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The present paper deals with the group of paraphilias (perversions) and the resulting sexual offenses. The author attempts to show that 'these reactions, rather than being psychopathic, are essentially psychogenic in their nature, their symptomatology and etiology being traceable to unconscious emotional factors, while the antisocial character of their behavior giving it a psychopathic façade, is entirely incidental and secondary, and is also predicated on psychogenic situations.'
Summing up a longer discussion about the relation of perversions to neuroses, the author states that paraphilias and neuroses are basically the same, both representing arrested psychosexual development.
This thesis is demonstrated by the presentation of three cases, two of which are sex offenders, and the third, a hysteric, who had only technically escaped arrest for sex offenses.
The author makes a plea for the recognition and treatment of paraphilias as neuroses rather than psychopathies, for the recognition of the criminality in the case of sex offenders as being merely a neurotic symptom.
Karpman is justified in making this plea to psychiatrists of prisons and psychiatric hospitals. Psychoanalysts will find no quarrel with it. The reviewer cannot agree, however, with the author's division of psychopathic states into 'idiopathic' and 'symptomatic' types and his distinction between a 'psychopathic' and 'psychogenic' etiology.
It seems likely that with more knowledge of the interpersonal relationships the idiopathic cases, too, would probably be found to be 'essentially psychogenic' in etiology. For the reviewer it is very difficult to grasp the concept of an idiopathic group or to understand psychopathy other than as a result of faulty development of interpersonal relationships.