ABSTRACT
In view of the extensive nature of the concept and the multiplicity of its components, as indicated by the large number of relevant clinical pictures and the voluminous contemporary psychoanalytic literature, the sadomasochistic perversion is difficult to define. It might, in fact, be better to speak of a multiplicity of sadomasochistic pictures, all differing from each other. This chapter attempts to highlight certain clinical characteristics that will help us distinguish some areas of differing significance and severity. It presents two case studies that illustrate different levels of organization and severity of the perversion. The first is a relatively minor instance which it was possible to work through, whereas the second was permanent and dramatic. The clinical symptomatology and the rapid appearance and disappearance of sexual acting out would seem to justify the theories of the Kohut and Winnicott schools, which see perverse sexuality as a defence against anxiety and the threat of the collapse of identity.
