Comparison of selected experimental MMPI profiles of sexual deviates and sociopaths without sexual deviation.
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Current researches in sexual deviations have rightly stressed deficiencies and faults in the mother/child relationship, fears of annihilation and an inability to achieve separation and independence. As a result of this the role of the father in the patient's family structure and in their psychotherapies and psychoanalyses has been somewhat neglected, also because the fathers are usually described as cold, distant, uninvolved, etc. The author believes that the obliteration of the father figure, whether accidental or deliberate, is an important part of the psychopathology. It follows that in the late stages of a therapy there should be a careful examination of the original establishment of the father as a second object, as its internalization is essential for a healthy sexual development. The obliteration of the father figure can cause serious problems in terms of the understanding of the transference and countertransference. The paper includes a clinical description of a case where such problems were much in evidence.
The prophylaxis and clearing-up rate of deviating sexual behaviour of adolescents could be favourably influenced, if doctors, teachers and judicial administrators had a better knowledge of the phenomenology of sexual delicts as well as sexual delinquents. 87 expert opinions on juvenile sexual delinquents were analysed under this aspect. In the majority of cases sexual delicts of adolescents reveal a far more extensive disturbance in their individual and social development.
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The author, after discussing theoretical aspects of the development and treatment of sexual deviations, describes methods of behavior therapy which when used in combination and by experienced clinicians will yield promising results. In addition, a number of cases are reported, and these indicate some special problems associated with the therapy of sexual deviations.
A study conducted in a mental hospital involved 157 male adolescents (aged 14-17 years) with psychopathy (n = 42), oligophrenia (n = 49), and schizophrenia (n = 66) who displayed some sexual deviations. Homosexual manifestations were found to be the most frequent form of sexual deviations (61%). Other forms included sadomasochistic actions, heterosexual aggression, sexual claims to relatives, exhibitionism, etc. The mechanisms of the development of deviant sexual behaviour differed in the framework of the nosology and type of deviations.
Using audiotaped descriptions of sexual experiences and a direct measure of penile erection, it is possible to specify more precisely erotic cues in sexual deviates. Results indicated that such cues are highly idiosyncratic. Some tentative conclusions and suggested application for the method are discussed.
Clinical work with offenders and victims is cited to support the concept of rape as a sexual deviation, as well as a sexual offense. It is suggested that rape is directed toward the sexual expression and gratification of needs that are not basically sexual, and that it represents a developmental crisis for the offender, which in turn triggers a situational crisis for the victim.
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This paper presents an historical account and a critical analysis of the diagnostic problems surrounding our understanding of the sexual deviations and their position in our classification system. Appropriate therapy can only be based on accurate diagnosis. Exceptions of this principle of psychiatric care cannot be made for social/political reasons without incurring formidable difficulties both for the diagnostician and the patient as well.
Among manifold causes and conditions there are two essential roots: unfavourable social background and cerebroorganic disturbances. Crime prevention must increasingly concentrate on infancy and youth. Emphasis is laid upon crime preventive possibilities of sex education and the importance of child neuropsychiatry within the framework of complex public measures to combat criminality.
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In this paper, sexual perversion is discussed and connected with the absence of the father and with the failure of a primary relationship with a mother who is incapable of leading the child to the threshold of Oedipus. Sexual perversion may be considered as the expression of a narcissistic personality organisation which makes massive use of splitting and projective identification as a defence against separation anxiety. This prevents homosexual perverts from dis-identifying from their mothers and from attaining a distinct gender identity. The clinical case of a homosexual male patient is presented, where the absence of the father underlay his resentment, conveyed in the transference by means of lamentations and boredom, with which the patient sadistically tormented the analyst, thus giving vent to his deep resentment over an absent and unreliable father and over a mother from whom he could only be separated at the cost of persecutory anxiety and feelings of jealousy.
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