Meetings of the New York Psychoanalytic Society

October 28, 1958. ON SADISM, MASOCHISM, AND AGGRESSION: THEIR ROLE IN SYMPTOMFORMATION. George Gero, M.D.

The author points out the difficulty in distinguishing which of the dual drives, sexual or aggressive, causes conflict, and notes that etiological distinction is especially difficult with respect to the sado-masochistic and aggressive drives. It is the theme of this paper that sado-masochistic components of the sexual drive can be fully understood only in the framework of the phallic phase, the Oedipal situation, and the bisexual organization. Sadism and masochism appear in the child's unconscious sexual fantasies and masturbation. In such sexual fantasies the sexual act is typically cruel, painful, bloody, yet an exciting and pleasurable event. The mythology of the child depicts the father as the cruel attacker, the mother as the victim. The genital sensations of the child increase in intensity and become clearly differentiated in the phallic phase. During this phase and the Oedipal period the drive patterns of the individual are reorganized. The sadistic acts are identified with the male role, the masochistic with the woman's role. It is suggested that sado-masochistic fantasies in the phallic phase are of phallic nature, and are associated with fantasies of injury to the genital organs, the penis or its female equivalent, the clitoris. Under pressure of guilt or anxiety, regressively, anal or oral drives may conceal the phallic sadistic fantasies.

The element of pain in sado-masochistic fantasies has to be viewed in a broader concept. In the child's mind, to suffer pain is the sexual destiny of women, but the child, through sensations in his or her genitals, senses that that pain is connected with intense pleasure. Whenever in fantasy or behavior pain is a conscious goal, the unconscious yearning is for pleasure. Repression of the pleasure function of the genitals, because of Oedipal guilt, results in a distortion of the sexual concept. In women