`Psychopathia Sexualis'

¹ Consultant Psychiatrist, United Manchester Hospitals, Manchester Royal Infirmary, Swinton Grove, Manchester, M13 OEU

Three main factors emerge from Psychopathia Sexualis as important in the causation of sexual pathology in man. The abnormal sexual anlage, so much favoured by Krafft-Ebing as underlying sexual perversion, has been revealed over the past go years since Psychopathia Sexualis was written as a complex neuro-endocrine diathesis. This predisposes the individual to organize sexual experiences which would normally be extinguished and replaced by more mature and adaptive forms of sexual behaviour. In some cases this abnormal anlage is predominantly genetic in origin, whilst in others the nervous system is sensitized in utero or through brain damage to organize abnormal sexual stimuli. The content of the perversion is determined by the quality of the sexual experiences to which the individual has been exposed during development. Krafft-Ebing expressed this second factor in terms of `associationism'. The analytical emphasis on the pertinacity and singular importance of infantile sexual experience is no longer tenable as a single major theory of aetiology. Learning theory, which has opened up such a new dimension in the treatment of perversion, has emphasized how abnormal sexual experiences have to be continually reinforced throughout development if they are permanently to influence adult sexual behaviour. The abnormal personality of so many perverts and deviants is the third important factor. This, although predominantly constitutional in origin, complements the experiential factor. It renders the individual dependent upon solitary sexual practices and phantasies, which are constantly reinforced by solitary masturbation—a factor so much emphasized by Krafft-Ebing and now revived by learning theorists.

There are many who will decry my attempts to resurrect Krafft-Ebing to what I believe is his rightful place as the founder of modern sexual psychopathology and who will consider his emphasis upon constitutional factors as stultifying and sterile. I hope, however, I have demonstrated that many of the advances in the field reviewed in this lecture are based upon his approach and justify the inclusion of Psychopathia Sexualis as one of the major contributions to the study of abnormal sexual behaviour in man.