Gender and perversion

Springer-Kremser, M., Leithner, K., Fischer, M. & Löffler-Stastka, H. (2003). Gender and perversion-- what constitutes a "bad mother". Archives of Women's Mental Health, 6 (2), 109-114. DOI: 10.1007/s00737-002-0153-3
Löffler-Stastka, H., Ponocny-Seliger, E., Fischer-Kern, M. & Leithner, K. (2005). Utilization of psychotherapy in patients with personality disorder: the impact of gender, character traits, affect regulation, and quality of object-relations. Psychology and Psychotherapy, 78 (4), 531-548. DOI: 10.1348/147608305X42217


Based on case material obtained through psychoanalytic psychotherapy with female patients from a psychosomatic gynecological outpatient clinic, the characteristics of the psychic structure of these patients who presented symptoms of deliberate selfharm and of misusing and mistreating their children, are outlined. Another common trait is the embeddedness of their perverse behavior in a generational chain of transmission. Female patients who mistreat their children had been victims of traumatising experiences in their own biography, inflicted by their mothers and directed towards their bodies. Female perverse behavior, therefore, is fundamentally different from male perversion: the perverse act in women is aimed against themselves and/or their children. Currently used diagnostic statistical manuals lack categories to describe this symptomatology adequately. Further research is requested to understand a mother's perverse actions and thus develop treatment strategies, without marginalizing these patients.


To proceed, the aim of the study was to generate hypotheses for examining gender differences in variables with predictive value for the utilization of psychotherapy in patients with personality disorders (PDs). Personality traits, affect experience and regulation, the quality of object relations and interpersonal problems within the process of psychotherapy planning were assessed in psychiatric outpatients. Besides the structured clinical interviews for DSM-IV I+II, variables were assessed with the Shedler-Westen assessment procedure (SWAP-200), the affect regulation and experience Q sort (AREQ), the quality of object-relations scale (QORS), and the Inventory of Interpersonal Problems (IIP). Correlation and group difference statistics, regression and canonical correlation analysis were performed. Predictors concerning the utilization or non-utilization of psychotherapy were a schizoid PD rating a self-report of subassertive behaviour related to interpersonal problems in women, and a narcissistic PD rating in men. Canonical correlations between predictors and quality of object relations or interpersonal problems were found in women, while in men there was merely a tendency for predictor and affect regulation to be related.The results suggest that for men it is more important to interpret the dominating affect, while for women, understanding the pathological object relation pattern is useful for successful therapy planning. Influences of the specific dyadic constellations were investigated in different medical consultation setting. 


Henriette Löffler-Stastka,

Medizinische Universität Wien, Universitätsklinik für Psychoanalyse und Psychotherapie, Währinger Gürtel 18-20, 1090 Wien