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May 15, 1956. THE ROLE OF NARCISSISM IN MASOCHISM. Isidor Bernstein, M.D.
Masochism appears in patients in the form of perversion, neurosis or character disorder and poses many clinical and theoretical problems. Clinical material from the analysis of three patients is presented to illustrate genetic, dynamic and economic aspects of the role of narcissism in moral masochism, especially from the point of view of the re-establishment of lost or threatened object-relationships. The author stresses the narcissistic character of the child-parent relationship and the method by which masochism serves regressively to restore it. These patients were primarily interested in themselves—their appearances, their physical conditions, how they looked or sounded to others; relationships with others were governed by their attempts to gratify narcissistic needs.
As children, their body attributes and ego functions were in the service of parental narcissism; their successes became not their own successes but those of the parents, and they felt cheated of the gratification that otherwise would be derived from their own accomplishments. The preoedipal relationships of the patients were seriously disturbed. They felt themselves to be a part of the important parent, or the parent a part of them.
Blurring of ego boundaries was especially apparent in two of the reported cases; in one, there was a strong suggestion of a symbiotic mother-child relationship. Besides the narcissistic ties, there were strong oral attachments, and under conditions of actual or threatened loss, introjection of the object took place with a merging of the images of self and the loved object.
The sequence leading to the masochistic syndrome is summarized: 1, strong narcissistic and oral attachments; 2, disappointment with feelings of helplessness, loss and rage with sado-masochistic fantasies; 3, endopsychic restoration of the object relationships through introjection with splitting of the ego into an idealized g