The Psychoanalytic Quarterly

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The Perverse Attitude Toward Reality

Lee Grossman

To cite this article: Lee Grossman (1993) The Perverse Attitude Toward Reality, The
Psychoanalytic Quarterly, 62:3, 422-436, DOI: 10.1080/21674086.1993.11927387

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Psychoanalytic Quarterly, LXII, 1993

THE PERVERSE ATTITUDE

TOWARD REALITY
BY LEE GROSSMAN, M.D.

Freud's ( 1940a) tentative distinction between the defensive ma­

neuvers in neurosis and those in perversion can be extended to
good clinical effect. In general, neurotic defenses may be thought of
as directed against wishes, whereas perverse defenses are directed
against perceived reality. It is suggested that the perverse approach
to reality is not limited to frank sexual perversions; it defines a
class of operations that involve taking certain liberties with reality.
Clinical material is used to demonstrate the perverse attitude and
some of its implications for technique. The role of the superego is
considered.

A probation officer in analysis was troubled by his frequent

thoughts about molesting young girls. On one occasion, he in­
tentionally brushed against the buttocks of a teenage girl in his
charge, after the thought "came to him" that he would like to do
so. He understood the episode as evidence that, because he
could not prevent the thought, he acted on it-in effect, the
thought made him do it. His analyst pointed out that he talked
about the thought as if it were not he doing the thinking. He
agreed; he had just "received" it.
After some discussion of the uses to which he put this claim of
passivity with respect to his thinking, the analyst wondered what
was left out of the account. How was it that the only thought he
had attended to at the time was the wishful one? His analyst
suggested that he might not have let himself become aware of all
his thoughts at the time. The patient confirmed that he had had
another thought, about getting in trouble; but he had "turned
down the volume on reality." He allowed himself the gratifica-
 THE PERVERSE ATTITUDE TOWARD REALITY 423

tion of a forbidden wish by finding a way to disavow the trou­

blesome reality of the possible consequences of his action. He
knew about it, but it was not so "loud" that he had to treat it as
important. 1
This is a simple example of two defensive maneuvers which
are aimed at two different targets. The patient's insistence on his
passivity was directed against his forbidden wish: he did not
"want" to act, he was "compelled" to do so by an "intrusive"
thought. His "turning down the volume on reality" was directed
against a troubling perception of reality (an idea of the conse­
quences), rather than against the impulse. Freud (1940a, p. 204)
tentatively distinguished between the defensive operations in
neurosis and those in perversion on this basis: in neurosis, the
wish is renounced, disguised, or otherwise inhibited, out of re­
spect for dangers perceived in reality; whereas in perversion,
the perception of reality is altered, and the wish retained. Al­
though Freud was careful to note that this distinction was not
absolute, I believe it has broad utility in everyday clinical work:
it gives us a basis to define a class of phenomena that has in
common the defensive alteration of the sense of reality.
h\though the phenomena that comprise this c\ass are quite
varied, their common effect upon reality makes them similar in
one clinically important respect: when unpleasurable affect
threatens, reality no longer has its compelling quality. Broadly
put, this accounts for the difficulty in treating the perverse pa­
tient; and this difficulty is shared, in varying degree, by the
other phenomena in the class. Included in this class are perver­
sions, "character perversion" (Arlow, 1971; Grossman, 1992),
"fetish equivalents" (Calef, et al., 1980), some compulsions, e.g.,
kleptomania (Zavitzianos, 1971), "negation as a character trait"
(Weinshel, 1977), depersonalization and derealization (Freud,
1936; Arlow, 1966; Renik, 1978), confusing dream and reality
(Calef, 1972), and others.

1 I am indebted to Dr. Janis Baeuerlen for this exam le.

p
424 LEE GROSSMAN

I wish to survey some of these entities briefly, in order to

consider the kind of thinking involved in all of them, and then
offer a clinical example, to consider the challenges to treat­
ment such cases present. Finally, I will comment on the role
of the superego in the type of defensive maneuvers under dis­
cuss10n.
In his discussion of "character perversion," Arlow (1971) de­
scribed the"unrealistic character" who responds to problems by
seizing on a peripheral detail, beating around the bush, ignor­
ing the demands of reality. One such patient "prefers to treat
reality as if it were a bad dream" (p. 3 18). In treatment, such
patients seem unwilling to draw obvious conclusions; "when an
interpretation is offered, the patient 'looks away,' that is, he acts
as if he had not heard what had been said or he focuses his
attention on some insignificant detail, or he turns to a new sub­
ject without acknowledging the transition" (pp. 318-319). Arlow
drew the connection between the trait described and its origins
in voyeurism and fetishism (p. 322), in which the perception of
the penisless female genital stirs up such intense castration anx­
iety that the reality of the perception has to be disavowed, or
attention has to be focused intensively on a peripheral detail,
away from the disturbing aspect of the perception. The detail,
the fetish, serves as a representation of the female penis, and
negates the disturbing perception. As Arlow put it, "The voyeur
is compelled to look but not to see" (p. 322); he is not compelled
to accept what he sees as important. The fetishist finds some­
thing else to look at, in order to distract his attention from what
is disturbing.
Arlow described two other related character traits under the
heading of character perversion. One is exemplified by the petty
liar, who reassures himself that if he can obscure the truth from
others, he need not face the truth himself. Arlow noted that the
lie is a fetish equivalent, a" 'screen' percept" (p. 326). But it also
discredits the truth, as if to say it may just as well be a lie. The
other trait can be seen in the practical joker, who inspires anx­
iety in others and then takes pleasure in exposing the hoax.
 THE PERVERSE ATTITUDE TOWARD REALITY 425

Arlow observed the similarity of this trait to the defenses of the

transvestite (p. 326), in which the perverse activity implies that
femaleness (i.e., penislessness) is only an appearance.
Character perversion is not uncommon, but it escapes notice
because the disturbance is relatively mild and the patient does
not complain of it (p. 318). Arlow restricted his discussion to
male patients; but character perversion occurs in women as well
(Grossman, 1992).
Greenacre (1955) identified "[f]orms of fetishism which are
not always clearly linked to the genital functioning (such as cer­
tain drug addictions, kleptomanias, special religious practices,
the use of lucky charms) ...[which] seem to occur in the female
as well as the male" (p. 59, n.).These and other related clinical
phenomena are sometimes labeled "fetish equivalents." In other
words, they share the defensive practices with frank sexual fe­
tishism, even though they have different aims. Zavitzianos
(1971) referred to kleptomania as "the female fetishism" (p.
303), and noted in passing that there are similarities between
perversion and psychopathy (p. 304)-suggesting the impor­
tance of superego functioning in the disorder.
Calef, et al. (1980) considered enuresis as the "functional
equivalent of a fetish." In the case they described, the patient
"experienced the analysis as a dream from which he did not wish
to be awakened....[R]eality [was] discounted as unreal, ...un­
important, even non-existent" (p. 295). Note that the clinical
problem was that the patient took the same liberties with un­
pleasant treatment realities as he did with other threatening
perceptions.
Weinshel has studied a variety of nonpsychotic patients with
focal defects of reality sense.Under the heading of "negation as
a character trait," he described a woman who protected herself
from disturbing reality by a variety of actions that conveyed the
sense, "I didn't mean it" (Weinshel, 1977).In another contribu­
tion, Weinshel (1986) reported the perceptual distortions of
three neurotic women in analysis who, at stressful moments,
transiently gave up their reality testing capacity in favor of un-
 LEE GROSSMAN

realistic illusions.Arlow (1966) described the "dissociation of the

function of the observing self from the experiencing self" in
hysterical hallucinosis, which he saw as opposite from deperson­
alization. In the former, "there is maximal investment in the
function of immediate experience and an almost complete oblit­
eration of the function of self observation." In the latter, "self
awareness is heightened and the sense of participation in action
is minimized or alienated" (p. 463).
Calefs (1972) case of a patient who insisted on the reality of
his dream, and disavowed the reality of his waking life, is a
fascinating counterpart to Freud's (1940a) case, mentioned in
passing, of a paranoid man whose dreams accurately repre­
sented reality which was denied in waking thought (p. 202).
Calefs patient complained of insomnia, until they discovered
that the patient was dreaming that he was awake. Renik (1978)
discussed the role of the restriction of attention with respect to
certain perceptions in depersonalization.
Freud (1923) described how little boys disavow their percep­
tions of the female genital and "believe that they do see a penis,
all the same. They gloss over the contradiction between obser­
vation and preconception by telling themselves that the penis is
still small and will grow bigger ..." (pp. 143-144). In his next
contribution, Freud considered the position of the ego with re­
spect to conflict with either the id or external reality. He wrote:
... it will be possible for the ego to avoid a rupture in any
direction by deforming itself, by submitting to encroachments
on its own unity and even perhaps by effecting a cleavage or
division of itself. In this way the inconsistencies, eccentricities
and follies of men would appear in a similar light to their sexual
perversions, through the acceptance of which they spare them­
selves repressions (1924, pp. 152-153; italics added).

Note that this "cleavage" is similar to (i.e., shared with, but not
limited to) the perversions; and that it is an alternative to re­
pression.
Freud described the conditions for this type of thinking as a
 THE PERVERSE ATTITUDE TOWARD REALITY 427

"split in the ego" (1927, 1936, 1940a, 1940b). In his paper,

"Fetishism" (1927), he discussed the simultaneous holding of
the belief that women have penises, and the knowledge that they
do not (p. 154). But in the same paper, he described the same
process in an obsessional patient without a fetish, with respect to
the disavowal of his father's death: 'The attitude which fitted in
with the wish [that his father were still alive] and the attitude
which fitted in with the reality existed side by side" (p. 156).
Although Freud found that fetishism provided a particularly
fruitful opportunity to study the splitting of the ego, he did not
consider the disavowal on which it is based to be limited to it
(Freud, 1940a, pp. 203-204). In a discussion of derealization,
Freud (1936) described the situation in which the testimony of
the senses is disavowed (p. 244); the perception coexists with the
judgment that it is unreal. He likened the phenomenon to deja
w. He told the story of the king who kills the bearer of bad
news: the king "determines to treat the news as non arrive" (p.
246).
Disavowal, which Freud links to the splitting of the ego, is one
of a class of defensive maneuvers by which an intolerable reality
is made bearable. By disavowal, I understand the stripping of
disturbing meaning or consequence from a perception, without
altering the perception itself. I am following Renik (1984) in this
usage. Related efforts to cope with intolerable perceptions in­
clude distraction of attention from the disturbing percept, and
illusory distortion of perception (as in Weinshel's [1986] cases).
Note that fetishism involves both disavowal of the perception of
a penisless genital, and distraction from it by attending to the
fetish object.
Disavowal, distraction, and illusion are defensive maneuvers
directed against a threatening perception, which remains avail­
able to consciousness in some form. To say that a "split in the
ego" is involved, as Freud does with respect to disavowal, is to say
that the person is adept at keeping two apparently contradictory
ideas in mind, without feeling the obligation to reconcile the two
(Freud, 1940a, p. 203). The perception is available; but it does
 LEE GROSSMAN

not have the evidentiary value to influence the cherished belief.

It is precisely this facility, which I am calling the perverse atti­
tude toward reality, that creates technical problems, about
which I will have more to say later. Such patients can distinguish
reality from fantasy; but when it suits them not to, they do not
find reality compelling.
Of course, the distinction between neurotic and perverse at­
titudes is not so hard and fast in practice. Every neurotic defense
alters the perception of reality in some sense. Most obviously,
the repression of a wish alters one's conscious self-perception, as
well as altering one's understanding of conditions in the world
as a consequence. Perceptions (and "reality") are never passively
received "objective" facts, but constructions. Furthermore, ev­
eryone uses both neurotic and perverse approaches in some
mixture. But the attitude I am describing amounts to avoiding
reality as perceived. It makes a substantial difference in working
with a clinical phenomenon, whether we understand the mech­
anism involved as an effort to disguise or renounce a wish for
fear of perceived consequences, or as an effort to evade the
implications of what is perceived. In the latter case, the degree of
license to disavow, alter, or ignore what is in front of one's eyes
has far-reaching consequences for treatment.
Examples of these phenomena are commonplace in every
practice: my introductory vignette is a case in point. Another
common version of taking these liberties with reality can be seen
in the patient who tells a dream in such a way that the analyst
always has to struggle to distinguish when the patient has
stopped talking about the dream and begun to talk about real­
ity-a distinction that does not seem to concern the patient. A
woman I have described elsewhere (Grossman, 1992) regularly
held grudges against people for injuries she dreamed about, but
which never happened; and she dismissed unwanted memories
with the thought that she had merely dreamed them.
A less common, if more striking example also came up in
work with dreams:
A man in analysis began a Monday hour announcing that he
 THE PERVERSE ATTITUDE TOWARD REALITY 429

had "that dream again" Sunday night. "It's funny; I never

dream, as you well know. But I've had this identical dream twice
before: I drive my car into the garage and leave it there. While
walking, I witness an accident-puddles of blood. It is the corner
of Nimitz and St. Andrew streets. The driver couldn't control
the car."
The man was most impressed by the fact that he had had the
same dream twice before. I was most impressed by the fact that
he was talking as if I had heard it before, which I had not. He
was certain that he had told me the dream twice before. In fact,
he knew which days: he had the dream Wednesday and Friday
mornings, and reported it in his Wednesday and Friday hours.
At this point I reminded him that we had not met on Friday; he
had not shown up. He was puzzled for a moment, but then he
realized that, while driving to the hour, he had skidded on a slick
patch of road and spun out into a ditch on St. Andrew Street. He
then recalled that, on Wednesday, he had been driving on the
Nimitz Freeway and had blown a front tire; he had struggled to
control the car and pull over safely.
He described the accident on Friday. During the skid, he had
felt he was in a dream. Immediately upon getting out of the
car, he found he was surveying the damage coolly, "as if I
wasn't there." He remembered thinking calmly, "it never hap­
pened." In fact, he had gone home and thought no more about
the accident, or about the hour he had been heading for.
The phrase, "it never happened," reminded him of an inci­
dent from adolescence. It had been his habit to go to a certain
bookstore, where he would look at sexually stimulating maga­
zines, while trying not to be conspicuous. Often he would get an
erection, which he would "try to control." On the occasion he
now recalled, he ejaculated. Immediately he felt as if he were in
a dream, and he found himself thinking, "it never happened."
As might be expected, he could not say whether this had hap­
pened more than once; indeed, even as he described the mem­
ory, he found himself wondering whether he had just dreamed
it all in the first place.
430 LEE GROSSMAN

He wondered about the dream. The car seemed important to

him; in fact, he had been thinking about the dreams (sic) as
"driving dreams." As he thought about the accident, he did not
recall having experienced any fear that he might have been
injured; instead, as it was happening, he had worried about
damaging the car. "But," he said, "I suppose the car is an ex­
tension of myself." He recognized the allusion to his penis in the
words, but repeated that he had felt no danger. The "accident"
in the dream reminded him that his mother used to call it an
"accident" when he wet the bed as a child, which he had done
well into latency. She would joke that she had seen an elephant
or some other animal come into his room in the night and wet
his bed. He would recall waking to find he was "in a puddle,"
with no idea what had happened; apparently he was often con­
fused about whether it was a dream. Sometimes he would con­
vince himself that he had seen the elephant-"witnessed the
accident."
The patient was an only child, whose father left his mother
and him when he was three. The divorce left the mother im­
poverished, and forced the two of them into a small apartment
in which privacy was compromised. It seems that when mother
would have a man spend the night, the child was exposed to
their sexual activity-which the mother would subsequently
deny, insisting that the child had been dreaming. His mastur­
bation was another occasion for a collusion that "it never hap­
pened"; she tacitly agreed not to notice it, and he found a way
to detach himself from it, as if it were not he doing it.
This example demonstrates an array of defensive operations,
both "neurotic" and "perverse." To focus on the latter: his deja
raconte, depersonalization, derealization, confusion of dream
and reality-all represent ways of discrediting troublesome per­
ceptions of reality that allow him to gratify certain wishes in
relatively unmodified form. What the patient did with the
dream itself is a prime example: he treated it as a reality, and he
treated the reality to which it alluded as a dream. The dream
wish might be expressed as, "I wasn't driving; it was only a
dream."
 THE PERVERSE ATTITUDE TOWARD REALITY 431

There is nothing very unusual about taking reassurance from

a dream in that form. Freud (1900) described a similar process
in his discussion of examination dreams (pp. 273-276). Renik
(1981) pointed out the reassurance in "typical anxiety dreams"
and "superego dreams" along these lines as well. What is more
unusual is what the patient did whi/,e awake. He did not merely
make a claim in his dream; he continued to make it in waking
life. His conviction of already having told me about the
"dreams" was a falsification, an enactment of a fantasy, which
supported another disavowal in which he told himself he had
merely dreamed the events. Taking these liberties with reality
helped him to keep the threatening preconscious perception of
the accident away from the center of his awareness. Note that he
did not forget the accident, or the hours he missed; he had them
in mind, but they had lost the force of reality-they were treated
as if they were a dream, whereas his daydreamed version was
treated as reality.
This example may seem cause for optimism. After all, the
patient seemed to discover and reveal a good deal about his
castration anxiety; he seemed to have recovered some key mem­
ories; all in one dramatic hour. But (as my patient constantly
reassured himself}, appearances are deceiving. The fate of this
material, and much like it, was to be doubted, altered, dis­
counted as an interesting fiction, blurred out of existence, or
ignored, as we continued in our work. The hour might as well
never have taken place. His conscience, modeled as it was on
that of his parents, did not compel him to accept the testimony
of his senses when those perceptions threatened him. To the
contrary, he was more than willing to give up his frightening
perceptions as if they were bad dreams.

THE ROLE OF THE SUPEREGO

I am following a line of thought suggested by Calef (1972) and

others in conceiving of this liberty with respect to the demands
of reality as a compromise of a function of the superego. Calef
432 LEE GROSSMAN

raised the question of the "relationship between the functions of

conscience and the kind of conviction necessary to be achieved
through analytic work" (p. 169, n). He and his co-workers also
suggested that the "clinical observations of the reversals of fan­
tasy and reality"-the way reality was disavowed in his case re­
port-provided a "clue ... as to how the superego functions or
fails to do so in reality testing and in the vicissitudes of convic­
tion" (Calef, et al., 1980, p. 295, n.). From the standpoint of
analytic work, this aspect of the functioning of conscience is
crucial: Does the patient have the honesty to face a disturbing
perception of reality sufficiently to consider it, or does reality
lose its status when it is perceived as threatening?
Arlow described a "superego subverted by anxiety" (1971, p.
333). In my earlier case report (Grossman, 1992), I suggested
that the need to escape depressive affect may have similar ef­
fects on the functioning of conscience. In my example above, as
in Arlow's (1980) discussion, it was possible to infer the role
played in superego formation by identification with corrupt as­
pects of the parents' ways of handling disturbing reality. Wein­
shel's (1986) study of perceptual distortions also noted the con­
tribution to his patients' superego functioning by the parents,
who had been "egregiously unconcerned about respect for re­
ality and reality testing" (p. 363).
It is worth stressing that the "subversion" of the superego is
relative and variable. For instance, Weinshel (1986) noted that,
in each of the cases he reported, the patient felt that she was
doing something wrong; they all realized that "rejecting a real­
istic appraisal of reality was contrary to the precepts of their own
conscience" (p. 363). The man in my example had fewer such
misgivings.

CONSIDERATIONS FOR TECHNIQUE

The clinical significance of this distinction is that it makes it

possible to anticipate certain difficulties in treatment. To the
 THE PERVERSE ATTITUDE TOWARD REALITY 433

extent that patients have the liberty to discount the conse­

quences of what they perceive, they will be able to evade threat­
ening perceptions (including self-perceptions) in the analysis on
which the reconsideration of their experiences depends.
In practice, this means that apparent gains of insight, insofar
as they threaten certain wished-for gratifications, may evapo­
rate. The patient may recall the words, but discount the signif­
icance. The whole treatment may take on an "as if' quality, as
ideas are stripped of their consequence in reality. At the same
time, fantasies are treated as fact; the patient may admit that
"really" he or she knows something is not the case, but insist on
acting as if it were. This applies most dramatically to the rela­
tionship to the analyst, which is treated as simply real. In some
treatments, the analyst becomes a fetish object (Renik, 1992).
This has implications for technique in two respects. First,
these operations represent a kind of resistance that commands
precedence over all others. Not much can be accomplished if the
patient discounts the significance of every disturbing fact before
him or her, until the discounting itself is made the subject of the
work. Second, access to understanding these types of liberties
with reality often will require the analyst to take a stand with
respect to the demands of reality-not as the authority on its
nature, but as the advocate of giving reality its due. I believe this
is done routinely in small ways by every analyst in every treat­
ment, although it is not always so conceived. My reminding my
patient that we had not met on certain days is a simple example.
In the extreme, the analyst may have to be the unilateral
spokesperson for reality. For example, a man in analysis found
himself in the position of having his job eliminated. Another job
was available to him, but it would require moving to another
town. Gradually, it became clear that he was continuing to act as
if the analysis could go on indefinitely. The analyst pointed out
his doing so, and the patient talked freely of his wish that he
would never have to leave. But despite this apparent awareness,
the patient continued to live his life as if there were no imminent
threat. Although money was running out, he made no plans to
434 LEE GROSSMAN

move. He had not made the steps necessary to take the new job.
He paid no attention to the impending interruption of analysis.
This situation persisted for some time, with the analyst calling
attention to these maneuvers as he recognized them. Much of
the fantasy was elaborated: that the analyst would see the pa­
tient for free, or even support him; that the analyst would in­
tervene in magical ways to preserve the relationship; and so on.
Hostile and aggressive meanings were also considered. The pa­
tient was willing to consider his "fantasy," but with the hidden
stipulation that the painful reality was also to be considered a
fantasy, with no other status.
Finally, the analyst told the patient that it was clear that they
would not be able to continue past a certain date, and that he
needed to make plans accordingly. The patient found this a
rude shock at first. He felt the analyst had no right to "take [his]
fantasies away." He described it as the analyst waking him up.
This led to more conviction about the power of his fantasies,
especially with respect to the analyst's power to bestow and with­
draw special gifts. It also led to more awareness of the facility
with which he neglected troublesome realities, and something of
the history of his experiences of "rude awakenings" and his way
of coping with them by telling himself he was dreaming. He also
began to make his moving plans.

DISCUSSION

The phenomena described above are common examples of a

suspension of the functions of conscience with respect to the
obligations of reality testing. The consequence of this ability to
attend selectively to reality, and to disavow, alter, or ignore trou­
blesome perceptions, is dramatically exemplified in fetishism,
transvestism, and other perversions; but it is not limited to
them. The extent to which reality suffers is extremely variable
among the different entities; but all of the conditions share an
 THE PERVERSE ATTITUDE TOWARD REALITY 435

attitude toward reality that mitigates its full weight and signifi­
cance. A troublesome perception may be treated as a dream, as
a movie, as a joke, or as a trivial matter. It is not obliterated; it
is available to consciousness in some form. But it is stipulated,
acknowledged for the record, stripped of significance, altered,
and/or ignored. Taking such liberties with reality requires the
collusion of conscience.
In my view, the various phenomena considered in this inves­
tigation are more closely allied to perverse than to neurotic
processes, in that they involve an attempt to alter the perception
of a threatening or painful reality, rather than renounce or
disguise the wish that stirs up the expectation of punishment.
These maneuvers occur in men and women; they may be mo­
tivated by anxiety or by depressive affect. Frank sexual perver­
sions may be thought of as a subtype of the class of perverse
processes.
Defensive operations aimed at reality are not always obvious;
we tend to assume that certain obstacles have been surmounted,
certain gains have been consolidated, when they seem to make
sense to the patient and they make sense to us. Sometimes the
first suspicion that the patient is taking certain liberties with
reality is the realization that the patient is not improving as we
might have expected. A retrospective look then may help us
notice that the patient has not used the understanding we
thought he or she had gained as something real.
The analyst's awareness of these varieties of disavowal will not
make them disappear; after all, the ego and superego functions
that are compromised are just those that are needed to collab­
orate fully in the analytic work. But it can make a difficult treat­
ment situation somewhat more manageable. The analyst's abil­
ity to anticipate such difficulties will make it easier to call the
patient's attention to the various ways he or she disavows trou­
blesome perceptions. That then becomes the focus of the work.
But the analyst must also be prepared to speak for the demands
of reality when the patient refuses to credit it.
 LEE GROSSMAN

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--- (1971). Character perversion. In Currents in Psychoanalysis, ed. I. W. Marcus.
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--- (1980). The revenge motive in the primal scene. j. Amer. Psychoanal. Assn.,
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CALEF, V. (1972). 'I am awake': insomnia or dream? An addendum to the forgetting
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