Sadomasochism revisited: From Couch to Culture

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Sado-masochism, sexual and non-sexual, has been an aspect of human interaction describing the inflicting or receiving of pain. Although we are inclined to think of sado-masochism to be associated with Freudian origins, the term itself has its foundations in the writings of the Marquis de Sade (1740-1814) and Leopold von Sacher-Masoch (1836-1895). The sexual practices of sadism and masochism are shown in the illustrations of the Kama Sutra as far back as the 2nd Century A.D.

Freud and other psychoanalytic theorists provide the foundation of understanding sadism and masochism. Freud explored theoretical issues in “The Economic Problem of Masochism” SE19 (155-176), “Three Essays on the Theory of Sexuality” (1905), SE 7 (123-243), “Instincts and Their Vicissitudes” SE14 (109-140) and “A Child is Being Beaten” SE17, (175-204). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in the section on Paraphilic Disorders (685) refers to “algolagnic disorders” which involve pain and suffering (sexual masochism disorder and sexual sadism disorder). The reference can be seen as paraphilias (perversions) which “primarily concern the individual’s erotic activities and others concern the individuals erotic targets. Examples of the former would include intense and persistent interests in spanking, whipping, cutting, binding or strangulating another person …Examples of the latter would include (for example) intense or preferential interest in children, corpses, or amputees…”.

“The Economic Problem of masochism”

Freud raises the question as to the existence of a primary masochism or whether masochism is instituted as a function of sadism. If primary masochism is accounted for in a fusion of the life and death instincts it suggests a greater difficulty resolving masochism in analytic treatment. If, however, masochism is fundamentally a function of sadism, the emergence of masochism in the transference provides an opportunity to resolve the masochism in the treatment process. An example of the latter suggests resolution in the transference in the following case vignette:

A young woman in treatment for two years, three times a week, sitting up, relates that her mother castigated her verbally, calling her, for example, a “stupid fucking bitch”, “worthless” and that she would never amount to anything. She felt pain and demoralization. The woman’s husband ignored her and physically abused her. In treatment she frequently missed sessions and did not pay for sessions on time. The therapist, recognizing her annoyance with the patient, initially wanted to punish her. Eventually, she recognized the transference aspects of the patient’s acting out, indicating to the patient that she wanted the therapist to inflict hurt on her (the patient) castigating her the way her mother and husband did. The patient was afraid the she would be abandoned if she didn’t accept the negative treatment. Eventually the acting out diminished substantially. She indicated to her husband that if he did not change his behavior, she would seek a divorce.

This case vignette illustrates how masochism is linked to sadism in the developmental process. To the extent that primary masochism is an aspect of this process, is the extent to which resolution of the transference is reduced if not made impossible. Freud elaborated his theory of masochism in his paper, “Three Essays on the Theory of Sexuality”.

If you would like to contact Sy Coopersmith, his email is:

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