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These books, first published in 1979 and 1983 respectively, have now been republished. I have chosen to review them together since I believe that my experience in reading them will be shared by other readers and applies equally to both volumes. It is an experience dominated by the question ‘What could have happened to this man, who can write so brilliantly and show such intuition, that his personality deteriorated so drastically in the last tragic years of his life?’ It is not perhaps a laudable question to pose, but it is one that is difficult to avoid.
The book on perversion has as its central thesis the assertion that the pervert is alienated from himself and his object by his exclusive and never-ending focus on the intricacies of his perversion to the exclusion of his other needs and other, human, attributes of his object. There is much clinical material to support this formulation and the author describes many variations on this theme. However, I was left uncomfortable with Khan's almost total emphasis on the failure of the environment, specifically Mother, in the formation of a perversion. There is very little, if any, consideration of the infant's consitutional capacity to tolerate frustration and to accept the confines imposed by reality. The existence of a Father is barely acknowledged, and the question must remain whether this absence might, in some cases, be due to the pervert's own difficulty in tolerating the psychic reality of Father and the primal scene.
The second book is most accessible and contains some fascinating case material. A valuable idea in its concerns the provision of an analytic space in which the patient can be accommodated in the state in which he presents himself, and without asking him to adapt to the analyst's requirements. Although it can demand huge practical resources to do this (Khan employed a houseboy and a secretary, and was willing to extend sessions, to see patients late at night, etc.), there is a principle in this which is