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I have called this a preliminary report, because I have much more material relating to the case than I can possibly crowd into a paper of moderate length. It makes no claim to originality. If it has any novelty it is only in the application of psychoanalytic methods, for therapeutic purposes, to a concrete case of self-mutilation. So far as I know there is no published psychoanalysis of a case of self-mutilation. If the external limitations of space and time did not prohibit, I should like very much to present the case more fully; for instance, I have not included a study of the patient's dreams, of which she had a great many.
The question as to whether this is a case of masochism or not comes immediately, of course, to mind. Krafft-Ebing defines masochism as the desire to experience pain from the sexual object. In this case, however, object and subject are one. Besides, he says, “the extreme consequences of masochism, however, are checked by the instinct of self-preservation, and therefore murder and serious injury, which may be committed in sadistic excitement, have here in reality, so far as known, no passive equivalent.”1 This is a case of self-inflicted serious injury. But Krafft-Ebing records only two cases of female masochism and one of these was in (the “initial stages of paranoia persecutoria.”2 This patient was not insane. For the purposes of this paper, therefore, perhaps it would be better to leave the question of definition and comparison undecided for the present.