Perversions and borderline states were, by accident of fate, Masud Khan’s chief preoccupation in his clinical work during the last three decades of his life. In an earlier volume, The Privacy of the Self, he presented what he called the natural and private crystallization of his experience with his patients and teachers; notably, in the latter category, Anna Freud, John Rickman and D.W. Winnicott. In this later book he takes his cue from Freud who, as he says, diagnosed the sickness of Western Judaeo-Christian cultures in terms of the person alienated from himself . Masud Khan’s basic argument, succinctly stated in his Preface, is that the pervert puts an impersonal object between his desire and his accomplice. This object can be a stereotype fantasy, a gadget or a pornographic image. All three alienate the pervert from himself, as, alas, from the object of desire .With its wealth of clinical and theoretical insights, Masud Khan’s Alienation in Perversions makes a major contribution to our understanding of perversion formation.