ABSTRACT
If the choice is between having perverse or sadomasochistic fantasies or activities and experiencing psychic death, the perversions will always win out. Of course the sadomasochistic fantasies are in themselves quite fascinating. Sadomasochistic or sexually and aggressively tinged feelings enlivened him because they were the only kind of aliveness he experienced from his mother, who herself had never been able to feel alive in a consistent and modulated way and thus couldn't teach this to her son. As a child and adolescent the patient was not recognised by his mother as a separate person with his own needs and identity. This strong sense of self, a boundaried and delineated ego, had, for many reasons, never been adequately developed by Mr. A. First, his mother had constantly impinged on and violated his boundaries, both sexually and otherwise. Second, she had never recognised his psychological existence as a separate, stand-alone person.
