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Sexual violence is a highly topical subject of concern to both the medico-psychological and the legal professions. The main issues are the responsibility of the perpetrators of sexual assaults and the possibility of therapy for them. Our approach to this problem has changed greatly in the last century, these individuals now being seen no longer as monsters but as complex psychopathological personalities. Psychoanalysis has made a substantial contribution to this development, by regarding perversion as a universal model and no longer solely as a pathology and by placing it at the root of unconscious functioning, sexual life and psychic life in general.
Psychoanalysis therefore has a great deal to say in the present debate and, in order for its voice to be heard, needs a protagonist sufficiently involved in work with those who commit violent sex crimes. Claude Balier's qualifications are exemplary in this respect: as a psychoanalyst and physician in charge of a prison psychiatric unit that he himself created and organised, he concentrated initially on the problem of violent behaviour in general, to which he devoted an important earlier book (Balier, 1988, Psychanalyse des comportements violents, Paris: Presses Univ. France), turning subsequently to the specific topic of sexual violence, which he now deals with at length.
The two facets of his work throw right on the overall problem of violent acts and at the same time provide valuable information on their sexual form. As the titles of his two books show, behaviour is the principal form of manifestation of these pathologies, in which the act supplants a psychic life ‘that is obliterated’ (p. 21). The author thus distinguishes the classical concept of enactment, which results from psychic conflict and is therefore meaningful, from ‘behavioural acting out’, which is a much more invasive and systematised mode of functioning.
Balier goes on to describe the expression of a ‘madness’ or ‘disproportion’ in these subjects, involv