With the concept of death drive interwoven with life drive, Sigmund Freud attempted to make sense of clinical phenomena: masochism, pain, traumatic neuroses. With masochism, Freud notes that pain becomes such an object, allowing a part of the subject’s body to be identified with the big Other’s body. The masochist cannot give up the lost fusional jouissance. Masochism does not have the same status in psychoses as in neuroses, though a sort of jouissance of the Other is present but cannot be situated topologically. Thus, in masochism, it is not the death drive which functions but the life drive. The enigma of masochism is revealed if we understand that self-annulment evokes in phantasy the lost fusional pleasure which the subject cannot give up, and is as such a jouissance. Experience shows that numerous illnesses are born from this self-punishing need.