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March 25, 1983. PSYCHOTIC ANXIETY UNDERLYING SEXUAL PERVERSION. Joyce McDougall, M.D.
Charlotte Schwartz opened the scientific meeting of the National Psychological Association for Psychoanalysis by drawing a sociological parallel to sexual perversion in the individual. She quoted from Terrence du Prés' book, The Survivor, and told of frequent “deaths by excrement” in the concentration camps of World War II.
Ms. Schwartz was followed by Miriam Altman who introduced Dr. McDougall by telling about her work at the Paris Institute of Psychoanalysis with a nine-and-a-half-year-old psychotic boy named Sammy (Dialogue with Sammy) and restating Dr. McDougall's major theses in Plea for a Measure of Abnormality.
Using Bion's concept of the need object and Melanie Klein's ideas about the depressive position, Dr. McDougall elaborated Freud's formulation regarding the early psychic origins of sexual perversion. Freud saw changes in the heterosexual and genital nature of sexuality as attempts to resolve the Oedipus complex and avoid castration anxiety. Dr. McDougall pointed out that because Freud idealized the mother-infant relationship, he often underestimated its influence on sexual development. Since the mother's breast is the earliest object of need and sexual desire, it is also an object of hate, according to Bion, because it is not under the infant's control and the wish for the breast is bound to be frustrated at times. Longing for the mother turns into thumb sucking which is the earliest autoerotic activity and the foundation of later sexuality. Dr. McDougall emphasized that the mother's reaction to thumb sucking and normal masturbation is very important in the development of sexual perversions. Autoaggression is often linked to the maternal denial of autoeroticism and later finds an outlet in the violence associated with the sex act.
Dr. McDougall repeatedly emphasized the view that sexual perversion is more than a way to deal with conflicted libidinal needs, but that sexual