Perverse Thoughts in Adolescents: A Clinical Note on Intrusion

Professionals working with adolescents—whether in therapy rooms, classrooms, or safeguarding roles—will eventually hear something that catches in the chest. A young person might confess to sexual thoughts about a sibling or parent. They might fear they’re a paedophile, describe violent fantasies, or say they imagine being watched while undressing. These thoughts often arrive with intense shame, secrecy, and a desperate need either to confess or reject the thought entirely.

And at that moment, many clinicians quietly wonder:

Is this just an intrusive thought? Or is it something perverse?

We need to pause here, because the word perverse carries weight. In everyday language, it suggests something morally wrong or deliberately deviant. But in psychoanalytic theory, perversion means something very different. It’s not primarily about behaviour, and it’s not even always about sex. It refers instead to a psychic structure—that is, a specific way the mind organises and defends itself in response to emotional pain. When we speak of psychic structure, we’re not talking about fortune-telling or mysticism. We’re talking about patterned ways of feeling, defending, symbolising, or collapsing that shape how a person experiences themselves and others. Like the architecture of a building, psychic structure holds together the inner world—sometimes rigidly, sometimes defensively, often unconsciously. And just like a building may be designed to withstand storms, certain structures of mind are developed to withstand emotional catastrophe. The concept helps us understand not what a person does, but why—what psychic position they are speaking from, and what kind of emotional truth their mind is trying to survive.

How does perversion function as a defence?

The person defends against unbearable emotional states by denying them and instead acting out scenes that reverse or control them—often through sexuality, dominance, or shock. The emotional pain doesn’t disappear; it’s re-routed into action. This can look provocative on the outside, but internally, it’s often a desperate attempt not to feel helpless.

For example:

• An adolescent who feels abandoned by a parent may unconsciously stage a fantasy in which they seduce, control, or manipulate—replacing the feeling of being unwanted with a performance of being desired.

• A young person who feels chronically humiliated may begin to eroticise shame itself—turning scenes of exposure or punishment into rituals of control.

• A teenager terrified of emotional need may adopt a hyper-sexualised persona—not out of pleasure, but to defend against the vulnerability of real intimacy. If I make myself untouchable through seduction, I can’t be abandoned again.

In all of these examples, the content may be sexual, but the function is emotional. The scene replaces the feeling. The act replaces the thought. The adolescent isn’t seeking pleasure—they’re trying to survive.

As psychoanalyst Donald Meltzer writes in Sexual States of Mind, perversion isn’t defined by what’s done, but by the attitude to meaning. The child, locked out of the parental couple’s emotional world—a psychic “claustrum”—converts emotional torment into a mental theatre of reversals. It is not about gratification. It is about managing the unmanageable.

But what about intrusive thoughts?

Many adolescents describe thoughts that are violent, incestuous, or sexually disturbing. On the surface, these may look perverse. But clinically, they often stem from a very different psychic position.

Rather than emerging from perversion, these thoughts often signal an obsessional collapse—a breakdown in the mind’s ability to symbolise and metabolise internal experience. The thought doesn’t stimulate—it horrifies. It doesn’t create control—it brings moral panic. These adolescents don’t feel powerful; they feel contaminated, assaulted by their own minds.

What we are witnessing here is a failure of symbolisation.

When the mind can’t convert emotional experience into symbolic thought, raw affect floods the system. The result? Intrusive, fragmented, uncontainable content that feels both alien and persecutory.

Two very different psychic processes

We must learn to distinguish:

• The perverse structure, which protects against emotional collapse through controlled, often eroticised enactment.

• The obsessional collapse, where the mind is overwhelmed by undigested thought-content it cannot contain or symbolise.

Both can involve dark, disturbing material. But the function of the thought, the experience of the adolescent, and the clinical task are entirely different.

So how do we tell the difference?

When faced with a disturbing thought, don’t rush to interpret the content. Instead, ask:

• What is this thought doing psychologically?

• Is it a defence against emotional knowing—or a failed attempt to know something unbearable?

• Is it a performance of control—or a sign that control has been lost?

If we misread collapse as perversion, we retraumatise the adolescent.

If we assume control where there is terror, we miss the call for help.

If we treat confession as performance, we shut down symbolisation.

Final Thought

Psychoanalysis gives us something that diagnostic labels never can: language for suffering.

A word like perverse must be used carefully—but not discarded. It names something real: a psychic stance shaped by emotional catastrophe. Our job is not to police the content of thoughts, but to understand the structure they emerge from.

Because the therapeutic task is not to reassure or correct.

It is to help thinking begin again.

To make space where space had collapsed.

To bring feeling back into the world of symbol.

To help the young person survive—not just the thought, but the feeling that gave rise to it.