This paper outlines the author’s view that certain individuals are “Slaves of Quantity,” condemned to a destiny dominated by the quantity of excitation that cannot be psychically elaborated. The sadistic killer known as M, in the film of the same name by Fritz Lang, and an extreme masochist interviewed by the author, illustrate the features of these perverse disorders, which are also linked to extreme psychosomatic states. The origins of these “slaves of quantity” are related to traumatic factors early in life. Freud’s fundamental notions about anxiety and his debate with Rank on birth trauma shed light on a way to more clearly conceptualize the distinction between neurotic and perverse modes of psychic functioning.