Content uploaded by Stephen Blumenthal
Author content
All content in this area was uploaded by Stephen Blumenthal on Mar 02, 2022
Content may be subject to copyright.
MOTHER NATURE AND FATHER TIME:
OEDIPAL IMBALANCE AND THE
PREMATURE STRUCTURING OF REALITY
IN COMPULSIVE SEXUAL BEHAVIOUR
STEPHEN BLUMENTHAL
The author proposes that particular oedipal dynamics in individuals
suffering with compulsive sexual behaviours tend to be characterized by
imbalance between maternal and paternal functions. The maternal object
is experienced as overwhelming and potentially annihilating. The paternal
object is relatively weak and incapable of moderating fear of symbiosis.
There is failure to develop a triangular space within the mind to enable
the capacity to apprehend psychic reality and to relate. Compulsive sexual
behaviours are defined as a series of compelling sexualized enactments,
which function as a ‘curative device’to prevent psychic collapse. Due to
a lack of adequate internalized paternal function, perverse enactments
signify premature attempts to structure reality. Enactment mitigates
emotional contact and manifests within the here-and-now of treatment.
The psychotherapist has to contend with enticements and pressures to act,
sometimes in a retaliatory way. The setting or frame, representing the
paternal function, is an arena for these dynamics to be manifest. There is
an inducement to be drawn towards ‘management’rather than the ‘being
with’of the maternal function.
KEYWORDS: SEXUALITY, SEXUAL DEVIANCE, COMPULSIVE
SEXUAL BEHAVIOUR, PERVERSION, OEDIPUS COMPLEX, CORE
COMPLEX, PSYCHOANALYTIC TECHNIQUE, ADULT
PSYCHOTHERAPY
INTRODUCTION
Mother Nature and Father Time are ever present in the human story; they speak to
us from our pre-history. They are the essence of the story of creation –the primor-
dial wholeness of the Garden of Eden, pure Mother Nature, followed by expulsion
by the father heralding the birth of shame, self-consciousness and culture. Even the
‘objective’scientific account of the birth of the universe with the Big Bang has this
narrative written into it –time and space, an ordered universe, is born from the pri-
mal unity of the singularity; all that exists expanded from a point of infinite density.
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16 doi: 10.1111/bjp.12717
Mother equals nurture, symbiosis and when unmitigated, is potentially pure
chaos. Father stands for separation, lore, structure and culture. Normal development
requires the creative force of Mother Nature and the structuring function of Father
Time, but they can be poisonous too. The toxic, oedipal mother won’t let go. She
restricts freedom and maintains an anti-developmental symbiosis. At her worst,
she devours her infant. The toxic father is violently intrusive. He violates the bond,
he corrupts or he exerts no phallic power and abandons his offspring.
1
Psychoana-
lytic therapy requires that we work between these prototypes: the maternal, the
receptive, the chaos of free association and free floating attention; and the paternal,
structuring, interpretive, masculine. Birksted-Breen (1996) captures this aptly in her
notion of penis-as-link:‘Breast and penis represent different functions and are inter-
nalised as different functions; the breast has to do with the function of being with,
the penis with the function of giving structure’(p. 653).
The technical challenges of one particular area of psychopathology, that of com-
pulsive sexual behaviour or perversion, highlights particular consequences of the
collapse of ordinary oedipal structures and the implications this has for the treatment
of such problems. The term ‘perversion’is frequently used in the psychoanalytic lit-
erature to denote perverse character types or to connote corruption. In this paper, I
wish to highlight a more specific use of the term as used by psychoanalytic writers
such as Glover (1933), Gillespie (1952), Glasser (1979) and Rosen (1979). In this
use, perversion refers to a series of compelling actions, a sexualized action narrative
so to speak, which is used by the person afflicted as a solution to the anxieties relat-
ing to close, intimate contact with the object and with their internal world. Essen-
tially this relates to a two-person relationship, in other words the realm of the
maternal, Mother Nature. In considering such problems, it is important to distin-
guish between the so-called ‘true perversions’and deviant, perverse aspects of
behaviour which might be a feature of normal sexual life. In the former, sexual devi-
ance is compulsive, persistent and always preferred (Glasser, 1979). It is this spe-
cific case of ‘true perversion’that this paper will address.
Even within this narrow definition of perversion, it nevertheless represents a
broad spectrum of psychopathology. Glover (1933) regarded perversions as having
the function of preserving a reality sense and preventing disintegration of the per-
sonality, a notion that has been reiterated by psychoanalytic writers since then (for
example, Rosen, 1979; Glasser, 1979; Limentani, 1987). In this important contribu-
tion which has stood the test of time, Glover (1933) proposed that a developmental
series exists in which different levels of perversion with regard to psychopathologi-
cal intensity run parallel to the developmental order of psychoses, transitional states
and neuroses. In some cases, perversion is more extreme and is associated with psy-
chotic states. Libidinization is a means of overcoming anxiety and has a compensa-
tory function to maintain psychic integrity. It represents a ‘primitive cure’which
helps to ‘patch over flaws in the development of reality-sense’(p. 499). The perver-
sion functions as ‘a prophylactic or curative device’, protecting the personality from
disintegration. This is achieved by ‘a sacrifice of freedom of adult libidinal function’
(p. 498).
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal2
Theory and technique are intimately connected and the clinical manifestation of
the pathology in the consulting room is instructive to the formulation of the underly-
ing organization. The countertransference in working with compulsive sexual behav-
iours is specific. People suffering with these afflictions provoke a visceral response
in us. This can move the psychotherapist from the focus on trying to understand the
patient to evoking a maternal, id-like reaction of indulgence or turning a blind eye,
or the paternal one of being judgemental. In both cases, our neutrality is com-
promised and it is these shifts, or countertransference enactments, that instruct us
about the shape of the object world in the patient. I will explore in this contribution
the way in which perverse behaviour communicates via a concrete form of symboli-
zation, primitive infantile needs and defences against anxiety caused by contact with
the object. I hope to show in the clinical material that follows, the way in which the
psychoanalytic clinician is inevitably drawn in to concrete, non-symbolic modes of
relating. Contact with the patient is predictably lost and has to be rediscovered in
the course of the work.
In considering these technical aspects of working with perversion, the setting or
psychoanalytic frame inevitably takes centre stage. My thesis is concerned with the
way in which the perversion has the function of providing a degree of premature
structuring of the mind due to the weakness of the paternal function and the over-
whelming nature of the maternal object which threatens symbiosis. If the breast has
the function of ‘being with’, and the penis has the function of structuring (Birkstead-
Breen, 1996) the transferencecountertransference dynamics are inevitably played
out around the setting. There is often a persistent invitation by the patient to invoke
an endless engagement at the level of the frame, which Winnicott (1986/1955)
defines as ‘the summation of all the details of management’(p. 297). This is felt to
provide the patient with a sense of safety, but ultimately it hampers a deeper involve-
ment. This ‘being with’is associated with emotional connectedness, the hallmark of
good mothering and ultimately the aim of psychoanalytic treatment. As a result, such
a clinical presentation impedes an ‘ordinary’analytic transaction.
In this contribution, I do not claim to make an all-encompassing statement about
perversion in its vast range of manifestations. I describe a particular patient in which
there is a typical and strong compulsion to engage in sexual acting out. These enact-
ments maintain psychic integrity. They do so by providing a premature structuring
of the internal world of the patient in the context of a denuded oedipal structure.
This has a particular impact upon the psychotherapist, and consequently trans-
ferencecountertransference enactment sheds light on understanding the underlying
mental state that provokes this response. Whilst this is by no means universal, there
are certain common recognizable elements in the material that have a degree of
generalizability.
CLINICAL MATERIAL
Mr P
2
was deeply troubled as he anticipated his 40th year. A late student, he was
battling his way through a teacher training. He was disturbed by the content of his
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 3
mind and the prospect of placing himself in a professional role. He had drastically
underperformed in his life, had shown such promise, but could not manage to trans-
late this, and so he had floundered, stuck in an eternal adolescence. Mr P suffered
various addictions in his life: to alcohol and cannabis, from which he had abstained
for many years; but his compulsion to seek out prostitutes persisted. In desperation,
he was fortunate to meet a psychotherapist at the student counselling service he
attended who recommended a clinic for a consultation for psychoanalysis. There he
had a fraught meeting with the female consultant, who was concerned by Mr P’s
actions. He declared to her that after the first appointment he looked at internet sites
to find prostitutes openly in a cafe near the clinic. She referred him to a specialist
clinic for the treatment of compulsive sexual behaviours.
The patient may enter the room in the first appointment leading with his hand as
he comes through the door whilst holding the rest of his body back, or ask for a pen
or a glass of water. One gets used to managing the enactment in working with per-
version, the putting into action of a conflict which cannot be represented in words,
and the expression of this concretely in the interaction with you at this anxious
moment of impending emotional contact, a potentially disturbing encounter when
two internal worlds collide. The invitation is to be censorious, even humiliating, or
on the other hand to indulge it and land up feeling victimized. One has to tread the
fine line between staying still and resisting being drawn in, whilst not being perse-
cuting. How would Mr P show me his symptom concretely in the transference?
How would he try to provoke me with some action?
Mr P is tall and strikingly good looking. He fixes me with his doe eyes in a
seductive, searching way, studying my face intently, which makes me feel uncom-
fortable, the projection of his anxiety about this first encounter. I wonder what will
be the enactment and prepare myself for the handshake at the end, but it is his wish
to use my dustbin to discard an empty cup on departure which I address, saying:
I think it is important for you not to use my bin, even though you want to,
because you come here with a problem of action, and our job is to try to
understand what is underneath. I know this might be difficult for you, but we
will try to see if we can think about it next week.
Mr P did not use my bin, but a host of other enactments characterize the therapy at
entry or departure. His strong need to do something in order to reduce his anxiety is
clearly in evidence. The something he does has the effect of evoking a structuring
function in me in drawing attention to the frame.
Mr P speaks to me of his tightly constructed action narrative, which provides tem-
porary relief from the tyranny of his unbearable suffering. There are periods when
he spends many hours on his motorbike driving around with frenzied urgency in
search of the perfect hooker who gives him ‘just the right look’of acceptance. He is
expert at studying her eyes, much like he studies my face. This is followed by a rit-
ual of undressing in which she strips him down to his underwear. He achieves a
state of bliss when she gently pulls his pants down and comments with impressed
delight that he is well endowed. He repeats this ‘script’over and over again, with
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal4
only minor variation. The excitement he obtains is predictably followed by despair
as the temporary relief from his suffering wains and he becomes gripped once again
by the same compulsion with hopeless certainty.
Mr P is dismissive of the significance psychotherapists ascribe to his primary rela-
tionship when I enquire about his mother, which alerts me to its importance. He
claims to have been close to her in childhood, yet a series of fragmented screen
memories which emerge slowly, along with me experiencing her in the transference,
gives a different picture; one of unmitigated chaos. The following memories surface
gradually and roughly in the order in which they appear here. His historical narra-
tive, like his mind, is fragmented and disorganized. Mr P’s mother left father to
marry a childhood friend and moved to another country when he was 21. Later, in
his twice weekly therapy, we piece together that it was shortly after this that he
started his search for the ecstatic scene with the perfect prostitute.
At 18, Mr P suffered a drug-induced psychotic episode and saw ‘triangles in
faces’, composed of the two eyes and the mouth, which he experienced as menac-
ing. The image still haunts him 20 years later, causing him an overwhelming vis-
ceral bodily chill in the pit of his stomach he describes as ‘liquid fear’when he
recalls it. He approached his mother in a panic, feeling he was going mad, and she
told him to go to bed. In relating these experiences to me, Mr P conveys terrifying
anxieties about his damaged mind and of losing his sanity within the treatment
itself. Might Mr P’s communication about his seeing ‘triangles in faces’relate to the
here-and-now in which he experiences my eyes as menacing? The way he fixes me
with his eyes would suggest that it does. Might Mr P be communicating that I will
be like his disengaged mother who could not help him with his psychotic anxieties
and told him to go to bed? Mr P conveys his feeling that he is doubtful about my
potential to help him.
Mr P traces his problems with sex to age 8 when he was invited to compare his
penis with a friend who laughed hysterically at his, telling him he was deformed
and he would not be able to have sex, which he said he later discovered was
unfounded. I do not share my speculation that this may stand in the place of his
mother’s rejection of his penis which he cannot think about directly, an après coup
3
transformed into a fixed, concrete idea. Moreover, it is my impression that Mr P’s
preoccupation with his genital endowment is a displacement of his worries about his
mental endowment. He has good cognitive capacities, but his ability to make use of
his talents is significantly impaired. Out of the blue memories occur which are not
synchronous with the loving mother who now appears as depressed and frightening.
She did not protect him from father’s rejection of him and his relentless bullying
and physical aggression, despite it being clearly evident. He conveys a sense of
being overwhelmed by a too powerful maternal object, whilst simultaneously lac-
king the organizing principle of a paternal function. She grounded him for the entire
holiday because he crawled through the fence into the neighbour’s garden to retrieve
a ball at age 8. On the other hand, he tells me of an at times emotionally intense and
an overinvolved relationship with her.
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 5
There is a fragment of a dream from early childhood in which she had ‘the
demonic look of a witch’, which makes sense to me with regard to the tenacity with
which he holds my face with his eyes. Eyes threaten, they signify incursion into his
mind. His mother is experienced as intrusive and overpowering. Mr P thinks sponta-
neously of one of his earliest memories from the age of 4 or 5 of leaning on the bot-
tom ledge of the cupboard in his room whilst rhythmically wailing over and over:
‘my mother doesn’t love me, my father doesn’t love me, my brothers don’t love
me; I just want to die, I just want to die’. This bottom ledge of the cupboard later
became the secret hiding place where he kept his porn collection, the harbinger of
his serious addiction later on.
Mr P is the third of three boys. Might it have been that his frightening mother
was depressed at the time of his birth? I find myself wondering whether he experi-
enced this as having something to do with his being a boy and having a penis. This
seems to be a toxic version of Mother Nature. Perhaps he is compelled to study
faces to keep himself safe from an intrusive, engulfing, but abandoning mother, and
he has dedicated his life to an infantile ritual which corrects for the imagined disap-
pointing nappy change and reaffirms his manhood over and over again.
This may seem overly literal and reconstructive, rather than focused on the here-
and-now, but in perversion, a concrete atmosphere pervades the interaction. Freud
(1927)‘s account in Fetishism reflects this –it encompasses the symbolic as well as
the highly concrete and herein lies the deft elegance of the fetishism paper in capturing
an essential feature of the psychic functioning of perversion (for example, ‘the foot or
shoe owes its preference as a fetish …to the circumstance that the inquisitive boy
peered at the woman’sgenitalsfrombelow…’; p. 155). There is an interweaving of
actual, concrete bodily preoccupation with the sense of the displacement of worries of
his mental potency and a sense of being defective. At some point I perhaps crudely
put this speculation to Mr P, but he denies it, declaring that she was delighted to have
another boy. Nevertheless, he responds by telling me that she has since told him that
when he was 1 or 2, she contracted a sexually transmitted disease, which must have
been from father. A neighbour apparently saw him kissing another woman at the time,
but he denied it. Later still, he says that his mother told him that when the midwife
presented him to her following his birth, she declared that it was ‘another one with a
spout’.
Mr P describes his preoccupation with a relationship with a woman who is des-
perate to have his baby. She provides nurturance and unconditional love, but he
treats her with disdain. He feels intensely attached to her, but he finds it impossible
to tolerate too much closeness and he becomes repelled by a particular look on her
face which makes her seem ‘old’, maternal perhaps. He describes to me a feeling of
horror deep in his belly, perhaps akin to the psychotic episode, which causes him to
want to run away. But he finds he cannot be without her either, and after declaring
his wish to separate and distancing himself from her, he inevitably returns because
her absence provokes such powerful feelings of despair which only abate in her
presence or in the periods of manic excitement when he is searching for sex.
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal6
THE CORE COMPLEX IN PERVERSION
We will return to a further discussion of Mr P in a moment, but before doing so, I
want to make a few statements, which will provide the background for the later dis-
cussion. Glasser’s (1979, 1992) conceptual framework of the core complex provides
the basis for the thesis of this paper, namely that the absence of a benign structuring
paternal object exposes the (boy) child to the overwhelming anxiety of unfettered
chaos, and sexualized behavioural repertoires provide a premature structuring of
reality. This mitigates the sense of risk associated with contact of being enveloped
and annihilated. This tendency to engage in sexualized behaviour represents a primi-
tive language of action. This has implications for working with perversion, which
manifests itself in a particular way in the transferencecountertransference. Mother
Nature is experienced as a fecund jungle where dangerous, rapacious creatures
proliferate at an alarming rate, unabated.
In his seminal work, ‘Towards a general theory of seduction’, Laplanche (1989)
describes the infant’s birth into a world of the mother’s body and her sexuality, but
without a sufficiently developed ego to manage the intense arousal associated with
the proximity to a sexual mother. Father is characteristically a distant figure, who
has not imposed himself sufficiently on the motherchild dyad (Perelberg, 1999),
and staked his claim upon his (boy) child (Campbell, 1995). The infant is thereby
exposed to an over-libidinized relationship with his mother in desperate need of
dilution. In some cases, which doubtless arises from a combination of factors –the
state of innate physical arousal, an over-invested or neglectful mother, the actual or
experienced absence of a father, the presence of a corrupt father or perhaps the
absence of a father imago in the mind of the mother the boy may be particularly
susceptible to the development of a perversion.
This particular oedipal constellation is implicitly (but as you will see, not explic-
itly) the subject of Glasser’s (1979) notion of the core complex. He describes the
sexualization of aggression as a defence arising from the fantasy of fusion with an
idealized mother, but the experience is of an avaricious object who is simulta-
neously engulfing, intrusive and annihilating, as well as indifferent and rejecting.
Withdrawal in pursuit of safety portends unbearable loss, abandonment and disinte-
gration, but self-preservative aggression threatens the destruction of the maternal
object. Consequently, the aggression is sexualized in order that the object is pre-
served. The result is a profoundly agonising to-ing and fro-ing of sadomasochistic
engagement; moving from outside-in induces feelings of being swallowed up and
annihilated, and moving from inside-out is filled with the overwhelming fear of
oblivion. Rey’s (1986) claustro-agoraphobic dilemma bears some relation to the
core complex, but it is also distinctly different. In the latter case, libidinized aggres-
sion is used to maintain contact at a distance.
This pattern is evident with Mr P, who cannot tolerate being with his girlfriend
and he cannot bear being away. I experience this directly with him he conveys an
urgent intense need of me, but equally so, he distances himself from emotional con-
tact. What is both implied and unstated in Glasser’s formulation is the role of the
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 7
paternal object in failing to mitigate core complex anxieties, resulting in the failure
of the person to develop a triangular space within the mind to enable the capacity to
relate. This necessitates the erection of the perverse defensive constellation, which
represents a premature attempt to structure reality.
We can only speculate as to why this particular ‘prophylactic’(as Glover calls it)
is used as a solution to this lack of oedipal structuring. Whilst there are common
themes with other clinical presentations, the consequences of sexualized aggression
are specific and quite different from, say, other forms of addictive behaviours or of
borderline pathology. In the consulting room there is frequently a degree of seduction
and control, as one is engaged in a sado-masochistic dance of sorts, in which contact
is desperately sought and then repudiated. The patient may be gratified by this, which
is difficult to tolerate as a psychotherapist and risks provoking retaliation.
The notion that the patient repeats rather than remembers (Freud, 1914) is infi-
nitely more complicated when one is trying to manage sexualized aggression.
Rey (1988) describes action as the most primitive language. We might call it our
mother tongue (Perel, 2007). Action precedes thought, framing perception and sen-
sation. Combinations of actions of the subject on his object and vice versa lead to
the internalization of action schemas. The way in which the mother acts upon the
infant’s body, the emotional tone of the relationship she has with her baby, are
incorporated via the sensory and somatic realms, a domain which cannot be symbol-
ized in the usual way. They distinctively lie outside the verbal domain and the psy-
chotherapist has to be particularly attuned to this in the analysis of perversion.
Some of these primitive action schemas can remain split off and unintegrated,
and function in an autonomous manner. Hence, Mr P does not recognize the links I
attempt to make verbally, he is so immersed in his actions. He does not have a
semantic framework within which the interpretation meets with a set of verbal
schemas, rather his memories reside in a series of fragmented après coups and
bodily actions. As will be seen in the transaction below, one is inevitably drawn in
to a concrete enactment with the patient, which in my experience is more subtle and
implicit in comparison with the more explicit enactment of the borderline patient,
for example.
A SESSION
Let us look further at how Mr P manages the terror of contact via the sexualization
of aggression and thereby deals with the potential for chaos which constantly
threatens. His attempt to structure reality is premature and reflects the particular
oedipal constellation in perversion: the absence of a paternal object to provide the
containment to his (maternal) container, necessary for mental life. Looking back at
this encounter with the benefit of hindsight, I became aware of a degree of concrete-
ness in my response to Mr P towards the end, perhaps partially attributable to my
own personal shortcomings and in part to a typical countertransference response in
working with perversion, in which one can be inadvertently drawn away from the
symbolic to the literal (I will discuss this in more detail later). Here is an exchange:
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal8
On a hot day, Mr P enters the room in his full motorcycling regalia. In a slow
deliberating manner, he removes his jacket first, his leather trousers and then his
shoes before lying down on the couch. I am in a dilemma; I could raise it, I could
wait, or I could talk to him about the dilemma. I decide that the latter option risks
an entanglement, and opt for something simpler by drawing attention to it.
I say: The undressing ritual.
He replies angrily: That’s utterly laughable …It’s what I have to do, I have to
wear leather trousers. It’s for safety for the motorbike. Should I not wear them?
I say: It may seem laughable to you, but I think it is for safety here too, in a
slightly different way though. I’m thinking of how you bring right into the
room the undressing ritual; that is the very reason for you seeking my help.
Mr P told me that it was ‘a blind alley’and he did the same at Sex and Love
Addicts Anonymous (SLAA) meetings, but then after a pause he concedes: …
I suppose, to be honest, the thought has crossed my mind that there are
women in the room at the Fellowship and I might have wondered if they feel
turned on…
As if surprised by his concession, he then reiterates for good measure: But it’s
definitely not the case here, before continuing to deride my observation, whilst
simultaneously granting: I suppose what happens here is a portal onto my life.
Mr P then told me that he had had a ‘slip’and used prostitutes. He felt deeply
ashamed. He told me that I do not offer him ‘kind words, reassurance and practical
advice’, which he got elsewhere, at the Fellowship.
After some further work in the session, I said: I think that you know where to
get reassurance. You do worry that I’m going to be critical, but you also hope
that I’ll be able to see beyond that and to see the pain that you’re in, behind
your addiction. How deeply troubled you are, how you are struggling to man-
age all your conflicting feelings: anger, wanting to hold on, with me, with M
(his girlfriend), and to try at least to make sense of the chaos that’s inside. I
think that’s why I draw attention at the beginning to your undressing ritual,
because there’s a ritual there that keeps you safe from getting too involved
with me and with the utter chaos that you feel yourself to be in.
Following a silence, Mr P says:
I was thinking yesterday when I left my friends in the City …I went to see
them for a coffee and I thought: What do I do now? Where do I go? Where is
home? …
I literally wanted to lie down on the road and die. I didn’t know what to do, I
didn’t know what to do with my body …I’m constantly moving around,
going from here to there doing these different things like going to university,
or having a coffee, but what do all these activities really mean? They’re just
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 9
actions, activities; it’s like they’re just a discharge of energy. They’re mean-
ingless. I don’t want any of them, none of it is where I want to be. I just feel
desperate…This loneliness, the pain …I’ve got to put myself somewhere, to
put my body somewhere in space…With as little direction as this it’sno
wonder I place my body on a therapist’s couch …I haven’t got a fucking clue
how to do things. I don’t know how to do life. Silence …
…The attention that I get from girls stops me thinking about it for a bit. If
I’m in one of my 24-7 acting out phases, I’m thinking about all the things I
could be doing if I wasn’t doing this. The life that I want; if I could only do
some writing, or make some music or read a book. But then when I do stop, I
can’t do those things at all, it’s just pain, it’s sheer pain. It’s like there’s a fan-
tasy that I could actually sit down and do these things. But the reality is that
it’s all loneliness and pain inside, and I can’t. I can’t do the things I want to
be doing. I can’t concentrate on anything.
Mr P then backtracked and seemed to spend the rest of the session trying to repu-
diate the contact he had made with his troubled soul and with me.
DISCUSSION
As patients ourselves, we know intimately the challenges of facing the ever-elusive
realm of free association. Allowing oneself the full range of possibility of one’s
thought processes in the presence of someone else in its purest form can only really
be an aspiration. As psychoanalytic therapists we know the struggle to allow uni-
mpeded free floating attention. We know the constant search for structure in the
form of narrow, focused thinking, as opposed to allowing free rein. Facing the chaos
of the unconscious is frightening and it requires the structure of the frame to feel
safe enough. In this context, Ogden (1989) remarks:
Along with the sense of excitement, there is also an edge of anxiety. For both
therapist and patient, the danger posed by the (first) meeting arises to a large
extent from the prospect of a fresh encounter with one’s own inner world and
the internal world of another person. It is always dangerous business to stir up
the depths of the unconscious mind’(p172, parentheses are my own).
If this is the case in a ‘normal’analytic encounter, Mr P’s fear is exponentially
greater. He experiences disarray when he stops to reflect. His undressing ritual is a
communication, but it is also an impediment to understanding. He exerts control,
and thereby reduces his anxiety. He acknowledges his need to sexualize contact at
Fellowship meetings, but disavows the erotic with me when I make the link.
Stoller (1975) referred to perversion as ‘the eroticised form of hatred’. The notion
of the sexualization of aggression is an invaluable conceptual tool for understanding
the transference. It may be argued that such enactments are common in working
with many different groups of patients, but the particular admixture of seduction
and ‘attack’seems to me to be a distinguishing feature when working with a person
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal10
who engages in sexualized behavioural repertoires of this kind. I use the word
‘attack’advisedly, as it is of course inexact. Bleger helpfully remarks:
I think it is hasty to speak in terms of an ‘attack’on the frame whenever the
patient does not comply with the frame. Since the patient ‘brings what he
has’, this is not always an attack but rather a reflection of the patient’s own
organization (even though it may be disorganized) (Bleger, 1967, fn).
Consequently, rather than an obstacle, such non-compliance on the part of the
patient provides helpful information and needs to be harnessed therapeutically.
The transference is thus not so much sexualized, as in the case of a transference neu-
rosis. Rather the transference–countertransference is imbued with eroticized aggression
Mr P’s undressing ritual represents both a seduction and an ‘attack’and can
therefore be more precisely described as a transference perversion. This enacted ver-
sion of the psychopathology as represented in the room allows the possibility of appre-
hending it. There needs to be a recognition of the need of the patient to make use of
action to control the psychotherapist, and to shape the interaction in such a way as to
avoid emotional engagement.
Mr P desires and dreads emotional closeness. Contact is tragically sought and is
unbearable. He anticipates being colonized and ego resources are deployed in that
direction, always attending to his safety, so that there is nothing left for ordinary
ego activity. The undressing ritual is an attempt to bring order and structure to the
chaos within him. I think he feels a persistent sense of insecurity, that his mind will
implode and he will fall apart. The prospect of a close contact with his therapist and
with his internal world feels perilous and unsafe. This element of the transference
relates to an ever present maternal object which represents a threat to his psycholog-
ical self. There is a failure of the triadic relationship, the benign presence of an oedi-
pal father, who can moderate this intensity.
Mr P is able to articulate some of this. He is responsive to my interpretation
about the threat of chaos, and temporarily, he allows himself a contact with the
troubled world inside and the pain and suffering he experiences. In this moving
encounter, he is able to express the feeling that his body is a thing, an empty shell
without a purpose. One wonders whether these thoughts represent a deeper thought
process, a screen memory of the lack of regard for his body, a regard he now seeks
by hiring it.
At the root, the terror of contact in Mr P seemed to me to signify a fear of break-
down. Glover’s (1933) notion of the perversion being a defence against psychosis is
apt. Without Father Time to help to structure his reality, Mr P seemed overwhelmed
with a sense of threat to the integrity of his personality. The session powerfully con-
veys a sense of annihilatory anxiety. I think he was terrified of the invasive menac-
ing eyes of his therapist and the ‘triangles in faces’was not simply an experience in
his youth, but maintained an ominous influence in the present. It conveys his fear of
invasion with me directly. Actions in the form of driving around looking for the per-
fect prostitute, reflected within the treatment as action with the coffee cup and the
undressing ritual, are an attempt to establish precarious safety.
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 11
Within the transference, I am predominantly a threatening, engulfing maternal
object and at this point in the treatment, Mr P struggles to find a safe paternal figure
in the therapeutic relationship who can come between him and his mother in a
benign way, lessening the need for enactment. There is a window of this following
my comment recognizing the pain he is in behind his addiction, which seems to
enable Mr P to make contact with his troubled state of mind and with me. In retro-
spect, I think I failed to recognize the departure from his friends in the City as a
transference communication signifying the terror he faced in leaving the session. Mr
P captures a typical pattern encountered in such work. He constantly shifts from a
mode of engagement to withdrawal and a disavowal of contact. This can have a diz-
zying, disorienting effect as a recipient.
My lack of recognition of the impending separation may have been a counter-
transference enactment –Mr P is markedly sensitive to the end of sessions and will
typically extend his time in the room as much as he can. It is possible that his
despair following my interpretation reflected not only his denied internal state, but a
sense of the despondency he feels about his struggle to function as a person who
can receive something nourishing and hold on to it. The impending end of the ses-
sion, Father Time, may be experienced with a sense of hopelessness (he leaves his
City friends), because he is unlikely to maintain the connection with a good internal
object who can help him to resist the seductive power of his perverse solution.
THE SETTING
Birksted-Breen’s (1996) notion of penis-as-link has particular relevance to the chal-
lenges of both understanding and working with perverse psychopathology, with its
preponderance of enactment as a central feature of the clinical picture. The male
organ is not only symbolized by the phallus, according to Birksted-Breen, but has
further symbolic value as the signifier of a structuring function which promotes
mental space and thinking. This is essentially the paternal function, which is defec-
tive in a variety of psychopathologies, including perversion. The maternal object
has a different function, that of ‘being with’.Adeficient penis and its linking and
structuring function is internalized and omnipotent phantasy may be clung to as a
desperate alternative. Birksted-Breen stresses that this is of course more than the
actual father; it is a function.
I would partially concur with Limentani (1988), who argues that in perversion the
father is typically excluded in the transference, and there is a corresponding induce-
ment for the therapist to reflect this in the countertransference. In this case, there is
a particular character to Mr P’s evocation of the structuring function with me. I sug-
gest that the functions of ‘being with’and of structuring are represented in the con-
sulting room as emotional engagement and the psychoanalytic frame, respectively.
Faimberg (2014) invokes Winnicott in describing the paternal function as the psy-
choanalytic frame. Containment, according to Birksted-Breen, is not just a maternal
function as described by Bion (1959), but is the coming together of ‘being with’
and structuring. A reliable setting provides the structure which enables the descent
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal12
into the chaotic, potentially symbiotic world represented by Mother Nature. They
work together.
Mr P is fleetingly able to tell me and himself about the state of chaos which reigns
underneath. But his action rituals situate him; they engage me in a particular relation
to him, in which I attend to the boundaries of the treatment, to reiterate the treatment
frame by pointing out what he is doing rather than what he is saying. My interven-
tions are focused on his undressing ritual rather than his verbal utterances, and I am
aware of his inducement to get me to behave in my interpretations by attending to
these. He prods me to focus on structure rather than engaging in an intimate emo-
tional contact.
A wide range of patients with complex presentations tend to provoke responses
in analysis which are based around the frame. Yet there is a particular character to
Mr P’s engagement which both captures this common tendency and also has some-
thing quite specific to it. The coffee cup incident, which marked the start of his ther-
apy, and the undressing ritual, are amongst many enactments within the therapy. He
uses the space in a way that evokes comments about the frame and the management
of the setting. I have to be watchful not to be the critical parent, whilst risking just
that. Such a relation with me has the potential to maintain a static situation, which is
utterly familiar. He knows intimately the censorious attitude that is predictably pro-
voked. He complies or he may rebel. He may do so openly or covertly, concealing
his pleasure, which itself provides gratification. In doing so, he avoids a deeper con-
nection with me and with himself, the elusive elixir we wait patiently for, which
promotes change and enables psychic development.
Mr P’s fears of emotional contact in treatment are of course real. It is a common
experience in treating perverse patients that they become more disturbed as the work
progresses, as the perverse defences unravel and emotional contact begins to be
established. But it is only through this work that the patient can begin to separate
himself from the therapist and from the symbiotic archaic maternal object. All the
time though, resistance in the form of provoking a premature structuring through
enactment predominates and threatens to undo the work.
I am mindful of the unorthodoxy and potential to derail the treatment when I
invited Mr P not to use my dustbin to throw his cup away. It may be argued that it
would be better to interpret his action rather than intervene with an instruction born
of the superego, and thus a countertransference enactment. Clearly, clinical judge-
ment should prevail; I am not proposing this in every case, but such intervention
has therapeutic value in addressing the technical challenge of working with action-
oriented individuals. In some respects, the concreteness of the intervention matches
the patient who has difficulty with symbolizing in the usual way. In the case of such
patients, the longing for contact is so great, as are the anxieties about longing, and it
is this which makes ordinary interpretation of such action ineffectual. The marking
of the coffee cup as a currency of communication was helpful later in the develop-
ment of a matrix of meaning beyond action. (On one occasion I talked to Mr P of
his aggression towards his girlfriend and he left his cup on my table in fury with me
for pointing this out.)
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 13
CONCLUDING REMARKS
In Totem and Taboo (Freud, 1913), the father, who imposes limits through his lore
is killed and devoured, and through the act the sons realize that they cannot live
without his prohibitions. Access to all the women is not the freedom they hoped for,
chaos is frightening. Limitation is the source of meaning. The world of instinct,
stimulated by mother, Mother Nature, requires the lore of the father, Father Time.
Mr P had not ‘devoured’his father and he suffered with a lack of limits and a fear
of being overwhelmed by his internal world. He lived with the illusion that there
were no limits and his ritualistic enactment of the perverse scenario functioned to
perpetuate this myth.
The absence of a benign paternal object and the presence of an overwhelming
maternal object are fertile ground for psychic destitution. This represents the triumph
of chaos over order. Enactment, in the form of perverse behaviour, provides tempo-
rary relief in the form of a premature structuring of the mind. A sadomasochistic
dynamic can take hold and psychotherapy, dominated by ritual and procedure, with a
denuding of emotional contact. This protects the psychological self from being taken
over and colonized. The therapist’s observations constantly risk the exposure of
shameful vulnerability and consequently the re-enactment of the early trauma relating
to the archaic maternal object. The self can remain deeply buried and concealed for
reasons of safety. Our purpose is to strengthen the character to withstand such pres-
sures, so they no longer have to be so compelled by safety. This can only be achieved
through the maternal function of ‘being with’. But this ‘being with’requires the evo-
cation of a benign Father Time, who is literally and symbolically the custodian of
time, who sets a limit, thereby providing a safe setting for contact to be established.
ACKNOWLEDGEMENTS
I am grateful to Heather Wood, Donald Campbell and Stanley Ruszczynski for their
helpful comments on an earlier draft of this paper.
NOTES
1. Peterson (1999) describes these archetypes as follows: ‘The Great Mother is creation and
destruction simultaneously-the source of all new things, the benevolent bearer and lover of the
hero; the destructive forces of the unknown, the source of fear itself, constantly conspiring to
destroy life …The Great Father is the wise king and the tyrant, cultural protection from the
terrible forces of nature, security for the weak, and wisdom for the foolish. Simultaneously,
however, he is the force who devours his own offspring, who rules the kingdom with a cruel
and unjust hand, and who actively suppresses any sign of dissent or difference’(p. 90).
2. Mr P provided his full consent to the use of this clinical material. All identifying informa-
tion has been altered in order to protect confidentiality.
3. The term après coup was introduced by Lacan as a translation of Freud’sterm
Nachträglichkeit or afterwardsness. Freud first described this in the unpublished Project and in
Studies in Hysteria (Breuer & Freud, 1895). It refers to the retroactive attribution of meaning to
an earlier traumatic event. The earlier memory is ‘reprinted’in the context of later experience.
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal14
REFERENCES
Bion, W. (1959) Attacks on linking. International Journal of Psychoanalysis 40: 308.
Birksted-Breen, D. (1996) Phallus, penis and mental space. International Journal of
Psychoanalysis 77: 64957.
Bleger, J. (1967) Psychoanalysis of the psychoanalytic frame. International Journal of
Psychoanalysis 48: 51119.
Breuer, J. & Freud, S. (1895) Studies on Hysteria.SE 2.
Campbell, D. (1995) The role of the father in a pre-suicide state International Journal of
Psychoanalysis 76: 31523.
Faimberg, H. (2014) The paternal function in Winnicott: The psychoanalytical frame. Interna-
tional Journal of Psychoanalysis 95(4): 62940.
Freud, S. (1913) Totem and Taboo. SE 13, pp. vii162.
Freud, S. (1914) Remembering, Repeating and Working-Through (Further Recommendations
on the Technique of Psycho-Analysis II). SE 12, pp. 14556
Freud, S. (1927) Fetishism. SE 21, pp. 14957.
Gillespie, W.H. (1952) Notes on the analysis of sexual perversions. International Journal of
Psychoanalysis 33: 397–402.
Glasser, M. (1979) Some aspects of the role of aggression in the perversions. In I. Rosen
(ed). Sexual Deviation (2nd Edition). Oxford: Oxford Univ. Press.
Glasser, M. (1992) Problems in the psychoanalysis of certain narcissistic disorders. International
Journal of Psychoanalysis 73: 493503.
Glover, E. (1933) The relation of perversion-formation to the development of reality-sense.
International Journal of Psychoanalysis 14: 486–504.
Laplanche, J. (1989) Towards a general theory of seduction. In: Laplanche, J., New Foundations
for Psychoanalysis. Oxford and Cambridge, MA: Basil Blackwell.
Limentani, A. (1987) Perversions treatable and untreatable. Contemporary Psychoanalysis
23: 41537.
Limentani, A. (1988) Between Freud and Klein. London: Routledge.
Ogden, T. (1989) The Primitive Edge of Experience. London: Karnac.
Perel, E. (2007) Mating in Captivity. London: Hodder and Stoughton.
Perelberg, R.J. (1999) Introduction. In: Perelberg, R.J. (ed.), Psychoanalytic Understanding
of Violence and Suicide. London: Routledge.
Peterson, J. (1999) Maps of Meaning: The Architecture of Belief. London: Routledge.
Rey, H. (1986) Femininity, sexuality and inner space. In: Universals of Psychoanalysis in the
Treatment of Psychotic and Borderline States, pp. 26376. London: Free Association Books.
Rey, H. (1988) Schizoid phenomena in the borderline. In: Spillius, E. (ed.), Melanie Klein
Today. London: Routledge.
Rosen, I. (1979) Sexual Deviation, second edition. Oxford: Oxford University Press.
Stoller, R.J. (1975) Perversion: The Erotic Form of Hatred. London: Karnac.
Winnicott, D.W. (1986/1955) Holding and Interpretation: Fragment of an Analysis. London:
Hogarth (The International Psycho-Analytical Library).
STEPHEN BLUMENTHAL D.Clin.Psychol., F.Inst.Psychoanal is a psychoanalyst and clini-
cal psychologist in private practice and at the Portman Clinic, Tavistock and Portman NHS
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Mother Nature and Father Time 15
Foundation Trust. He is a Fellow of the British Psychoanalytical Society and an Associate
Fellow of the British Psychological Society. He has a particular interest in understanding the
connection between the mind and behaviour, and the risk of acting out in ways which are
harmful to self and others. He is interested in the public understanding of psychological ideas.
He is author of a number of books, including Assessing Risk: A Relational Approach. He has
published many peer reviewed research papers, and he has also written a number of articles
in the popular press. Address for correspondence: [sblumenthal@tavi-port.nhs.uk]
© 2022 BPF and John Wiley & Sons Ltd.
British Journal of Psychotherapy 00, 0 (2022) 1–16
Stephen Blumenthal16
