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The complex and enigmatic construct of masochism poses a difficult theoretical and clinical challenge. Psychoanalytic interest in masochism first began in 1895 when Krafft-Ebing introduced the term. At the time masochism referred to a sexual perversion in which erotic pleasure was fused with subjugation to a punishing love object. When Freud (1905) first applied the term in the Three Essays on the Theory of Sexuality, he used it in a similar sense to' denote sexual excitement associated with physical pain or humiliation. As his theory evolved, Freud came to realize that masochism was a universal but atypical phenomenon which presented problems to his basic theoretical formulations, such as the pleasure principle, the repetition compulsion, and the nature of the drives. These concerns led Freud to make basic changes in his meta-psychology of masochism.
The change which would prove most fateful for Freud (1924, 1933) and his followers is the association of masochism with femininity. Despite contemporary psychoanalytic opinion to the contrary, the idea continues to persist that women innately enjoy suffering. This notion has found acceptance both in the culture at large and within parts of the mental health community. The most recent edition of the Diagnostic and Statistical Manual of Mental Disorders