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Understanding the Pleasure of Pain

The forms of masochism.

People can be their own worst enemy. Why do some seem to seek out pain and suffering? Patterns of self-destructiveness exist in varying degrees in all of us. This Women’s History Month, I want to rethink masochism, which played a part in Freud’s ideas of feminine psychology, and which contemporary psychotherapists have expanded on.

AdolfoTeranTeller/Pxhere/Public Domain
Source: AdolfoTeranTeller/Pxhere/Public Domain

"Masochism" means deriving pleasure from the experience of pain and humiliation. The word comes from Leopold Sacher Masoch (1835–1895), an Austrian writer who disapproved of this use of his name and its association with the practice of a perversion.

Freud described three types of masochism: erotic, feminine, and moral. Below I elaborate on a fourth and new understanding of masochism introduced by French psychoanalyst Marilia Aisenstein.

1. Sexual masochism

Sexual masochism refers to the erotic practices of those who seek orgasm through torment and humiliation. Sexual excitement is found in physical suffering. Being on the receiving end of pain and cruelty includes being bound, beaten, or otherwise made to suffer physical harm of some degree. Masochism is habitually found accompanied by sadism in the same individual; however, generally, one orientation represents a predominant sexual proclivity.

For example, Bob Flanagan was a poet and performance artist born with the disease cystic fibrosis and was told he wouldn’t live beyond the age of 7 or 8. He lost two sisters to CF in their early youth, yet Flanagan went on, despite this disability, to study literature at university and lived to age 43.

His performance work involved self-inflicted pain and torture, despite at times offending public sensibilities, and emerged from his lifelong battle with his incurable illness.

Flanagan said that he managed to outlive the predictions of his doctors through his performance work, which armed him with the ability to “fight pain with pain.” His self-inflicted suffering alleviated the involuntary pain caused by his lifelong illness and its medical treatments. As he described, these masochistic practices were a way to master the anguish associated with his illness and strengthen his will to stay alive.

The pleasure of erotic or sexual excitation, often unconscious, lies at the root of the next two categories: feminine and moral masochism.

2. Feminine masochism

"Feminine masochism" means deriving pleasure from psychological suffering, the pain inflicted by oneself or others. In his 1932 essay “Femininity,” Freud connects masochistic pleasure with those who embody the “feminine” personality traits traditionally associated with women, such as passivity and dependence. Yet, he did not claim women are intrinsically masochistic, which is a common misconstrual of his ideas.

Feminine masochism is common in both men and women. Karen Horney, too, rejected the notion of women's innate masochism. Its root is not biological but an aspect of derailed development and the result of social and cultural norms.

Yet, there is a lingering myth about women's masochism that has become part of the popular culture so that many women internalize this belief. Women in frustrating jobs where they are paid less than men, or those in painful relationships or exhausted by meeting the needs of children as well as spouses, come to believe that somehow they are to blame. Psychologist Paula Joan Caplan, the author of The Myth of Women's Masochism, argues that often women’s behavior should instead be attributed to the ability to work hard for delayed gratification and reward, the capacity to put other people's needs ahead of one's own when necessary. ''The same behaviors that are defined as masochistic in women,'' she said, ''would be defined quite healthily as sacrificial, or courageous, or facing realities, or hard work, in men.''

The hallmark of “feminine” masochism is behavior that unnecessarily jeopardizes one’s own best interests. These are acts of self-sabotage, often accompanied by self-deprecating attitudes, that can be understood as an unconscious pleasure in self-denial. This type of masochism is also apparent in the accident-prone.

Physician Lissa Rankin argues, “The number-one sign that someone is a masochist is that they are unable to say no.” This usually stems from a desire to please someone or seek approval or one's fear of disappointing another. But I disagree with Rankin; not being able to say "no" can also be a sign of a developmental problem resulting from a deprived child environment, one that can be worked through in therapy.

Why do some people repeatedly self-sabotage or involve themselves in painful activities and relationships despite conscientious efforts to do otherwise? What motivation fuels this quest for failure?

Elisabeth Young-Bruehl suggests this kind of masochism is “strongest in people whose means for being aggressive was interfered with in their earliest years” as with children who were prohibited from expressing anger or kept from “messy” play or freedom in bodily movement, as is often the case with depressed or abusive parents.

Nancy McWilliams agrees and adds these are often people “with a history of traumatic or sadistic abuse” and suggests masochistic behavior often occurs in people when they are subject to dissociated states. One of the aims of therapy, she suggests, is to help the patient “access the state of mind in which the self-destructive act was committed.”

Masochism as a non-sexual behavior of self-inflicted pain includes cutting or acts of self-mutilation. Such individuals often describe relief sought through such self-created pain. McWilliams says such patients claim “that the sight of their own blood makes them feel alive and real, and the anguish of feeling non-existent or alienated from sensation is profoundly worse than any temporary physical discomfort.”

3. Moral masochism

This is the second form of desexualized masochism. Freud coined the term “moral masochism” in 1924, describing a state of mind arising from an unconscious sense of guilt and satisfied by means of suffering that assuages such guilt feelings.

Moral masochists take pleasure in being punished or tormented by ideas, fate, or God, and the humiliation they feel in their lives can substitute for sexual activity, as with some religious cults or martyrdom, or practices of asceticism martyrdom, or religious flagellation. Self-punishment is intended to distract or relieve feelings of guilt and other painful emotional states. The idea is that people seek suffering to reduce feelings of guilt, which are usually unconscious.

Yet moral masochism is not necessarily pathological. Praise-worthy expressions of this form of masochism can be seen when people risk their safety, even lives, in the service of others or the greater social good—people with heroic devotion like Dr. Martin Luther King, Jr., Mother Teresa, and Mahatma Gandhi.

4. Adaptive Masochism

"Adaptive masochism" is discussed by contemporary French clinician Marilia Aisenstein, who claims masochism “has gotten bad press.” She aims to redeem it by elaborating a positive form of masochism in early infant development that she calls “primary erotogenic masochism.” This is how she describes it.

At times, in early infant development, the child is faced with powerful frustrations of hunger and aloneness. This type of masochism involved adaption and the gradual ability of an infant to tolerate the tension that goes with delayed gratification. This requires being passive in such moments of waiting for something one wants. Practically speaking, it is helpful in such moments for the mother or primary caregiver to give the infant words to express the frustration: “I see you’re hungry and want to have your milk. It will be a few minutes, but it will be here.”

According to Aisenstein, this early stage of positive masochism “is what helps us to endure disappointments, ruptures, and also illnesses and pain.” She sees masochism as the “guardian of life,” a descriptor used by Benno Rosenberg. This masochism, in earliest life, allows one to suffer the displeasure of waiting for something worthier than short-term comfort.

Aisenstein claims all the above masochistic behaviors (sexual, feminine, moral) are a sign that this earliest state of primary masochism had not been lived through fully. In other words, there has been a failure in constructing positive masochism, one that nurtures the ability to tolerate internal tension and passivity.

A friend gives a vivid illustration of this dynamic in later childhood when he describes his favorite memory growing up: going for an ice cream sundae. Among the two scoops dripping with chocolate syrup was the epitome of pleasure: the cherry on top, which he saved for last. And it was all the more delightful because it was waited for, a different kind of pleasure in pain.


Aisenstein, M. (2021, March 6). Primal Erotogenic Masochism, Which I See As The Navel of Psychoanalytic Treatment. Presented at Boston Group for Psychoanalytic Studies, Boston, MA, United States.

McWilliams, N. (1994). Psychoanalytic Diagnosis. New York, New York: Guilford.

Young-Bruehl, E. (1992). Freud on Women. New York: Norton.

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