Defense Date


Graduation Date

Summer 2011


Immediate Access

Submission Type


Degree Name



Clinical Psychology


McAnulty College and Graduate School of Liberal Arts

Committee Chair

Bruce Fink

Committee Member

Jessie Goicoechea

Committee Member

Robert Coufal


Diagnosis, Forensic, Lacan, Paraphilia, Perversion, Psychoanalytic


The work of Jacques Lacan (1901-1981) provided clinicians with three main diagnostic ontological structures: neurosis, psychosis, and perversion. All three diagnostic structures indicate fundamentally different ways of solving the problems of alienation, separation from the primary caregiver, and of castration, or having limits set by the law on one's jouissance. Of the three, perversion remains by far the least understood and least discussed. To date, Lacan's diagnostic system--not to mention his corpus in general--has been largely ignored by psychotherapists in the United States. Where Lacan has been taken up within psychotherapeutic discourse, discussions are often restricted to the field of psychoanalysis and are usually theoretical, rather than clinical, in nature. There is a shortage in general of published clinical case material utilizing Lacan's diagnostic structures, and in particular of cases of perversion. In addition, even in texts on Lacanian theory, very little has been written on what Lacan said about perverse structure. In this dissertation, I strive to make Lacan's perverse structure--and, by extension, his diagnostic system--not only comprehensible to psychotherapists and psychoanalysts alike, but indispensable. I elucidate perversion by utilizing two main methods: qualitative clinical case study and qualitative hermeneutic reading of what Lacan said about perversion. Perversion is compared and contrasted with neurosis, and Paraphilia is seen as a descriptive diagnosis that could apply to either perversion or neurosis. Both of the case studies presented here involved an outpatient forensic context, and so I also address forensic treatment concerns. Implications for the psychoanalytic and forensic treatment of sexual offenders are discussed by making crucial distinctions between neurotic and perverse individuals.