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In “The Paths to Formation of Symptoms,” Freud writes, “The kind of satisfaction which the symptom brings has much that is strange about it.”1 His line springs to mind when thinking about the symptoms addressed in this collection of essays, The Clinical Problem of Masochism, edited by Deanna Holtzman and Nancy Kulish. The satisfaction gained from masochistic symptoms defies common sense, and yet is so commonplace and so difficult to relinquish that it begs to be understood.
This book does an admirable job of making sense of masochistic symptoms and their clinical presentation, including the common countertransference responses of analysts working with masochistic patients. Despite coming from differing theoretical backgrounds, the authors of the various essays describe strikingly similar experiences with their patients. Most of them employ useful clinical vignettes to illustrate the particular theoretical understanding with which the author approaches his or her patients.
The essays in this collection are sandwiched between the editors’ very thorough introduction and their briefer conclusion. Holtzman and Kulish summarize the papers in both the introduction and the conclusion, but I felt that they tried to do too much in the introduction—giving me, at least, more than I could readily grasp at that point in my reading. The conclusion, in its minimalist way, would have served me better as an introduction.
One more quibble is that there were times when a little more editing of the essays themselves would have enhanced their readability. The sequence of the essays seems to have been deliberately chosen, and they do build upon each other; however, in a book focused on clinical issues, the first essay, by Otto Kernberg—largely devoid of clinical examples and focused on diagnostic levels of pathology—made this reader apprehensive about the rest. Fortunately, the essays become more clearly written