A metasynthesis of published case studies through Lacan's L-schema: transference in perversion

Transference in perversion is characterized by specific problems such as a defiant and polemic attitude, erotic transference, projections, and aggression. Such transference poses particular problems in the treatment of perversion and might render analytical work with these patients impossible. We propose that Lacan’s L-­‐schema can contribute to separating productive from counterproductive aspects of transference as it distinguishes between an Imaginary and a Symbolic dimension in transference. In this meta-­‐synthesis of eleven published case studies on sexual perversion, patterns of transference are analyzed. On the Imaginary dimension, we found that patients with perversion tend to (un)consciously engage the analyst in a relationship characterized by identification, fusion and rivalry. On the Symbolic dimension, we found that perverse patients are able to question their motives, lapses, symptoms, and subjective identity. The thematic analysis revealed the importance of the position of the analyst in this work, which is described within the L-­‐schema as being the representative of the otherness in the Other. Implications for clinical practice and recommendations for further research are outlined