Hit me baby, one more time: A brief overview of sexual masochism

In a previous blog, I briefly examined the psychological literature on sexual sadism. Today’s blog looks at its counterpart – sexual masochism – often viewed as two sides of the same coin. Sexual masochists comprise those individuals who derive sexual gratification from receiving physical and/or psychological pain. The sexologist Richard von Krafft-Ebing coined the term ‘masochism’ in his 1886 sexology book Psychopathia Sexualis deriving the name from the 19th-century novelist Leopold von Sacher-Masoch, whose book Venus in Furs (well known to us that are big Velvet Underground fans) depicts a man’s humiliation and suffering by a female dominatrix. There are other names for the same phenomenon – such as ‘algolagnia’ – that refer to those people who have a craving for pain. Algolagnia was coined by the German physician in the late 1880s but never caught on in the same way as the term ‘masochism’.

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) acknowledges the overlap between masochism and sadism but they are classed as two distinct entities. The DSM-IV defines masochism as when the individual experiences “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer” over a six-month period. To distinguish it as a disorder rather than a non-problematic sexual preference, the masochistic sexual urges, fantasies and/or behaviours have to cause “clinically significant distress or impairment in social, occupational, or other important areas of functioning”. Interestingly, other paraphilic behaviours such as hypoxyphilia (examined in a previous blog) come under the rubric of sexual masochism.

Early empirical studies such as those published in the Kinsey Reports in the late 1940s and early 1950s reported that a quarter of both males and females had experienced sexual arousal from being bitten by their partner during sex although later studies have reported much lower figures of around 3% to 5%. In a late 1980s, a study published in the Journal of Sex and Marital Therapy, by Dr Ethel Person (Columbia University, New York, USA) and colleagues surveyed college students about their sexual behaviours and fantasies. Results showed that around 4% had been tied up or sexually degraded during sex, and that 1% had spanked, whipped, or hit a consenting partner during sex (although ‘consenting partner’ does not necessarily mean they enjoyed being smacked, whipped or beaten). Dr Charles Moser (Institute for Advanced Study of Human Sexuality, California, USA) claims about 10% of the adult population engages in sadomasochistic activity.

Masochistic fantasies are not uncommon. For instance, in a 1980s study published in the Archives of Sexual Behavior, Dr Claude Crépault and Marcel Couture (University of Quebec, Canada) reported that 46% of men had sexual fantasies of being kidnapped and raped by a woman, 12% had fantasies relating to being humiliated, and 36% fantasized about being bound and sexually stimulated by a woman.

Although there is a lot of evidence showing that sexually masochistic desires, fantasies and behaviours are relatively common among men, there has been some dispute about women’s interest in sexual masochism. Research certainly indicates that consensual sexually masochistic behaviour by females can occur and some authors argue that there is a biologically based tendency towards submissiveness in females. However, some claim that it is very rare in women. Back in 1977, Dr Andreas Spengler (University of Hamburg, Germany) has claimed that almost all women who participate in sadomasochist activities are prostitutes that have no personal preference for such activity. However, a number of more recent studies among sadomasochists (1985-2002) have all indicated that a small but significant minority of women engage in both sexually masochistic and sadistic activities (13% to 30%) – very few of which were prostitutes. However, when compared to male sadomasochists, female counterparts were less likely to need sadomasochist activity to fulfil their sexual satisfaction.

Research has also indicated that men are more likely than women to experience masochistic desires during adolescence although a significant minority of male masochists do not express an interest in such behaviour until they have reached adulthood. Studies of sadomasochists show little difference in sexual orientation. For instance, Spengler’s study of 245 male sadomasochists reported that 30% were heterosexual, 31% were bisexual and 38% homosexual. Other studies have found much higher levels of heterosexuality although amongst female sadomasochists there tends to be higher levels of bisexuality than in the study by Spengler.

In a 1985 study carried out by academics at California State University and led by Dr Norman Breslow, 182 sadomasochists (of which 52 were women) were surveyed. One-third of the men (33%) were dominant, 41% were submissive, and 26% were both. Similar results were found among the females. Spanking and ‘master-slave relationships’ were the most preferred sexual activities for both male and female sadomasochists although there were some minor differences. More females preferred bondage and restraint whereas more men preferred pain and whipping. Klismaphilia may also have been a co-morbid paraphilia as 33% men and 22% of females made sexual use of enemas.

A more recent Finnish study led by Dr Laurence Alison reported in the Archives of Sexual Behavior reported that flagellation and bondage were among the most popular activities among sadomasochists. However, there was a wide range of lesser activities that carried greater risk of physical harm including piercings, hypoxyphilia, fisting, knifeplay, and electric shocks. There were also major differences depending upon sexual orientation (for instance, gay men were more likely to engage in activities such as “cock binding”). Most interestingly, the research team identified four sadomasochistic sub-groups based on the type of pain given and received. These were:

  • Typical pain administration: This involved practices such as spanking, caning, whipping, skin branding, electric shocks, etc.
  • Humiliation: This involved verbal humiliation, gagging, face slapping, flagellation, etc. Heterosexuals were more likely than gay men to engage in these types of activity.
  • Physical restriction: This included bondage, use of handcuffs, use of chains, wrestling, use of ice, wearing straight jackets, hypoxyphilia, and mummifying.
  • Hyper-masculine pain administration: This involved rimming, dildo use, cock binding, being urinated upon, being given an enema, fisting, being defecated upon, and catheter insertion. Gay men were more likely than heterosexuals to engage in these types of activity.

There are many theories on why people engage in such behaviours from traditional learning theories (based on both operant and classical conditioning) through to psychoanalytic interpretations. Most of these theories place the origins of the behaviour within a developmental framework and argue that the root of the paraphilic behaviour begins in childhood. Somewhere in childhood and adolescence, the individual starts to associate pleasure with pain, and then become sexualized in adulthood.

In a 1995 paper published by the sexologist Kurt Freund and colleagues, they noted there was a distinct difference between commonplace consensual and play-oriented sadomasochistic activities and more dangerous and potentially fatal practices of a small minority of hardcore sadomasochists. As with many paraphilias, sexual masochism would only classified as a mental disorder if it causes significant psychological and physical impairment (that in very extreme circumstances may be life threatening). This has been echoed by Dr Richard Krueger (New York State Psychiatric Clinic, USA) who noted in a 2010 review on the diagnostic criteria for sexual masochism that the main criticisms and concerns surrounding this behaviour (and paraphilias more generally) is that they should not be included in the DSM because they are not mental disorders, they are unscientific, they are unnecessary, and to do so pathologizes groups who engage in alternative sexual practices” (p.348).

However, in 2006, Dr Charles Moser and Peggy Kleinplatz (Carleton University, Canada) argued in the Journal of Psychology and Human Sexuality that there is no evidence that sadomasochists more often need emergency services “than practitioners of other sexual behaviours” (p. 106), although this has been disputed by others in the field. The review by Dr Krueger concludes that:

“While masochistic and/or sadomasochistic behavior occur with some frequency in the population and is associated with generally good psychological or social functioning, there are a very small number of cases where masochistic fantasy and behavior result in severe harm or even death. These cases clearly indicate a sexual interest pattern that has become pathological. Since so little is know about this behavior, further research is indicated, and inclusion in the DSM would facilitate this” (p.353).

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Alison, L., Santtila, P., Sandnabba, N. K., & Nordling, N. (2001). Sadomasochistically oriented behavior: Diversity in practice and meaning. Archives of Sexual Behavior, 30, 1–12.

Baumeister, R. F. (1988). Masochism as escape from self. Journal of Sex Research, 25, 28–59.

Breslow, N., Evans, L., & Langley, J. (1985). On the prevalence of roles of females in the sadomasochistic subculture: Report of an empirical study. Archives of Sexual Behavior, 14, 303–317.

Crépault, C., & Couture, M. (1980). Men’s erotic fantasies. Archives of Sexual Behavior, 9, 565–576.

Donnelly, D., & Fraser, J. (1998). Gender differences in sado-masochistic arousal among college students. Sex Roles, 39, 391-407.

Freund, K., Seto, M. C., & Kuban, M. (1995). Masochism: A multiple case study. Sexuologie, 4, 313-324.

Hucker, S. J. (2008). Sexual masochism: Psychopathology and theory. In Laws, D.R. & O’Donohue, W.T. (Eds.), Sexual Deviance: Theory, Assessment and Treatment (pp. 250-263). New York: Guildford Press.

Kinsey, A. C., Pomeroy, W. B., Martin, C. E., & Gebhard, P. H. (1953). Sexual behavior in the human female. Philadelphia: Saunders.

Krueger, R.B. (2010). The DSM diagnostic criteria for sexual masochism. Archives of Sexual Behavior, 39, 346–356.

Moser, C., & Kleinplatz, P. J. (2006). DSM-IV-TR and the paraphilias: An argument for removal. Journal of Psychology and Human Sexuality, 17, 91-109.

Ormerod, D. (1994). Sado-masochism. Journal of Forensic Psychiatry, 5, 123–136.

Paclebar, A. M., Furtado, C., & McDonald-Witt, M. (2006). Sadomasochism: Practices, behaviors, and culture in American society. In E. W. Hickey (Ed.), Sex crimes and paraphilia (pp. 215–227). Upper Saddle River, NJ: Pearson Education.

Person, E.S., Terestman, N., Myers, Goldberg, E.L. & Salvadori,  C. (1989). Gender differences in sexual behaviors and fantasies in a college population. Journal of Sex and Marital Therapy, 15, 187-198.

Sandnabba, N. K., Santtila, P., Alison, L., & Nordling, N. (2002). Demographics, sexual behaviour, family background and abuse experiences of practitioners of sadomasochistic sex: A review of recent research. Sexual and Relationship Therapy, 17, 39–55.

Sandnabba, N. K., Santtila, P., & Nordling, N. (1999). Sexual behavior and social adaptation among sadomasochistically oriented males. Journal of Sex Research, 36, 273–282.

Spengler, A. (1977). Manifest sadomasochism of males: Results of an empirical study. Archives of Sexual Behavior, 6, 441–456.

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 600 research papers, four books, over 130 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on March 4, 2012, in Compulsion, Obsession, Paraphilia, Psychiatry, Psychology, Sex, Sex addiction and tagged , , , , , , , , . Bookmark the permalink. 16 Comments.

  1. Hello

    I found your blog very enlightning. My question to you is this, how does a person deal with a masochist (male). I have someone like that in my life and his behaviour goes from being in my life intensely and displaying this behaviour, to then cutting comunications until such time as he is ready to return.

    I know realise that he has this condition as he seems to meet most of the criteria (especially the sub-groups involved in typical pain administration and Hyper-masculine pain administration).

    There isnt much information out there and now that I know what this person has, I wonder what is the best way to deal with it. Any and all thoughts are very welcome.

    Many thanks

    • Hi Princess. In all honesty I can’t really answer your question because we all deal with people and situations in different ways. It is up for you to decide whether having a relationship with this person gives you the things you want in life. Mark

      • Thank u kindly for ur reply. what u said is right and deep down i know im being used to enable this behavior and that this person is very much uncapable of caring. he is so much ur typical masochist u could write a book on him. i know i need to distance myself from this relationship as it is psychologically damaging me. please do keep blogging. I have been reading them and they are so very well written and clear and very educational.

        thank u for your time Dr. i appreciate it.


  2. Interesting article. I was sexually abused by a teenage boy when I was 5 to 6 years old. I just learned the term for what he did to me is frotteurism. Franky, I didn’t know there was a term for it. However, as a result, I was taught sexual arousal through pain and bondage while he rubbed himself against me and masturbated. I guess now I could be termed as a masochist. Though I’ve never acted it out looking for physically abusive relationships in reality, I have struggled my entire life with fantasies of sexual bondage, pain, and humiliation. Just thinking about it arouses me. I’ve pretty much just dealt with it my entire life (I’m now 62), but have only recently started delving into the effects it has had on me throughout my lifetime trying to understand why this happened to me. With 50 Shades of Grey coming out and someone giving me that dang book to read, it resurrected a lot of pain over my own struggles. I find it interesting all these women fantasizing over being abused and bound, while all I want is to be free and loved. Anyway, thanks for the in-depth article. I’ve been doing a lot of research on the subject lately which is definitely eye-opening. I’m currently writing my own story into a fiction novel about a woman struggling to overcome the effects of childhood sexual abuse.

    • There’s a difference between consensual BDSM (bondage, discipline, dominance/submission, sadomasochism) and abuse. Abuse is something done by one partner in the relationship against the other partner’s will, and without any regard to the damage done. Millions of people, however, enjoy bondage, pain, and humiliation within the context of a mutually beneficial, fulfilling relationship (which may consist of anything from a single “scene” between acquaintances in a club to a loving, monogamous marriage). It’s up to the participants to decide how intense the experience should be and what level of physical and/or emotional risk is acceptable. For some people, occasionally spicing things up in the bedroom with some playful spankings or easily escapable bondage is enough; others make a 24/7 lifestyle out of dominance and submission. The main thing is that you never have to give up (or for that matter, accept) a greater level of control than you’re comfortable with. It’s often said that the submissive partner is actually the one in control of what’s going on, as s/he may at any time use a “safeword” which brings all activity to a halt. Trust between partners is crucial. In an abusive relationship, you may genuinely fear for your safety; in BDSM, although you may venture into some dark and scary places, there’s an underlying assurance of security. Ultimately, BDSM has about as much in common with actual abuse as riding a r oller coaster does with driving a mountain road at night in a car with faulty brakes. If you’re really not comfortable exploring these fantasies, that’s fine – but please realize that it’s not an either/or decision between the partner who ties you up and beats you and the one who supports and cherishes you.

  3. I’m not judging individuals who prefer the BDSM lifestyle, and I’m quite aware of everything you’ve pointed out above. However, coming from an abusive background puts a totally different light upon the subject, when I, as a child, didn’t have the choice to have these propensities or not. They were given to me through abuse, and not through a loving, supportive relationship from someone who cherished me. There is a huge difference there. As a result, I carried with it a lot of guilt and shame that only the abused child can understand. I really would prefer the freedom, in my viewpoint, of learning what a loving relationship is without being tied up and spanked. Unfortunately, I’ve never had a decent relationship with a loving man because of the poor choices I’ve made in life. Nevertheless, if others find BDSM their cup of tea, that is fine. For me, it makes me relive the innocence stolen from me when I was bound by another.

    • I may understand where you’re coming from better than you realize. Although I was never sexually abused as a child, I was emotionally abused by my father to the point that I wished he would actually haul off and give me a black eye just once so I could get him out of my life and not have that awful feeling of dread all the time in the pit of my stomach, wondering when would be the next time he went into one of his rages and I’d have to stand there and try not to cry while he told me how stupid and worthless I was. As a young adult, I was hospitalized for over a year, and one of my roommates molested me. She threatened to hurt herself or to hurt me if I wouldn’t give into at least some of her desires. I was afraid to tell anyone for fear they’d blame me, since our first kiss had been consensual. This went on for several weeks and left me feeling soiled, and it was literally years before I could contemplate the prospect of someone feeling sexually attracted to me without a violent visceral response of revulsion and rage. I’m not going to catalogue all my miseries here, but suffice it to say I’ve long forgotten, if in fact I ever knew, how it feels to be healthy and whole.

      I’ve worried since puberty that I would be incapable of a healthy relationship. I’d read enough psychology to know that abused girls all too often grow up to become abused women. Furthermore, I didn’t believe I had anything to offer the sort of man I wanted to be with. In my mid-20s, I was involved for nearly a year in an emotionally abusive relationship with someone I was never romantically attracted to in the first place; I accepted all the blame for the problems between us, and although I was miserable, I was the one who resisted the inevitatable breakup. Once I emerged from that fog I told myself I would be better off alone. It was about a year later that I met the man who is now my husband. Happy ending? Yes. For the first time in my life, I know what it is to be deeply cherished for being the person I am. And yet something in me doesn’t quite trust this kind of love. I trust HIM, but not my own feelings of security. Something inside me tells me one day he’ll realize he was wrong and I’m actually not so precious after all. Sometimes when he deals with conflict in his quiet, patient way, I half wish he would scream at me and say all the horrible things I’m used to hearing. I have to make a conscious effort sometimes not to sabotage my own happiness.

      I’m sorry if my previous post seemed to imply that there was a simple solution to your personal pain. The journey to wholeness is a hard road, and no one can walk it for you, though many will try. I’m more in my element dispensing facts than kind words, but I saw so much of myself in your post that I couldn’t help wanting to reach out and offer you some little thread of comfort and hope. Even for broken people, sometimes miracles happen. . . . I hope that you will find your way to the purest desires of your heart.

      P.S. As a writer myself, I know the catharsis of the written word, and its power to reclaim some part of whatever it touches; as a voracious reader, I know the written word as the vehicle of empathy. I hope I get the chance to read your novel someday.

  4. Great post. I used to be checking constantly this weblog
    and I am impressed! Extremely useful information specially the ultimate phase🙂
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  5. “Met” a woman who lives in another city via a mutual male friend who lives there. She is black, (I’m vanilla!), a semi-retired IT professional. You’d never imagine what lurks in her heart! We have discussed this pain/pleasure nexus and want to explore it much more – as a topic! – when she visits in a few days. Ok, yeah, that other exploration, too.

    I’ve asked her what happened in her life – or didn’t – that got her to love being subservient and pain and how they heightens her sexual pleasures. She had a very normal two parent upbringing, although they were very prudish. No sexual abuse. “C” told me that she has a memory playing with a female friend around age nine. As part of the play, the friend tied her up. And C noticed that she liked it.

    By the time she was in her early twenties, she had submissive fantasies. She found a man who would dominate her. Pain and arousal came along over the years.

    My point is: the desire for submissiveness can be totally self-generated. No childhood abuse needed, Freud go home.

    One of C’s most important standards is trust. She will do without BDSM rather than doing it with the wrong man. Trust at many levels, from not exceeding a boundary, to something relational I can’t explain. After “S”, she was married for ten years. Surely with hubby, no? No. She didn’t have the same level of trust with him that I attained in a few weeks.

    Of the some fifty men she has had sex with, only four have met this standard. OK, now five.

    I have introduced perhaps a half dozen women to “light bondage,” tying them to the bed. All loved it. The Fifty Shades of Gray phenomena proves that BDSM is not abnormal. I read one stat that said 47% of interviewed women admit to having fantasies of bondage and rape. Not very fem-PC, eh? Most of the “Bodice ripper” romance novels are about giving in, submitting to urges and a dominant male.

    One of the surprising facts about female submissives is that they are thought to be weak, poorly informed and educated. It’s the exact opposite! Often sort of female “Type A” personalities, high self esteem, well educated. That’s C. A stroll through any BDSM dating site like http://www.collarme.com with show this, read the posts. Mostly well written, good grammar, confident, etc.

    As you indicated, many very loving couples choose the Dom/Sub lifestyle. Although somewhat of a minority, they aren’t weird, they have chosen to go deeper into sex than most. Universally they claim the relational bond is much greater than with plain sex.

    Thanks for giving me some background info I was seeking. Thanks for letting me expound a bit so that some later traveler may learn something.

  6. hurt me please

    Female masochist here. I think my sadism developed as a result of severe and long time school bullying. I felt absolutely helpless as everyone took their turns making me miserable. I’ve been name called, laughed at, isolated, slapped, beaten, sexually harassed threatened and even spat on.

    Basically violated on all levels. When harassment hit it’s peak when I was 13, I began having vivid masochistic fantasy. I dream that I was dog and had to obey orders. For some reason, it was highly arousing. I began read in bdsm stories online. Ever since, I wanted so badly for someone I trusted (boyfriend) to recreate the s/m element.

    Call me a sl.ut, hit me, choke me with your u know, that kind of thing. He seems all for it, but I feel embarrassed in a bad way that I want to play out a sex slave thing (I’m part black so it’s kind of awkward)

  7. Bethany Sanders

    Female exclusive masochist present. There needs to be more info out there. I’ve been a masochist my whole life, no childhood trauma here. Other kids were getting in trouble for playing with themselves at story time and I was playing in fire ants. Totally overpowers sex for me. People like me are so rarely discussed in anything. It’s miserable trying to find information, especially when you’re a confused kid that knows instinctively somehow that other people aren’t doing what you are. I came to terms with myself a long time ago, the crappy part is being totally incapable of having normal relationships and.. surprise.. most sadists don’t make great boyfriends. -.- Also you know.. not the safest of all things.. progressively so..

    Why do we never get more research? It seems like the information hasn’t progressed any further than where Alfred Kinsey left it!

  8. Late in life I became acquainted with submissive behavior. As a Doctor I was more interested. People of low self esteem feel unworthy of ‘good’ things. One coping mechanism is to sabotage feeling good by negative behavior. ” I feel a need to be punished”; thus seek behavior which could be construed as punishing. It is my belief; it maybe quite incorrect that that pathogical low self esteem maybe due to poor polygenic inheritance of self esteem…this coupled with mid or higher conscience is a recipe for neurotic behavioural disturbances.
    Submissives may also seek submissive behavior in an attempt to escape feelings of worthlessness . It is better to be used & not feel worthless than VV.Total female submission may link to an absence of female or feminine identity .( is this inherited? Is there an indentity gene on the X chromosome )..she therefore abandons herself to her Dom in order to feel useful as a woman .in a sexual role.( this a similar dilemma & coping mechanism in an exaggerated form to what one sees in the workaholic .the aim is approval seeking). It would be very interesting to see the results of twin studies in female submissive,if such exist. In alcoholism identical twins have a correlation factor between 60& 70% ,this suggests a strong genetic influence. There seems to me a spectrum of submissive behavior. It seems in many cases to be self reinforcing behaviour. I notice in medical literature that treatment results are poor,that is,if people seek treatment.
    I just have respect for the numerous ways people cope from total denial to total acceptance of submissive behaviour. As the saying goes “whatever floats your boat”. I have found in my journey to acknowledge & respect people’s feeling for what they are … not to judge. This is the reality of some people , many cope with,some are unable to do so.

    • You did notice that this was about sadomasochism and not dominance/submission… right? They’re quite different.. though they may occasionally overlp.

  9. Personally I find it strange that everyone keeps looking masochism or sadism as a decease or illness…Although some take it to far that isn’t always the case, not to mention people who are sadists or masochists aren’t any different than you or I most of the time. You may say whatever you wish, keep in mind, anyone who is a sadist or masochist still has feelings and just because they like to give or receive pain doesn’t mean being treated like something less than human is very hurtful but of course not everything in the article was saying such.

  10. Hi! I found your post quite interesting, and I was wondering if you have written something about enjoying pain out of a sexual context, if not, could you elaborate? I would love to read your thoughts and so on that.

  11. TKU,I was fascinated that although people have near identical anatomical structure that perception varies from pain to pleasure for the same stimulus .To my knowledge there is no acceptable explananation at present. In genetics the research seems to be progressing to finding different pathways ( neurological ) in different people ,then trying to group people by pathways.Another OPINION NOT FACT ,is people who genetically inherit poor self esteem
    develop these pathways as a consequence to inheritance of low esteem. It can be a mystery
    to such a person & it is a mystery to Medecine . I don’t think this should be shunned as it may lead to great understanding here & elsewhere in the understanding of emotions.I know
    COGA are pursuing this work in Alcoholism…& a number of alcoholic woman seek refuge
    In masochism.

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