Perverse modes of thought

Subtle, nonpsychotic disturbances in thinking may cause significant impairment of intellectual functioning and interfere with a patient's capacity to make use of psychoanalytic treatment. As these come under interpretive scrutiny, the intellectual exchange between patient and analyst may emerge as a theater for the enactment of perverse sexual fantasies. In this paper, the author describes these disturbances in thinking and proposes a model that explains their underlying structure and their link to the associated fantasies. Interpretation and working through of the condensed part-object and whole-object transferences that emerge in the analysis of these forms of thinking may lead to some measure of clinical improvement.