佛洛伊德說:「精神官能症是變態的反面」，有些人把這句話解釋成:在精神官能症(NEUROSIS)中被壓抑的自然本能直接表達出來，就是變態了(Freud, 1905d: SE VII, 165)。拉岡則完全推翻這種解釋(S3, 113, 250)。首先，我們不能把驅力看成可以直接釋放的自然本能，驅力的滿足並沒有零點。第二，正如，上面所說，變態主體和驅力的關保繁複夾雜，與精神官能症主體並無二致。由演化的觀點來看，變態和精神官能症的等級相同，兩者都已達到伊底帕斯情結的第三「時間」(S4, 251)。也就是說,變態「展現了(與精神官能症)相同的多向度變化、相同的豐足、相同的節奏以及相同的發展階段」(S4, 113)。所以我們有必要以另-種方式解釋佛洛伊德的話:變態和精神官能症的結構相反，而結構化的程度卻是旗鼓相當(S4, 251)。
精神官能症的特色是疑問不可免，而變態的特色則是疑問不存在。變態主體不會懷疑自己的行为是在为大他者的痛快服務。因此變態主體極少感到他必須接受精神分析，而且在少數例外中，變態主體所以要接受分析，也都不是想要改變自己面對痛快的應對模式。許多精神分析師主張精神分析治療並不適合變態主體，原因或許就在這裡。即使在拉康派當中，也有部分分析師持同樣的看法。他們指出變態主體心中毫無疑問，與精神病患者恰好形成對比，所以要變態主體站在「不知者」的位置去面對一個「被假定知道的主體」是不可能的(Clavreul, 1967)。不過大多數拉岡派分析師並不贊同這個論點，因烏這完全不符合拉岡自己的立場。例如在1956-57年的講座當中，拉岡便提到接受佛洛伊德治療的一位年輕女同性戀，並指出她的夢境明顯表現了變態主體的轉位效應(transference) (S4, 106-7 ;見Freud, 1920a)。此外，在1960-61年的講座中，拉岡提到轉位效應所用的主要例證就是阿其比亞迪思( Alcibiades)，而在拉岡心目中，阿其比亞迪思很清楚的是變態患者(見E,323;「阿其比亞迪思絕不是精神官能症患者」)。也就是說，變態主體和精神官能症患者涉及不同的問題，各自的治療方向當然會有差異，但是拉岡仍然主張，兩者都可以站在同樣的立足點上接受治療。這樣的主張還有一個重要的含意:精神分析治療變態主體，並不以排除變態行为為其目標。
(perversion) Perversion was defined by Freud as any form of sexual behaviour which
deviates from the norm of heterosexual genital intercourse (Freud, 1905d). However, this
definition is problematised by Freud’s own notions of the polymorphous perversity of all
human sexuality, which is characterised by the absence of any pregiven natural order.
Lacan overcomes this impasse in Freudian theory by defining perversion not as a form
of behaviour but as a clinical STRUCTURE.
What is perversion? It is not simply an aberration in relation to social
criteria, an anomaly contrary to good morals, although this register is not
absent, nor is it an atypicality according to natural criteria, namely that it
more or less derogates from the reproductive finality of the sexual union.
It is something else in its very structure.
(S1, 221)
The distinction between perverse acts and the perverse structure implies that, while there
are certain sexual acts which are closely associated with perverse structures, it is also
possible that such acts may be engaged in by non-perverse subjects, and equally possible
that a perverse subject may never actually engage in such acts. It also implies a
universalist position; while social disapproval and the infraction of ‘good morals’ may be
what determines whether a particular act is perverse or not, this is not the essence of the
perverse structure. A perverse structure remains perverse even when the acts associated
with it are socially approved. Hence Lacan regards homosexuality as a perversion even
when practised in Ancient Greece, where it was widely tolerated (S8, 43). (This is not
because homosexuality or any other form of sexuality is naturally perverse; on the
contrary, the perverse nature of homosexuality is entirely a question of its infringement of
the normative requirements of the Oedipus complex (S4, 201). Thus Lacan criticises
Freud for forgetting at times that the importance of heterosexuality in the Oedipal myth is
a question of norms and not of nature (Ec, 223). The analyst’s neutrality forbids him from
taking sides with these norms; rather than defending such norms or attacking them, the
analyst seeks merely to expose their incidence in the subject’s history.)
There are two main ways in which Lacan characterises the perverse structure.
● The PHALLUS and DISAVOWAL Perversion is distinguished from the other
clinical structures by the operation of disavowal. The pervert disavows castration; he
perceives that the mother lacks the phallus, and at the same time refuses to accept the
reality of this traumatic perception. This is most evident in FETISHISM (the ‘perversion
of perversions’; S4, 194), where the fetish is a symbolic substitute for the mother’s
missing phallus. However, this problematic relation to the phallus is not exclusive to
fetishism but extends to all the perversions (S4, 192–3). ‘The whole problem of the
perversions consists in conceiving how the child, in his relation to the mother…identifies
himself with the imaginary object of [her] desire [i.e. the phallus]’ (E, 197–8). This is
why the preoedipal imaginary triangle plays such an important role in the perverse
structure. In the perversions, the phallus can only function as veiled (see Lacan’s
discussion of the role of the veil in fetishism, transvestism, homosexuality and
exhibitionism; S4, 159–63).
● The DRIVE Perversion is also a particular way in which the subject situates himself
in relation to the drive. In perversion, the subject locates himself as object of the drive, as
the means of the other’s jouissance (S11, 185). This is to invert the structure of
FANTASY, which is why the formula for perversion appears as
in the first schema in ‘Kant with Sade’ (Ec, 774), the inversion of the matheme of fantasy. The pervert
assumes the position of the object-instrument of the ‘will-to-enjoy’ (volonté-dejouissance),
which is not his own will but that of the big Other. The pervert does not
pursue his activity for his own pleasure, but for the enjoyment of the big Other. He finds
enjoyment precisely in this instrumentalisation, in working for the enjoyment of the
Other; ‘the subject here makes himself the instrument of the Other’s jouissance’ (E, 320).
Thus in scopophilia (also spelled scoptophilia), which comprises exhibitionism and
voyeurism, the pervert locates himself as the object of the scopic drive. In
SADISM/MASOCHISM, the subject locates himself as the object of the invocatory drive
(S11, 182–5). The pervert is the person in whom the structure of the drive is most clearly
revealed, and also the person who carries the attempt to go beyond the pleasure principle
to the limit, ‘he who goes as far as he can along the path of jouissance’ (E, 323).
Freud’s remark that ‘the neuroses are the negative of the perversions’ has sometimes
been interpreted as meaning that perversion is simply the direct expression of a natural
instinct which is repressed in NEUROSIS (Freud, 1905d: SE VII, 165). However, Lacan
rejects this interpretation entirely (S4, 113, 250). Firstly, the drive is not to be conceived
of as a natural instinct which could be discharged in a direct way; it has no zero degree of
satisfaction. Secondly, as is clear from the above remarks, the pervert’s relation to the
drive is just as complex and elaborated as that of the neurotic. From the point of view of
genetic development, perversion is at the same level as neurosis; both have reached the
third ‘time’ of the Oedipus complex (S4, 251). Perversion therefore ‘presents the same
dimensional richness as [a neurosis], the same abundance, the same rhythms, the same
stages’ (S4, 113). It is therefore necessary to interpret Freud’s remark in another way:
perversion is structured in an inverse way to neurosis, but is equally structured (S4, 251).
While neurosis is characterised by a question, perversion is characterised by the lack
of a question; the pervert does not doubt that his acts serve the jouissance of the Other.
Thus it is extremely rare for a perverse subject to demand analysis, and in the rare cases
when he does, it is not because he seeks to change his mode of jouissance. This perhaps explains why many psychoanalysts have argued that psychoanalytic treatment is not
appropriate for perverse subjects, a line which even some Lacanian analysts have taken,
comparing the certainty of the pervert with that of the psychotic, and arguing that
perverts cannot take the position of ‘one who does not know’ before a ‘subject supposed
to know’ (Clavreul, 1967). However, most Lacanian analysts do not take this view, since
it is a view completely at odds with Lacan’s own position. In the seminar of 1956–7, for
example, Lacan points to the dream of the young homosexual woman whom Freud
treated as a clear manifestation of transference in a perverse subject (S4, 106–7; see
Freud, 1920a). Also, in the 1960–1 seminar, Lacan’s principal example of transference is
that shown by Alcibiades, whom he clearly regards as a pervert (see E, 323; ‘Alcibiades
is certainly not a neurotic’). Thus Lacan argues that perverse subjects can be treated at the
same level as neurotics, although there will of course be different problems in the
direction of the treatment. One important implication of this is that the psychoanalytic
treatment of a perverse subject does not set as its objective the elimination of his perverse
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