The patient, a man in his late twenties, reported a periodic desire to be injured by a woman operating an automobile. This wish, present since adolescence, he had by dint of great ingenuity and effort, gratified hundreds of times without serious injury or detection. Satisfaction could be obtained by inhaling exhaust fumes, having a limb run over on a yielding surface to avoid appreciable damage or by being pressed against a wall by the vehicle.
Gratification was enhanced if the woman were attractive by conventional standards. Injuries inflicted by men operating automobiles or other types of injury inflicted by women had no meaning. He experienced pleasure from the experience, thus establishing the symptom as a perversion rather than a compulsion.
Although psychiatry no longer uses the word perversion (problematic sexual compulsions are now called ‘paraphilias‘) the introduction to the case study says, in a rather understated way, that “some perversions, while representing formidable psychopathology, are also tributes to the complexity of the human mind.”
The article additionally notes that the patient “was ashamed of his symptom but somewhat proud of its unusual nature.”
Link to PubMed entry for case study.
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