Franco De Masi. International Journal of Psychoanalysis. Volume 88, February 2007.

‘The only respectable thing about my life is my birth. The rest is unpublishable.’ This is what Norman Douglas, 20th century English writer who settled in Capri declared to his biographer. Douglas was referring to his attraction for young boys and for his love for one of them, with whom he had cohabited for a long time. Another declaration of his had been: ‘Surround yourself with children and adolescents, only this keeps the mind young.’ For the paedophile (and Douglas was one) the child is indeed, not only a sexualized being but also an object which brings energy and vitality. (Lowenfels, 1962)

Paedophilia: Classical times and the contemporary era

At first sight, true paedophilia seems far from being violent. It is well known that in some historical eras some cultures admitted paedophilia. This could even take a ritualized and institutionalized character. In classical Greece, sexual relations between adult and adolescent males were frequent within contexts of spiritual and pedagogical development. While homosexual love for the adolescent was allowed, promiscuous homosexuality of a pornographic or mercenary nature was punished (Cantarella, 1992). Similarly, sexual relations with pre-pubescent children were severely punished: the boy involved in a sexual relationship could not be less than 12 years old. The phenomenon of ‘socially accepted’ paedophilia disappeared with the world of ancient Greece. It is now completely alien to us, because of the profound transformation of the adult-adolescent relationship over time and also because of shifts in the conception of sexuality and of generational differences.

As for paedophilia as a modern problem, it is important to underline that what seems to be a new phenomenon, characteristic of our age, is actually the social organization of paedophilia (and of perversion in general) rather than the underlying mental structure. What is new about paedophilia is its conspicuousness. On the internet there are sites offering products tailored to the tastes and preferences of the customer. Paedophile organizations, just like their counterparts dealing with other forms of perversion, aspire to emerge from the clandestine, so as to communicate freely and obtain validation and consent. This kind of self-promotion has the aim of dissolving the solitary nature of paedophilia and, by rendering legitimate the sexual choice of the adepts, erasing the transgressive motive and the subsequent liability. Currently, paedophilia is a widespread phenomenon with entrenched financial and touristic interests. The encounter between the industrialized western world and the developing countries allows the childhood of the poor and vulnerable to be violated on a systematic and global scale. Television reports show us little girls sold by their parents in remote rural areas, or young boys compliantly prostituting themselves. Precociously burned out by their struggle for survival in the cities, they offer their bodies to groups of westerners whose pockets are full of money.

Another characteristic of contemporary paedophilia is the volume of erotic and pornographic material in circulation, ranging from publishing to video production. The conspicuousness of paedophile behaviour and the increased attention given to it by the media and the public opinion (consider the events in the Roman Catholic Church in the USA and, more recently, in Brazil) suggest a likely future demand for psychoanalytic treatment also for this kind of disturbance. This work aims to be a contribution to possible clinical experiences in the field.

Paedophilia and psychoanalysis

Kraft-Ebing (1900) was the first to distinguish this sexual disorder. He coined the term paedophilia erotica, referring to a morbid predisposition and aiming to remove the stigma attached to it. The psychopathological status and the treatment of paedophilia are scarcely present in psychoanalytic literature. Only a few works describe the treatment of paedophile patients (Arundale, 1999; Glasser, 1988; Karpman, 1950; Socarides, 1959). A broad survey of paedophilia can be found in the volume edited by Schinaia (2001), which discusses in detail the psychoanalytical theories that can be applied. He also discusses the cultural expression of the condition as found in mythology, fairytales or literature. More recently, Socarides and Loeb (2004) have edited a review of therapeutic treatments of paedophilia and report case studies of patients who had abused children. In some cases, however, it is difficult to recognize the mark of true paedophilia. The main characteristic of some patients seems to be a mental structure similar to psychosis (in one case there occurs a psychiatric hospitalization for a clearly psychotic episode) and which emerges as the main focus of the treatment.

Freud seems to have considered paedophilia more as an occasional act than as a perversion as such. In his Three essays on the theory of sexuality (1905), he states that children are substitute objects for those who are not able to have a sexual relationship with other partners; only exceptionally are they the exclusive object (p. 146). His early clinical cases abound with episodes of child seduction by servants, nannies or relatives. It is this that may have induced him to reason that the origin of neurosis is seated in early sexual trauma. One of the reasons for the paucity of analytical literature on this subject is that paedophiles very rarely ask spontaneously for therapy. Even the treatments prescribed following conviction are accepted only as alternatives preferable to a sentence. Now, a therapy which is not freely chosen and which does not allow for deep and systematic interrelating, often keeps the paedophile area split and encapsulated. Thus, even in the presence of some improvement in some aspects of the personality, such therapies do not guarantee that paedophile behaviour will not reoccur.

Definitions

First of all, there is the problem of how to consider paedophilia. Can the paedophile act be unique, an exceptional event which has nothing to do with the whole personality of the person who commits it? Or does it derive from the structure of the personality and tend to repeat itself? Is the paedophile capable also of having a sexual relationship with an adult, and of leading an apparently normal married life, or is he entirely dedicated to an erotic relationship with a child?

Does the act of sexual abuse by the paedophile on the child always imply violence, tending, at the extreme, to criminal aggression? Or is it necessary to make some distinctions between criminal sexual aggression on minors (as can be made with criminal sexual aggression on women) and true paedophilia which in itself is far from any violence? Sexual abuse of the underaged is not always synonymous with paedophilia, but can stem from other psychopathological conditions (such as schizophrenia and mental deterioration). In these cases we talk of secondary paedophilia.

In a study at an Italian psychiatric hospital (Jaria, 1969), almost half of the 156 patients who had abused minors were mentally disabled. The next largest group were schizophrenics, then the alcoholics, and finally people with mental disorders due to old age. It is clear that such statistics record numbers of people sentenced and who are not, therefore, representative of the true paedophile. The latter usually manage to avoid criminal prosecution, being highly skilled in avoiding the legal consequences of their acts.

It is also important to distinguish true paedophilia from the sexual violations which happen within a family. Despite the fact that there are profound analogies between these two conditions (they both ignore the incest taboo and the difference between generations), the parent who abuses his daughter or son is sometimes in a regressive position due to a real psychopathological condition. Glasser (1988) is right to remark that incest implies complex intrafamiliar dynamics which are completely alien to paedophilia.

Paedophilia can be divided into two forms: the structured and the occasional. When the sexual objects are exclusively children or adolescents, we talk of structured paedophilia, which can be either hetero- or homosexual. If the paedophile leads an apparently normal life and has sexual relationships also with adults we talk of occasional paedophilia. In this case, there is also a certain degree of awareness and of guilt over the paedophile act. However, even in the occasional forms observed in psychotherapy, in which the sexual act seems to have been committed in conditions of stress, the existence of a paedophile imaginary world can be discerned under a façade of an apparently normal sexuality (Glasser, 1988). Socarides (1959) thinks that occasional paedophilia is more prevalent in middle age or at the onset of old age, when important psychological changes alter the defences against sexual impulses.

Paedophilia can occur on its own or combined with other perversions, the most dangerous one being sadism. Taking into account this last aspect, I tend to distinguish between two forms of paedophilia: the romantic and the cynical. ‘Romantic’ paedophilia is nurtured by the eroticized and idealized figure of the little boy or girl. Norman Douglas, James Barrie (author of Peter Pan, 1995) and Lewis Carroll (Alice in Wonderland, 1971) could be examples of this kind of paedophilia. The world of the ‘romantic’ paedophile is in fact centred on the life of young people, both concerning his affection and his erotic fantasies; the desired object is more often an adolescent than a child. This does not mean that this form of paedophilia is limited to the sublimation of sexuality. It also culminates in a concrete sexual approach. One famous literary example of ‘romantic’ paedophilia is found in Nabokov’s Lolita (1959), in which a university lecturer, rather lonely and melancholic, falls passionately in love with an adolescent girl. In describing the encounter between the erotic dependency of the adult and the cynicism of the adolescent, Nabokov establishes an ambiguity around the role of the victim. The girl, who has grown up too quickly in a cynical, middle-class environment, appears much more resilient than the academic, who is completely defenceless and enslaved to his own passion. In this form of paedophilic love, the adult too can end up as dominated victim.

In ‘cynical’ paedophilia, the underlying fantasy is sadistic: a state of mental excitement is only reached through imagining maltreatment or violence on the child. The pleasure does not derive from the sexual desire, but rather from being able to do anything one wishes to a submitted object. The child is more liable than others to become the object of criminal sadistic fantasies. Often this aim is achieved through the use of pictures or video from the illegal paedophile-pornographic trade.

It is legitimate to wonder whether in ‘cynical’ paedophilia sadism is an avoidable factor or whether it is an intrinsic part of the perverse structure of paedophilia. From a psychodynamic perspective, it is possible to intuit why sexuality addressed to children can be a fertile ground for sadism. If the child is desirable because submissive and psychologically defenceless, it is possible for the asymmetric relationship (adult-child, dominant-dominated) which characterizes the paedophile perversion to undergo an extreme escalation towards sadistic excitement. Even so, paedophilia, although characterized by an asymmetry of the relationship, a quality which it shares with sadomasochism, does not lead necessarily to the pleasure of sadistic violence. This is why it is necessary to make a distinction between the forms of criminal sexuality on children and adolescents and paedophilia as such which in itself is far from violence. Even though the paedophile sexual act is always an abuse, ‘romantic’ paedophiles often show altruistic features or educational and creative skills in their relationship with the children. This is in contrast with the ‘sadistic’ ones who do not have any relationship with the children and are not in the least fascinated with the world of childhood.

Characteristics of the paedophile world

1. In paedophilia the relationship is ‘asymmetric’. Paedophile love can be seen as a defence from relating with an object perceived as independent.

2. In the paedophile the idealization of the body of a child or adolescent is matched by an aversion for the physical aspect and psychical and emotional world of the adult. As soon as the child shows any sign of secondary sexual characters, the rapid and unexpected rise of the adult physical form destroys the idealization of the child’s beauty.

3. The paedophile wants to be a boy and to mix with other boys in the world of playfulness and imagination. Just like Peter Pan, he wants to stop time and to realize the myth of eternal youth. This explains why the paedophile tends to choose professions which allow a constant immersion in the world of childhood or adolescence. For the paedophile imagination, parents do not exist: the child is a puer beatus, self-generated and totally self-sufficient.

4. Paedophiles have often had an isolated childhood. As children, they felt excluded by their peers and envied their vitality. As adults, they desire to possess those very children they admired and envied. The loving and sexual relationship with the child or adolescent also expresses a fantasy of recovery of the vitality that they lost or never possessed. Who cannot remember the writer Aschenbach, his creativity blocked, and tormented by the idea of getting old, who in Death in Venice (Mann, 1983) falls in love with the adolescent Tadzio? While claiming to be the only people able to understand children or adolescents, the ‘romantic’ paedophiles distort the world of children because they sexualize it: the child’s warmth and intimacy are often misunderstood as an invitation to sex.

In the case of paedophilia, the sexualization of psychic reality could be due to early trauma or sexual abuses. However, it is often the case that the adult paedophile has not been the young victim of sexual violence; he may, on the contrary, have been privileged or have been the object of psychological seductions on the part of one or both parents. It is not unusual for paedophiles to have been intelligent, sensitive and privileged children who had an enchanted childhood. The end of childhood may have been traumatic, following the loss of trust in the parents. They may have thereafter sought refuge in a sexualized world, seen as a continuous source of excitement and support. The experience of an infantile sexualized withdrawal determines the unconscious belief of the paedophile that all children are ‘naturally’ desirous of sexual experiences. The patient described by Arundale (1999) claimed that his most fervent wish was to make children happy and he daydreamed of a happy country in which it was permissible to have sexual relationships with them.

I now want to say something about the origin of perversion in general and of paedophilia in particular. Perverse behaviours find their roots in infancy. They express a dependency on a state of mental excitement which must absolutely not be confused with the exertion of relational sexuality. Sexuality, which is present in the paedophile perversion, is sustained by fantasies which are self-generated in a state of psychic withdrawal. This state alters the perception of psychic and emotive reality and has an addictive quality. Thus, the paedophile sees in the child and in the adolescent someone who desires sexuality and who constantly proposes themselves as a sexual object. Devious sexual behaviour often stems from early infancy in abandoned, deprived or isolated children. These children take refuge in a fantasized, sexualized world. It is this state of mind that, later on, combined with the disillusion caused by the adult world and with the reluctance of growing up, will sustain the evolution towards paedophilia.

An analytical therapy

I now present a paedophile patient, homosexual, whose paedophile fantasies are tightly interwoven with sadistic and masochistic ones. Analytic therapy, conducted at a rate of four weekly sessions, began 14 years ago and is now coming to an end. In this article I focus mainly on the nature of the pathological structure underlying my patient’s paedophilia and describe the transformation that occurred in analysis. The perspective I propose underlines the specific nature of the analytic work with this kind of patient and seeks to determine what needs to be analysed in the first place. By this, I am not intending to make an artificial distinction between a true analytic cure (which is based on the transference and countertransference dynamic, the interpretation of fantasies and of pathological identifications, etc.) and the cure of the ‘paedophile nucleus’. As previously described, I consider the world of paedophilia being determined by a sexualized nucleus, split from the rest of the personality, which is constantly trying to seduce the healthy part of the patient.

The main analytical task is to help the patient to neutralize the power of this pathological structure. The analyst will be constantly drawn in the patient’s sexualized world, which is at the basis of paedophilia. Within the dreams and fantasies belonging to this world, he will progressively come to represent, in the transference, the parental figures of the past, his internal objects or a new figure who will facilitate the development of the healthier part of the patient.

‘Michael’ is a 30-year-old man whose objects of sexual attraction are children or pre-pubescent boys. He dedicates to them his professional time, as a teacher, and as much as possible of his free time. He is truly attracted by children and adolescents and finds a nourishing pleasure in their company. Despite the presence of perverse fantasies which have, as an object, adolescents with whom he identifies, the idealization of the world of childhood and adolescence makes Michael more of a ‘romantic’ paedophile than a ‘cynical’ one. However, I believe that, without analytical help, even the ‘romantic’ part of Michael would sooner or later have given way to the ‘cynical’ component.

The sadomasochistic fantasies go back to his early infancy. He remembers how as a little child he could reach states of mental orgasm through fantasies based on stories of submission, injuries and pain. His homosexuality established itself during adolescence. At that time, he started to feel sexually attracted by his peers. He has never had a real relationship, and on the occasion of a few attempts he has found himself to be impotent. The attraction towards paedophilia was perhaps meant to be a solution to this failure: when he was about 25 years old he attempted to seduce sexually his pre-adolescent brother and fell in love with the 10 year-old son of a neighbour. In childhood, a privileged relationship with his mother placed him in a special position in relation to his siblings (one elder sister, two sisters and two brothers younger than him). In adolescence, this relationship deteriorated as the mother, also attracted by the adolescent world, developed an idealized bond with a boy of Michael’s age. Michael also found this boy very handsome and desirable. From then on, the patient, full of rage, distanced himself from her. At the time, his relationship with his father was already very troubled. After the early childhood, apparently free from conflict, the father had tried to educate him in an authoritarian way, pushing him towards a position of rebellious submission, mixed with feelings of fear and persecution. Despite the fact that Michael is now an adult able to take an intellectual and professional role in the social sphere, he has no significant contact with adults. He constantly seeks to meet with children and adolescents (strictly males only) and he dedicates himself to setting up playgroups in which he has the role of facilitator. These same children and boys are the object of his sexualized fantasies.

The perception of his isolation and the fear of becoming completely dominated by his paedophile and sexual fantasies pushed him to ask for analytical help. I recall one of his first dreams in analysis: A child is kidnapped and taken to the brothels of Southeast Asia. On his return he appears completely transformed: he looks brain damaged like an idiot, he seems to have Down’s syndrome. The content of this dream highlights the patient’s anxiety of not being able to control his sexualized excitement (the brothel), perceived as dangerous matter irreversibly destructive of the mind. For a long period in the analysis, the sessions are dominated by sexual, sadomasochistic and paedophile fantasies, described in fine detail. A typical fantasy, with many variations, is the one in which a homosexual relationship between an adult and a young boy is transformed into a sadomasochistic one in which the patient, identified with both partners, draws pleasure from the active acquiescence of the boy and from the sadistic initiatives of the adult. This kind of fantasy, not in the least masked, appears also in dreams, which are not dissimilar from the constructions made by the patient in the wake state. For long periods, the consulting room is literally invaded by dreams set in dark caves through which monstrous figures break; primitive animals are ridden in crescendos of excitement, while children are frantically stripped of their clothes, penetrated or made the objects of sadistic violence.

It is during this first period that Michael develops with me a polemical and aggressive transference. In particular, I become the object of malignant projections and of fierce criticism for being unable to think and for my arrogant, adult narcissism. If I were to frame the analytical relationship of the first years of this analysis from the perspective of perverse transference, I should say that Michael is using a consolidated technique which consists in projecting into his interlocutor irritation and rage to the point of provoking in the latter a counter-aggressive reaction. As soon as he feels that the wanted effect has been achieved, he becomes cold and rational and, from his achieved superiority, he can stigmatize the behaviour of the other. In this aggressive way of relating, he always finds someone to attribute responsibility and blame: in the past, it was the parents and now it is the analyst in the transference. He also comes into conflict with other people in his everyday life. If they happen to have an authoritative role, they become for him persecutors whom he hates and whom he provokes with an ostentatious display of innocence.

During the sessions he shows a distinctive ability to isolate single sentences of mine from the context. Once separated and distorted, the sentence will appear to him particularly obscure, stupid and offensive. Having found a blatant element of offence on my part, he can voice his polemic. As an analytical victim he has the right to attack and beat me pitilessly. As is easy to imagine, this counter-transferential knot is not always easy to undo. Michael seems to have a particular ability to create between him and the other a climate of irritated mistrust. The perception of the silent or defensive response by the interlocutor is the starting point for a new attack. I must say that, of all my patients, he is the one who has most strongly tested my counter-transferential stamina. To give a brief example of the perverse way in which Michael tends to transform the other into a bad object while putting himself in the position of the innocent victim, I describe the way he responded on one occasion, when I announced to him that I had to cancel one session. Not in the least disappointed, Michael asks me the reasons for this cancellation. I let him know the reasons (joinery works next door to my consulting room, which will render the session impossible, because of the transport of materials as well as the noise), but he says that he is not satisfied and insists several times on my giving more information on the works. When I reply that in my opinion he has received enough information, he rebels, attacking me and accusing me of denying him knowledge and of inhibiting his curiosity.

A delicate problem in the analysis of Michael is represented by the choice of how to respond to him: the understanding of his mental state must include a firm position which challenges his arrogant assertion of himself over others (and in the transference over myself) and at the same time analyses the continuous attack upon the potential positive dependence on a human object. Although they originate in traumatic past experiences, the resentment and the spite in the transference also represent an attack on parental figures as such. In other words, resentment and spite have the role of sustaining the idea, central to paedophilia and to perversion in general, that parents do not exist, or, if they do, are denigrated and degraded objects (Chasseguet-Smirgel, 1985). The attacks on parents (and on the analyst in the transference) serve the purpose of justifying and idealizing the paedophile world, seen as superior to any other. Despite his conscious rage for the betrayal and the unreliability of his mother, the patient shares the same fantasy world. Just like her, he is fascinated by the world of male adolescents. He is sexually attracted by it and, like her, he would like to seduce handsome boys. However, Michael is not at all prepared to take into account his clear identification with his mother: any interpretation in this sense provokes irritation and anger.

Sexualization

The dreams and the accounts of the patient are constantly coloured by sexualization.

In one dream in his third year of analysis, the patient is with a little boy. They are embracing and rolling in the snow. The patient is experiencing a sexual pleasure: the docility of the child excites him and the pleasure comes from a sense of total agreement and adaptability on the part of the object. The coldness (the snow) and the malleability refer undoubtedly to the absence of emotions in the physical interpenetration. Thus, the dream hints of the possibility of penetrating and annihilating the object, by crushing him. This excites the patient. The psychological ‘malleability’ of the young partner confirms for the patient his superiority and his triumph over a submissive and controllable object.

In one of the following sessions, Michael talks about Nino, a young boy with whom he has been playing a board game. Nino wants to show his skill at the game. In the eyes of the patient, however, Nino is trying to put himself forward as a homosexual object of pleasure. A casual and fleeting touching of the hands becomes for the patient an implicit homosexual advance; he must reciprocate, for the young boy cannot be exposed to disappointment. For him, Nino is a source of pleasure and happiness. Paedophile homosexuality appears to him a revelation: it is the true dimension of life.

I have described this sequence in order to emphasize to which extent the paedophile dimension has for Michael the character of an ecstatic revelation. The patient talks about the adolescent group as though a self-contained entity, a monad full of balance and wisdom in which, for the main part, no outsider is needed for the exercise of sexuality. These wise and exceedingly good boys masturbate and have sex with each other. In the sexualized mental state of the patient, the boy becomes an object providing a continuous source of pleasure. He is equated to the penis which is always at his disposal and readily excited when stimulated. The erect penis of the boy can be sucked at will: all the homosexuals are fighting for it. It is the excitement of this sexual-oral infantile world of greediness which promises the existence of an enchanted land of absolute and endless gratification. To keep the excitement alive and to fuel the pleasure, any inclination to love and care for the object must be annihilated and sacrificed in the name of triumph and possession. The excitement springs from the certainty of possessing the object of pleasure in an exclusive way, from the sense of domination in using it, including a certain dose of sadism in the touching, pinching and tormenting it, and in the perceiving it as ready to his commands.

In order to be able to draw pleasure from his fantasy, Michael must go far away from the world and from the presence of the parents and the analyst. Their existence will lower the level of mental enthralment and the vividness of the perverse fantasy. The delusional nature of the paedophile withdrawal (‘the other reality’) becomes evident in some dreams which are authentic psychopathological constructions. In one dream, for instance, his brother Antonio appears, whom the patient attempts to seduce erotically. Antonio defends himself, pushing him away. Michael then ‘materializes’ a flying carpet and invites the brother to sit on it. The brother does so, becoming immobile and passive: now the patient can suck his erect penis. The transformation performed by the patient through the ‘flying carpet’ places the object in the ‘other’ sexualized world and thrusts the patient into a dimension beyond reality. In this dream (as in a few others from this patient), the delusional aspect specific to paedophilia is represented precisely by the transformation of the brother’s figure. Initially pictured as an alive and independent person, the brother becomes a passive and sexualized object. This change happens through the use of the omnipotent instrument of fantasy (the flying carpet which, defying the reality principle, allows one to fly). In my opinion, this dream also shows the effects of sexualization, which deadens the vitality and the autonomy of the object and of the patient himself.

Transformations in analysis

First phase

This period is characterized by the patient’s relentless propaganda, aiming to impose on me the superiority of his perverse world. It has also the most difficult counter-transferential moments. The patient often attacks me, not least because he sees in me a possible antagonist who could deprive him of a fantastic and excited world which brings him pleasure and the triumph of possession. In order to avoid the risk of being pulled in turn into the sadomasochistic circle, I try, in these instances, to keep in mind that Michael has been a suffering and ill child. As I said earlier, the first part of the analysis is constantly dominated by the exciting power of paedophile, sadomasochistic fantasies, appearing both in daydreaming and in the dreams.

As soon as he starts the analysis, Michael gives up masturbation, a habit which in the past had taken an exasperated compulsive form and had been present since his early childhood. During the entire first phase of the analysis, however, he uses the night dream in order to enter into the same masturbatory dimension which he denies himself in the wake state. During this period, the dream is not a dream, but an action into the dream. Typically, his ‘dreams’ reproduce a perverse-paedophile scene culminating with a nocturnal emission. It is obvious that dreams of this kind do not refer symbolically to anything else: they are indeed actions. However, even this sort of dream is important. Throwing light on his internal world, they allow me to describe to the patient his mental processes, in particular his conflicts and the attempts by his perverse component to seduce and overcome the healthy part. In this sense, even though the patient usually offers very few associations to his dreams, his dream production allows a constant visualization of his mental functioning. Later on in the analysis, they will become an important vehicle of communication, highlighting the function that the analyst has in his internal world. Sometimes, they also clarify the nature of his changes of perspective and of his evolving processes.

Every so often. there are glimpses of a self-torn by cruelty. For example, in a dream belonging to this period, a white shark has been caught by a fisherman. The bones can be seen through the cuts on its body, but the fisherman refuses to finish it off, as he wants to bring it home still alive to eat it fresh (see De Masi, 2003, p. 95). His associations reveal that the shark represents his libidinal self, healthy and voracious. The sadism belongs to the man who is excited by the idea of devouring live flesh. Contrary to what happens when Michael enters a perverse state of mind, in this dream he expresses his anxiety and his fear for his self, which is exposed to a sadistic brutality. This distinction between persecutor (the fisherman) and victim (the shark), exposes him to feelings of pain and to the perception of cruelty. By contrast, when perverse colonization prevails, all emotional contact is erased.

The patient dreams: two boys are fighting. At the end one of them says that he now needs to ‘deflate’, meaning that he needs a rest; he announces that he is going to suck his own erect penis. The patient feels excited, as if he recognized in the boy’s words something belonging to himself. Next to them, the gym instructor does not intervene, not giving much importance to the boy’s words. My hypothesis is that in the dream the boy represents the sexualized part which excites and conquers him. The instructor who does not intervene is a parental figure (the analyst) emotionally absent and indifferent to the danger of a sexualized withdrawal.

In a session of the fifth year of analysis, Michael describes a holiday at his parents’ home, where he felt marginalized and inferior in relation to his siblings who were with their partners. Late in the evening, he takes refuge in the toilet, and with a photo portraying adolescents, he constructs an excited fantasy in which a satyr seduces a young boy. The world is transformed into this exclusively sexualized reality: he is possessed and conquered by this world.

In the following days, this exciting mixture stays with him, inflaming his mind and trapping him. In a session the patient regrets having set off, once again, this perverse paedophile experience. He is powerless: he feels like an allergic organism coming into contact with some pollen able to create an explosive reaction. He can only try to avoid the explosive allergen but, once the contact has taken place, he can neither oppose nor fight it.

This clinical material characterizes one phase of the analysis in which the patient’s wish to evade the power of the sexualized paedophile nucleus becomes evident. In this period he starts to conceive the existence of a boy who does not masturbate, does not indulge in orgiastic activities and maintains his mind open to contact with the world. In other words, there starts to emerge a perceptive self, which observes and enters into conflict with the sexualized part.

When the patient resists the fascination of the perverse paedophile part, the evidence of his masturbatory madness thrusts him into a state of despair. At the same time, the atmosphere in the analytic relationship changes. Attacks and polemics decrease: the patient seems to be less colonized by the world of perversion and less compelled, in the transference, to make polemical attacks on the parental figures.

Second phase

In the second phase of analysis, a new configuration of the paedophile fantasy emerges. In order to illustrate it, I present a session preceding a summer separation. Michael talks about Mario; he says that he found the adolescent distant and elusive when they were separating for the summer holidays. He had a dream full of anxiety: he is sitting on this adolescent’s knees in an atmosphere of playful, erotic intimacy. Mario progressively moves far from him and disappears. The patient feels lonely and desperate. He claims that he is responsible for the disappearance of Mario: he should have mobilized all his energy to keep the boy with him. Mario, says the patient, is wise. He knows the secret of life and of being happy. His presence would have made him happy; he (the patient) needs his continuous proximity. He is to blame as he has not done enough to keep the boy with him. The disappearance of the boy is his own responsibility.

Listening to the patient, I wonder, naturally, whether he has not represented, in the dream, the anxiety of the imminent summer separation. However, within myself, I deem this interpretation not very plausible. I know that, at this stage of the analysis, Michael can be irritated about the summer separation, and he may displace his anger into a lateral polemic, but he is not anxious. By then, my hypothesis is that the anxiety in the dream does not refer to the analytic separation but describes the experience of a child who is no longer able to sustain the illusion of possessing the hallucinated breast which makes him feel nourished. The anxiety is provoked by the disappearance of this delusional object and by the simultaneous absence of the real object. In the dream, the boy allows the patient to have a temporary good experience of maternal holding, but, as soon as the experience of affectionate support and tender physical contact comes to an end, he falls into a primary depression. My intuition is that the dream describes Michael’s internal world and has to do with his dependency on an idealized fantasy object. In the dream, therefore, the lost ideal object (or, if you will, the self-object) is not a symbolic maternal substitute, but a fantasy object which is instead of the mother. This dream seems to point to a fusion with an ideal object. Here the union is not eroticized, but represents a need which is indispensable for the support of the self and which prevents him from falling into the nameless dread.

I say to the patient that he wishes to experience a reciprocal and meaningful relationship: this would prevent him feeling so terribly non-existent for the other. In the dream, there is a part of him, the unheld child, who takes refuge in Mario’s lap. As for who is guiding whom and who needs whom, and which needs are these, it is all very confused. I add that being with the young boy in an idealized withdrawal prevents him from having a relationship with me: he no longer needs to ask himself the question, before our separation, of whether I can be the object who is able to understand his needs and be with him during the analytical separation. In the dream, the illusion of being happy and self-sufficient in his worshipping of the boy-idol vanishes and he feels accused by the idealized object of being the cause of his own misery.

Third phase

In this period also, the patient is still spending most of his free time in the group of male adolescents, sharing their dreamy life and trying to be one of them. The need to be integrated into this group of boys is constant and their absence is felt as deadening. I also realize that his search for relationships exclusively with boys is at the same time a way of reinforcing his male identity. In adolescence, Michael had indeed excluded himself from his group of male peers and had stayed in contact only with female figures (his mother and some school girlfriends). He had, in his own words, ‘feminized’ himself. Frequenting this group of boys, with its conflicts, uncertainties and naive beliefs, is also helping to decrease his idealization of the adolescent world.

In this period the analytical relationship is stronger: the patient turns to me as someone who can help him to know himself and understand the world. The sexualized fantasy appears sometime, according to the vicissitudes of the transference and to moments of conflict. For instance, during a brief, unforeseen absence of mine, he dreams that he takes a Chinese stick and beats up his penis, while the analyst appears with a confused expression. However, this is immediately followed by: he is searching paedophile sites on the internet, but the analyst appears and protects him, while he perceives a tiny flame throwing light in the room.

In the first dream, the sexualized withdrawal emerges again as an omnipotent defence aimed at erasing the perception of the absence of the analyst. The latter becomes equated with a distracted and confused parent; in the second, the presence of the analyst in the paedophile world witnesses an increased permeability of the masturbatory retreat and allows for a certain degree of insight. In this period, it is more frequent that Michael himself realizes how his relapses into paedophile fascination are linked to his pathological identification with his mother (something that at the beginning of therapy he refuted vehemently). The relapse into the paedophile fantasy also occurs in analogous situations of frustration. For instance, after having entered in conflict with an adolescent, the son of some friends, he constructs a fantasy in which this boy lies in a cellar ready for abuse by adults.

The new element, which is starting to make its appearance in the sessions, is the fact that the perverse fantasy can be gradually understood and deprived of its invasive power within the analytic hour. The definite exit from the paedophile world coincides with his falling in love with a real, alive object: an 18 year-old boy. For the first time in his life, Michael experiences a loving relationship, free from sexualized fantasies, with a real and separate object. However, this first experience of being in love, kept secret, exposes him to a destabilizing emotional turmoil. The loss of the boy, who at some point leaves him, causes a long period of psychic pain, acute somatic sufferings (insomnia and anorexia), depression and panic. The experience of pain and disillusion, shared in the analytic relationship, pushes Michael towards a more determined emancipation from the adolescent word. In fact, from that moment onwards he starts to value his relationships with adults, seen as more reliable and less disappointing than adolescents. In his friendships with his contemporaries, some female figures gradually appear. However, the relationship with this young person, the first in his life, has helped the patient to recognize the existence of an affective world, which had previously been denied at all levels. He will keep thinking of this relationship as something which can be kept safely in his memory and can represent the key for understanding the significance of the loving experience, which had previously been unfathomable, because unknown.

It could be stated, that, at this stage, the paedophile ground has been sanitized. The face of a young boy, which previously suggested reliability, tenderness and love, also of a sexual nature, no longer produces fantasies of this kind. For the patient, a relationship with adults is now more rewarding. In the analytic relationship, his emotional dependence on me is stable and is no longer negated by fantasies of fusion with the adolescent figure.

Even though not completely eliminated, the power of the paedophile nucleus has greatly decreased. When the paedophile fantasy reoccurs, the patient is now able to link it to the object and to the emotional constellation which has generated it. He can now understand that this fantasy is a defence against unpleasant emotions. The paedophile world is now felt as a residual element of the past. It cannot be removed from memory and could well become active again, but it appears well balanced and contained by the more insightful parts that the patient has developed. In the patient’s words, it could only be reactivated in the presence of ‘bad masters’, i.e. if he erased from the mind his links with emotional reality. In this case, he would become trapped once again in the claustrophobic world of paedophilia.

However, Michael does not believe any longer in the poet of the Middle Ages who proclaims that being in the ‘castle with Ganymede’ is preferable to normal sexuality.

Observations

I believe that paedophilia can be considered a sexual perversion with specific features. Perversions are characterized by a psychic withdrawal in which a sexual fantasy is central to the reaching of masturbatory pleasure. The basic fantasy and the way by which it is obtained varies according to the nature of the perversion (whether it be sadomasochism, exhibitionism, transvestism, fetishism, paedophilia or other), but the aim of producing an exciting masturbatory situation is the same. The sexualized fantasy, already present in the early infancy of the future pervert, blocks the development of the healthy part of the personality luring it into the experience of addictive pleasure (De Masi, 2003). In my opinion, paedophile perversion is sustained by a specific delirious nucleus, a misconception (Money Kyrle, 1971), a pathological organization of the internal world in which a highly idealized, sexualized and worshipped object takes the place of the parental figures.

This nucleus, split from the rest of the personality, appears to be the sole source of gratification and exerts a very strong power over the patient, orienting and colouring all aspects of his life. The split between sexualized retreat and the rest of the personality is well described in the case presented by Socarides (1959). His patient, seriously traumatized from infancy, used to live two separate psychic lives. In one of them, which we will call A, the patient perceived himself as a kind person, capable of having relationships. When he was invaded by anxiety he would enter psychic life B, in which the only aim was to possess sexually a young boy. During sexual activity, the partner was meant to remain immobile and not experience any pleasure. The split between these two internal parts allowed him to carry on his paedophile activity without having to ever come into conflict with it. In the case reported by Glasser (1988), the patient had two kinds of paedophile experience. One part of the experience was centred on the beauty of the adolescent which led him to worship him; while the second was totally sexualized and centred on the anal penetration of the young boy as the way of attaining a permanent orgasm.

My patient also presented an analogous split between idealizing aspects and sexualizing ones. In this case, however, the paedophile fantasy would not intervene in order to sedate the anxiety but was part of a sophisticated and complex delusional construction. In the course of the analysis, the misconception relating to an absolute wellbeing to be obtained from the world of ‘boy-ness’ was fiercely defended by my patient and was the focus of inflamed polemics with me. The patient wished to find in my person someone who shared his belief and his enthusiasm for this world, which presented itself as ineffable and suffused by an atmosphere of pleasure at all levels. In order for him to be able to sustain this delusional construction I was asked to share his own delusion.

We may wonder what might have been the negative factors which pushed this patient towards an idealization of the infantile world and to confer to the latter such a strongly delusional character. Some traumatic family patterns might have oriented him towards the world of paedophilia. His mother, who had stimulated his narcissistic expectations in early childhood, had subsequently betrayed him by falling in love with her son’s playmate. In analysis the patient had progressively become aware that the maternal betrayal was at the basis of his homosexual orientation and his aversion to the female world. Together with the female world, that of the parents had also been devalued. Michael recalled his father as a person exacting submission and imposing on him systematic punishment. The hatred for his father was perhaps even deeper than that he felt for his mother. The sole world to survive and have become idealized was that of childhood. This was the happy world of playfulness and imagination. In his mind, this world had been rigidly opposed to that of the adult. The boy would immediately be distanced and lost when he grew up-when girls would make their first appearance in his narrative. Michel could not understand, literally, why, when attracted by female figures, a boy would tend to remove himself from the adolescent and exclusively male group.

I have several times emphasized the ‘romantic’ element in Michael’s paedophilia, which found its roots in his idealization of the world of childhood. It was possible, in fact, to perceive some positive elements in his idealization of this world, even though that same idealization would entail an altered perception of psychic reality. The most specifically perverse element of his paedophilia was strictly connected with his infantile sexualized withdrawal and included a sadomasochistic fantasy in which a dominated object would participate actively in the pleasure of the partner. One of the most frequent fantasies of that period was riding a horse which in the end would collapse with exhaustion and surrender itself to the power and control of the patient. From this altruistic submission of the animal, which would exhaust itself on the orders of the master, the patient would receive an enormous sensual pleasure. This kind of fantasy, continuously reshaped and enriched over the years, explains the establishment of the sadomasochistic perversion in adult age.

I thought it important, from a technical point of view, to keep separate and distinct the perverse and the idealizing aspects, as I saw in the latter some relational elements which could be developed. As the analytic process progressed, the relation between the sexualizing and the idealizing parts has been modified to the advantage of the second. After the first period, characterized by the addictive, sadomasochistic excitement we moved to the second in which idealization and fusional dependence on the world of childhood prevailed (this world being deployed partly in an antianalytical mode). We eventually reached the third stage in which the patient could face in a stable way his psychic and emotional worlds. I believe that this transformation has been made possible by the fact that I have constantly placed myself alongside the patient when scrutinizing his perverse fantasies, helping him, session after session, to distinguish between the healthy parts to be nurtured and the sexualized parts to be contained and transformed. In so doing, I was consistently preoccupied with analysing without let-up the confusional areas. The risk of being identified with an absent and confusing parent (this is how I appear in the dream of the Chinese stick-see ‘Third phase’) was always present and could become real as soon as my analytical responses were not discriminating enough. In one session, for instance, the patient had brought the photo of an adolescent football team getting ready for a match. Two of the boys featured had their hands on their genitals. This was for the patient clear evidence that all adolescents masturbate each other. The polemical vehemence of the patient towards me (I was seen as an interlocutor denying his statement) had been so strong in that particular session that I had become unable to think. I trivialized the whole issue and ended up making the remark that the position of the boys’ hands might have been completely casual. The following day Michael came back even more angry. He attacked me by asserting that I had said that masturbating was normal, that all boys do it (this was, in reality, what the mother would say when he was trying to explain to her the pleasure that he got from masturbation). I think that in this case the patient was right to attack me. I had not understood the problem of the previous session and I had behaved like a distracted and confusing mother. I had given him a trivializing answer which he had taken as an invitation to masturbation, while he needed to perceive me as the parent who understands the experience of the child but does not support his sexualized excitement. This clinical fragment shows how important it has been for the patient to be offered an experience in which good and bad sexuality are clearly distinguished. It is also worth noting that in the first of the sessions described the patient is trying to colonize me with his sexualized propaganda (hence my improper counter-transferential reaction). In the following session, by contrast, the healthy part of the patient is predominant and opposing the sexualized component, which has been successfully projected into me. The two aspects are split and in both sessions I am used to represent one of the two (either the sexualized or healthy aspect) which are projected outside himself.

I consider that, as well as believing himself able to get rid of his analytical dependence through possession of an idealized object (as suggested in the dream of Mario-see ‘Second phase’), Michael also developed, from the beginning, an enormous psychological dependence on me. The latter is explained by his extreme need to liberate himself from confusional areas, perceived unconsciously as dangerous sources of madness (in this sense the dream at the beginning of analysis-see ‘An analytical therapy’-is highly significant).

Long years of work have been necessary to allow the patient to escape the power of the sexualized area and to open himself to the emotional growth within the analytical relationship. When this happened, I realized the extent to which the sexualized withdrawal had stripped his mind, rendering the world of affective relationships very difficult to explore. In fact, the incipient exploration of the affective sphere found Michael completely unprepared and exposed him to a destabilizing emotional turmoil.

Conclusion

Because of the addictive quality of the sexualized nucleus, treatment of paedophile perversions turns out to be painstakingly long and hard. The main characteristic of this treatment is the initial distance between the two members of the analytic dyad. For, however much the analyst is prepared to understand the patient and to listen empathically to him, he will, to begin with, perceive the world of paedophilia as incomprehensible, disheartening and distant. In order that the hope of a possible transformation is not erased by cynicism and by the obstinacy with which the patient defends his position, the analyst must maintain for a long time a balance and a sustained interest in the mysterious singularity of the paedophile world. We are not completely powerless in our dealing with paedophilia if we succeed in properly ‘understanding’ it.

The outcome of this case suggests that, if analytically treated, some forms of paedophilia are open to therapeutic transformation. I must also emphasize, however, that, in Michael’s case, the attraction towards the world of paedophilia was matched from the very beginning by the anxiety of becoming totally colonized and engulfed by it. This element, which I considered positive from a prognostic point of view, may not be present in other cases of paedophile perversion.

In this paper, I have tried to focus on the analytic relationship and on the evolution of the patient’s paedophile nucleus. Therefore, I could not describe in detail the analytical work dedicated to the structure of his personality, to his anxieties akin to psychosis and to his inclination towards sadomasochistic relations, all of which occupied the analytic transference for a long time. The patient’s particular form of homosexuality, implying a total refusal and hatred for the female figure, was also dealt with extensively. However, I do not consider all these aspects to be specific of paedophilia. The latter can inscribe itself in very different personality structures, as can be inferred from the literature on this subject, and as I have noticed in other cases brought to my attention.