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PubMed1992

The aggression response and the Rorschach.

We propose the addition of four aggressive indices for Rorschach scoring: aggressive content, aggressive potential, aggressive past, and sado-masochism scores. Interrater agreement is presented and ranges from 92-100%. Nomothetic comparisons are made between groups with higher base rates for violence with mixed results, although the sado-masochism frequency was significantly higher in severe psychopaths than in moderate psychopaths. Idiographic use of the aggression indices is emphasized, with a particular focus upon inferring the quality, intensity, and directionality of intrapsychic aggression in relation to self and object representations.

Adult↗

PubMed1996

The role of socialization in male anorexia nervosa: two cases.

Social isolation, competitiveness and self-defeating masochism are the major themes in male and female Anorexia Nervosa. A relationship is seen between Anorexia Nervosa and Perversions, where there is a preconscious reenactment of traumatic situations. This dynamic of competition and masochism is described in two cases of male anorexia and seen as part of many other cases.

Adult↗

PubMed1981

Cognitive development and female psychology.

Freud was an astute observer, but his understanding of female psychology was distorted by centration on biological forces, the adult neurosis, libido theory, the Oedipus complex, and male psychology. His views on the role of penis envy, narcissism, and masochism in women, and on the female superego, currently are being updated on the basis of new data emerging out of psychoanalytic investigation and direct observational studies. It has become clear, for example, that core feminine gender identity develops very early and that it is mediated in large part by cognitive development and learning rather than by the impact of the observation of genital differences between the sexes. The little girl's level of cognitive organization does not permit her at first to construct logical, consistent categories of female and male, predicated or coordination of criteria of inclusion and exclusion. She puts girls and women into one group out of intuitive recognition that they "go together" and builds up a view of herself as female on the basis of what she feels as her mother's daughter and what she perceives of the way her parents and other significant object see her. Her mother's feelings about her, about herself, and about females in general influence her greatly, and her father's responses to and expectations of her have an important impact on her self-image and self-esteem. Her representation of herself as female at first does not necessarily take genital differences between the sexes into account. The discovery, some time in the second or third year, that the genitals of boys and girls are different from one another presents the girl with a number of problems, however. Her cognitive organization makes it extremely difficult for her to apprehend her complex, incompletely demarcated, and to a large extent internal, unobservable, and impalpable sexual organs. Her initial conclusion is that she lacks desirable body parts which are possessed by other beings. Because of the narcissistic-exhibitionistic libidinal organization of that period of life, this represents a painful narcissistic injury. The intensity of the girl's castration reaction and the degree to which she will be able to overcome it in the course of further development are determined by multiple internal and external developmental factors. Masochism, narcissistic vulnerability, and penis envy are neither limited to the female sex nor normal outcomes of female development. Where they are prominent features in the psychopathology of female patients, it is insufficient to interpret them as emanating from penis envy as a bedrock, primal cause. Detailed clinical examples are presented to illustrate the thesis that through exploration and explication of the multiple sources of such symptomatology in a female analysand is the most effective way of relieving the symptomatology and releasing the potential for emotional growth.

Adolescent↗

PubMed1998

Word-association patterns of mental hospital patients.

The present study concerned an attempt to corroborate the classic findings of Rapaport, Gill, and Schafer in distinguishing mental hospital patients from control subjects, using a new objectively scored word-association test. 12 computer-scored objective scales were used to compare groups of 101 mental hospital inpatients (n = 75, including 37 on a prison ward) and outpatients (n = 26) and 101 control subjects matched with the patients for sex, age, racial and ethnic status, and education. A stepwise multiple discrimination analysis of the scores on the 12 scales of the test significantly distinguished the groups. Scales weighted most highly were Masochism, Antonyms, and Aggression. Subsequent t tests suggested that control subjects scored higher on Aggression, Self-reference, and Masochism scales, whereas patients scored higher on Rejections (nonresponses to stimulus words). Of these, only Self-reference and Rejections were items identified by Rapaport, et al.

Adult↗

PubMed1984

Dream dimension differences during a life change.

Dreams reported from laboratory awakening of stably married women differed from those of women undergoing divorce: The former dreamed of the experiment; the latter had more threat themes. Those coping well during the divorce had more positive motives in the last dream than those who were depressed. Dreams of the nondepressed divorcées increased in anxiety from first to last dream report, whereas those of the depressed increased in masochism. Affiliation motives were common in dreams of the married subjects, while harm avoidance predominated in the divorcées' dreams. Nurturance and abasement were also common needs in the dreams of the depressed sample.

Adaptation, Psychological↗

PubMed1998

Identity confusion, bisexuality, and flight from the mother.

This paper deals with the effects of an oral-sadistic annihilating mother on her male and female offspring. The all-powerful nature of these mothers, and the corresponding helplessness of the fathers, produce in their offspring a sense of identity confusion, a struggle with their bisexuality, and a need to distance themselves from their mother. Everything unwanted in the mother is externalized onto and into the child, particularly suffering and pain, which are necessary for the maintenance of the (pathological) mother-child relationship. Positive movement (i.e., success) on the child's part threatens the balance of this relationship, is perceived by the child as a hostile and destructive triumph over the mother, and causes the Negative Therapeutic Reaction in therapy. The child's inherent masochism acts to preserve the early infantile omnipotence and leads to his/her assumption of all responsibility for the mother's affective states. The child's self-destructiveness also functions as a release for unconscious aggression toward the mother, due to the lack of boundary differentiation between the two.

Anxiety Disorders↗

PubMed2001

Self-effacing wit as a response to oppression: dynamics in ethnic humor.

Theories of self-effacing ethnic humor are analyzed from the perspectives of psychological defense and acculturation. These processes are contrasted with masochism as explanations of self-directed wit. Developmental paradigms are appealed to in conceptualizing the sociocultural function of humor. Identification with the aggressor is conceptualized as a transitional mechanism to assimilate the minority into the host culture. Turning against the self is developed as an alternate mechanism that uses humor as a means of self-empowerment. Reframing and splitting are posited as integral to the defensive process of ethnic humor. The method of luring the aggressor into a situation that is then used against him is construed as the kamikaze maneuver and conceptualized as an ambush technique in which the role of self-effacement facilitates aggression. The analytic elements of these approaches are explored with reference to Jewish humor as a stereotype of the wit of a transient and oppressed people, and annotated examples are offered from published anthologies. Illustrative vignettes, ranging from the mundane to the clinical, are annotated in the discussion. Directions for further inquiry are outlined for issues unresolved in the research literature.

Defense Mechanisms↗

PubMed1982

Paraphilic sexuality and child abuse: the parents.

The parents of three children with a history and diagnosis of abuse dwarfism responded to an interview on erotosexual history in such a way as to indicate a nondescript erotosexual existence, or else a censored one. One additional couple, known on a personal basis by a youth worker, colluded in child abuse that was, in fact, a paraphilia of masochism by proxy. Two boys were beaten by their father as masochistic surrogates for their mother who instigated their beatings. Sexual intercourse between the parents was contingent on the beatings.

Child↗

PubMed1975

The depressive character.

The depressive character is characterized by perpetual and unsuccessful efforts to maintain self-esteem and to avoid a sense of helplessness. Such individuals suffer from chronic depression which may or may not be masked, but which permeates their character. Although the condition is among the commonest seen in many of our clinics and practices, it remains without a generally accepted diagnostic form. It is suggested that the essential, clinical, dynamic, and structural features of the depressive character are: (1) consistently low self-esteem and a sense of helplessness, dependent object relations and chronic guilt; (2) self-directed aggression and masochism are frequent but not invariable; (3) extensive use of the mechanism of denial is as common as the previously described obsessional defenses seen in patients subject to psychotic depression; (4) often the depressive character suffers from intense oral envy; (5) depressive character traits may help to ward off any of the basic anxieties, namely, object loss, loss of love, castration anxiety, and superego anxiety (guilt) (6) the depressive character may be similar to a number of related disorders, namely, the obsessional character, hysterical characters with a large oral component, and depressive borderline states; (7) sensitivity to loss, sadness, and fragility of self-esteem makes the depressive character especially vulnerable to regression into overt depression; (8) the persistence of oral incorporative mechanisms, ambivalent, dependent object relations, ego versus superego tension with depressive affect, and sensitivity to loss are characteristic of the ego of the depressive character.

Adult↗

PubMed1986

Prevalence and psychodynamic interpretation of premorbid hyperactivity in patients with chronic pain.

The prevalence of premorbid hyperactivity in chronic pain patients and its psychodynamic interpretation are discussed both from the literature and from personal observation. In up to 70% of the cases, chronic pain patients were found to show hyperactivity tendencies throughout their life history. From a psychodynamic point of view, these tendencies may be situated in a context of overcompensated dependency needs, excessive bodily narcissism, phallic rivalry, masochism and perfectionism. The pathogenic implications of these findings and hypotheses are discussed and suggestions have been made for future research.

Adult↗

PubMed1978

Causes for the premature interruption of psychotherapy by private practice patients.

Thirty patients who discontinued private psychotherapy prematurely were evaluated. Factors stemming from the dynamic interaction between the patient and the treatment process were the most common reasons for dropping out, followed by chronic character traits such as impulsivity and masochism. It is hoped that this assessment of variables in the premature termination of therapy will serve to alert the therapist to the probability that treatment will be aborted, suggest which mechanisms will cause interruption, and enable the therapist to use preventive measures sooner.

Adult↗

PubMed2001

Normal and pathological altruism.

The psychoanalytic literature on altruism is sparse, although much has been written on this topic from a sociobiological perspective. Freud (1917) first described the concept in "Libido Theory and Narcissism." In 1946 Anna Freud coined the term "altruistic surrender" to describe the psychodynamics of altruistic behavior in a group of inhibited individuals who were neurotically driven to do good for others. The usefulness and clinical applicability of this formulation, in conjunction with the frequent coexistence of masochism and altruism, encouraged psychoanalysts to regard all forms of altruism as having masochistic underpinnings. Since then, there has been a conflation of the two concepts in much of the analytic literature. This paper reexamines the psychoanalytic understanding of altruism and proposes an expansion of the concept to include a normal form. Five types of altruism are described: protoaltruism, generative altruism, conflicted altruism, pseudoaltruism, and psychotic altruism. Protoaltruism has biological roots and can be observed in animals. In humans, protoaltruism includes maternal and paternal nurturing and protectiveness. Generative altruism is the nonconflictual pleasure in fostering the success and/or welfare of another. Conflicted altruism is generative altruism that is drawn into conflict, but in which the pleasure and satisfaction of another (a proxy) is actually enjoyed. Pseudoaltruism originates in conflict and serves as a defensive cloak for underlying sadomasochism. Psychotic altruism is defined as the sometimes bizarre forms of caretaking behavior and associated self-denial seen in psychotic individuals, and often based on delusion. We consider Anna Freud's altruistic surrender to combine features of both conflict-laden altruism and pseudoaltruism. Two clinical illustrations are discussed.

Altruism↗

PubMed2003

Guilt about being born and debt concerning the gift of life.

A very powerful form of preoedipal guilt stems from a sense of having damaged the life-giving parent with one's most basic needs. A related phenomenon is the child's sense that another subjectivity has deliberately chosen to give and sustain the child's life. This experience gives rise to a compelling mixture of awe, reverence, and obligation, a sense of guilt about being born, of debt concerning the gift of life. This sense of guilt and debt are part of every child's development. Depending on how conflicts surrounding them are negotiated, the child can come to feel either an appetite for living or a crushing sense of selfishness and unworthiness. Such forms of guilt and debt may lead not only to masochism generally, but to a particularly pernicious form of negative therapeutic reaction that can sabotage psychoanalytic work. A patient may feel, for instance, that a successful psychoanalysis is a selfish indulgence and an immoral betrayal of a sacred duty to rescue his or her parents from their misery. Guilt about being born and the sense of debt concerning the gift of life are linked to various developmental, psychodynamic, interpersonal, and cultural phenomena.

Adult↗

PubMed1985

Thoughts about early pathology.

In this paper, I have presented the assumption that some symptom pictures such as attachment to pain, the masochistic character, the negative therapeutic reaction, a basic depressive response, and anhedonia are rooted in a prevalence of organismic distress during the symbiotic phase. Neuroscientists taught us that early experiences are associated with the neuronal structuring of the developing brain, which then affects concurrent or subsequent reactions. In particular I followed Ginsburg's (1982) assumption of a neuronally, genetically given aggressive drive potential which influences and is influenced by early experiences, and which can interact with other gene potentials. In some patients aggressive drive components contributed to a less than harmonious basic core associated with failure of the early infant/mother interaction. Unpleasure prevailed during the symbiotic phase; aggressive energies predominated and enmeshed with the neuronal encoding, the early structuralization in both the neurophysiological and psychological meaning. Thus, the structuring of the function of internalization and the emerging self-object experience were disturbed from early on. This then continued to foster a proclivity for unstable (fusion and) diminished neutralization tendencies. As biological discharge phenomena evolve into vague psychological awareness, such an infant does not attain a sense of well-being, but rather attains a sense of "not-well-being" (Joffe and Sandler, 1965) which remains continuous or can be triggered--kindled--by any reactivating constellation, and the object is experienced as a source of unpleasure. This is in line with Mahler's bad mother and bad self-introjects. Primary narcissism has not evolved well or, said differently, is invested more with aggressive than with libidinal cathexis and is in an unfortunate association or balance with primary masochism. Aggressive drive components subsequently color fantasies, readiness for and severity of conflicts. The aggressivization of self-feelings and of the function of internalization with its influence on--and exacerbation of--the rapprochement crisis is traced into later symptomatology. The basic pathology as described in this paper then compounds the oedipally derived problems.

Adult↗

PubMed1991

Sadomasochism, sexual excitement, and perversion.

Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement. Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a teasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.

Adult↗

PubMed1994

Homosexual erotomania and HIV infection.

A case of homosexual erotomania is described in a patient with AIDS-related complex. Direct involvement of the central nervous system was thought an unlikely cause, as specific stressors appeared to have precipitated a reactive psychosis. A psychodynamic understanding of these factors and their interaction with the patient's masochism, fetishism, and personality disorder provided an alternative explanation for the onset of the paranoid illness and its symptom content. The psychodynamic aspects of acute psychotic disorders without evidence of cognitive impairment in patients with HIV infection is a neglected area of study.

AIDS Dementia Complex↗

PubMed2003

The observing ego as voyeur.

A resistance to self-observation and self-reflection is discussed in which there is a perversion of the observing ego. The observing ego has been unconsciously recruited in the service of enacting an unconscious fantasy: the fantasy of being an excited observer of a primal scene who is punished for making forbidden observations. This voyeuristic observing ego is pathologically enmeshed in a love triangle with the patient's seductive superego (i.e. identification with the desired but unfaithful parent) and with the patient's punitive superego (i.e. identification with the rivalrous parent). This unconscious scenario is played out in the clinical situation as the patient unreflectively cycles through phases of denial (i.e. self-seduction) and moral masochism (i.e. self-betrayal). A case study illustrates how humor may be employed to free the observing ego from being enthralled by a perverse superego. Humor may unconsciously enable a rebellious attitude toward the omnipotent sadism of a perversely oppressive superego and thus enable the observing ego to break free from its pathological enmeshment.

Denial, Psychological↗

PubMed2005

Submission, inhibition and sexuality: masochistic character and psychic change in Austen's Mansfield Park.

Mansfield Park is Austen's most controversial novel. 'Squarely taking on such issues as class, gender, sexuality, religion, education, theatricality, and colonialism, Mansfield Park now appears to occupy a more critical place in Austen's canon and in literary and cultural history generally than that perennial favorite, Pride and prejudice' (Johnson, 1998, p. xiii). Austen's heroine, Fanny Price has generated heated controversy because of the provocative contradictions in her character which this paper argues tally with the psychoanalytic understanding of moral masochism within the masochistic character As a child neglected at home and then sent to a frightening new environment, in which she was lowest and last, Fanny Price needed the love and protection even of those who mistreated her. She needed to control and influence them with submission and the inhibition of her aggressive impulses and through a vigilant scrupulousness. Austen created a plot in which she also dramatized the seeds of change that lie within the submissive character, within the repressed and inhibited psychosexual desire linked to the father which can drive the reemergence of wishes for love and satisfaction in situations of relative safety.

Adult↗