Book Reviews

F EARFUL S YMMETRY: T HE D EVELOPMENT AND T REATMENT OF

S ADOMASOCHISM . By Jack Novick and Kerry Kelly Novick.
Northvale, NJ: Jason Aronson, 1996, 416 pp., $40.00.

If a psychoanalyst’s understanding and analytic work with either chil-

dren or adults is guided by a developmental point of view, it is essen-
tial that the analyst be empathically in touch with the child in the
grown-up, as well as the adult-to-be in the child. Having been trained
in both child and adult analysis is of the greatest help in that regard. It
is felicitous that Jack Novick and Kerry Kelly Novick spent almost fif-
teen years at the Hampstead Child-Therapy Clinic (now known as the
Anna Freud Centre), originally as students and subsequently as
researchers and staff members. Strongly influenced by Anna Freud,
they assimilated a developmental point of view within the orientation
and traditions of that setting. Fearful Symmetry reflects that ambiance,
and it is appropriate that they have dedicated this volume to Anna Freud
on the occasion of the one hundredth anniversary of her birth.
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The volume brings together articles the Novicks have written over
a period of twenty-five years, some of which have never been published.
Peripheral to the main topic of sadomasochism, and grouped under the
heading “Mechanisms,” are chapters titled “Varieties of Transference in
the Analysis of an Adolescent” and “Externalization as a Pathological
Form of Relating.” In “Projection and Externalization,” the authors call
attention to the prevalent confusion between the two terms, and various
of their connotations that fail to take into account Freud’s references to
this subject (e.g., Freud 1911, 1915). From an ego developmental frame
of reference the Novicks underscore the “controversial issue” of
whether “projection can occur prior to structure formation, especially
minimal differentiation of self and external world” (p. 104). Freud
(1915) wrote of a general disposition to “attribute to everyone else our
own constitution and therefore our consciousness as well” (p. 169).
Their main point seems to be that externalization is an inherent part of
the process of early development. Even though it may function as a
defense, it is broadly applicable and can be generalized. By contrast, the
mechanisms of projection and introjection are more discrete mecha-
nisms that serve defensive purposes only after the development of the
capacity to distinguish between internal and external.
Subsumed under the heading “Clinical Manifestations” are the
chapters “Attempted Suicide in Adolescence,” “Ego Disruption in an

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 PSYCHOANALYTIC TECHNIQUE

Abused Little Girl,” and “Borrowed Trauma in the Analysis of a Young

Adult.” The main focus, though, is on the concept of masochism, its pre-
monitory sources, expressions, and transformations developmentally,
and the clinical vicissitudes and treatment of sadomasochism. The
initial part of the book, headed “Development,” centers on masochism.
The chapters “The Essence of Masochism,” “Masochism and the
Delusions of Omnipotence,” and “Postoedipal Transformations” are in
that section. Technical considerations are discussed in “Sadomasochism
and the Therapeutic Alliance,” the final chapter of the book.
The Novicks suggest that the anlage of masochism, what they call
the “first layer,” originates in early infancy, “in the child’s adaptation to
a situation where safety resides only in a painful relationship to the
mother” (p. 22). Yet, although “adherence to pain” (Valenstein 1973;
Glenn 1984) may be a preoedipal forerunner—termed “proto-
masochistic” by Loewenstein (1957) when referring to the seductive
behavior of an eleven-month-old infant—sadomasochism as such is not
explicitly differentiated until later. According to the Novicks, sado-
masochism is first structured in beating fantasies that are commonly
1273
evolved during the oedipal phase (pp. 3–13). Such fantasies may be
transient, but for some individuals they take hold tenaciously in that
form, and in idiosyncratic improvisations in fantasy and perverse action
throughout life. In a salient chapter, “The Essence of Masochism,” the
Novicks systematically outline and clinically illustrate the sequential
transformations of masochism from infancy into toddlerhood and then
into the phallic-oedipal stage, latency, and puberty. The delusion of
destructive “omnipotence” in thought and deed is central in their
schema of an epigenetic sequence for the clinical expression and
treatment of masochism. They single out omnipotence as a major deter-
minant of “the masochist’s resistance to change through experience or
analysis” (p. 50).
As the point of departure for the development of a sense of omnip-
otence they return to Ferenczi’s formulation (1913): “All children live
in the happy delusion of omnipotence, which at some time or other—
even if only in the womb—they really partook of” (p. 232). But in con-
trast to the secure, smiling infant referred to by Freud (1914, p. 91) as
“His Majesty the Baby,” the Novicks write: “the image we get from
analysts describing omnipotent fantasies of adult patients is of a raging,
hostile tyrant whose behavior is fueled by envy and is a compensation
for feelings of helplessness and shame” (p. 51).

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 Book Reviews

It is to the credit of the authors that they consistently maintain a

developmental perspective and seek the early preoedipal sources of
various clinical states and syndromes. However, this becomes a baffling
endeavor when it comes to the earliest presets, the anlagen from which
emerge such familiar psychoanalytic concepts as masochism and
omnipotence. Ferenczi’s appealing picture of the child living “in the
happy delusion of omnipotence . . . even if only in the womb” may be
more metaphor than fact, at least in its literalness. An epistemological
and semantic problem concerns the qualitative nature of a sense of
omnipotence, as such, and the degree to which it can be retrospectively
attributed to states of mind and mental content in the neonate and young
infant. To return to the tendency to “attribute to everyone else our own
constitution and therefore our consciousness as well,” it becomes
understandable that we are compellingly inclined to impute adulto-
morphic qualities of awareness and discrimination to the mental activity
of the young infant. A mental sense of narcissistic omnipotence may
come to the fore in the course of developing or not developing a dis-
criminative awareness of self and object, but is it plausible to assume
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that it is present in the mind of the infant? If it is not, how and from what
mental state does it emerge? Although their point hardly settles the
question, the Novicks do refer to “infantile omnipotence as a state of
mind characteristic of the first eighteen months of life, the period Piaget
called the sensorimotor period” (p. 50). An essay by Wolff (1996),
together with a series of responsive commentaries by child analysts,
several of whom are also investigative observers of neonate and infant
development, addresses the question of whether levels of affective and
cognitive mentation are artifactually assigned to the infantile mental
state and its contents, based on retrospective extrapolations from child
and adult analysis and on inferences persuasively drawn from an adult
frame of empathic reference.
Just what is meant by the term masochism and its “fearful sym-
metrical,” sadism, has become increasingly ambiguous, not only in the
public domain but in our own field of psychoanalysis. The extent to
which the terms elude succinct definition and description, and yet are
invoked in psychoanalytic discourse, has made it something of a
catchall term. The Novicks acknowledge and trace the historical and
epistemological problems that encumber the concept of masochism.
Nevertheless, with a versatility born of their rich clinical experience
and systematic application of a developmental perspective, they write:

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 PSYCHOANALYTIC TECHNIQUE

“We delineate the epigenesis of masochism as an adaptation to a dis-

turbed environment, a defense against aggression, and a mode of
instinctual gratification” (p. 15). What they consider a satisfactory defi-
nition follows: “Masochism is the active pursuit of psychic or physical
pain, suffering, or humiliation in the service of adaptation, defense, and
instinctual gratification at oral, anal, and phallic levels” (p. 16).
The richness of this book lies in the coherence of its theoretical and
conceptual framework, abundantly correlated with clinical vignettes
and data. Beyond the informative substance of a good scientif ic pre-
sentation is the extent to which it serves as a stimulating point of depar-
ture for a rethinking of the “old” and familiar, and the puzzling-out of
the new. So it is with this volume by Jack and Kerry Kelly Novick.
Their developmental approach is systematic, making the collection a
rewarding contribution to the literature on sadomasochism and allied
topics. The authors interdigitate child and adult psychoanalysis in both
theoretical and clinical frames of reference, demonstrating how recip-
rocally informative and complementary are both fields.

REFERENCES 1275

FERENCZI, S. (1913). Stages in the development of the sense of reality. In First

Contributions to Psychoanalysis. New York: Brunner/Mazel, 1980, pp.
213-239.
FREUD, S. (1911). Psycho-analytic notes upon an autobiographical account of
a case of paranoia (dementia paranoides). Standard Edition 12:9–79.
——— (1914). On narcissism: An introduction. Standard Edition
14:73–102.
——— (1915). The unconscious. Standard Edition 14:166–215.
GLENN, J. (1984). A note on loss, pain, and masochism in children. Journal
of the American Psychoanalytic Association 32:63–73.
LOEWENSTEIN, R.M. (1957). A contribution to the psychoanalytic theory of
masochism. Journal of the American Psychoanalytic Association
5:197–234.
VALENSTEIN, A.F. (1973). On attachment to painful feelings and the negative
therapeutic reaction. Psychoanalytic Study of the Child 28:365–392.
WOLFF, P. H. (1996). Infant observation and psychoanalysis. Journal of the
American Psychoanalytic Association 44:369–474.

Arthur F. Valenstein
140 Foster Street
Cambridge, MA 02138–4746
E-mail: Afval@warren.med.harvard.edu

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