Perversion: Chaired by Friedemann Pfäfflin, Ulm

The panel was introduced by the chairman, Dr Friedemann Pfäfflin. He noted that psychoanalysts spend a large proportion of their time dealing with material in their patients' dreams and phantasies that can be thought of as perverse. However, once phantasies spill over into overt deviant behaviour the patient may be more likely to end up in prison rather than on the analyst's couch. Although the analytic theory of psychosexual development was in part founded on the exploration of perverse behaviour, very few analysts have patients with manifest perversions in treatment.

Pfäfflin spoke about the way in which the term ‘perversion’ has been dropped from the psychiatric classification of disorders as it was felt to be too moralistic. However, he says, the term ‘paraphilia’, which has been substituted, still refers to deviation from norms. Colloquial language retains the stigmatising and disapproving implication of the term ‘perversion’. Freud, however, took the word and attempted to transform it into a psychoanalytic technical term. The polymorphously perverse innate predisposition (Anlage) is the foundation of all normal or abnormal psychosexual development.

He went on briefly to summarise different theoretical conceptualisations of perversion. Initially it was seen as a leftover of untransformed partial drives. Later it was thought of as a defence against castration anxiety, then as a defence against pre-oedipal anxieties and affects. He pointed out that perversions are to be found on all structural levels, and are not determined simply by specific behaviour but rather by the inner object relationship. He queried whether we should distinguish between perversion demonstrated in manifest sexual behaviour and perverse object relations. He also mentioned the perennial unresolved question of what are the factors that give rise to enacted perverse behaviour rather than to a particular neurotic symptom. Should perversion be thought of as the result of a structural,