NCJ Number
168191
Date Published
1997
Length
6 pages
Annotation
This paper describes the psychodynamics of a psychotherapeutic interaction between a therapist and a patient who engaged in sadomasochistic ways of relating to sexual partners.
Abstract
Mr A was a bisexual patient whose confusion about his sexual identity and whose perversion were part of his defenses against the violence of the primal scene as he had experienced it and the cruel, chaotic behavior of his parents. Through his perversion he replayed his childhood traumas, but in a way that enabled him to feel in charge of others and himself. In reality he was perpetuating a sadomasochistic way of relating, denying the separateness of others and his own fears and destructiveness; however, a small part of him, the more mature part of his self, knew that the "sexual magic" (Coen 1995) he pursued was only an illusion that masked, but did not alter, his underlying depression and sense of inadequacy. This part of him, looking for guidance, led him to ask for psychotherapy. From the beginning of the therapy, the therapist knew that he would reproduce with her the sadomasochistic interaction, playing either the victim or the persecutor. This proved to be the case. When it was time for the treatment to end, the therapist concluded that Mr A had learned to trust her a little, such that he could share with her terrifying fantasies and fears. The patient's concern was whether the perceived abandonment by the therapist would fuel his destructiveness or whether her alliance with his next therapist would enable him to contain his destructive impulses.