A More Positive View of Perversions

Traditionally psychoanalysts have viewed perversions as neurotic symptoms that require treatment. Though I agree they are no doubt neurotic symptoms, the requirement for their treatment, in my view, should be based on the degree of subjective discomfort they cause the patient. In former times the degree of guilt and shame connected with perversions was very great. They were totally unacceptable socially and usually had to be hidden, even from most intimate acquaintances. The law took a very dim view of perversions and, if caught, the patient might be incarcerated for many years, as well as being publicly ostracized. In view of this, the treatment of a perversion became almost a necessity. In the light of the current sexual revolution and a much more enlightened legal and social point of view, the matter of how much subjective discomfort accompanies a perversion must be examined much more thoroughly and individually in each case. Many people can now flaunt, or at least publicly display, their perversions without any strong sense of guilt and without any fear of legal or social reprisal. Though it is true that a perversion represents a neurotic symptom and, therefore, an inhibition of a person's full expression of his erotic drive, so do many other symptoms—such as compulsivity—which are much more socially acceptable or even socially rewarded.

One of the main determinants in the analytic removal of a symptom is motivation and, if a perversion causes little subjective discomfort, there may be very little motivation to invest all the energy that is required to unearth the unconscious root of it and work through all the resistances and defenses involved. Sometimes even