Desire,Pain and Thought: Primal Masochism and Psychoanalytic Thought

In the recent past, there is little that I’ve read that has led me to reevaluate how I’ve thought about a basic psychoanalytic concept. This slim book changed that. Marilia Aisenstein, a prominent French analyst, and a member of the Paris Psychosomatic School, presents American analysts with an entirely new way of thinking about masochism. At first, I was skeptical of this novel conceptualization, as it challenged most of what I thought I knew about masochism, especially how it appears in psychoanalytic treatments. We are all familiar, for example, with the self-hating patient, who desperately holds on to this self-state and, when analysis brings about a more optimistic view, experiences a negative therapeutic reaction that can lead to dangerous outcomes. We also understand that a patient who continually complains that he/she is mistreated by a spouse, but never thinks of ending the relationship, may be in the throes of an unconscious masochistic need. Before reading this book, I believed most psychoanalysts thought of masochists as deriving pleasure from pain that fulfills some unconscious need.

Aisenstein’s contribution to psychoanalytic thinking is to differentiate between pathological masochism, the active search for pain, and primal erotogenic masochism, which she posits as essential to the survival of the individual and the development of resilience. Aisenstein reminds us that Freud (1924) conceptualized primal erotogenic masochism as he tried to understand the negative therapeutic reaction, and she poses the questions, “is it possible that pain and the search for pain govern psychic life?” (p. 1), ¹ and what then becomes of the pleasure principle?

Through her work with Bruno Rosenberg (1991), who published a similar idea, and Michael Fain, both part of the Paris Psychosomatic School, Aisenstein has refined her ideas. Especially meaningful was an unpublished paper by Fain, who, Aisenstein tells us, described the type of masochistic patient for whom “bad-over exciting conditions have prevented pleasant passivity from establishing itself [italics added]. All that is registered in the mind is the lack of this experience. In such cases only activity is valued, and phallic narcissism will infiltrate the ego ideal” (p. 7).

It is my impression that this term pleasant passivity isn’t one that is part of the psychoanalytic lexicon of most analysts in North America. For me, it brought to mind patients who in their lives are in constant motion and in analysis find it difficult to freely associate because they cannot tolerate taking the time to see what emerges, instead looking for instant explanations. For me, at first, the most baffling statement Aisenstein makes is “Masochism is a ‘guardian of life’; without it we would commit suicide.” However, in following her thinking, I became convinced of the centrality of this concept and its clinical importance. In her elaboration of this idea, Aisenstein suggests that anyone searching for suffering is dealing with a failure of primary erotogenic masochism. She continues, “this primary erotogenic masochism is the vestige of, and witness to, a phase of formation where there is a mixture of the two drives: Eros and the death drive” (p. 3). This is where many American psychoanalysts might tune out, as our metapsychological thinking, when it occurs, has become mostly devoid of thinking about drives and instincts since the theory wars of the 1970s and 1980s (Schmidt-Hellerau 2006).

In fact, from the 1960s to the 1980s, there was a significant debate among American analysts about metapsychology in general and certain of its concepts in particular. In the course of this discussion, a number of suggestions were made. Specific to this paper, the need for a metatheory at all was disputed (Klein 1976), and metapsychology was considered not a psychology (Gill 1976). Thus, the idea was emphasized that the only theory that analysts needed was clinical theory (Klein 1973; Schafer 1978). Since then, metapsychology, this “serious obstacle to the development of psychoanalysis” (Gill 1988, p. 46) seemed to have been “effectively destroyed” (Holt 1985, p. 289):

For a certain time after this fight had ended, psychoanalysis went on contenting itself with clinical theory as a frame of reference. However, it took only a few years for a second wave of attacks to be unleashed, this time against the technical implications of clinical theory. Now we are in the strange situation that clinical theory, which was thought to be emphasized by freeing it from its metapsychological burdens, is itself the target of an assault (Busch and Schmidt-Hellerau 2004).

In contrast, French psychoanalysts have kept Freudian metapsychology alive, and Marilia Aisenstein is very much part of this tradition. If we tune out this thinking, ² we miss out on this fundamental revision of masochism that Aisenstein has brilliantly elaborated. ³

Aisenstein is very convincing in presenting the clinical importance of waiting and its fundamental role in living a successful-enough life. She also presents us with the question of how an urgent need morphs into desire. She argues that:

by binding the libido (a force that pushes) and the death drive (a movement that unbinds and immobilizes), primary masochism makes it possible to integrate the capacity for waiting. This obviously comes about by virtue of the mother’s psychic work. (p. 20)

Aisenstein then makes a statement that at first seems to go against common sense but that is truly eye-opening if one follows her thinking. “Desire is masochistic in essence because it implies waiting, the putting into abeyance of all action and psychic work [emphasis added]. Similarly, the transference, which is the only instrument of analysis, is only conceivable when the patient becomes a desiring object” (p. 25). ⁴

Aisenstein also adds to our understanding of masochism in the feminine with the idea of “feminine endurance” (p. 27). She introduces this concept with a conversation between two women (p. 27):

“How are you?”

“I’m exhausted, and you?”

“I’m dead. . . . What shall we do this evening?”

“Let’s go to the cinema. Before the film we could pop over to Chantilly. . . . There’s a flea market . . . .”

Aisenstein focuses on the idea that the tiredness of these women is something they live with, like an old companion. She skillfully relates this to primary erotogenic masochism and the capacity to wait. Aisenstein reworks Freud’s view of masochism in women to something positive, “greater tolerance to pain and to the frustrations of life in women” (p. 34). This capacity for waiting, however, is not limited to women.

Throughout the book, Aisenstein supports her hypotheses with material from her psychoanalytic practice. I found this very helpful in understanding her theoretical views. In addition, one can only be impressed with the breadth of her knowledge. How many analysts present examples from early Greek philosophy, like Tertullian’s (1929) Apologeticum, written sometime between ad 193 and 217, to substantiate their views?

A previous review of Aisenstein’s work (Busch 2018) holds true for this book as well: “Along with all one can learn from this book, what sets it apart is that it is a pleasure to read due to Dr. Aisenstein’s clear thinking, the beauty of her language, and her use of metaphor” (p. 620). As the reader might have already guessed, I’m a fan of Aisenstein’s work. It has helped me understand concepts in new ways and confirmed some of my own thinking (i.e., concrete thinking and language action). This is especially true in her short presentations of Pierre Marty’s work (e.g., Aisenstein and Smadja 2010b). Her descriptions of the work of the Paris Psychosomatic School (Aisenstein and Smadja 2010a) presented an entirely new way of thinking about these patients that was extraordinarily helpful, and one that was very different than the way I was trained.

In short, Aisenstein’s work presents new ways of thinking about psychoanalytic concepts that are well argued and beautifully written. For those not familiar with her work, I would strongly advise becoming acquainted with it. You will meet one of the finest minds in psychoanalysis and will grow from it. I believe I have.