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At least 379 records · Page 21Linked to original sources
PubMed1991

Sadomasochism and the defense against recall of painful affect.

Defense against recall of painful affect is proposed as a significant element in the complex entity of neurotic sadomasochism and symptom formation. This formulation requires that the fantasy of reversibility--what happened can be undone--be analyzed in the transference and predict, for the patient, a painful feeling of loss and rage. The structure and tenacity of the powerful resistance to this work has the regressive, anal nature of reversibility which is also seen in the sadomasochistic characteristic of self and object interchangeability. The perceived threat of loss may be understood as related to early object loss, either whole or partial, and is associated with a flawed body image. Because the formative circumstances lie deep within the patient's past, reuniting residual affect, historical event, and early wishes by means of reconstruction is the only means of resolution. But, because it requires the relinquishment of the sustaining illusions of the sadomasochistic structure--omnipotentiality, omnipotence and bisexuality--the process will be experienced by the patient as intensely narcissistically dangerous. Vignettes from the analyses of two women illustrate the thesis and suggest the scope and direction of its clinical application.

Adult↗
PubMed1991

A sadomasochistic transference: its relation to distortions in the rapprochement subphase.

The development of a rageful sadomasochistic transference early in an analysis is presented. We describe key interventions that foster its resolution and offer a reconstruction of the patient's early life, focusing on difficulty in the rapprochement phase. We believe that the intense and difficult to manage sadomasochistic transference was linked to a repudiation of both preoedipal and oedipal triangulation, resulting in the perpetuation of a hostile dependent mother-child dyad and in the patient's unconscious belief that sadomasochistic interactions were the only means of establishing and maintaining a close relationship.

Adult↗
PubMed1996

On trauma, perversion, and "multiple personality".

The role of perverse sexuality as an organizing influence in "multiple personality" is explored in this paper. Following a brief review of psychoanalytic thinking on sexual trauma and perversion, the author discusses his own views on dissociation and "multiple personality." A clinical case is then presented in which transsexualism, homosexuality, and sadomasochistic heterosexual practices were manifested during altered ego states. Analysis of the transference revealed the centrality of sadomasochism in this patient. It is hypothesized that various perverse structures may be formed within these seemingly autonomous, amnestic states, in order to contain anxiety and encapsulate the aggression which resulted from early psychic trauma. Issues relating to diagnosis, countertransference, reconstruction, and psychoanalytic technique are discussed also.

Adult↗
PubMed1998

An application of the concept of the therapeutic alliance to sadomasochistic pathology.

This paper traces the history of the therapeutic alliance concept, examining how it has been used and misused, at times elevated to a central position and at others rejected altogether. The loss of this concept created a vacuum in classical psychoanalysis that has been filled by rival theories. The continuing usefulness of looking at the treatment process through the lens of the therapeutic alliance, particularly in relation to the manifold difficulties of working with sadomasochistic pathology, is suggested. To this end, revisions of the theory of the therapeutic alliance are suggested to address some of the difficulties that have arisen in conceptualizing this aspect of the therapeutic relationship, and to provide an integrated dynamic model for working with patients at each phase of treatment. This revised model acknowledges the complexity of the domain and encompasses the multiple tasks, functions, partners, and treatment phases involved. The utility of the revised theory is illustrated in application to understanding the sadomasochistic, omnipotent resistances of a female patient through the phases of her analysis.

Adult↗
PubMed1998

Perverse defenses in neurotic patients.

Distinguishing perverse defenses from the concept of obligatory perversion allows perverse defenses to be examined in neurotic patients. Perverse defenses against reality, one's conflicts, and relationships with others are connected with affect intolerance, difficulty with analytic collaboration, and analytic impasse. Perverse defenses, including the cultivation of states of distraction, excitement, and pomposity, as well as perverse sadomasochistic relations with others, protect against the unbearable: intense affects, painful ideas, and loving, committed need of a valued, distinct person. Patients' perverse, vindictive refusal to be reasonable provokes perverse countertransference reactions whereby the analyst stands in judgmentally and critically for the seemingly absent demands of reason, morality, and analytic progress.

Countertransference↗
PubMed1973

Pornography.

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Erotica↗
PubMed1989

Paradoxical punishment as it relates to the battered woman syndrome.

The main goal of this article is to suggest some processes by which the behavioral interactions of an abusive couple can be developed and maintained. A summary of these processes as they have been adapted from the animal analog and human research follows. First, the pairing of abuse (punishment) with love and affection (reinforcement) could indicate that the battered woman responds to the reinforcement that follows an abusive incident. Second, the battered woman may seek to escape the fear of the tension-building phase but during the escape behavior she is punished (physical abuse), which fortifies and strengthens her initial fear. However, after the abusive incident, there is an absence of tension and fear (negative reinforcement) compounded by the positive reinforcement of the contrition phase. Thus, a cyclical pattern of behavior evolves and sustains itself. Possibly augmenting the vicious cycle is habituation or negative adaptation to the physical abuse, as well as the lack of opportunities to learn adaptive behavioral responses that may break the cycle of violence. Finally, the need for primary reinforcement (i.e., love and affection) may be so powerful that it somewhat mitigates the abuse endured to obtain it.

Animals↗
PubMed1974

Battered wives.

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Adaptation, Psychological↗