This book examines the forces of sadomasochism in the clinical domain where transference and countertransference reside. Psychoanalysts write in depth about cases where sadomasochism is present for both analysand and analyst. Four cases present the unfolding analytic exchange where life and death forces collide. Each case is accompanied by three discussions illuminating the complex phenomena that often include lifelong perversions and painful narcissistic difficulties. Through the case presentations and discussions, psychoanalytic therapists will find maps for guiding their own work with sadomasochistic processes. Treatments where sadomasochism is prominent abound with dramas containing control and denigration, domination, and submission. Often there is a history of over stimulation and under stimulation from infancy and childhood influencing the formation of object relations and unconscious fantasy. Since Freud first introduced the concepts of component instincts and psychosexual development, psychoanalysts have been exploring sadomasochism in its various forms. The belief that togetherness involves tormenting pain creates a sense of life and death struggle that is imbued with powerful instinctual gratification. Unconscious sexualized scenes of both dyadic and triadic forms carry humiliation and conquest.

chapter One|14 pages

Introduction to sadomasochism in the clinical realm

ByHarriet I. Basseches, Paula L. Ellman, Nancy R. Goodman

chapter Two|11 pages

Intersecting forces and development of sadomasochism

ByPaula L. Ellman, Nancy R. Goodman

part I|66 pages

Case Presented by Paula L. Ellman and Discussions

chapter Three|16 pages

Sadomasochism in work and play with Diane

ByPaula L. Ellman

chapter Four|17 pages

Discussion of the case of Diane

ByAlan Bass

chapter Five|16 pages

Discussion of the case of Diane

ByJack Novick, Kerry Kelly Novick

part II|61 pages

Case Presented by Nancy R. Goodman and Discussions

chapter Seven|16 pages

Sailing with Mr. B through waters of “hurting love”

ByNancy R. Goodman

chapter Eight|11 pages

Discussion of the case of Mr. B

ByJames S. Grotstein

chapter Nine|14 pages

Discussion of the case of Mr. B

ByMargaret Ann Hanly

chapter Ten|17 pages

Discussion of the case of Mr. B

ByTerrence McBride

part III|72 pages

Case Presented by Andrea Greenman and Discussions

chapter Eleven|21 pages

Eating for emptiness, eating to kill: sadomasochism in a woman with bulimia

ByAndrea Greenman

chapter Twelve|17 pages

Discussion of the case of Mariah

BySteven Ellman

chapter Thirteen|15 pages

Discussion of the case of Mariah

ByShelley Rockwell

chapter Fourteen|14 pages

Trauma, archaic superego, and sadomasochism: discussion of the case of Mariah

ByLéon Wurmser

part IV|61 pages

Case Presented by Richard Reichbart and Discussions

chapter Sixteen|7 pages

Discussion of the case of Mr. A

BySheldon Bach

chapter Seventeen|18 pages

Discussion of the case of Mr. A

ByHarriet I. Basseches