ABSTRACT
Catatonic schizophrenia was once common among the chronically institutionalized schizophrenic patients of many mental hospitals. George was greatly relieved by the exposure of his “perverse” fantasy, and his therapist’s acceptance of it, and was soon able to talk about his inexplicable silences and periods of catatonic immobility. In the course of psychotherapy as an adolescent, George had fallen in love with an older woman and was frightened by the emergence of the fantasy of penetrating into her buttocks. George began to talk about his experiences more freely, and much of his bizarre behaviour became more understandable. He began to understand that entering the room had aroused frightening and exciting thoughts about sexual entry into his therapist, and that his perverse fantasy had the same meaning for him. Given contributing factors, such a dynamic can eventually lead to a crystallized sexual perversion in the form of sadomasochism or fetishism, whose essential meaning may be difficult to recognize.
