stolorow & Grand, 1973) described a 25-year-old male patient with marked ego weakness and profound masochistic trends in his personality who, during the early weeks of his treatment, confessed to an unusual perversion involving bugs: he would stroll about outside until he found a woman standing alone, would walk up to her and, when she was not looking, would place a bug upon her shoulder. He would then tell her there was a bug on her. If the woman then brushed the bug off and squashed it with her foot, the patient would experience intense sexual excitement. He would then go home and masturbate to the image of the woman squashing the bug.
As described in the earlier report, material elicited during the first two years of treatment led to the formulation that the patient's perverse activity (in which the bug was equated both with the patient and his penis) had developed from an infantile fixation upon anal-erotic and masochistic stimulation in combination with a need to regressively retreat from his phallic strivings in the face of threats of castration by both the oedipal father and the oral-sadistically conceived pre-oedipal mother.
Such a formulation viewed the patient's perverse activity solely in terms of the vicissitudes of object-instinctual investments and the need to ward off dreaded object situations. In this brief addendum I shall attempt to show how a deeper understanding of the perversion was gained as its function within the narcissistic sector of the patient's personality was discovered during the third and fourth years of treatment. According to this additional formulation, the patient's perverse activity served a vital narcissistic function: it represented an abortive, primitively sexualized attempt to restore and maintain the cohesiveness, stability and positive affective colouring of his crumbling self-representation (Stolorow, 1975).
A dream which the patient presented at the beginning of the third year of treatment foreshado