The secret: study of a perverse transference.

This clinical communication describes the analysis of a perverse transference in an overtly bisexual man. An intricate interplay between heterosexual and homosexual relations enabled him to maintain some heterosexual functioning and to counteract or evacuate intolerable affects and vengeful impulses--originating from early traumas--through perverse acting out with sexual partners. Building on the notion that patients with sexual perversions recreate aspects of their perversion in the transference/countertransference relationship, where it must be analysed, the author illustrates through detailed clinical material how she was drawn into the fabric of her patient's perversion and how this was worked through. She offers an object-relational understanding of his perversion as a complex erotised defensive/reparative/vengeful manoeuvre permitting the disavowal and magical reversal into triumph and sexual pleasure of perceived threats to his personal or sexual identity. Engaging or changing in analysis evoked fears of losing his identity by surrendering to the analyst, rooted in the patient's early experience of serving as his mother's fetish-object. The author suggests that the patient needed to turn the analyst into a perverse partner (disavowing her other-ness) in order to reverse and triumph over this core trauma. She attributes the good treatment outcome to the detection and working through of the perverse transference and monitoring of her countertransference.