ABSTRACT
A life and death struggle is at the core of sadomasochism. The elements of the erotic sadomasochism, such as humiliation, domination, submission, merger, intense arousal, and ultimately orgasm, appear as intra-psychic conflict and in object relations representations. There are many instances when sadomasochism presents as though it were a matter of aggressivised sexuality when in fact the sexualised content may be in the service of many other motives, particularly defending against and expressing narcissistic issues. Leo Rangell sees sadomasochism as representing a form of aggression. Marquis de Sade wrote many scenes of the erotic form of sadomasochism from his prison cell. Unrecognised sadomasochism often threatens treatment with negative therapeutic reactions. Analysts suggest that sadomasochism only emerges in the face of sexual trauma forced on a child by an abusing adult. The analyst can be felt as torturing the analysand by inviting the intimacy of the analytic dialogue while also maintaining the time of the session, beginning and ending, and expecting payment.
