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Clinical features of masochism have been discussed by Freud (1924), who made the distinction between moral, feminine and erotogenic masochism; Reik (1941), who described moral masochism at length; and Lagache (1961), who emphasized the importance of aggressivity. Most writers, however, insist on the problem of masochism as a character trait or as a sexual perversion, and many discussions have centred on the question of primary or secondary masochism (Reich, 1932) as well as on guilt feelings (Nacht, 1938). All of these studies have added considerably to our understanding of the metapsychology of masochism. Nevertheless, many questions still remain unsolved.
The first question is the very definition of masochism. The first clinical descriptions of algolagnia or sexual algophobia emphasized the element of pain or suffering as the specific element. This remains true of Freud's (1924) description, in which he distinguishes three forms of the masochistic syndrome. It is all too apparent that this 'longing for suffering' is present in most cases, if not in all. But is it really possible to consider this longing as the basic requirement of the masochistic fantasy?
Suffering, as Darcourt (1968) points out, is after all a subjective experience and there is some inner contradiction in saying that the masochist 'feels pleasure through pain', a contradiction that was mentioned by Freud. When Lagache (1961) remarks that one can speak of the passivity of the masochist by saying that
the passive, dependent, submissive child must experience some satisfactions at being submitted to the beneficent omnipotence of the other,
he makes an important point in replacing 'suffering' by 'state of well-being', a state of diminished tension which initiates pleasure. This, of course, applies to what Lagache (1961) has called the 'narcissistic masochistic position', which does not cover all the varieties of masochistic behaviour, but is enough to prove that suffering per se is not a constant