I have, for some years,maintained that what we label as the narcissistic character should more accurately be called the narcissistic-masochistic character, since masochistic defenses are inextricably interwoven with narcissistic pathology. Futhermore, it is my view that narcissistic and masochistic personalities are not clearly distinguishable nosological entities, and there is great theoretical and technical advantage in conceptualizing a single narcissistic-masochistic character with different clinical presentations at different points in life and therapy. I will try to illustrate this thesis by focusing upon a subset of narcissistic-masochistic patients who present an unusual transference manifestation; they experience the treatment itself as terribly painful and dysphoric, and they place a great burden on the analyst’s capacity to maintain the analytic setting.