Swales, S. (2012). Perversion: A Lacanian Psychoanalytic Approach to the Subject. New York: Routledge.
Encountering a patient who in the initial sessions does not see himself as lacking is by no means an uncommon event. Most often, this type of patient is obsessive, and his difficulty in seeing himself as lacking in relation to the therapist can be attributed to his structural reasons for negating the Other and attempting to neutralize the Other’s desire.
Correspondingly, the obsessive often fears seeing himself as dependent (even in terms of knowledge) upon the therapist Other.
The obsessive prefers not to see himself as desiring because it threatens him with aphanisis and reveals to him that he is a subject lacking in being.
The process of getting the obsessive to face his own lack in the process of analysis is referred to as hystericizing his desire, and this involves regularly reminding the obsessive of the Other’s presence and desire. 241
However, the perverse patient, as mentioned above, can have a sure answer to the question of identity at the level of jouissance while remaining perplexed at the level of desire. The therapist, then, should foster the perverse patient’s curiosity in himself. Why does he desire what and how he desires?
It is thus important for the therapist to highlight manifestations of the pervert’s putting himself into question, for instance by ending a session when a pervert says, “I don’t know why I …” The therapist’s task of inscribing lack into the pervert will be an ongoing one throughout the process of therapy. 242
For instance, a masochistic patient who has undergone several months of therapy might escalate the dangerous practices in which he engages in the (usually unconscious) hope that the therapist’s anxiety will peak and s/he will enunciate a prohibition of those activities.
In this example, the masochist’s actions put the therapist in somewhat of a bind: if the therapist enunciates a prohibition, s/he deviates from analytic neutrality and the therapy might suffer from the associated risks (e.g., that the pervert attribute to the therapist a lasting wish that he stop engaging in those especially dangerous masochistic practices such that the pervert will repeatedly demand via his actions that the therapist play the role of lawgiving Other and the treatment will become stuck at the levels of perverse enactment and of demand);
if, on the other hand, the therapist does not prohibit the masochist’s dangerous practices, at the most the masochist might end up getting a serious injury or even getting killed and the therapist might face malpractices charges. At the least, the therapist risks being put into the position (illustrated in Jiménez’s 1993 case of Matías) of impotent witness of the pervert’s dangerous and/or criminal activity. 244