Abstract
If the field of perversion has diminished in successive editions of DSM, Dany Nobus wonders why psychoanalysts insist on preserving it as an entity? He offers four reasons: the appeal to authorisation of the term by Freud and Lacan; the fact that even though perverts rarely enter a clinic, psychoanalysts do see patients caught up in the socio-legal nets of perverts, as well as perverse behaviours in patients not diagnosed as perverse; categorizing patients as perverse enables analysts to discredit those who destabilize their professional comfort; and finally, the classification ‘pervert’ is sometimes used by psychoanalytic institutions to reject certain candidates. While he stresses that analysts have a responsibility to work through their own perverse traits, he asks whether the term has outlived its usefulness?
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Notes
- 1.
Foucault, M. (1978). The History of Sexuality. Volume 1: An Introduction. R. Hurley (Trans.). New York: Random House, p. 47.
- 2.
For general historical surveys of how the term ‘perversion’ entered European sexological discourses and the Western cultural imagination during the second half of the nineteenth century see, for example, Lanteri-Laura, G. (1979). Lecture des perversions. Histoire de leur appropriation médicale. Paris: Masson; Rosario, V.A. (1997).The Erotic Imagination: French Histories of Perversity. New York and Oxford: Oxford University Press; Roudinesco, É. (2009). Our Dark Side: A History of Perversion. Cambridge: Polity; Schaffner, A.K. (2011). Modernism and Perversion: Sexual Deviance in Sexology and Literature 1850–1930. Basingstoke: Palgrave Macmillan; Chaperon, S. (2012). Les origines de la sexologie (1850–1900). Paris: Payot; Mazaleige-Labaste, J. (2014). Les déséquilibres de l’amour. La genèse du concept de perversion sexuelle, de la Révolution française à Freud. Paris: Ithaque.
- 3.
Freud, S. (1905d). Three Essays on the Theory of Sexuality. S.E. 7: 123–242. J. Strachey (Trans.). London: Hogarth, 1953.
- 4.
See American Psychiatric Association. (1987). DSM-III-R. Washington, DC: American Psychiatric Press. Following widespread social protest and extensive discussion, the term ‘homosexuality’ was removed from the 7th edition of the DSM-II in 1974, and replaced with ‘sexual orientation disturbance (homosexuality)’, to be restricted to “individuals whose sexual interests are directed primarily toward people of the same sex and who are either disturbed by, in conflict with, or wish to change their sexual orientation.” The DSM-III (1980) continued to refer to ‘ego-dystonic homosexuality’ (category 302.00), yet this term was removed in the DSM-III-R. In the DSM-IV-TR (2000) category 302.9 (‘sexual disorder not otherwise specified’), had as an example “persistent and marked distress about sexual orientation”, which could refer equally to heterosexuality as to other sexual orientations, although it is no doubt less likely to be applied to the former case, because a predominantly straight culture is less likely to instill anxiety, shame and anger in those who identify as heterosexual than in those who do not. The latest on-line update of the 10th edition of the International Classification of Diseases [(ICD-10), 2015] still refers to ‘ego-dystonic sexual orientation’ in its category F66-1. It should also be noted that the psychoanalytic community has been much slower than its psychiatric counterpart in adopting a non-discriminatory policy against homosexual candidates for training—the American Psychoanalytic Association (APA) in 1991, and the International Psychoanalytical Association in 2002. See World Health Organisation. (1992). The ICD 10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. Geneva: World Health Organisation. On the homophobic policies of the psychoanalytic establishment, see Roughton, R.E. (1995). Overcoming Antihomosexual Bias: A Progress Report. The American Psychoanalyst, 29 (4): 15–6; Roughton, R.E. (2002). The International Psychoanalytical Association and Homosexuality. Journal of Gay and Lesbian Psychotherapy, 7 (1/2): 189–96; Isay, R.A. (2009). Becoming Gay: The Journey to Self-Acceptance, revised and updated edition. New York: Vintage Books, pp. 147–67.
- 5.
Foucault, M. (1989). Archaeology of Knowledge. A.M. Sheridan Smith (Trans.). London: Routledge, pp. 130–1.
- 6.
Butler, J. (1990). Gender Trouble: Feminism and the Subversion of Identity. London and New York: Routledge, p. 136.
- 7.
American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition (DSM-III). Washington, DC: American Psychiatric Press, pp. 266–7. A critical analysis of the changing psychiatric terminology for sexual disorders, and the decision-making processes underpinning the changes, would require a book-length study. At the risk of providing the reader with a simplified ‘wikipediatic’ survey, the changes can be summarised as follows. In the first edition of the DSM (1952), ‘sexual deviation’ (category 320.6) was included as a type of ‘sociopathic personality disturbance’ (alongside ‘antisocial reaction’, ‘dyssocial reaction’ and ‘addiction’) and defined as “deviant sexuality which is not symptomatic of more extensive syndromes, such as schizophrenia and obsessional reactions … [and which] includes most of the cases formerly classed as ‘psychopathic personality with pathologic sexuality’. The diagnosis will specify the type of the pathologic [sic] behavior, such as homosexuality, transvestism, pedophilia, fetishism and sexual sadism (including rape, sexual assault, mutilation)”, pp. 38–9. In the DSM-II (1968), section 302 (sexual deviations) was completely revised to include eight examples: homosexuality, fetishism, pedophilia, transvestitism, exhibitionism, voyeurism, sadism and masochism. It specified that the category of sexual deviation should be reserved for individuals whose sexual preference is “directed primarily toward objects other than people of the opposite sex, toward sexual acts not usually associated with coitus, or toward coitus performed under bizarre circumstances, as in necrophilia, pedophilia, sexual sadism, and fetishism”, p. 44. When the DSM-III (1980) was published, ‘sexual deviation’ was replaced with ‘paraphilia’, under the broader category of ‘psychosexual disorders’, whereas the term ‘ego-dystonic homosexuality’ (category 302.00) was substituted for ‘sexual orientation disturbance’. In the DSM-III-R (1987) ‘psychosexual disorders’ were replaced with ‘sexual disorders’, including the sub-set of the ‘paraphilias’, and ‘atypical paraphilia’ became the ‘paraphilia not otherwise specified’. In the DSM-IV (1994) and DSM-IV-TR (2000), paraphilias were defined as “recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving (i) nonhuman objects, (ii) the suffering or humiliation of oneself or one’s partner, or (iii) children or other nonconsenting persons that occur over a period of 6 months [Criterion A], which cause clinically significant distress or impairment in social, occupational, or other important areas of functioning [Criterion B].” In DSM-V (2013), category 302.9 has been renamed as ‘unspecified paraphilic disorder’, which no longer includes any reference to sexual orientation. See APA. (1980). Diagnostic and Statistical Manual of Mental Disorders (DSM), third edition (DSM-III). Washington, DC: American Psychiatric Press; APA. (2000). Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Press; APA. (2013). Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). Washington, DC-London: American Psychiatric Publishing.
- 8.
APA, 2013, op. cit., pp. 685–6.
- 9.
Dean, T. (2008). The Frozen Countenance of the Perversions. Parallax, 14 (2): 93.
- 10.
ibid., p. 96.
- 11.
The psychoanalytic literature on perversion remains vast, and although some authors recognise the problematic status of the concept, it continues to inform psychoanalytic theory and practice across institutional and intellectual boundaries. For recent non-Lacanian psychoanalytic views, see for example, André, J., Catherine, C . and Guyomard, P. (Eds). (2015). La perversion, encore. Paris: Presses Universitaires de France. For a Klein-inspired approach, see Wood, H. (2014). Working with Problems of Perversion. British Journal of Psychotherapy, 30 (4): 422–37.
- 12.
For perversion as père-version, see for example, Lacan, J. (1975–6). Le Séminaire. R.S.I., Ornicar? 5, leçon du 8 avril 1975, pp. 37–46; Lacan, J. (1995). “Spring Awakening.” S. Rodríguez (Trans.). Analysis, 6, p. 34.
- 13.
Freud, S. (1916–17). Introductory Lectures on Psycho-Analysis. S.E. 16. J. Strachey (Trans.). London: Hogarth, 1963, p. 337.
- 14.
Freud, S. (1915c). Instincts and their Vicissitudes. S.E. 14: 109–40. J. Strachey (Trans.). London: Hogarth, 1957.
- 15.
Freud, S. (1927). Fetishism. S.E. 21: 147–157. J. Strachey (Trans.). London: Hogarth, 1961.
- 16.
Falzeder, E. (Ed.) (2002). The Complete Correspondence of Sigmund Freud and Karl Abraham 1907–1925. C. Schwarzacher (Trans.). London and New York: Karnac, p. 106. See also Rose, L. (1988). Freud and Fetishism: Previously Unpublished Minutes of the Vienna Psychoanalytic Society. The Psychoanalytic Quarterly, 57: pp. 147–66.
- 17.
Freud, S. (1940a)[1938]. An Outline of Pychoanalysis. S.E. 23 S.E. 23: 139–207. J. Strachey (Trans.). London: Hogarth, 1953, p. 204.
- 18.
On perversion as a historical (and contemporary) diagnosis of sexual self-control, see the fascinating recent study by Mazaleigue-Labaste, J. (2014). Les déséquilibres de l’amour. La genèse du concept de perversion sexuelle, de la Révolution française à Freud. Paris: Ithaque.
- 19.
The closest we have in English to this type of work is the recent book by Stephanie Swales, which remains hugely instructive, despite the fact that it tends to interpret Lacan’s remarks on perversion from a streamlined (post) Lacanian perspective, rather than problematising the text. See Swales, S. (2012). Perversion. A Lacanian Psychoanalytic Approach to the Subject. New York and London: Routledge. The most succinct post-Lacanian synthesis of Lacan’s take on perversion can be found in Fink, B. (1997). A Clinical Introduction to Lacanian Psychoanalysis: Theory and Technique. Cambridge, MA and London: Harvard University Press, pp. 165–202. Lacan’s scattered comments on perversion have also been discussed extensively in Fondation du Champ freudien. (1990). Traits de perversion dans les structures cliniques. Paris: Navarin.
- 20.
Lacan, J. (2007)[1969–70]. The Seminar, Book XVII: The Other Side of Psychoanalysis. R. Grigg (Trans.). New York: W. W. Norton & Company.
- 21.
Lacan, J. (1998)[1957–8]. Le Séminaire, Livre V : Les formations de l’inconscient. J.-A. Miller (Ed.). Paris: Seuil, pp. 230–1. My translation.
- 22.
ibid., p. 336. My translation.
- 23.
See, for example, Castanet, H. (1992). Regard et perversion. A partir des Lois de l’Hospitalité de Pierre Klossowski. Nice: Z’éditions; Millot, C. (1996). Gide Genet Mishima. Intelligence de la perversion Paris: Gallimard; Jadin, J.-M. (1997). André Gide et sa perversion. Paris: Arcanes; Castanet, H. (1999). La perversion Paris: Anthropos, pp. 113–85; Uvsløkk, G. (2011). Jean Genet. Une écriture des perversions. Amsterdam and New York: Rodopi.
- 24.
It is not uncommon for Lacanian psychoanalysts to refer to ‘perverse traits’, by which they mean non-normative, atypical sexual features in a patient’s clinical picture, yet these are generally reserved for neurotic and psychotic patients whose sexual interests fall outside the mainstream … Indeed, for a Lacanian, the ‘perverse trait’ almost by definition, and quite paradoxically, indicates that the patient is not perverse, which raises the question as to how the sexual interests of someone who is considered to be perverse, in a structural sense, ought to be understood. Not as a symptom, surely, because this would render the underlying structure neurotic again. For a more detailed discussion of this problematic, see Nobus, D. (2009). Perversion as Symptom: On Defining the Sexuality of the Other. Analysis, 15: 21–30.
- 25.
On the problematic issue of the fantasy as something that needs to be ‘confessed to’, see Freud, S. (1919e). ‘A Child is Being Beaten’: A Contribution to the Study of the Origin of Sexual Perversions. S.E. 17: 175–205. J. Strachey (Trans.). London: Hogarth, 1955.
- 26.
On the notion of sujet-supposé-savoir, see Lacan, J. (1994). The Four Fundamental Concepts of Psycho-Analysis. A. Sheridan (Trans.). Harmondsworth: Penguin, pp. 230–43.
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Nobus, D. (2017). Perversion in the 21st Century: A Psychoanalytic Conundrum. In: Caine, D., Wright, C. (eds) Perversion Now!. The Palgrave Lacan Series. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-47271-3_9
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