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The Chairman opened the panel and drew attention to the differences between the panellists, regarding their theories as well as their patients and styles.
The first contributor, Lee Grossman, spoke on ‘Psychic reality and reality testing in the analysis of perverse defences’. He distinguished between patients with an intact reality sense, who needed only to be made conscious of a fantasy in order to recognise it as such, and others who avoided testing the reality of their perceptions; his point was therefore that the latter possess a reality sense but refuse to use it, in effect claiming that their psychic reality is just as real as the reality tested. The work of analysis in such cases was consequently less a matter of discovering the patient's psychic reality than of showing him how and why he was actively confusing reality and fantasy. Like the other contributors, Grossman attributed this phenomenon to disavowal, but he also had the original idea that these patients were diverting their attention from undesirable perceptions. In conflictual situations they focused on peripheral, relatively insignificant objects.
While the perversions were the most obvious example of this structure, Grossman thought that they formed part of a much wider range of phenomena, and he therefore preferred to speak of a perverse attitude to reality. This attitude carried the risk of collusion between patient and analyst, in which the latter was likely to take the former's psychic reality to be ‘a kind of reality’. For instance, the fetishist, by obliterating the difference between the penis and the fetish, discredited the meaning of a perception. So the pervert perceived the female genitals clearly but then rejected their discovery.
In his view the pervert was perfectly capable of distinguishing his fantasy from what, in the subject's own judgement, was real. His pathology lay in the permission his conscience granted him to maintain his convictions without verification. Grossman added that,