A Sadomasochistic Transference - Beth J. Seelig, MD

self-object. The particular vulnerability of narcissistic characters to failures of
empathy on the part of the analyst is one of his concerns. Stern's (1985) work
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on the function of attunement between infants and mothers highlights the critical
importance of the very early mother-child experience in validating the child's
budding sense of agency, and the negative consequences when the sense of agency
is thwarted. Consistent misreading of the child's cues by the mother is one source
of serious pathology in the child, which is clearly manifested in the rapprochement
phase, as described by Mahler et al. (1975), and which often takes the form of
sadomasochistic character pathology. Although Stern and Mahler have remarkably
different concepts of the origins of the infant's earliest sense of self, parts of their
theories overlap, though with different emphases. Both accounts are useful to our
understanding of the genesis of sadomasochistic pathology in this patient and
other similar patients.
During the rapprochement phase of development, according to Mahler, the
child's euphoric sense of itself (the so-called love affair with the world) succumbs
to the necessity of reconciling its expansiveness with the realization of limits.
Cooper (1988) argues that the narcissistic injuries from this period of life
inevitably invoke reparative masochistic mechanisms to restore self-esteem. The
child does this, according to Cooper, by declaring its suffering ego-syntonic—
willed by itself. Thus he sees at least some minimal masochistic characteristics as
universal, part of normal development. He goes on to argue that if narcissistic
humiliation is excessive, then the child is rendered incapable of authentic selfassertion;
accordingly, the goal becomes "not a fantasied reunion with the loving
and caring mother" but rather "a fantasied control of a cruel and damaging mother"
(p. 128). He correctly concludes that the goal of sadomasochistic defenses is not
sexual pleasure, but the stabilization of the self-concept and self-esteem, thereby
shifting our understanding of masochism from an exclusive focus on the superego
(punishment to preserve pleasure) to narcissistic defenses to preserve self-esteem.
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In a paper on masochism, Kernberg (1988a) contrasts the depressivemasochistic
patient's extreme vulnerability to disappointment with that of the
narcissistic personality "who is over-dependent on external admiration without
responding internally with love and gratitude, [while] the depressive-masochistic
personality typically is able to respond deeply with love and to be grateful" (p.
108). He agrees with Cooper that masochistic patients obtain narcissistic