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This book grew out of a series of American Psychoanalytic Association discussion groups devoted to clinical issues of masochism. The topic is highly germane, since masochism as a clinical entity has moved from being regarded as a symptom, a type of sexual perversion in the limited sense, to take on a more encompassing sense. Having attained an expanded scope in psychoanalytic thinking, the concept has allowed analysts to view the clinical picture in a variety of ways. Many see the search, tolerance, and desire for pain, suffering, and humiliation, as experienced by many patients, as expressions of masochism. The book calls to mind a similar collection, edited a quarter of a century ago by Robert Glick and Donald Meyers, Masochism: Clinical Psychoanalytic Perspectives. Two of the contributors to that volume, Glick and Stanley Coen, are contributors to this volume as well.
Before giving an overview of our current thinking on masochism, I will summarize each contribution. The volume is led off by Otto Kernberg, who emphasizes an object relations framework and points out the importance of general personality structure, particularly narcissistic and borderline types, to theory and technique. Victims subject to sexual abuse in childhood and traumatized object relations will vary in their ways of handling object relations and may need to subject themselves to personal pain and humiliation; some will long for narcissistic partners to control through their suffering. Therapeutic considerations will frequently involve the transferential reliving of sadomasochistic repetitions in which the analyst is persecuted as the object of attack. Particularly in work with borderline patients, Kernberg has found transference-focused psychotherapy effective; he warns against countertransference emotion, often a response to the patient's persecutory aggressive impulse. Rather