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Joseph, B. (1971). A Clinical Contribution to the Analysis of a Perversion. Int. J. Psycho-Anal., 52:441-449.

(1971). International Journal of Psycho-Analysis, 52:441-449

A Clinical Contribution to the Analysis of a Perversion

Betty Joseph

In the literature on perversions, so far as I can ascertain, there is a great deal about the meaning of various perversions, the mechanisms involved and similar aspects, but a paucity of detailed clinical reporting. This lack is unfortunate, since my impression is that, while one may deduce a great deal from these patients' symptoms, activities and history, this is therapeutically comparatively useless unless one can analyse the manifestations of the perversion in the transference. One would expect that the main aspects of the perverse symptomatology will appear in the transference if only one can locate them. This may not appear particularly difficult with more overt sadistic perversions, but can be very tricky with certain apparently unaggressive perverts and fetishists, particularly perhaps those whose material is very repetitive and whose behaviour seems somewhat passive.

I want in this paper to bring clinical material from the early stages of the analysis of a rubber fetishist to discuss: first, how aspects of the perversion manifested themselves in the transference; and second, how the way in which they emerged enabled me to gain insight into this patient's psychopathology. I think that certain elements in his psychopathology which stand out as particularly important may be of some general significance in the field of perversions.

My plan is as follows: first, I shall describe my patient and his problems, and then outline briefly certain ideas about his character structure and psychopathology, stressing those elements that I believe to be specific to his difficulties.

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