You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Mentalization includes the ability to apprehend and reflect upon one's subjective state, as well as an appreciation of one's agency (Fonagy & Target, 2006). Masochism is a character pattern that is traditionally defined as pleasure in pain or suffering (Million, 1996). In some cases the etiology of this character pattern may mirror failures on the part of the caregiving surround that contribute to deficits in the ability to mentalize self (Fonagy, Gergely, & Target, 2007; Benjamin, 1988). When this occurs masochism may be more profitably understood as an inability to register pain, rather than pleasure in pain. A case example demonstrates that when a deficit in mentalization underlies masochistic functioning, treatment may include interventions aimed at helping the patient improve the ability to reflect upon his or her mental state, especially negative affect such as pain and anger, and connect to a sense of agency.