Perversions and Near-Perversions in Clinical Practice. New Psychoanalytic Perspectives: Edited by Gerald I. Fogel, M.D., and Wayne A. Myers, M.D. New Haven/London: Yale University Press, 1991. 262 pp.

The eleven papers in this book, most of which were presented at a symposium sponsored by the Association for Psychoanalytic Medicine, expand the definition of what is considered perverse and offer a number of current theories on perversion. The attempt to present a broad perspective succeeds, but an unfortunate consequence is that the volume strays from a clinical focus. The title of the book leads one to expect a large amount of clinical material, but there is only one detailed case history (by Wayne Myers) plus a number of brief vignettes and references to fictional characters. The "near-perversions" are given more attention than the full-blown perversions; and several important syndromes, notably, homosexuality, are not discussed in detail.

In the first paper, Arnold Cooper presents a brief but elegant historical review of the development of concepts of perversion. He points out that the more recent ideas increasingly stress the role of preoedipal factors, aggression, and the vicissitudes of narcissistic development. He then delineates his own theory of a core trauma and three core fantasies as the basis of many if not all perversions. The core trauma is "the experience of terrifying passivity in relation