‘Psychic Reality’ And Reality Testing In The Analysis Of Perverse Defences

Dear Sir:

Lee Grossman asserts that ‘psychic reality’ is fantasy (p. 509), and later (p. 511) equates it with unconscious fantasy. His aim is to prevent any blurring between outer, material reality and the imaginary (p. 510). Reality testing is said to depend on the patient's capacity to distinguish between the two, and the perversity of his (usually it is a male) defences is that he does not test or question these against the congruence of his own experience in the process of reality testing. This experience, in turn, is based on ‘the testimony of his senses’, which, we are told, would inform him what is real and what is imaginary. That is to say, perverse defences are a form of dishonesty; the patient discounts what he accurately perceives (p. 513). He does so for a well known reason, namely the avoidance of painful reality. To correct such self-deception, Grossman, in addition to interpretation, ‘also took up a position on behalf of reality’ (p. 514). In other words, he confronts the patient with the reality which he calls consensual and ‘material’. And this, according to the author, the patient is able to judge ‘by his own standards’. The implication is, however, that the standards are, or should be, consensual, i.e. the same as the analyst's.

Grossman does not tell us what the consequences of this technique are on the transference. What happens when the analyst supplements the patient's superego with the help of his own personality and authority?

Another open issue linked with Grossman's clinical observation concerns sexual perversions. If his definition of reality testing is right, masturbation must be regarded as a perversion because the fantasy accompanying it is an illusion, as the patient usually knows. Yet he prefers to leave reality untested as he reaches out for hallucinatory satisfaction. That is to say, we all behave like ‘certain people [who] take liberties with the testimony of their senses’ (p. 513).

Grossman places a great deal of confidence in the te