*Full citations of publications quoted or referred to in this book may be found in the list of References on pages 221-231. Numbers in parentheses refer to numbered items on this list.
I prefer definitions anchored in clinical data rather than in theory, and so shall now set out several suggestions and hypotheses, based on observation, that will help elaborate these definitions.
First, when we use the word “sexual” in “sexual aberrations,” we should restrict it to conscious erotic excitement and avoid the larger psychoanalytic meanings, which call all pleasure “sexual”; this latter use has value in certain contexts but would only muddle us here. For instance, a gender identity disorder, such as effeminacy, is present most of the time independent of sexual excitement; it may be found in both perverse and nonperverse men.
Second, whether an aberration is a variant or a perversion is determined by one’s attitude toward the object of one’s excitement. If one’s choice of this object—man, woman, dog, part of the body, inanimate thing, whatever —is motivated by the desire to harm the object and is sensed as an act of revenge, then the act is perverse.
Third, every time the perverse act is performed with others or privately in masturbation, a triumph is celebrated.
Fourth, the trauma of childhood mentioned in the definition actually occurred and is memorialized in the details of the perversion. My hypothesis is that a perversion is the reliving of actual historical sexual trauma aimed precisely at one's sex (an anatomical state) or gender identity (masculinity or femininity),* and that in the perverse act the past is rubbed out. This time, trauma is turned into pleasure, orgasm, victory. But the need to do it again—unendingly, eternally again in the same manner—comes from one’s inability to get completely rid of the danger, the trauma. It happened; and, except at the moment when the act of perversion has pro-
•Valenstein says ihe trauma may not have been experienced literally but may have been an “experiential misconception” of a real event (114. P 9) gressed smoothly, one cannot make out to oneself, even though the memory is unconscious, that it did not happen. We do not need a steamy construct like “repetition compulsion" to explain the repeating; in perversion, one repeats because repeating now means that one will escape the old trauma and because revenge and orgasm deserve repeating. Those are reasons enough.
From Freud on, it has been said that precocious excitement contributes to perversion. I would agree, but only —as must usually be the case—when there has been too much stimulation and too little discharge or severe guilt. These will then be sensed as traumatic and will need to be transformed via the magic of the perverse ritual into a successful venture. With much gratification and little guilt at too young an age, on the other hand, I think the result is not perversion but aberration, a holding on, into adult life, to that deviant way of getting pleasure, which is not driven, as is perversion, by the need to harm an object.
Fifth, one has to ensure, over the years of trial and error in constructing fantasies, that one finally arrives at a rendering—the adult perversion—that works smoothly. One's failure in construction is marked on one side by lack of sexual interest—boredom—and on the other by anxiety. Both are manifested in disturbed potency. If the daydream is to work, the story must not arouse too much anxiety, which in unadulterated form is the enemy of pleasure. But one must reduce anxiety without also ending excitement. This is done by introducing a sense of risk into the story. A sense of risk; in reality, the risk cannot be great or anxiety will arise. One can only have the impression of risk.
This requires a few words now and in case material later. There are sexual acts in which gross risk-taking is essentiaclass="underline" for instance, hanging oneself to achieve orgasm. What we must distinguish, however, is that the risk buried among the fantasies of the sexual act is not the same as that which threatens in the real world; the risk from the noose—death—is not the risk—anxiety or guilt —that fantasy must avoid.
Sixth, the result of all this work of constructing the fantasy we know as the perversion is that one’s sex objects are dehumanized. This is obvious in, say, fetishism or necrophilia. But look closely at cryptoperversions such as rape, or a preference for prostitutes, or compulsive promiscuity (Don Juanism or nymphomania), which the naive observer may see only as heterosexual enthusiasms: in fact the object is a person with a personality, while the perverse person sees a creature without humanity—just an anatomy or clich£d fragments of personality (for example, “what a piece of ass,” “all men are brutes”). This is hardly a new idea. In 1930, E. Straus noted: “The delight in perversions is caused by . . . the destruction, humiliation, desecration, the deformation of the perverse individual himself and of his partner” (Straus’s italics).*
But these propositions do not tell how pleasure is introduced. If perversion is. the result of threat and the resultant hatred, whence comes pleasure? Unmitigated trauma or frustration has no lust in it, nor does rage. Pleasure is released only when fantasy—that which makes perversion uniquely human—has worked. With fantasy, trauma is undone, and in the daydream—the manifest content, the conscious, constructed story line of fantasy—it can be undone, over and over as necessary.
In redoing the world, daydreams contribute to pleasure first by ridding one of fear of the trauma being repeated. Second, the daydream has in it elements that simulate risk, so that excitement—tension—is introduced. Third, the daydream guarantees a happy ending, saying that this time one has not only surmounted the trauma but even thwarted if not traumatized those who *E. Straus, Geschehnu undErUbnis (Berlin, 1930), p. 113. Quoted in 7,
p. 80.
were the original attackers. Finally, when the daydream becomes attached to genital excitement and especially to orgasm, the “rightness” of the daydream is reinforced and the person motivated to repeat the experience under like circumstances.
Another problem: if perversion is erotized hatred, why (except for homosexuality) is perversion found more in males? If it is erotized hatred, then we will have to find hatred more—or in different form—in men than in women. This may be so. We shall study it further (chap. 8).
In order to begin to judge these ideas, draw on your own experience. Think of perversions with which you are familiar: necrophilia, fetishism, rape, sex murder, sadism, masochism, voyeurism, pedophilia—and many more. In each is found—in gross form or hidden but essential in the fantasy—hostility, revenge, triumph, and a dehumanized object. Before even scratching the surface, we can see that someone harming someone else is a main feature in most of these conditions. Later on we shall test these ideas harder by looking at conditions in which this mechanism is less manifest; we shall find that it still takes little clinical skill—or theory-making—to find the hostility mechanism. We shall also see the perverse act thread its way between anxiety and boredom in a search for the right sort of risk to create excitement.
It is too bad that my attempt to define fails to extricate us from an old problem: I cannot state how much perversion is needed before we can diagnose the condition as a perversion (just as there is no precise measure in, say, anxiety neurosis for the amount of anxiety that must be present, and no precise point at which character structure becomes character disorder). The demand is an artificial one, however; diagnosis in medicine is no more than a convenience, an effort to convey as much information as possible in the fewest words about the clinical features, underlying pathodynamics, and etiology.
Those of us who are psychiatrists all went to medical school, so we long for a diagnostic system that will communicate as well as that which covers most of the disorders other physicians study. And if the psychiatrist is like the sex researchers in that he does not believe there are psychic states that originate in conflict and are maintained by mental mechanisms like fantasy, repression, undoing, and splitting, he will keep pressing for psychiatric diagnoses that are as tidy as, say, “compound comminuted fracture of the femur,” “appendicitis,” or “rabies.”