ABSTRACT
The syntax of perverse thought reveals an ontology of its own. It might be described in two sentences: If I want it so much, I can’t not have it; and if it scares me so much, it can’t be real. This chapter deals with reality testing and the way perverse people more or less willfully avoid it when it is inconvenient. Clinical material is used to demonstrate how that works and some of the clinical pitfalls it creates for the therapist. Special attention is given to the notion of “psychic reality,” which Freud introduced to underscore the power of unconscious fantasy. The author argues that, with perverse patients, the entire therapy situation may inadvertently collude with the patients’ effort to blur the distinction between reality and fantasy. In such cases, the therapist may need to speak for reality.
