I’ve been going through old files of articles and clippings, trying to simplify my life. While younger people talk about productivity and greed, I look at the yellowed and dusty results of having produced and saved too much that has nowhere to go, except the trash. The exercise is gratifying and humbling, because I used to know and care about many more things than I do now. There are remnants of lost causes, one of which was my career.
I re-read ‘The Masochistic Personality,” by Stuart S. Asch, a psychiatrist who claims a difference between the sexual masochist and the personality type. The former gets his kicks by being dominated and abused by a certain type of person. The personality type is not specifically sexual but courts disappointment or humiliation. The term is derived from Leopold von Sacher-Masoch, a 19th century Austrian novelist who wrote about sexual gratification from self-inflicted pain. Some psychiatrists believe self-mutilation is also one of the traits.
The article focuses on the personality type, which has been dropped from the official list of psychiatric diagnoses, the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), although the term retains historical and descriptive usefulness. Asch says masochists desperately seek approval and love. The masochist is strongly self-critical, having introjected an abusing authority figure who approves of self-punishment for forbidden sexual or aggressive thoughts or behavior. Masochists will abase themselves repeatedly or in ever more humiliating gestures to obtain the approval or extract guilt from the unloving, rejecting love object. They tend to blame fate for their repeated failures.
Asch mentions animals, who apparently develop more intense bonds to an adult that inflicts pain in early life. Indeed, in human beings, there seems to be a pattern of stronger attachment to an abusing parent. Genetic theories have contributed.
Asch doesn’t discuss sadism, with that term attributed to the Marquis de Sade, who wrote in the 18th century about people who experienced sexual pleasure by inflicting pain on others. Sigmund Freud attributed this to fear of castration, which leads the sadist to act out his fear on others. In my view, masochists and sadists need each other, and each carries traits of the other, like two sides of a coin. The metal that binds them together is blame.
The coin of blame buys religions, lawyers, governments, soldiers and toys. Everything from religion to law to parenting holds self-sacrifice as a noble standard, in the name of loyalty, duty, or spiritual progress. Society at large reinforces the sado-masochistic power struggles that have become the “norm” for Western beliefs. To falter brings guilt and, often, punishment. The ominous “they” are blamed for universal problems that “we” feed into without acknowledging “our” contributions.
I read with the distance of time and recuperation from the world of medicine. There is such rigid judgmentalism built into the discipline that patients become guilty just by being patients. I can already hear the screams of protest from my former “colleagues,” who are masochists for putting up with this arbitrary system of classification known as the DSM-V and who collude with such an inhumane approach in the name of scientific objectivity.
Moreover, psychiatry as a discipline errs by not addressing the generalized ills built into the national psyche. For psychiatrists as a group to diagnose and presume to treat the individual effects of PTSD (Post-Traumatic Stress Disorder), for instance, without addressing the causes of PTSD—primarily war--is abhorrent. To attempt or pretend to treat symptoms of substance abuse or attention-deficit hyperactivity disorder (ADHD), or even depression, without delving into society’s contribution to the problems is, to me, an abdication of responsibility that puts the profession to shame.
What does this have to do with masochism? Maybe nothing, except that by taking such a narrow view, the institution of medicine begs to be punished, as though it knows it’s wrong but will continue unchecked until something or someone puts a stop to it.
The victim role is the hardest to give up. It's easy to blame someone else when things don't work out. The masochist holds grudges and denies his role in his own trajectory. He will find or create a controlling sadist to manage his life for him. Power struggles ensue, with each blaming the other when things go wrong. Unfortunately, healthier choices are overlooked in this struggle, one that erodes self-respect and mutual trust.
Drug use going up? Suicide rates rising? All manner of psychiatric and physical illnesses swelling like a pregnancy? Violence increasing? Fear and anger seeking catalysts to ignite them into something cataclysmic and definitive? Look for someone and possibly many people or groups to blame.
A retrospective analysis of “The Masochistic Personality” reveals more about psychiatry’s limitations than its strengths in understanding human nature. Perhaps psychiatry’s move from early, descriptive interpretations to the codified DSM, its increasing reliance on medications, technology, and “scientific,” measurable results, under the pretext of objectivity, renders it less human and compassionate, and thus less relevant to real life.
From the beginning of my studies in medicine and in psychiatry, I noted the preoccupation with pathology. What a difference from astrology, which shows the dynamic interplay of strengths, weaknesses, and how perception often determines the difference. Oriental belief in qi gives a similar picture of dynamic patterns, with a concentration on health maintenance.
In contrast, the Western love affair with trouble, under the guise of reason, logic, sequential, and binary thinking, that shows in its approach to medicine, is like putting blinders on to see only a narrow range of information and to deny everything outside the limited field.
No one else attempts to diagnose society at large, but I see unsettling correlations between Freud’s anal stage of psychosexual development and the current sado-masochistic world we live in. Have Americans been unable to mature beyond the “terrible twos,” the age at which Freud claimed toddlers learn sphincter control and appropriate use of power? Successful negotiation of this stage leads to good boundaries, healthy respect for self and others, and the ability to tolerate a degree of frustration. Shame and doubt mark those who fail at this task. They are prone to power struggles with internal and external authority figures throughout life.
A culture carries its own karma. I don’t understand the blame game. I don’t blame anyone or anything for what we have created, because blame only perpetuates the problem, at the expense of solving the problem. Not to avoid the problem but to understand that anyone could have created it, and everyone can learn from it – this is the challenge.