The construction of sadomasochism: Vicissitudes of attachment and mentalization

This paper integrates empirical developmental research with the clinical theory and treatment of sadomasochism. Three strands of argument illustrate the thesis that sadomasochistic relatedness develops from relational procedures originating in the mother-infant dyad. The first strand involves attachment research including data from infancy to adulthood and videotaped microanalyses of infant-mother dyads. The second strand addresses research on mentalization and its relationship to attachment. These strands suggest that sadomasochistic relatedness exists on continua from minor to severe as attachment modes move from secure to insecure to disorganized, and from the capacities for mentalized to prementalized recognition of the self and other. Specific relational procedural models representing insecure and disorganized attachment involve the regulation of contradictory emotions, motives, and messages conveyed through varied sensory modalities. These models suggest dissociative procedural ways of being with the other and managing internal states. They are incorporated into and shaped by later development. The third strand uses a clinical case to deepen these constructs, and illustrate the use of knowledge from infant research in work with adults. The discussion addresses the relationship of mother-infant interactions with sadomasochism and how sadomasochistic procedural relational models may contribute to the formation of sadomasochistic relatedness at different developmental levels.