6. Roman (f)




Psychopathology of Perversion: A Contemporary Clinical Reflection on Violence1


Pascal Roman, PhD.2


Abstract


The aim of this paper is to examine the psychopathology of perversion by evaluating the complex relationship between violence and psychopathology, and to introduce different metapsychological frameworks within which this mode of psychic functioning along with its concomitant personality organizations/adjustments may become clinically meaningful. The purpose is to contribute to the understanding of the psychic dynamics involved in what we call perversion at the service of the psychotherapeutic work. The author proposes a dual focus on the complex relation between act and psychopathology, and on the manner in which psychological judicial expertise encounters the question of perversion both clinically and politically. The author then develops a number of theoretical perspectives that allow for refining the psychodynamic understanding of different configurations of the psychopathology of perversion by locating it, from a structural perspective, between borderline and psychosis. He then attempts to show how clinical work with perversion is to be tested with adults and adolescents in the context of medical and legal practice.


Cet article s’inscrit dans un double projet qui consiste d’une part à interroger la psychopathologie de la perversion à partir de l’évaluation des rapports complexes entre violence et psychopathologie, et d’autre part de mettre au travail les repères métapsychologiques à partir desquels peut être pensé ce mode d’organisation/d’aménagement psychique de la personnalité. L’objectif, in fine, est d’apporter une contribution à la compréhension des dynamiques psychiques engagées dans ce que l’on nomme la perversion, au service de la mise en œuvre et du déploiement du travail psychothérapeutique. Dans un premier temps, l’auteur propose une double mise au point concernant les rapports complexes entre agir et psychopathologie, et la manière dont la pratique de l’expertise psychologique judiciaire rencontre la question de la perversion, tout à la fois d’un point de vue clinique et d’un point de vue politique. Dans un second temps, l’auteur développera un certain nombre de points de vue théoriques qui permettent d’affiner une compréhension psychodynamique des différentes configurations de la psychopathologie de la perversion, en la situant, d’un point de vue structurel, entre état-limite et psychose. Dans un troisième temps, la clinique de la perversion se trouvera mise à l’épreuve, à partir d’une pratique médico-légale, dans le double champ de la clinique adulte et de la clinique adolescente.

 

The aim of this article is both to examine the psychopathology of perversion, by evaluating the complex connection between violence and psychopathology - one may also say between action and psychopathology

- and also to work on metapsychological points of reference from which this mode of psychic organization / adjustment of personality might be thought of, in order to contribute to our understanding of the psychic dynamics involved in what we call perversion. This contribution is based on the experience of judicial psychological examination which frequently gives occasion to clinical encounter with sexual transgressions, where the question of perversion is central, as well as to clinical experience with adolescents who committed transgressive sexual acting out, in a framework of research and clinical practice of consultation and psychotherapy.

Before moving on to certain theoretical perspectives to refine a psychodynamic understanding of the psychopathology of perversion, a double focus on the complex relation between action and psychopathology as well as a grasp of how the practice of psychological judicial expertise meets the issue of perversion is needed. In anticipation, I will already note that the clinic of perversion will be put to the test in both the adult and adolescent clinical domains.


Acting and Psychopathology

As mentioned, the relationship between acting and psychopathology, especially between violent act and psychopathology is complicated. “Acting” is considered here as a generic formulation which, beyond violent expressions, points to escapes and to the communications of psychic life which can express themselves just as well in an other-directed mode (e.g., violence against people, sexual abuse, etc.) as in a self-directed mode (e.g., self-mutilation, addiction, suicide attempt, psychosomatic disorders or eating disorders, etc.). In this context, the point of view of psychic life by itself cannot provide a definitive indication since this issue is rooted in culture, i.e. it is involved in the singular modalities of organizations of ties. Culture is considered here as a reference to the established modes of ties (family, state, institution...) and their psychic productions (myths, beliefs, ideology...). Therefore, my reflection is necessarily situated in a specific culture which colors the theoretical construction and conceptual approaches, supported by a set of representations, codes and symbolic reference points.

We know that adolescence is like a privileged observatory of acting. Acting out in adolescence will be deployed in relation with alternations imposed by puberty. These (alternations of puberty) will necessarily redraw the landscape of the relationships between acting and thought thereby permitting some questioning concerning the meaning of acting in its multiple denominations. In this regard, different conceptions of the function of acting in mental life may be convened: act in order not to think? Act in order not to suffer? Act in order to feel existing? Act to withdraw from the overflow of excitement? Finally, act to re-act?

Thus, beyond the traditional conception of the opposition between thought and action, a space opens in which there is a place to consider that acting supports the process of thinking, i.e the process of the construction of the world as many authors such as Marty and Fain (1955) or Winnicott (“Playing is doing”, in Playing and Reality, 1957/1971) have clearly shown in their own way. In this sense, we can back the hypothesis which supports the process of symbolization. This theoretical choice is also an ethical one, since it’s about supporting a position of care to the benefit of subjects engaged in violent acting out. The acting out can then be understood as an escape from and / or resumption of the process of symbolization. If the pubertal crisis and the eruption of the instinctual surge that accompanies it tend to overwhelm the symbolization process, adolescent acting out, or the body in acting (Roman & Dumet, 2009) could be considered as having a biface structure and function: in fact, they are at the same time the traces of attacking the symbolization process (found in the expression of desymbolization) and the sign of an elaborative resumption, joining the work of teenage subjectivition, on condition that these acting outs find a reception area on the way toward symbolization.

It is in this context that different forms of self and other-directed acting out, reflecting the economic management of the issue of activity / passivity, will be considered. It should be mentioned that a divergence exists in terms of gender in the choice of action where men or young men invest massively in other-directed act outs and women or young women preferentially invest in self-addressed ones: we meet more women in hospitals and more men in prisons and this fact, to some extent, explains why most of the clinical and theoretical debates about perversion predominantly concern men.

 


Perversion in the Legal Arena

Perversion is here considered based on expressions of violent acting-out, and particularly violent sexual acting-out, clinically encountered in the judicial scene (currently and for several years, most violent situations judged in the courts of Switzerland, France and European countries have been concerned with sexual violence). Indeed, we can consider that the violent sexual act, if it is not reducible to perversion, opens a privileged observatory to this problem. The particular quality of judicial expertise in a clinical encounter and the echo mobilized in the psychopathological question of perversion should be questioned before opening a clinical and psychopathological debate. Indeed, one can consider that judicial expertise contains an opening to a perverse scene insofar as it intensifies the dimension of "seeing": it is the "seeing” the scene of the act, or "seeing" the act, which the expert clinician is confronted with. In other words, judicial expertise represents a privileged observatory of perversion (especially around sexual offenses), but this is also the place for the risk of a perverse drift. Thus, judicial expertise investigation could be a repetition of the perverse scene that it is summoned to explain. A number of elements specific to the mis-en-scène of the judicial process testify to this risk: the "data to be seen" by the court through recited words, photographic or film documents which were presented in different parts. Furthermore, requests made of the expert involve “seeing” the act, “seeing” the personality, etc. and, when not confronted with “seeing” the criminal record (pictures of the victim, places, objects...), the expert must “make appear” a certain number of elements through his expertise. These elements contribute to a form of general theory of perversion3 related to the judicial scene.

From this point, it seems important to me to be able to support an ethical statement that allows containing and limiting the risk of an inherent perverse drift in the judicial expertise situation. This ethical statement builds on the fact that, in any case, psychological judicial expertise is concerned with the personality of the subject, not the act, and the suspect should be presumed innocent until proven otherwise. A double requirement may be stated in support of this ethical position (Roman, 2007, 2013b): psychological judicial expertise serves as a support for the subject (as such it helps the process of subjectivation, and judicial psychological expertise requires a suspension of judgment on the part of the expert (the suspension of all judgments whether they concern the facts covered by judicial experts, the conduct of the investigation and of the instruction, and the decision-making of lawyers …).

This ethical position, anchored in the professional psychologist, guarantees the protection of the subject from the risk of judicial and political exploitation, by which he is in danger of being held hostage. Indeed, the question of perversion is a complex psychopathological issue and is, as such, taken into political stakes. We can measure the risk of the designation of perversion on the judicial scene: indeed, perversion scares and worries, but it is also fascinating, and it intensifies exclusion from the social scene: Is this thought-out from the pathological point of view? Its reputation of incurability leads the court to pronounce the longest possible imprisonment penalty. Is it considered from the perspective of immorality? The necessity to protect society (and for society to protect itself from its own perverse shadow areas) pleads in favor of an increase in the length of the penalty. One would then think that our society today would have to reach a new criteria for the social expulsion of perversion, a criteria that we could, following Foucault (1977), locate on the side of the loathsome and the monstrous.

 

In this regard, it is important that the expert be able to operate a transformation and introduce a gap regarding the specific judicial expertise mandate to “see”. Here, in defending the place of the psychologist as the judicial expert within the methodological choices, interest or even necessity of recourse to projective tests (Rorschach, TAT) can be highlighted. Thus, I propose that the use of projective tests in the process of psychological assessment provides a release from the violence of “the visual” (Bonnet, 1996; Roman, 1998) and opens on another scene, that of the subject and subjectivity. In the context of acting, from the perpetrator’s point of view and in relation to the victim, subjectivity is precisely called into question. However, this release builds on a paradox: it is from the seductive/exciting offer of Rorschach and TAT cards (a “given to see” to the subject which is necessarily exciting) that release from the scene of the act, scene of excitation, can be settled. In this context, the stance of the psychologist is obviously decisive: how would he be able to contain this paradoxical offer? How could he ensure the subject that his own psychic movements are not exposing him to the violence of “the visual”, through a mirror reflecting what he has done (as a perpetrator) or suffered (as a victim)?


Metapsychology of Perversion

Some theoretical points of reference will help to understand the stakes of the psychopathological discussion about perversion. If we refer to the works of Freud (1905), we note that he wavered between a conception of perversion as a constitutive element of psychosexual development and a conception of perversion as a specific psychopathological entity, a structure4 defined as the “negative of neurosis”. What can we understand from the “negative of neurosis”? For Freud, perversion is conceptualized as a structure, in which the relation to castration is blocked and made, somehow, the “negative” of the recognition of the structuring function of the law. From there, one may ponder that perversion should be understood as a modality of the adjustment of personality, specified by specific terms of psychic functioning, as defined by Bergeret (1974), rather than as a structure.

French psychoanalyst, Bergeret, in accord with Freud, uses the metaphor of the crystal. Personality is structured along three major lines in terms of psychogenetic development: neurosis, psychosis and borderline. These lines, as well as the neurotic and psychotic lines, are considered to be stable and describe the subject’s psychic functioning according to an adapted or decompensated modality. As such, Bergeret has remained loyal to the Freudian concepts of continuity between normal and pathological and to the idea that the structural basis of the subject cannot prejudice the registry of the personality as pathological or non- pathological. Bergeret points out that borderlines experience two forms of adjustment: maladjusted and perverse.

In the same period in which Bergeret devoted a significant part of his work to defining the borderline, in the United States Kernberg was exploring the different registers of borderline personality organizations. His essential contribution, from my point of view, is the distinction that he has made between the narcissistic and borderline registers which Bergeret called ‘a-structurations’. Indeed, Kernberg, in the context of a metapsychological approach in terms of object relations, distinguishes two types of adjustment: Borderline personality and Narcissistic personality. Borderline personality is characterized by the over-investment in external reality, due to the lack of a sufficiently secure construction of the internal object. Narcissistic personality is characterized by over-investment of internal reality to compensate for the fragility of the construction of the link to the other. This distinction is the basis of a valuable identification of different configurations in the field of perversions.

Marty (2007), in a current and a more procedural perspective, proposes to consider perversion as a special modality of linking to the object, “an attempt to maintain a libidinal link with the object” (p. 15). Perversion is thus defined as a libidinal regression unrestricted by repression. Splitting, understood as a defensive modality, as well as the mobilization of partial and unbound drives have primacy at the heart of perversion. This theory adheres to Bonnet’s remarks about the place of “seeing” in perversion. In fact, for Bonnet (2008) the fantasy or perverse scenario belongs to a form of the logic of psychical survival. This fragile scenario opens on an expression “in acts” of the above. Indeed, the scenario aims to "instigate affect in the other and thereby enjoy it through this intermediary" (p. 26) given the subject’s inability to allow him/herself to be affected by the other for fear of the risks the encounter may impose on his/her identity. For Bonnet, it is the drive, rather than the personality, that is structured perversely. This stance should be remembered since it allows us to avoid the risk of perverse diagnostic assignment.

 

Balier (1988, 1996), in his project of making a general psychodynamic model of violent acts, offers a double distinction, heuristic at the theoretical level and very telling at the clinical level. On one hand, he distinguishes the registers of violence: original, primary and secondary, in reference to Aulagnier’s work that is concerned with the different instances of psychic construction (1975). On the other hand, he differentiates between two perverse forms: the perversion which he refers to as “acting out”, underpinned by fantastical activity, following which the act accomplishes (acts) the fantasy that cannot be transformed in representative ways; and perversity, which is a “resort to the act” inscribed within a logic of survival in the face of the threat of collapse; it is a question of annulling the other and making him/her disappear as a condition of survival.

From these different theoretical benchmarks, a model of the continuity of perversion/perversity can be proposed. Following Balier (1996), I suggest retaining the idea that there would not be a perversion but perversions which could be described less in reference to a structure than to various witnesses of different modalities of perverse adjustment (in the broader sense of the term). Nevertheless, these perverse modalities would find specificity by referring to personality structure from which these adjustments are deployed. In reference to the “a-structurations” described by Bergeret (1974), perversion would constitute a form of borderline personality adjustment. The function of acting would here consist of guaranteeing oneself as subject through twists of the link to the other. Perversity would be in breach of these adjustments which, no longer underpinned by psychic fantasies, would get involved in unbinding, and be inscribed in a psychotic structural line. Attaining the other through the violent act would contribute to the fight against the subject’s collapse. Finally, the definition of a narcissist-depressive adjustment allows us to understand an adjustment in which the depressive dimension is central; the function of the violent act in this configuration would be that of an anaclitic support.

In this theoretical-clinical context, we can discuss the specific destiny of the drive as it presents itself respectively in perversion and in perversity. In perversion, a reversal of activity/passivity occurs such that the position of activity is delegated to the other (for the subject who presents an adjustment in the register of perversion, the other is necessarily the origin of seduction, to which the pervert complies). In perversity, the reversal of passivity/activity reflects the risk of passivity and imposes on the subject the investment of a position that valorizes activity (the other is experienced as threatening to his integrity and must therefore be actively destroyed). In the psychodynamics of narcissistic-depressive adjustment, alternative investment in active and passive positions (depending on the moment, the other is the seducer or the seduced, in a back and forth between the two positions) opens onto a psychopathological configuration in the form of perverse risk.

The table below illustrates the specificity of personality adjustments in the field of perversion through a double reference: the structural line of reference as well as a procedural registration in a clinical and metapsychological approach.

 

The presentation of this table and the clinical, psychodynamic and psychopathological coordinates that it contains calls for a number of comments:

Firstly, this table specifically concerns the manner in which different perverse configurations which constitute the “perverse field” (Balier, 1996) can be identified through the clinic of violent sexual acts. This modelling involves a precaution regarding clinical work with respect to the intrication of different factors associated with different highlighted categories. Thus, the reference to a certain type of violent sexual act is proposed by way of illustration without the ambition of establishing itself as a truth of the clinic and of psychopathology.

Secondly, the table establishes and proposes the differentiation of three kinds of perverse adjustments between borderline and psychosis: for the borderlines, in the register of narcissistic - depressive adjustments (here identified in the form of perverse risk) and adjustments in the form of perversion; for psychosis, in the register of perversity.

Finally, following Bonnet (2008), it is necessary to underline that the field of perversion is traversed by a singular modality of the treatment of affects involving the “splitting of affects” (the affect is projected onto the other to protect against the disorganizing potential of the encounter).


Clinical Expression of Perversions

Each of the three forms of adjustment (perverse risk, perversion and perversity) will be the object of a clinical illustration.

One of the central indicators of perverse participation in psychic functioning manifests itself in the clinical relationship through the traces that the "technique of intimacy" leaves behind (Khan, 1981). This "technique of intimacy" can take the form of a quest for closeness or possible sharing with the clinician, a quest for confirmation or reinsurance, or even complicity, which Bonnet (2008) identifies as the “splitting of affect”. This element, which must be considered in the transferential relation unfolding during the psychological examination, deserves to be included in the clinical understanding of perversion insofar as it testifies to a form of repetition of the act at the heart of the clinical relationship.

For each situation, I will present the judicial context of the encounter, the principal clinical elements in

support of the subject’s narration of the facts and a brief discussion.


Bertrand, 35 years old: perversity

Bertrand is met at the request of the presiding judge for investigation. The meeting takes place in the prison where he has been incarcerated for a few weeks, for the investigation of the rape of a prostitute (he compelled her with violence to unprotected fellatio.). Before that, he had been convicted three times and had experienced long periods of imprisonment. He had been sentenced to 12 years in prison for rape when he was 20 years old, to 2 years shortly after his conditional liberation for pandering, and again for vandalism in the same period. Bertrand's discourse is dominated by rationalizations that aimed to release him from guilt. He develops an ambiguous discourse particularly vis-à-vis the prostitutes and the relationship which he has regularly maintained with them since the end of his adolescence, after being introduced by a friend a few years older than himself: He allows himself to not pay prostitutes since their activity is immoral and, by virtue of the sexual contract made, he feels entitled to resort to violence and force prostitutes.

Here is how Bertrand recounts the charges against him:

Bertrand says that he approached a young female prostitute in the street. After asking her price he took her in a car with him, parked in a parking lot and locked the door from the inside so that she could not get out. After being undressed, he forced the young woman, holding her by the neck, to perform fellatio without protection. He then ordered her to leave his car without paying her.

One might consider, regarding Bertrand's purposes, that the victim exists paradoxically only in the denial of a subjective position. Faced with the risk of psychotic breakdown, this negation maintains minimally, and in a fragile manner, his libidinal investments. The unassumable passive position (here represented by the position in fellatio) is imposed on the other in a violent movement that contributes to saving the 'vital' position of the subject. It is this position that determines the dimension of perversity, presenting itself as a bulwark against the risk of psychic disorganization.


Jacques, 55 years old: perversion

Jacques is met in judicial assessment at the request of the judge. The meeting takes place in the prison where he is kept in protective custody. He is interviewed under caution for raping minors involving the son of one of his brothers with whom he was in a privileged relationship. Previously, one of his daughters had reported being the victim of rape and sexual assault by her father from the time of her childhood up to her adolescence; the statute of limitation of these facts has made the legal action impossible to implement against him. Jacques develops an ambiguous discourse in opposition to the charges against him: He insists on the "aesthetic" quest behind what he calls his "pedophilic deviances" which refer to a form of childhood nostalgia (could this be about a possible experience of self as a child in the seductive experience?). At the same time, he puts forward the idea of a sexual demand that children may have in relation to him, seeking to justify his involvement in sexual relationships. We understand that this movement reflects a form of “confusion of tongues between adults and children” (Ferenczi, 1933/1982); the child’s emotional demand (to be understood within the register of infantile sexuality) is interpreted by the adult (Jacques) as a request for the realization of adult genital sexuality.

 

In the clinical encounter, Jacques's speech is full of intellectual and cultural references which actualize the dimension of seduction: Jacques seeks intellectual complicity with the psychologist at all costs, in an eminently narcissistic mission (to find support in the narcissistic investment of the relationship).

Here is how Jacques recounts the charges against him:

Jacques reports facts in a very smooth, commonplace way, and without guilt. He insists on the philosophical aspect of his quest for sexuality with children whom, as he says, are complicit in his actions. He insists that he has sodomized the teenager who makes a complaint for acts which occurred when he was between 6 and 12 years old, although the teenager does not “recognize” this aspect of the sexual relation, something that Jacques said he did not understand. Jacques also talks spontaneously and with a certain complacency about sexual relations which he has imposed on one of his daughters from the age of 7 to 12.

The clinical reading of Jacques’s involvement in violent acts can offer a representation of the psychical dynamics which underlie them: the victim finds him/herself assigned to an entry in the form of 'libidinal project', in the service of the instinctual satisfaction of the perpetrator. This project is characterized by a twist of the subject's position (reversing passivity / activity) with the active position delegated to the other designated as seducer, if necessary without his knowledge. In this context, there arises some confusion between libidinal project and murderous project, dominated by a porosity of the instances of Jacques’ psychic life as well as the risks of violent breaks tied to it. The numerous marks of reaction formation in Jacques’s speech further testify to the eminently narcissistic register of his psychic function.


Louis, 37 years old: perverse risk

Louis is met in prison in the context of judicial expertise. This was a second opinion during the investigation because Louis questioned the conclusions of the first expert because he felt they were not favorable toward him. He feels that the expert was biased: he would straightaway “identify with victims” who filed a complaint against him. Louis was interviewed with caution for child molestation at his work (he is an educator in a children's home for youth protection services).

Louis looks like a failed man: he admits to the facts alleged against him without protest. He merely seeks to justify such transgressive acts by referring to life circumstances that he believes connect him, as in a mirror, to the children he has abused. He describes a situation of abandonment and loneliness in his emotional life: his companion left him a few months earlier for another man, “depriving” him of his little 5-year-old daughter, whom he sees rarely because of the distance that separates him from the town where she currently lives. He said that children for whom he is responsible as a part of his job are also confronted with experiences of separation or abandonment: children, boys and girls, who have been victims of his violent sexual acts are described as “being emotionally deprived”. Louis indicates that socially he is an introvert, that he has never been questioned or condemned for this kind of act, and that he was, before his incarceration, involved in associations and union plans. However, he says that he has few social contacts outside of these institutional relations; all friends turned away from him after the couple’s separation as they were all his ex-companion’s friends.

Here is how Louis recounts the charges against him:

Louis reported the facts with great emotion: at bedtime rituals, he provided intimate caresses and was himself caressed sexually several times by several children from the center where he is an educator. It's hard for him to understand why victims endorsed the complaint, while they had appreciated his caresses; he believed that this was a “violent” situation for him. He insisted also on the attachment that binded him to these children for whom he was responsible in a context of child protection. He also recalls his professional vocation, anchored in his own history of child abuse and the precarious nature of ties within his family. Louis wants to apologize to the children and it’s difficult for him to understand that he is presently forbidden to communicate with them.

Thus, we can see in Louis’s case, paradoxically, the significance of a double movement, a paradigmatic

swing between the active and passive modalities of expression and the instinctual treatment tied to what I designate as a configuration of a perverse risk. This is an unstable configuration; the adjustments are not fixed by the pressed need for maintenance of completeness (as in perversion) or by a psychic survival under duress of the risk of integrity loss (as in perversity). Here, it is mostly the survival of the tie which is committed: one can indeed consider that Louis’s victims are invested in as a form of extension of himself (his history, his emotions). Sexual abuse, limited to the sphere of touching, is registered also in a contra-depressive modality. In this regard, it is necessary to focus on the alternation of active and passive investment in instinctual modalities (mastery versus abandonment, dependence versus fight against the link), whose trace we can also identify in the transgressive modalities (compelled to touch children versus compelling children to touch him).


Kevin, 17 years old: perversion in adolescence?

The question of perversion in adolescence is a complex one insofar as the diagnostic and/or predictive dimension of a psychopathological tracking in this time of psychic maturation is heavily exacerbated. Bonnet (2008), following Freud’s (1905) first intuitions, proposes that we consider the time of adolescence as a time of "transitional perversion" (echoing Freud’s 1905 concept of “the polymorphously perverse child”). He emphasized that in this psychoaffective maturational period, voyeuristic and/or exhibitionistic movements can contribute by their regressive dimension to support a reorganization of the quality of ties with the environment (transitional over-investment in partial instincts at the expense of instinctual (re-) unification...). Bonnet, referring to the testimony of non-pathological clinical expressions of perversion, insists on the lack of equivalence between perversion and psychopathology.

To clarify these proposals, it is necessary to take a look at the central issues of adolescence concerning the management of passivity and/or of the experience of passivation tied to the pubertal experience: indeed, the puberty experience (the “puberty trauma”, as Gutton named it in 1991) confronts the teenager with a feeling of inflicted strangeness around the transformation of the body. The risk for the teenager would be to become overwhelmed by the passive feminine position (and its extensions from the point of view of homosexuality) to the detriment of investment in an active male position able to support identity. The acts of a teenager would be a fight against the passive position, unsymbolizable by virtue of an investment in a maniacal masculinity (Neau, 2005) related to infantile / narcissistic masculinity (Lefebvre & Dusaucy, 2005). This investment must be understood in the context of environmental conditions which do not allow a secure investment of the passive position, particularly in the context of traumatogenic environments.

Kevin is indicted for acts of rape committed in group with the participation of two other teenagers. He was 15 years old at the time of events; the victim was a 13-year-old girl. Incarcerated for two years in protective custody, he is met in the framework of academic research at the age of 17. He has formally agreed to participate in the research and has, moreover, his parents gave consent as well.

Here is how Kevin recounts the charges against him:

I went with her into an alley with two friends. Just before they came, she performed fellatio on me. They mounted one by one and she performed fellatio on them all. Another time, with two other buddies, I told the girl: 'wait for me' in the alley and she performed fellatio on each of us in turn when the others arrived. The victim accused me of having sodomized her and having brought in the others.

Kevin thinks that the teenager, who filed a lawsuit for rape, was not opposed to performing fellatio on him and his friends, and he puts forward his impression that she had consented.

Thus, here we can see the fragility of the construction of the other – subject; the main indication of this fragility could be found in highlighting the “consent” of the victim by Kevin. This functions as a denial of the place of the other’s desire. One may here see that the question of a way out from a form of ‘transitional perversion’ in post-adolescence imposes itself in an acute manner and that, moreover, this question depends, in large measure, on the environment’s capacity to support the work of instinctual unification in the face of the experience of unbinding linked with the encounter of partial drives (Bonnet, 2008). This is of course the whole stake of the accompaniment of the way out of the adolescent process and the elaboration of the perverse scenario. This accompaniment can find support, where required, in the judicial sanction marking a limit in reality. One may assume that supporting this elaboration reduces the risk of an authentic perverse adjustment by freeing the narcissistic investment of the libido for the sake of an objectal investment. But also at stake is the gaze the clinician may cast on adolescence and the adolescent process as a space for transformation and potential readjustment.



Psychopathological Assessment of Perversion(s) and Psychotherapeutic Stakes

As mentioned, clinical work in the “perverse field” is plural, regarding which it is important to clarify the psychodynamic anchors in order to produce an understanding at the psychopathological level.

 

If, following Ciavaldini (2005), we consider a violent sexual act as an "unachieved affect" then the quality of the impediments of affect and their defensive context could be brought to light. This would involve accompanying the transformation of the regime of affect through the emotional sharing which founds the psychotherapeutic work. It is from this perspective that the clinician must be able to identify and support, both precisely and flexibly, the specific tonality of perverse adjustments in order to accompany its deployment on the way to the binding process. This accompaniment particularly focuses on putting to work the effects of affect splitting, the structuring role of which in the field of the psychopathology of perversion we know through Bonnet (2008). Transforming the affect entails supporting its emergence and its path to finding meaning as well as contributing to its accomplishment on a path of symbolization. Moreover, it is at this price that care in the context of perversion can contribute to preventing transgressive repetition (for the benefit of victims and perpetrators), in so far as the work of symbolization constitutes a progredient way to overcome the compulsion for deadly repetition.

Clinical practice with perpetrators of violent sexual acts should make us attentive to the subtlety of the care process. As Verschoot (2014) reminds us: “To cure does not consist of ‘lifting the denial’ or ‘bringing an end to the splitting’ at all costs: although that is technically possible, it would immediately cause psychical collapse and bring the risk of renewed appeal to a hetero or auto-aggressive act (violence against others or suicide). Denial is not a barrier to care, but to relating to otherness. The framework limits the influence, but cannot prevent it” (p. 156).

We can probably say that beyond the psychodynamic issues that underlie the structuration of various adjustments or configurations of the perverse, therapeutic stakes depend largely on the nature and strength of the splitting of affects, as well as the power of denial that colors the defensive organization of the subject and that testifies to a true testing of subjectivity in the treatment. It is with patient and constant encounter with the subject engaged in the act that the psychotherapeutic approach can take its full meaning at the service of supporting the psychic plasticity and the work of symbolization of affects. Throughout this work a singular clinical stance leads the psychotherapeutic intervention. This position, well described by Ciavaldini (2003), consists of the project to survive the alienation perpetrators of sexual violence confront us with. This project is built upon the elements of external reality (the law, the frame, the judicial mandate) as an alternative to the fragility of the internal supports of the subject. If, as Ciavaldini (2003) holds, commitment to treatment under judicial mandate testifies to the recognition of the human side of the subject, including the most unbearable and unthinkable acts, then the conditions for the mobilization of a work of affect would open without which any caregiving perspective appears to be in vain.


References:

Aulagnier, P. (1975). La violence de l’interprétation. Paris: PUF.

Balier, C. (1988). Psychanalyse des comportements violents. Paris: PUF.

Balier, C. (1996). Psychanalyse des comportements sexuels violents. Paris: PUF. Bergeret, J. (1974). La personnalité normale et pathologique. Paris: Dunod.

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1 This paper was first presented as a lecture given on January 26th, 2016 at Tehran Psychiatric Institute, Tehran University of Medical Sciences (TUMS), in Iran.

2 Professor of Clinical Psychology, Psychopathology and Psychoanalysis.

3 The notion of “general theory of perversion” is a nod to J. Laplanche’s claim (1987) that the baby / young child would be confronted with what he called a "general theory of seduction" (or "primal seduction”) ... it means a situation in which the child cannot escape from confrontation with enigmatic / paradoxical and exciting messages. So, in my view, it is the same as the judicial scene in which the professionals of psychological expertise, inter alia, find themselves.

4 J. Lacan (1961) also embraces this position by focusing on the role of juissance in the psychic economy of perversion.

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