title: A metasynthesis of published case studies through Lacan's L-schema: Transference in perversion.
abstract: 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. The authors 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 11 published case studies on sexual perversion, patterns of transference are analysed. On the Imaginary dimension, the authors 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, they 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.
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium. Jochem.Willemsen@Ugent.be.
authors.forename: Jochem
authors.initials: J
authors.lastname: Willemsen
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
authors.forename: Ruth
authors.initials: R
authors.lastname: Inslegers
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
authors.forename: Reitske
authors.initials: R
authors.lastname: Meganck
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
authors.forename: Filip
authors.initials: F
authors.lastname: Geerardyn
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
authors.forename: Mattias
authors.initials: M
authors.lastname: Desmet
authors.affiliation: Department of Psychoanalysis and Clinical Consulting, Henri Dunantlaan 2, B-9000 Ghent, Belgium.
authors.forename: Stijn
authors.initials: S
authors.lastname: Vanheule
mesh_terms: D006801:Humans; D010262:Paraphilic Disorders / Q000523:psychology*; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy / Q000379:methods*; D014167:Transference, Psychology
keywords: Imaginary; L-schema; Lacan; Symbolic; case study; metasynthesis; perversion; qualitative research; transference