The term masochism was originally used in a narrow, specifically sexual sense (referring to perversions), but has come to

encompass for many analysts an exceedingly broad and variably determined range of clinical phenomena that bear no consistent relation to sexual excitement. In addition, these expanding clinical perspectives have long been entangled with Freud's shifting metapsychological constructions designed to ground masochism in instinctual theory. As a result, the term is used with little consistency and at varied levels of abstraction: loosely descriptive, dynamic, theoretical. It is not always explicit which meaning is intended or what inferences, if any, are meant to be drawn from the term. When used in its broadest sense, masochism may falsely suggest dynamic similarity between diverse phenomena, and is often ambiguous with respect to the presence or absence of underlying erotic or perverse excitement.