Perverse sexual behavior—from mild variations on heterosexual activity to fetishism to cross-dressing—is usually linked to sexual and/or aggressive conflicts in childhood. In this book, Dr. Arnold Goldberg explains and interprets perverse behavior in a different way, by drawing on concepts of psychoanalytic self psychology, a variant of psychoanalysis that originated with Dr. Heinz Kohut and that concentrates on the self as a psychological structure. Psychoanalytic self psychology, says Dr. Goldberg, makes disorders of perversion more understandable and more accessible to treatment.

Dr. Goldberg expands the definition of perversion, claiming that it is based on three essential components: sexualization (as distinct from sexuality); vertical splitting (where perverse action resides in the split-off part of the self and the other sector of the self, which knows right from wrong, is temporarily stilled); and psychological family dynamics. Dr. Goldberg explains each of these three dimensions and provides a number of illustrations. He also discusses the possibility of interpreting homosexuality as a compensatory structure, the relation of hostility to perversion, types of perverse behavior that are readily treatable, and the reasonable goals of such treatment.