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Current conceptualizations on masochism: genesis and object relations.

Masochism has become one of the most confusing and controversial clinical and diagnostic terms within the psychotherapy literature. When defined, however, as a self-defeating way of loving and individuating, masochism remains a particularly useful clinical construct. This article is designed to: (1) review the literature related to the definition, scope and relevance of masochism; (2) present a descriptive clinical overview of the masochistic personality; (3) describe and discuss the etiology of the disorder and (4) discuss masochistic object choice. Masochists' object relations are characterized by loving objects who give non-love in return in order: (1) to attain fusion with the primary object with whom they feel an impossible separation and (2) to heal a narcissistic injury by making critical and rejecting objects love and approve of them. Masochists tend to choose idealized but unloving partners with whom they behave as caretakers or self-objects. This frequently leads them into relationships with individuals who have borderline and narcissitic character structures. While borderline and narcissistic individuals initially fulfill the masochist's underlying wish for idealized symbiosis, they later recapitulate the erratic environment of the masochist's childhood.