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Between 1975 and 1980 a total of 169 patients were indicated for psychotherapeutic treatment. We excluded those patients: Who were psychotic or were seriously addicted Whose ability to communicate verbally was insufficient due to mental deficiency or brain damage Who were in prison or committed to psychiatric hospitals Who had been sentenced and were expected to go to prison during or shortly after therapy

The demographic and standardized data recorded are external data and give us little help in understanding the patients’ inner dynamics. The patient’s history is the best source for a clear analysis and description of his conflicts and structure, of the meaning and significance of his symptoms. With all our information on 86 mostly well documented and analysed cases we hoped to find a broad empirical basis — regarding not only the heterogeneity of the structures and problems involved, but also the great variety of possible psychodynamic ramifications of a perverse symptom. An appropriate method had to be found to do this.

From 1962 to 1979, 74 men and one woman considered sexually abnormal have received surgical hypothalamotomies in the Federal Republic of Germany. This paper reviews the neurophysiological assumptions behind the surgery, the criteria for surgery, and the effects and side effects of surgery as far as has been documented by medical, psychiatric, psychological, sexual, and social data. The neurophysiological bases for hypothalamotomies on humans with deviant sexual behavior appear dubious, the indications make use of questionable scientific and clinical categories and assumptions, few reliable data have been submitted for side effects, and follow-up studies are based on poor methodology. Restrictive regulations against this type of “experimental therapy” are suggested.