Richards A K
Int J Psychoanal. 1989;70 ( Pt 1):153-64.
The patient repeatedly and compulsively made stereotyped telephone calls to her mother and other female protective figures. She had a history of genito-urinary infections and operations consequent to urinary retention. These symptoms were relieved gradually in the course of analysis, in which this was interpreted as a sado-masochistic perversion based on a central fantasy of phallic intrusions on the mother. The fantasy was related to turning passive viewing into active exhibitionism, actively seeking to inflict pain on herself and others in an attempt to overcome early painful medical intrusions, misplaced identification with the father, complementary relationship with the passive, compliant mother, and consequent failed identification with the oedipal mother. In the analysis, she attained a gradual reorganization of adaptive functions which allowed identification with the father through her work, reconciliation with the rivalrous siblings, and enjoyment of her female sexuality in heterosexual intercourse with the use of a fetishistic requirement that the man be uncircumcised. The hypothesis was developed that whether called a symptom or a perversion, the treatment was the same so that it was most useful to think of it as a compromise formation rather than attempting to preserve a distinction largely based on moralistic considerations.
患者反复且强迫性地给她的母亲及其他女性保护者打模式化的电话。她有泌尿生殖系统感染病史，且因尿潴留接受过手术。在分析过程中，这些症状逐渐缓解，分析中将其解释为一种基于阴茎侵入母亲的核心幻想的施虐受虐癖。这种幻想与将被动观看转变为主动暴露癖有关，她积极寻求给自己和他人造成痛苦，试图克服早期痛苦的医疗侵入、对父亲的错误认同、与被动顺从的母亲的互补关系以及随之而来的与俄狄浦斯期母亲的认同失败。在分析中，她实现了适应性功能的逐步重组，这使她能够通过工作认同父亲，与有竞争关系的兄弟姐妹和解，并在与男性进行异性性交时享受女性性欲，她有一个恋物癖要求，即男性未行割礼。由此提出一个假设，即无论称之为症状还是癖好，治疗方法都是相同的，所以将其视为一种妥协形成而非试图基于道德考量来维持区分是最有用的。
