title: The depressed masochistic patient: diagnostic and management considerations--a contemporary psychoanalytic perspective.
abstract: This article considers the relationship between depression and characterological masochism from a contemporary psychoanalytic perspective. Nosology is discussed historically from Krafft-Ebing to the DSM-III-R category, self-defeating personality disorder. Masochistic character traits are conceptualized as attempts to cope with depressed helpless and hostile feelings that have become part of the core self-concept. Psychotherapeutic strategy for treatment of masochistic patients at different levels of characterological integration is discussed. Many questions about self-defeating personality disorder remain open at present. The need for psychoanalytically informed clinical research on characterological masochism and particularly the relationship between masochism and depression is stressed.
authors.affiliation: College of Physicians and Surgeons, Columbia University.
authors.forename: R C
authors.initials: RC
authors.lastname: Friedman
mesh_terms: D000328:Adult; D002605:Character; D002648:Child; D003866:Depressive Disorder / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D005260:Female; D005619:Freudian Theory; D006801:Humans; D008297:Male; D008398:Masochism / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D008960:Models, Psychological; D010554:Personality Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011575:Psychoanalytic Therapy; D012649:Self Concept