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In his article on the depressed masochistic patient that appeared in the spring 1991 issue of the Academy Journal (Vol. 19, No. 1), Richard Friedman briefly discussed certain of my views on masochism and depression. Since Friedman did not quite capture a concept I consider to be central, a correction needs to be made.
In a precis of my view that masochism is adaptive and defensive, he states, “Irving Bieber suggests that regardless of the particular constellation of traumatic events influencing the development of a masochistic pattern, the general functions served by masochistic pathology are to preserve life by fostering an unconsciously determined and irrational tie to a love object.” The statement would have been correct had he put a period following “to preserve life.” I have not proposed that the aim of a defensive, masochistic pattern is to foster an irrational tie to a love object. I have proposed that an irrational pattern of self-injury may be established in order to satisfy a rational wish for love. A child may learn that illness and accident will elicit warmth from a remote parent and develop patterns of disability. The objective is to defend against rejection, isolation and the deprivation of love.
According to Friedman's schema, the symptoms of depression and masochism are interchangeable. As he noted, I view depression and masochism as distinct entities though they may occur almost simultaneously. Depression, like anxiety, rage and inhibition, is a biological state accompanied by physiological changes, that is motoric retardation, cognitive blocking, insomnia, loss of appetite, and so forth. A depressive state may be suffused with a sense of helplessness or hopelessness but the distinction Friedman draws between the two compares a condition with itself. A distinction that can be made involves the triggering events of depression. A “reactive” depression may be brought on in a well-functioning individual by the loss of a beloved—a situation unrelated to ma