ABSTRACT
Sadomasochism in clinical work arises from intersecting forces of developmental phase fantasies, conflicts, and traumas. The tangle of sadomasochism becomes a familiar way of making contact, that is, to feel, to hurt, and to wish for grandiose solutions. Anna Freud wrote of the beating fantasy as central to the understanding of sadomasochism. The analyst takes note that sadomasochism with all its pains and pleasures is present. Recognising and making efforts to understand the countertransference allows for a window into "psychic sadomasochism". The influences of the oral, anal, and oedipal configurations, and trauma, each in turn and in combination affect the development of sadomasochism in the mind with a sense of there being no alternative. The recognition of "psychic sadomasochism" opens the transference/countertransference arena where meaning can be discovered and movement out of the sadomasochistic hold is possible. Sadomasochism begins to destroy differentiation; symbolisation is hampered.
