A Sadomasochistic Transference - Beth J. Seelig, MD

painful relationship, leading to an analysis that, in its opening phases, was
agonizing for the patient and, at times, for the analyst as well.
We shall present some detailed verbatim excerpts from the early analytic
material to convey the nature of the transference in which Miss T. was
alternatively angry at the analyst or at herself (sometimes at both) and the
difficulties this presented to the analyst's attempt to maintain an analytic stance.
We shall then draw attention to some key interventions that fostered resolution of
this aspect of the transference.
In the course of struggling to intervene in and interpret the transference, we
arrived at a reconstruction of the patient's early development. Her sadomasochistic
pathology (and the transference that derived from it) appeared to be the outcome
of an early and ongoing distortion in the mother-child bond, with concomitant
failure to achieve normative preoedipal and oedipal triangulation. We shall present
clinical material that led us to this reconstruction, focusing on the developmental
epoch during which rapprochement and preoedipal triangulation occur—more or
less successfully. The tentative nature of Miss T.'s preoedipal triangulation
appeared to be the result not only of her sadomasochistic entanglement with her
mother, but also of the way she perceived her mother as actively interfering in her
relationship with her father, and a corresponding feeling that her father quickly
withdrew from any potential struggle with her mother. As might be anticipated and
as is evident in the clinical material, Miss T.'s oedipal longings (both historically
and in their contemporary editions) were embeded in a sticky pregenital matrix in
which the quest for intimacy with more than one person was experienced as
strictly forbidden, and intimacy with one person was compromised by
sadomasochistic distortions.
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We believe that our reconstruction confirms and extends formulations by
Stolorow (1975) and Cooper (1985), (1988) on the preoedipal determinants of
sadomasochistic and narcissistic-masochistic character pathology. We shall focus
on those factors that militate against the patient's "escape" from the pathological
dyad to refuge with a third party. In addition, we shall emphasize how
sadomasochism sometimes may be invoked as the only viable means of
establishing and preserving a sense of mutuality, and here we shall draw on some
theoretical constructions of Stern (1985) and Benjamin (1989).
Background
Miss T. was psychologically minded and highly intelligent. She was
diagnosed as having a hysterical character with depressive and phobic features.
Once in analysis, however, she quickly developed an intense sadomasochistic
transference regression, demonstrating borderline structural features (as described