A Sadomasochistic Transference - Beth J. Seelig, MD

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and give up being bad. When she periodically found the courage to assert herself against mother (or analyst), this assertion took the form of raging tirades, which were later used as confirmation of her sense of badness. Another mechanism was critical in locking in her pathological tie to her mother: this was the narcissistic pleasure Miss T. took in feeling essential to the mother even if only as her phobic partner. Since she suffered from severe envy of all three siblings, any aspect of her relationship that gave her pride of first place—whether as mother's victim or phobic partner—was experienced as essential to her specialness. As Miss T. recalled it, mother interfered actively with any of her early efforts to form an attachment either to father or to her siblings, thus thwarting her attempts to extricate herself. She despaired of father as he was of no help, failing to intervene and thereby offering no alternative to the pathological motherdaughter bond. A new memory retrieved in the course of the analysis suggests the way in which triangulation was thwarted by Miss T.'s mother, a disruption father allowed. When Miss T. was four years old, her father took her on a rollercoaster. She sat on his lap and was thrilled by the experience. Upon their return home, however, when she ran to tell her mother about the exciting ride with Daddy, her mother went into a rage with her for having allowed her father to do such a dangerous thing. The affective valence of the experience was shifted 180 degrees: from pleasurable, erotically tinged excitement, to guilty humiliation-laden depression and suppressed rage. In this memory, father also failed her; he said nothing at all in response to his wife's scathing attack on their daughter. To turn to such a father to "make it up" would indeed be "ridiculous" - 981 - (it was the patient's longing for paternal rescue and her hopelessness at achieving it that were presaged in her initial dream). Her mother's message, as Miss T. interpreted it, was that she should be of one mind with her mother and also that she should not form a separate relationship with her father, as such a relationship would imperil the life-sustaining mother-daughter bond. In the analysis, Miss T. expected to be misunderstood, even while vociferously demanding that her analyst be an "analytic mirror." In essence, she was demanding that the analyst provide her with that empathic understanding of which she had felt deprived. When she perceived any failure of empathy on the part of her analyst, she felt entitled to unleash her intense aggression. However, when she thought that the analyst did indeed validate her account of events, she berated her for being so easily duped. The ease of regression and the intensity of the transference, which at times seemed to overwhelm Miss T.'s small remnant of observing ego, appeared to be related both to her distorted relationship with her mother and the resultant instability of the oedipal configuration. This instability manifested itself in a rapid shift from oedipal issues and object relations to
primitive dyadic maternal-infant issues, along with concomitant primitive defensive operations and intense, unmodulated affect states. Such shifting transference patterns are described by Kernberg (1984), (1988b) in his extensive work on character pathology. The intense, sticky, sadomasochistic tie to the analyst was a recreation in the transference of the perversion of intimacy that had been established between Miss T. and her mother. Neither could disengage from the struggle with the other. In the transference, Miss T. expressed this dilemma very clearly when she said "there's no choice … we'll sit in this battle for years and years." In struggling with this difficult transference, we came to the conclusion that Miss T.'s inability to let go of the painful bond had multiple determinants: the erotization of her suffering, the narcissistic gratification of being special, the - 982 - ego enhancement of a fluctuating identification with the aggressor, an inhibition (or repudiation) of preoedipal and oedipal triangulation, and the sense of intimacy (though distorted) generated in the sadomasochistic exchange. In the course of working through these issues, Miss T. also came to understand her guilty selftorture (alternating with her sense of victimization) as being the price she paid for her sadistic counterattack, her own participation in psychically abusing others as she experienced them abusing her. With this new understanding she became able to engage in the analytic process without the previous agony of being either the suffering victim or the guilty victimizer. Discussion Distortions in the Mother-Child Dyad as a precursor of Sadomasochism Zetzel (1968) in her classic paper, "The So-Called Good Hysteric," describes the variations in degrees of psychopathology in characterologically hysterical patients. In this paper, she uses the same rhyme about the little girl who was alternatively very good and very bad to describe the "not-so-good hysteric" as Miss T.'s mother had used in describing her daughter. Originally seen as a hysteric, Miss T. could be described as a Zetzel type II or III. Easser and Lesser (1965) called such patients "hysteroid," indicating that their problems were preoedipal. There is a growing body of work relevant to the kinds of early experiences that promote distortions in object relations and in self-concept like those Miss T. presents. Kohut (1971), in his well-known work on narcissism, stresses the importance of early empathic "mirroring" in the development of a normal self. He states that narcissistic pathology results from the mother's use of the child as a
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A Sadomasochistic Transference - Beth J. Seelig, MD

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