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Masochism remains an intriguing and perplexing concept, one that continues to change in relation to theoretical change. Masochistic phenomena
are currently understood to be complex and ubiquitous, overdetermined compromise formations with multiple origins and functions. Phenomenologically, the erotic form of masochism is the least controversial, while the definitions of other forms of masochism are frequently contested. Masochistic fantasies are the major medium for analytic understanding of the pathogenic conflicts in which masochistic disorder is embedded.
The problems of conceptualization are compounded because the seeking of suffering and pleasure in pain may be disguised and unconscious. Moral masochism is now a rather obsolete term, largely replaced by superego pathology. Perverse masochism is distinguished by overt sexual excitement in association with conscious fantasies of beating, bondage, and humiliation (Freud, 1905). Here there is no question of the strange linkage between pain and pleasure, aggression and sexuality. The analytic understanding of perverse masochism is the subject of this paper, with a particular focus upon erotized masochistic transference and its genetic roots. Newer explanatory propositions consider a neurobiological predisposition; oedipal and preoedipal issues; pleading guilt and innocence; avoiding greater pain and punishment; the price of love and internalization of aggression; the interaction throughout development of fantasy and reality; protracted distress without effective soothing; masochistic pleasure in pain; attachment or addiction to pain; the mastery of pain; and narcissistic injury. Sadomasochistic fantasy and relationships evolved through all the developmental phases with varying alterations and transformations. Altered fantasy may acquire additional, and altered functions.
In some forms of psychopathology, such as severe perversion, the oedipal organization is unstable and has been colored and distorted by unresolved