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THE CELEBRATION OF THE FIFTIETH anniversary of the White Institute, 1993, with a clinical conference and two days of reminiscences of founders, involved an in-depth view of innovations within the interpersonal psychoanalytic heritage. Given this framework, I chose to focus my clinical views and my work on a difficult type of patient, to whom I give the old label, masochistic personality. I would like to discuss my understanding of masochism, and my work with such a patient over many years of treatment. This patient suffered sexual abuse in his childhood; our work with that early trauma is part of the presentation.
Let me first make a few general observations about interpersonal psychoanalysis. It is open-ended and pluralistic. The psychoanalytic work centers on meanings and motivations as the patient tells his story. The patient as narrator (Spence, 1982) describes moments of experience in detail, and the analyst helps organize and reveal meanings in the narrated experience, other than those the patient is encapsulated in. The "analytic work" thereby reframes the patient's understanding of his reality by deconstructing the meanings he gives to his experience. A quote from Wallace Stevens's (1954) "The Man with the Blue Guitar" comes to mind.
The man bent over his guitar,
A shearsman of sorts. The day was green.
They said, "You have a blue guitar,
You do not play things as they are."
The man replied, "Things as they are
Are changed upon the blue guitar."