ABSTRACT
The therapeutic approach to a patient with perversion problems is no different from other forms of therapeutic encounter, except that in these cases the analyst is aware, from the beginning, of the complexity of the clinical situation and of the analysand's problematic position. Perversion is one of the possible expressions of an alteration of sexual behaviour, but not every behavioural anomaly in the field of sexuality is regarded as perversion. The complemental series of perverse manifestations, which extend, roughly speaking, from secondary, defensive entities to structured pathological organizations, guides the therapeutic approach and determines the course of the treatment. The perverse symptom is sometimes localized. For example, it may consist of a set of imagined scenes that accompany intercourse and permit orgasm. Such symptoms are often hidden in the initial interviews and are communicated only in the course of the ensuing psychoanalytic treatment.
