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This patient, as well as others of a similar type whom I have treated, is illustrative of those individuals whose attachment to pain signifies an original attachment to painfully perceived objects and inconstant objects at that. It appears that in the development of such individuals, instead of the early pleasurable object experiences being consolidated into love and a sense of trust, the opposite occurs. Early affects are predominantly painful and as such recur consistently, crystallizing in the direction of attachment to pain and distrust of objects. The painful affects are then held to, both as a defense and as an instinctually charged concomitant of object experience.
On this fundamentally pregenital base may be grafted more sophisticated object-oriented experience deriving from beyond the oral level; that is to say, from the anal and phallic levels. Thus, object experience moves progressively not only from "who eats whom," but also to "who controls whom," "who shreds whom," "who dumps on whom," "who pierces whom," "who shafts whom," and "who screws whom," whether heterosexually or homosexually. The amalgam of all three levels condensed as they are into specific current experience adds up to the pain and degradation of the transference neurosis or transference psychosis.