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The analysis of persons with pronounced masochistic trends is at the outset often relatively simple. There does not seem to be much resistance and the material is produced with little effort. In spite of this it proves difficult in the long run to achieve good therapeutic results.
Freud presumably had the same experience. In The Ego and the Id he wrote on the subject of negative therapeutic reaction: '… a sense of guilt, which is finding atonement in the illness … expresses itself only as a resistance to recovery' (pp. 71 and 72) and further (p. 79): 'The activity of the dangerous death-instincts within the individual's organism is dealt with in various ways; in part they are rendered harmless by being fused with erotic components, in part they are diverted towards the external world in the form of aggression, while for the most part they undoubtedly continue their inner work unhindered.'
These are not optimistic words, and the question arises whether blending with libidinal impulses and conversion into aggression directed against the outer world are actually the only possibilities of drawing the fangs of the dangerous death instinct.
I am of the opinion that there is a third possibility, which is of great importance in certain forms of masochistic impulses. And in the following pages I shall raise the question whether the death instinct or masochism can be sublimated like other drives.
Nowadays we probably all agree that aggressive impulses which are turned outward can be sublimated and are of vital importance to the individual. One must be able to defend oneself or one's family, to stand up for one's beliefs, to conquer one's love object, to earn one's livelihood, etc. This is quite obvious and requires no further comment. It seems equally probable that these functions may be accompanied by pleasurable sensations, not only on achievement of the objective but also during and because of the struggle itself. This is particularly obvious in sport.
But what about