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Letters to the Editors: Psychoanalytic Perspective on Perversion Reformulated

Denman, C., 2003. Letters to the Editors: Psychoanalytic Perspective on Perversion Reformulated. Reformulation, Autumn, pp.4-5.

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I read with interest Heather Wood's "Reformulation of Psychoanalytic Theories of Perversion" and I want to say at the outset that, of course, her conclusions which are humane and largely sensible in relation to outcomes and additions to the Psychotherapy File are unexceptionable. I was however very dispirited that she did not in her extensive review of the psychoanalytic theories of perversion appreciate the prejudice and contempt in which psychodynamic psychotherapists have traditionally held any form of non-heterosexual, non-genital sexual activity. This strand of theorising in psychoanalysis has been responsible for a systematic humiliation and oppression of generations of patients whose sexuality has become an illness from which they are supposed to suffer and from which they are required to seek release and whose "treatment", to be blunt, represented a smash and grab raid on their psyches and often their wallets, conducted by opinionated occupiers of a self-defined moral high ground.

Heather Wood discusses very little sexual behaviour in her paper but, for example, she talks about the idea that compulsive womanising is at least as, if not more, pathological than a loving homosexual relationship. This is probably a good characterisation of Stoller's position and, indeed, of much current psychoanalytic theorising but it is objectionable and for two reasons. First of all, it represents a decision to view having sex with a large number of different women as pathological, which it is not. It is merely culturally proscribed within modern Judo-Christian arrangements and it suggests that a loving homosexual relationship is somehow to be placed at the mild end perhaps of a spectrum of pathology. This reproduces the current social attitude to homosexuality - which is that is probably OK (just) if it is quiet, involves knitted jumpers, settled domestic arrangements and no overt display of anything that might frighten off what remains a rigidly heterosexual world.

Later, in the article, transsexuals are characterised in the following way

"transsexuals sometimes insist that 'the truth' is that they were born with the wrong body. Psychoanalytically oriented therapists might argue that 'the truth' is that they suffer from a burning discomfort with their given body."

Again, this distinction made within the discussion of a notion of 'truth' is an important one. However, erased from the account is an acknowledgement of the way in which psychoanalytic psychotherapists have systematically oppressed transgendered individuals and been instrumental in seeking to deny them surgery while at the same time characterising them in the most extreme and pathological terms.

In general therefore, my quarrel is with the tone of the article. It seeks to reclaim or reformulate buried treasure from the psychoanalytic world and does so by presenting those parts of the psychoanalytic perspective with which it is easy for benignly oriented therapists who are not conversant with the literature to identify. A more accurate picture of Psychoanalytic Perspectives on Perversion ought to have shown us the ways in which the hatred and contempt that analysts habitually attribute to so-called 'perverts' is in fact the hatred and contempt that they, themselves, display in full measure.

I would suggest that CAT therapists might do better to consider two categories of sexual activity: coercive sex and transgressive sex. In coercive sex, the consent of the other person involved is not sought or the individual is reckless in relation to consent. Coercive sex is rightly, in all its forms, illegal or proscribed. Individuals who desire to have coercive sex may be normal, have psychological problems or may have a specific sexual preference for coercion. Transgressive sex is sex that breaks the normal boundaries of a particular culture. Acts of transgressive sexuality have, at different times and in different places, included: masturbation, refusing to wear a burka, homosexuality, a preference for sexual positions in which the woman is entered from behind and the use of sex toys. Transgressive sex does not involve issues in which consent is questionable. It is best analysed not as a pathology or indicative of psychopathology but as a particular way of being in the world, in just the same way that gender or an occupation represents a particular way of being in the world. Sex, therefore, is as much or as little a subject for therapeutic discussion as religion, clothing, food or ice-skating. I have written about this distinction in my book "Sexuality, a biopsychosocial approach" to be published by Palgrave (Macmillan), towards the end of the year.

Dr Chess Denman

Consultant Psychiatrist in Psychotherapy
Head of the Psychotherapy Department
Addenbrookes Hospital, Cambridge

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Full Reference

Denman, C., 2003. Letters to the Editors: Psychoanalytic Perspective on Perversion Reformulated. Reformulation, Autumn, pp.4-5.

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