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1991 Sadomasochism, Sexual Excitement, and Perversion. J. Amer. Psychoanal. Assn., 39:333-362 (APA)
Sadomasochism, Sexual Excitement, and Perversion
Otto F. Kernberg, M.D.
ABSTRACT
Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement.
Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a teasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.
THE PRINCIPAL THESES OF THIS PAPER are: Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations. It is an essential part of the very nature of sexual excitement. Sexual excitement is a basic affect: it is a fundamental constituent of libido, which I see as a hierarchically supraordinate drive. This idea is in consonance with proposals in my earlier work that consider affects as the "building blocks" of drives (1976, pp. 85?07);
Associate Chairman and Medical Director, The New York Hospital-Cornell Medical Center, Westchester Division; Professor of Psychiatry, Cornell University Medical College; Training and Supervising Analyst, Columbia University Center for Psychoanalytic Training and Research.
Presented at the panel on "Sadomasochism in the Perversions," Fall Meeting of the American Psychoanalytic Association, New York, December 17, 1988. Accepted for publication April 27, 1989.
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(1982; in press). Sadomasochism may present as a specific perversion. This perversion is characterized by deriving pleasure from inflicting or receiving pain as an obligatory precondition for achieving sexual gratification and orgasm. This obligatory precondition implies a restriction in the variety, scope, and flexibility of sexual life. The degree of severity of this perversion depends on the degree of ego and superego pathology.
My basic theoretical frame stems from Freud's (1905) description of infantile sexuality. However, I consider the source of the libidinal drive to lie not in the excitation of erogenous zones per se, but in the affect of sexual excitement, which incorporates zonal excitation together with the cognitive aspects of early object relations and other communicative, neurovegetative, and psychomotor substructures of this affect. My view of sexual excitement as a basic affect also incorporates Erikson's elaboration of the theory of infantile sexuality in terms of modes and modalities of object relations implied in the activation of zonal excitation (Erikson, 1963, pp. 72?08).
In earlier work (1986), (1988a), (1989) I stressed the crucial importance of the levels of personality organization梚n other words, of psychic structure梬hen assessing perversions. The difference between perverse fantasies and their symbolic enactment in sexual relations and love, on the one hand, and a consolidated perverse structure, on the other, depends on the nature of ego and superego organization.
The psychodynamic meanings of perverse fantasies and actions lie on a continuum, from normality to psychopathic perversion. The structural characteristics of the different clinical types and degrees of perversion vary greatly, according to whether they are associated with an integrated tripartite structure of normality and neurosis, at the one extreme, a borderline and narcissistic personality structure in the intermediate realm, or with the syndromes of malignant narcissism, antisocial personality structure, and perverse organization in psychosis, at the other extreme. The degree to which the perverse tendencies are transformed into action depends on the predominance
- 334 -
of aggressive over libidinal components in the individual's instinctual equilibrium and the regressive nature of his personality structure, including the regression and/or disintegration of the superego, the predominance of splitting processes in the ego, the consolidation of a pathological grandiose self, and the weakening and loss of ego boundaries.
Some Illustrative Cases
The following five cases illustrate sadomasochism at various levels of psychopathology, short of actual psychosis. Listed in the order of the severity of the pathology, they should serve to put my discussion in context.
Case 1
The patient, a man in his early twenties, masturbated on the roofs of buildings and threw bricks on women walking on the street below; he reached orgasm at the moment when he either hit a victim or observed the extreme fright of a potential victim. This patient, temporarily hospitalized at the time of his evaluation under court order, presented a sadistic perversion unmitigated by any sense of guilt or any capacity of concern for his victims or for himself. He also evinced a combination of grandiosity, arrogance, and contempt as dominant characterological features. He illustrates the combination of a sexual perversion and a total deterioration or absence of superego functions in the context of a narcissistic personality structure. He was clinically not psychotic, and I formulated the diagnosis of a sadistic perversion in an antisocial personality. Sadistic perversion can also be present as part of psychosis, a further degree of this extreme psychopathology.
Case 2
A man, in his late thirties, was in psychoanalytic treatment because of a long-standing incapacity to commit himself to any
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loving relationship with a woman, sexual promiscuity, and growing dissatisfaction with his sexual life. He was white and had a black mistress, a colleague at work with whom he collaborated in creative projects. She loved him, accepting the limitations of their relationship, which had a sporadic, discontinuous quality stemming from him. Although he had had homosexual experiences in the past, and considered himself "potentially bisexual" as an expression of his sexual freedom and superiority, his current sexual experiences were almost exclusively heterosexual.
What he enjoyed most with his current mistress was a triangular situation: Having persuaded her to participate in a m閚age ?trois, he would offer her as a sexual partner to a close male friend. His sexual excitement peaked when, while she was having intercourse with his friend in the patient's presence, she would look at him with a loving expression indicating that she was submitting herself to this sexual relationship only because he had asked her to, and with him in mind as her sexual object. Analytic exploration revealed that the meanings of this scene included his unconscious wish to humiliate her as revenge against a hated maternal figure, and the reenactment and magical reversal of his fantasy of being the "excluded third party" of the primal scene: in his fantasy, it was now his friend (= father) who was really the excluded third party. While this was not an exclusive, obligatory, and constant aspect of his sexual behavior, it constituted his most intense and enjoyable way of achieving sexual gratification. This patient presented a narcissistic personality, and, in the transference, a typical "perverse" development (Kernberg, 1985) in the sense of a transformation of everything "good" received into something "bad." He showed a consistent though unconscious effort to utilize the understanding gained from me to demonstrate his independence from me, the futility of psychoanalysis, and the superiority of sadistic enjoyment to any other type of human interaction. At the same time, however, this patient presented good superego functions in all nonsexualized aspects of his daily life, and
- 336 -
responded positively to psychoanalytic treatment over an extended period of time.
Case 3
This case, reported in another context in an earlier publication (1976, pp. 181?82), is of a woman with severe sexual inhibition, a lifelong incapacity to masturbate because, immediately following any sexual excitement, the face of her mother would flash up in her mind stopping her from further masturbatory activity. Her only erotically exciting behavior was represented by cutting herself in various parts of her body; the excitement was produced by observing blood flowing from these wounds (unconsciously representing an infinite number of tiny vaginas). She developed, in the course of her treatment, the fantasy in the transference that, if I were willing to shoot and kill her, she would feel fully gratified sexually. My killing her would mean that she mattered to me more than anything else in my life, and it would unite us forever in a way in which no other human interaction could. This patient, with a severe personality disorder involving schizoid, masochistic, and obsessive features, functioned on a borderline level of personality organization. She responded very well to psychoanalytic psychotherapy over several years (with an early resolution of her self-mutilating tendency), but her sexual inhibition diminished only very slowly and gradually over the years. This patient illustrates a masochistic sexual organization at a very primitive level, in the context of both lack of activation of ordinary pleasurable features of sexual excitement and an inordinate development of the aggressive components of it. Here, the aggression dominant within sexual excitement was matched with a well-integrated yet extremely sadistic and self-punitive superego.
1991 Sadomasochism, Sexual Excitement, and Perversion. J. Amer. Psychoanal. Assn., 39:333-362 (APA)
Sadomasochism, Sexual Excitement, and Perversion
Otto F. Kernberg, M.D.
ABSTRACT
Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations, and of the very nature of sexual excitement. Sadomasochistic elements are also present in all sexual perversions. Sadomasochism starts out as the potential for erotic masochism in both sexes, and represents a very early capacity to link aggression with the libidinal elements of sexual excitement. Sexual excitement may be considered a basic affect that overcomes primitive splitting of love and hatred. Erotic desire is a more mature form of sexual excitement.
Psychoanalytic exploration makes it possible to uncover the unconscious components of sexual excitement: wishes for symbiotic fusion and for aggressive penetration and intermingling; bisexual identifications; the desire to transgress oedipal prohibitions and the secretiveness of the primal scene, and to violate the boundaries of a teasing and withholding object. The relation between these wishes and the development of erotic idealization processes in both sexes is explored in the context of a critical review of the pertinent psychoanalytic literature.
THE PRINCIPAL THESES OF THIS PAPER are: Sadomasochism, an ingredient of infantile sexuality, is an essential part of normal sexual functioning and love relations. It is an essential part of the very nature of sexual excitement. Sexual excitement is a basic affect: it is a fundamental constituent of libido, which I see as a hierarchically supraordinate drive. This idea is in consonance with proposals in my earlier work that consider affects as the "building blocks" of drives (1976, pp. 85?07);
Associate Chairman and Medical Director, The New York Hospital-Cornell Medical Center, Westchester Division; Professor of Psychiatry, Cornell University Medical College; Training and Supervising Analyst, Columbia University Center for Psychoanalytic Training and Research.
Presented at the panel on "Sadomasochism in the Perversions," Fall Meeting of the American Psychoanalytic Association, New York, December 17, 1988. Accepted for publication April 27, 1989.
- 333 -
(1982; in press). Sadomasochism may present as a specific perversion. This perversion is characterized by deriving pleasure from inflicting or receiving pain as an obligatory precondition for achieving sexual gratification and orgasm. This obligatory precondition implies a restriction in the variety, scope, and flexibility of sexual life. The degree of severity of this perversion depends on the degree of ego and superego pathology.
My basic theoretical frame stems from Freud's (1905) description of infantile sexuality. However, I consider the source of the libidinal drive to lie not in the excitation of erogenous zones per se, but in the affect of sexual excitement, which incorporates zonal excitation together with the cognitive aspects of early object relations and other communicative, neurovegetative, and psychomotor substructures of this affect. My view of sexual excitement as a basic affect also incorporates Erikson's elaboration of the theory of infantile sexuality in terms of modes and modalities of object relations implied in the activation of zonal excitation (Erikson, 1963, pp. 72?08).
In earlier work (1986), (1988a), (1989) I stressed the crucial importance of the levels of personality organization梚n other words, of psychic structure梬hen assessing perversions. The difference between perverse fantasies and their symbolic enactment in sexual relations and love, on the one hand, and a consolidated perverse structure, on the other, depends on the nature of ego and superego organization.
The psychodynamic meanings of perverse fantasies and actions lie on a continuum, from normality to psychopathic perversion. The structural characteristics of the different clinical types and degrees of perversion vary greatly, according to whether they are associated with an integrated tripartite structure of normality and neurosis, at the one extreme, a borderline and narcissistic personality structure in the intermediate realm, or with the syndromes of malignant narcissism, antisocial personality structure, and perverse organization in psychosis, at the other extreme. The degree to which the perverse tendencies are transformed into action depends on the predominance
- 334 -
of aggressive over libidinal components in the individual's instinctual equilibrium and the regressive nature of his personality structure, including the regression and/or disintegration of the superego, the predominance of splitting processes in the ego, the consolidation of a pathological grandiose self, and the weakening and loss of ego boundaries.
Some Illustrative Cases
The following five cases illustrate sadomasochism at various levels of psychopathology, short of actual psychosis. Listed in the order of the severity of the pathology, they should serve to put my discussion in context.
Case 1
The patient, a man in his early twenties, masturbated on the roofs of buildings and threw bricks on women walking on the street below; he reached orgasm at the moment when he either hit a victim or observed the extreme fright of a potential victim. This patient, temporarily hospitalized at the time of his evaluation under court order, presented a sadistic perversion unmitigated by any sense of guilt or any capacity of concern for his victims or for himself. He also evinced a combination of grandiosity, arrogance, and contempt as dominant characterological features. He illustrates the combination of a sexual perversion and a total deterioration or absence of superego functions in the context of a narcissistic personality structure. He was clinically not psychotic, and I formulated the diagnosis of a sadistic perversion in an antisocial personality. Sadistic perversion can also be present as part of psychosis, a further degree of this extreme psychopathology.
Case 2
A man, in his late thirties, was in psychoanalytic treatment because of a long-standing incapacity to commit himself to any
- 335 -
loving relationship with a woman, sexual promiscuity, and growing dissatisfaction with his sexual life. He was white and had a black mistress, a colleague at work with whom he collaborated in creative projects. She loved him, accepting the limitations of their relationship, which had a sporadic, discontinuous quality stemming from him. Although he had had homosexual experiences in the past, and considered himself "potentially bisexual" as an expression of his sexual freedom and superiority, his current sexual experiences were almost exclusively heterosexual.
What he enjoyed most with his current mistress was a triangular situation: Having persuaded her to participate in a m閚age ?trois, he would offer her as a sexual partner to a close male friend. His sexual excitement peaked when, while she was having intercourse with his friend in the patient's presence, she would look at him with a loving expression indicating that she was submitting herself to this sexual relationship only because he had asked her to, and with him in mind as her sexual object. Analytic exploration revealed that the meanings of this scene included his unconscious wish to humiliate her as revenge against a hated maternal figure, and the reenactment and magical reversal of his fantasy of being the "excluded third party" of the primal scene: in his fantasy, it was now his friend (= father) who was really the excluded third party. While this was not an exclusive, obligatory, and constant aspect of his sexual behavior, it constituted his most intense and enjoyable way of achieving sexual gratification. This patient presented a narcissistic personality, and, in the transference, a typical "perverse" development (Kernberg, 1985) in the sense of a transformation of everything "good" received into something "bad." He showed a consistent though unconscious effort to utilize the understanding gained from me to demonstrate his independence from me, the futility of psychoanalysis, and the superiority of sadistic enjoyment to any other type of human interaction. At the same time, however, this patient presented good superego functions in all nonsexualized aspects of his daily life, and
- 336 -
responded positively to psychoanalytic treatment over an extended period of time.
Case 3
This case, reported in another context in an earlier publication (1976, pp. 181?82), is of a woman with severe sexual inhibition, a lifelong incapacity to masturbate because, immediately following any sexual excitement, the face of her mother would flash up in her mind stopping her from further masturbatory activity. Her only erotically exciting behavior was represented by cutting herself in various parts of her body; the excitement was produced by observing blood flowing from these wounds (unconsciously representing an infinite number of tiny vaginas). She developed, in the course of her treatment, the fantasy in the transference that, if I were willing to shoot and kill her, she would feel fully gratified sexually. My killing her would mean that she mattered to me more than anything else in my life, and it would unite us forever in a way in which no other human interaction could. This patient, with a severe personality disorder involving schizoid, masochistic, and obsessive features, functioned on a borderline level of personality organization. She responded very well to psychoanalytic psychotherapy over several years (with an early resolution of her self-mutilating tendency), but her sexual inhibition diminished only very slowly and gradually over the years. This patient illustrates a masochistic sexual organization at a very primitive level, in the context of both lack of activation of ordinary pleasurable features of sexual excitement and an inordinate development of the aggressive components of it. Here, the aggression dominant within sexual excitement was matched with a well-integrated yet extremely sadistic and self-punitive superego.