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In the recent past, there is little that I've read that has led me to reevaluate how I've thought about a basic psychoanalytic concept. This slim book changed that. Marilia Aisenstein, a prominent French analyst, and a
member of the Paris Psychosomatic School, presents American analysts with an entirely new way of thinking about masochism. At first, I was skeptical of this novel conceptualization, as it challenged most of what I thought I knew about masochism, especially how it appears in psychoanalytic treatments. We are all familiar, for example, with the self-hating patient, who desperately holds on to this self-state and, when analysis brings about a more optimistic view, experiences a negative therapeutic reaction that can lead to dangerous outcomes. We also understand that a patient who continually complains that he/she is mistreated by a spouse, but never thinks of ending the relationship, may be in the throes of an unconscious masochistic need. Before reading this book, I believed most psychoanalysts thought of masochists as deriving pleasure from pain that fulfills some unconscious need.
Aisenstein's contribution to psychoanalytic thinking is to differentiate between pathological masochism, the active search for pain, and primal erotogenic masochism, which she posits as essential to the survival of the individual and the development of resilience. Aisenstein reminds us that Freud (1924) conceptualized primal erotogenic masochism as he tried to understand the negative therapeutic reaction, and she poses the questions, “is it possible that pain and the search for pain govern psychic life?” (p. 1),1 and what then becomes of the pleasure principle?
Through her work with Bruno Rosenberg (1991), who published a similar idea, and Michael Fain, both part of the Paris Psychosomatic School, Aisenstein has refined her ideas. Especially meaningful was an unpublished paper by Fain, who, Aisenstein tells us, described the type of masochistic patient for whom “bad-over e