EXPLANATION OF THE MANIFEST PREPONDERANCE OF SEXUAL PERVERSIONS IN THE PSYCHONEUROSES

The sexuality of psychoneurotics has perhaps been placed in a false light by the above discussions.  It appears that the sexual behavior of the psychoneurotic approaches in predisposition to the pervert and deviates by just so much from the normal.  Nevertheless, it is very possible that the constitutional disposition of these patients besides containing an immense amount of sexual repression and a predominant force of sexual impulse also possesses an unusual tendency to perversions in the broadest sense.  However, an examination of milder cases shows that the last assumption is not an absolute requisite, or at least that in pronouncing judgment on the morbid effects one ought to discount the effect of one of the factors.  In most psychoneurotics the disease first appears after puberty following the demands of the normal sexual life.  Against these the repression above all directs itself.  Or the disease comes on later, owing to the fact that the libido is unable to attain normal sexual gratification.  In both cases the libido behaves like a stream the principal bed of which is dammed; it fills the collateral roads which until now perhaps have been empty.  Thus the manifestly great (though to be sure negative) tendency to perversion in psychoneurotics may be collaterally conditioned; at any rate, it is certainly collaterally increased.  The fact of the matter is that the sexual repression has to be added as an inner factor to such external ones as restriction of freedom, inaccessibility to the normal sexual object, dangers of the normal sexual act, etc., which cause the origin of perversions in individuals who might have otherwise remained normal.

In individual cases of neurosis the behavior may be different; now the congenital force of the tendency to perversion may be more decisive and at other times more influence may be exerted by the collateral increase of the same through the deviation of the libido from the normal sexual aim and object.  It would be unjust to construe a contrast where a cooperation exists.  The greatest results will always be brought about by a neurosis if constitution and experience cooperate in the same direction.  A pronounced constitution may perhaps be able to dispense with the assistance of daily impressions, while a profound disturbance in life may perhaps bring on a neurosis even in an average constitution.  These views similarly hold true in the etiological significance of the congenital and the accidental experiences in other spheres.

If, however, preference is given to the assumption that an especially formed tendency to perversions is characteristic of the psychoneurotic constitution, there is a prospect of being able to distinguish a multiformity of such constitutions in accordance with the congenital preponderance of this or that erogenous zone, or of this or that partial impulse.  Whether there is a special relationship between the predisposition to perversions and the selection of the morbid picture has not, like many other things in this realm, been investigated.