Franco De Masi is accustomed to grappling with difficult subjects, having for many years been interested in the treatment of psychotic patients, a field that confronts the psychoanalyst with problems of both technique and theory (cf. De Masi, 1997, 2000, published in this journal). The present contribution, on sadomasochistic perversion, raises issues that are also hard to define and conceptualise.

Further reasons for the difficulty of the subject are the small number of patients who request psychoanalytic treatment for perverse behaviour, and hence the dearth of direct clinical experience with them, as well