Affiliated member of the WPA – World Psychiatric Association

Abstract Veronika Pachtinger; Barbara Brouwers; Pak-Maier, Sumi; Doctor, Ronald

Sexual Aggression; the paradox of disavowal

Freud’s theory on perversion is based on the idea of the existence of states of mind where the individual both knows and doesn’t know with disavowal as a central concept. In that context, we would like to talk about sexual agression as a perversion where someone may both consent and not consent to some form of action or inaction, where they may both anticipate the likely consequences of their actions or inactions and, at the same time, seem oblivious to them. More specifically, we will present clinical material that demonstrates the presence of such inner conflicts in some female patients who report  rape, domestic violence, high promiscuity and/or risky sexual behaviour. Since Trauma tends to be part of these patients histories, we will also refer to cases that show how trauma attacks the mind and makes it difficult for such patients to engage with their symptoms. When talking about PTSD symptoms, one could also argue that they indicate both the presence of disease and attempts to a resolution.


  • Barbara Brouwers
    Honorary Psychotherapist, West London NHS Trust.
  • Veronika Pachtinger
    Honorary Psychotherapist, West London NHS Trust.
  • Dr Sumi Paik-Maier
    PhD, Music Therapist, London.
  • Dr Ronald Doctor
    Consultant Psychiatrist,
    West London NHS Trust and Fellow of the British Psychoanalytical Society


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