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Personality / Styles

Masochistic Personality Style

Some people seem to be their own worst enemies. They give until they are depleted, stay where they are mistreated, turn down help they badly need, or find a way to spoil good things just as they arrive. The masochistic (or self-defeating) style is organized around an unspoken bargain: suffering is the price of love, safety, or goodness. Nancy McWilliams is emphatic that in psychoanalytic usage “masochism” does not mean a love of pain. A person who behaves masochistically endures pain in the hope, conscious or not, of some greater good, or to avert something that feels even worse, such as being abandoned (McWilliams, 2011, p. 269).

A note on the word. It comes from the name of the nineteenth-century Austrian writer Leopold von Sacher-Masoch, after whom the psychiatrist Krafft-Ebing named a sexual pattern; Freud later applied the term to nonsexual patterns of self-created suffering (McWilliams, 2011, p. 267). The personality style described here concerns everyday patterns of self-defeat, not sexuality. McWilliams stresses that many characterologically masochistic people are not sexually masochistic and vice versa (McWilliams, 2011, p. 277).

The style grows out of something admirable. The PDM-3 points out that self-sacrifice for one’s family or community is evolutionarily adaptive, and describes the masochistic style as an exaggeration or rigidification of the innate wish to put others’ welfare first (McWilliams & Shedler, 2026, p. 670). McWilliams notes that morality sometimes requires us to suffer for something worthier than our own comfort, and that some of history’s most praiseworthy acts of devotion to a cause involved risking health and safety (McWilliams, 2011, p. 268). People with this style are often loyal, enduring, devoted, and tireless on others’ behalf.

Everyone has a personality style, and most people have a blend. McWilliams writes that everyone behaves masochistically in some circumstances, often to good effect (McWilliams, 2011, p. 269). This page describes a pattern, not a verdict on anyone.

Style, Disorder, and the Space Between

Self-defeat comes in degrees. McWilliams observes that when anyone’s personality is problematic enough to count as a disorder, there is by definition something masochistic about it, since its core patterns keep working against the person. The masochistic personality proper is reserved for people in whom self-defeat is in the foreground rather than a by-product of something else (McWilliams, 2011, p. 270). Kernberg’s classification spans masochistic phenomena from the depressive-masochistic personality all the way to extreme self-destructiveness (Kernberg, 1988). Across the levels of organization:

Markers that the style has become a disorder include how automatic the bargain is, how many areas of life it governs, how much real harm results, and whether the person can look at the pattern with curiosity rather than as simply the way the world treats them.

Neither DSM-5-TR nor ICD-11 has a masochistic or self-defeating personality diagnosis. A “self-defeating personality disorder” was proposed in the 1980s and then dropped (see History). In ICD-11’s trait-based system, such features would be described through overall severity and trait qualifiers. In one of Bach and First’s illustrative cases, a man whose history included self-defeating behavior, such as letting peers take advantage of him, was classified as having mild personality disorder with prominent negative affectivity and detachment (Bach & First, 2018). That is one example, not an official translation of the style.

Inner World

The emotional world of masochistic people resembles that of depressive people, with one critical addition. Sadness and deep unconscious guilt are common, but most masochistic people can also feel anger, resentment, and indignation on their own behalf. They often see themselves as suffering, but unfairly: victimized, ill-starred, cursed through no fault of their own. Where depressive people are resigned to unhappiness as deserved, masochistic people protest against it (McWilliams, 2011, p. 271).

Little is known about temperament. Self-defeating patterns have not been researched as extensively as depression, and McWilliams suggests, from clinical experience, that people who become characterologically masochistic may be constitutionally sociable and object-seeking (McWilliams, 2011, pp. 270–271). Some observers believe childhood maltreatment pushes girls more toward masochistic and boys more toward sadistic patterns, but McWilliams stresses the many exceptions and that masochistic personality is common in both sexes (McWilliams, 2011, pp. 271, 287).

Typical pathogenic beliefs, as McWilliams lists them: If I suffer enough, I’ll get love. The best way to deal with my enemies is to show that they are abusers. The only reason something good happened to me was that I punished myself enough. She adds that people with this style often hold magical beliefs connecting assertiveness or confidence with punishment, and self-abasement with eventual triumph (McWilliams, 2011, p. 285). The PDM-3 adds one that matters greatly in treatment: the conviction that the clinician is interested in them only because they are suffering (McWilliams & Shedler, 2026, p. 672). Jack and Kerry Kelly Novick connect masochism to a fantasy of omnipotence, which they see as a major source of resistance to change (Novick & Novick, 1991).

Self-esteem is the key to the style. McWilliams’ shorthand is that characterologically masochistic people “attach their pride to self-sacrifice and care for others” (McWilliams, 1999, p. 174). The self-image resembles the depressive one (unworthy, guilty, deserving punishment) with an added sense of being doomed to be misunderstood, unappreciated, and mistreated. There may also be a pervasive, sometimes conscious sense of being needy and incomplete rather than simply bereft. Morally masochistic people may seem exalted in their suffering and scornful of those who couldn’t bear it so gracefully. McWilliams reads this not as enjoyment of suffering but as a compensatory way of supporting self-esteem (McWilliams, 2011, p. 277). A faint smile while recounting mistreatment is better understood as secondary gain than as pleasure in misery: the morally masochistic person may be fighting back by not fighting back, savoring the moral victory of exposing the other as the aggressor, while the more relational person may expect the suffering to bring more connection (McWilliams, 2011, p. 278). In the language of the PDM-3 M axis, the capacities most often affected are self-esteem regulation, agency, and internal standards and ideals.

Defenses

Masochistic people may use the depressive defenses of introjection, turning against the self, and idealization. McWilliams adds three more (McWilliams, 2011, pp. 271–274):

Reik described four functions masochistic acts can serve: provocation; appeasement (“I’m already suffering, so please withhold any further punishment”); exhibitionism (“Pay attention: I’m in pain”); and deflection of guilt (“See what you made me do!”) (McWilliams, 2011, p. 273). Unlike depressive people, who tend to retreat into loneliness, masochistic people may handle felt badness through projection, then act so that someone nearby demonstrates that the badness is outside (McWilliams, 2011, p. 278). Disowned anger often comes out as passive aggression (McWilliams & Shedler, 2026, p. 671), and the familiar help-rejecting complainer pattern belongs to this territory (McWilliams, 2011, p. 280; McWilliams & Shedler, 2026, p. 672).

On the adaptive side, the capacity for altruism is real. The goal in growth is not less generosity but adding self-assertion. McWilliams describes the aim of helping the masochistic person become capable of relishing self-assertion (McWilliams, 1999, p. 174).

Relationships

Emmanuel Hammer liked to say that a masochistic person is “a depressive who still has hope” (McWilliams, 2011, p. 274). The theory behind this, which McWilliams traces through Berliner, Menaker, and others, is that the early deprivation was not so complete that the child gave up on being loved. Many parents who are barely coping can still be jarred into action when their child is hurt or in danger. A child in that situation may learn that, although usually feeling overlooked, suffering enough can bring care (McWilliams, 2011, pp. 274–275). Leon Wurmser captured the logic in a book title, Torment Me but Don’t Abandon Me (McWilliams, 2011, p. 275). McWilliams adds that some masochistic patients recall that a parent was emotionally engaged with them mainly when they were in trouble or being disciplined, so that attachment and pain became linked, and that teasing, a mix of affection and cruelty, can have a similar effect (McWilliams, 2011, pp. 275–276). Some people were also richly praised for enduring hardship bravely and too little encouraged to look after themselves (McWilliams, 2011, p. 276). As always, these are theories about how a pattern may once have made sense, not accusations against the person or their family.

In adult life, the relational bargain shows up in several ways (McWilliams, 2011, pp. 273, 276–277):

The PDM-3 notes that an aggrieved, martyred tone can initially induce sympathy or guilt in others but eventually alienates them (McWilliams & Shedler, 2026, p. 671). McWilliams, following Nydes, notes a kinship with paranoia: both styles feel constantly threatened. The paranoid solution is roughly “I’ll attack you before you attack me”; the masochistic one is “I’ll attack myself first so you don’t have to do it.” She adds that the paranoid person sacrifices love for a sense of power, and the masochistic person does the reverse (McWilliams, 2011, pp. 276–277).

In Therapy

Transference means the feelings and expectations a person brings into the therapy relationship from earlier relationships. Countertransference means the therapist’s own emotional reactions, which can be a source of information as well as a risk.

Masochistic clients tend to replay with the therapist the drama of a child who can get care only by visibly suffering. The therapist may be cast as a parent who must be persuaded to rescue them. Alongside the wish for rescue runs a fear that the therapist will turn out to be uncaring or critical, will blame the victim, and will leave (McWilliams, 2011, pp. 278–279).

McWilliams names two common countertransferences: countermasochism and sadism, usually both. Therapists, especially newer ones, often start out excessively generous: cutting the fee, adding sessions, taking calls at all hours. When this only makes the client more helpless, the therapist notices unwelcome irritation and fantasies of retaliation (McWilliams, 2011, pp. 279–280). Because many therapists have depressive psychologies, they are prone to offer what would help them, not realizing it may reinforce the client’s belief that suffering pays (McWilliams, 2011, pp. 279–280). Therapists may also find themselves holding all the anxiety about a dangerous situation while the client becomes oddly casual about it (McWilliams, 2011, pp. 280–281). McWilliams warns that a therapist who denies feeling sadistic urges toward such a client is at risk of acting on them (McWilliams, 2011, p. 280). The PDM-3 notes that “victim entitlement” in particular can provoke irritated, judgmental, even sadistic countertransference (McWilliams & Shedler, 2026, p. 672).

What tends to help:

Timing is everything: confronting too soon, before there is a reliable alliance, will feel like blame. If the therapist does wound the client beyond a useful level, McWilliams recommends apologizing, without excessive self-reproach (McWilliams, 2011, pp. 284–285). In a 2016 talk at Adelphi University, as reported by a doctoral student, McWilliams described reducing idealization by helping masochistic patients put into words their identification with the aggressor, so they can talk about their self-attacks and gradually soften them (DeRubeis-Byrne, 2016).

What tends to backfire: sympathy and special accommodations that invite regression (McWilliams, 2011, pp. 279–280); explicit compassion that confirms that suffering is the route to care, or that triggers guilt over undeserved care (McWilliams & Shedler, 2026, p. 672); and antidepressant medication given to someone with a masochistic personality, which McWilliams reports most experienced clinicians find does little beyond feeding the belief that authorities and their magic are needed to feel better (McWilliams, 2011, p. 286). Esther Menaker warned as early as 1942 that features of classical treatment could feel like humiliating dominance and submission, and recommended attention to the real relationship and avoiding any trace of omnipotence in the analyst’s tone (McWilliams, 2011, p. 281).

Variations

The PDM-3 calls masochism “a many-headed hydra” (McWilliams & Shedler, 2026, p. 670) and describes three versions, each of which may involve disowned sadistic elements (McWilliams & Shedler, 2026, pp. 671–672):

McWilliams uses Blatt’s polarity in a similar way: relational masochists lean anaclitic, moral masochists introjective (McWilliams, 2011, p. 270). Arnold Cooper described a narcissistic-masochistic character in which narcissistic tendencies serve to bring about masochistic disappointment, and masochistic injuries confirm distorted narcissistic fantasies (Cooper, 1989). Kernberg’s depressive-masochistic personality is the most common blend with the depressive style (McWilliams, 2011, p. 270). Millon described an “aggrieved” self-defeating pattern (McWilliams, 2011, p. 268).

Empirical relatives. Research with the SWAP instrument found a “dependent-victimized” version of dependent personality: people drawn to relationships where they are mistreated, who express unconscious anger in passive-aggressive ways that can elicit cruelty (McWilliams & Shedler, 2026, p. 673). The PDM-3 adolescent chapter sees features of relational masochism in this pattern, tied to a belief that all relationships involve sacrifice and pain (Tanzilli & Sharp, 2026, p. 495), and notes that some young people with it unconsciously reenact a childhood scenario in which they got a parent’s attention only when in pain or danger (Tanzilli & Sharp, 2026, p. 496).

In older adults, the PDM-3 finds the style less common, partly because workplaces and new romances, its usual stages, recede. It may show instead as emphasizing frailties to make suffering visible, which can lead caregivers to dismiss real difficulties as attention seeking. The central task for clinicians and relatives is helping the person discover that attention and affection do not depend on being in pain (Del Corno & Plotkin, 2026, pp. 931–932).

How Different Thinkers See It

Freud

Masochism troubled Freud because his theory assumed that people seek pleasure and avoid pain (McWilliams, 2011, p. 267). In “The Economic Problem in Masochism” (1924) he wrote that if pain could become an end in itself, the pleasure principle, the “watchman” of mental life, would be paralyzed (Freud, 1924, p. 255). He described a moral type of masochism, which he called in certain respects the most important form, in which “It is the suffering itself that matters,” whoever or whatever inflicts it (Freud, 1924, pp. 257, 262). He linked it to an unconscious sense of guilt, which he proposed calling a “need for punishment,” and connected it with what he had named the “negative therapeutic reaction” (Freud, 1924, pp. 262–263). McWilliams describes the clinical feel of that reaction as a message of “Just try to help me—I’ll only get worse” (McWilliams, 2011, p. 280).

Reich and Reik

Wilhelm Reich included a “masochistic character” in his 1933 typology, stressing suffering, complaining, self-damage, self-depreciation, and an inferred unconscious wish to torment others with one’s pain (McWilliams, 2011, p. 268). Reik’s Masochism in Modern Man (1941) explored the functions of masochistic behavior described above (McWilliams, 2011, p. 273). McWilliams still recommends it: dated, but not so mired in metapsychology that a beginner would be put off (McWilliams, 2011, p. 288).

Object relations and relational writers

A line running through Berliner, Menaker, Hammer, and later Sheldon Bach and Leon Wurmser locates masochism in relationships: suffering as a way of holding on to a needed person and warding off separation (McWilliams, 2011, pp. 273–275). Emmanuel Ghent’s 1990 paper, which McWilliams says attained iconic status in relational psychoanalysis, argued that masochism is a perversion of the natural wish to surrender, challenging the Western equation of surrender with defeat (McWilliams, 2011, p. 268).

Brenner, Kernberg, Cooper, and the Novicks

Brenner linked masochistic personalities with sadistic dynamics (McWilliams & Shedler, 2026, p. 671), and McWilliams cites him, among others, for the point that morality sometimes calls for suffering (McWilliams, 2011, p. 268). Kernberg (1988) proposed a general classification of masochistic pathology, treating ego organization, object relations, superego development, and narcissistic organization, among other factors, as shaping its level and form, and reexamined its link to negative therapeutic reactions. Cooper (1989) argued that narcissism and masochism are so intertwined, developmentally and clinically, that it is useful to think of a single narcissistic-masochistic character. The Novicks (1991) reversed a classical assumption. Rather than the failure of infantile omnipotence pushing a child toward reality, they argued, real failures to achieve competent interactions with others push the child toward omnipotent solutions, which then fuel resistance in treatment.

Self psychology and control-mastery theory

Self psychologists such as Stolorow emphasized the narcissistic function of masochism: suffering as a way of shoring up self-esteem (McWilliams, 2011, pp. 277, 288). Control-mastery theorists see masochistic behavior as active mastery of an expected trauma and as a series of tests of the therapist, to be passed rather than failed (McWilliams, 2011, pp. 272, 285).

Feminist critique and empirical research

Feminist critics argued that a masochism diagnosis endangered women by pathologizing them. Reviewing the research on the proposed self-defeating personality disorder, Paula Caplan and Maureen Gans concluded that the evidence was scant and partly flawed, the criteria lacked face validity, the category overlapped heavily with others, and it remained dangerous, especially for women (Caplan & Gans, 1991). Later empirical work agreed that the diagnosis did not hold up as a distinct disorder. In a study of 1,200 psychiatric patients, its criteria hung together poorly and added nothing to predicting impairment beyond other personality pathology (Huprich et al., 2006). In a national clinician sample, self-defeating features did not form their own disorder, but many reappeared within a revised dependent diagnosis, and “revictimization” emerged as a trait tied to distinct developmental histories (Bradley et al., 2006). The PDM-3 acknowledges the debate over whether masochism is a style or a trait and concludes that some people are best described as organized along masochistic lines (McWilliams & Shedler, 2026, p. 671).

Examples

The nurse with high standards

McWilliams describes an exhausted intensive-care nurse to whom she suggested working fewer than 80 hours a week. The nurse looked at her intently and replied that maybe some professionals had low standards, but she was not one of them. McWilliams uses the exchange to illustrate moral masochism: self-esteem organized around the capacity to tolerate pain and sacrifice.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), p. 270

Getting the storm over with

A healthy woman McWilliams treated would announce her latest financial extravagances to her frugal husband whenever their relationship began to feel warm and comfortable, which reliably sent him into a fury. Together they worked out that as a child she had concluded that calm means a storm is coming. When her marriage went well, she began to fear, without knowing it, that her husband would erupt as her father had, and she provoked the outburst to get it over with and restore closeness. From her husband’s side, of course, she was not restoring pleasure but causing pain.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), pp. 272–273

Keeping a commitment

One of McWilliams’ most troubled masochistic patients panicked whenever she feared that her anger had driven McWilliams away. On one such occasion she persuaded a mental health center to admit her and signed herself in for 72 hours. Within half a day, calmer and wanting out, she sought McWilliams’ permission for early discharge. McWilliams replied that since the patient had known she was committing to three days, she expected her to keep the commitment. The patient was livid. Years later she told McWilliams that this had been the turning point of her therapy, because she had been treated like a grown-up who could live with the consequences of her actions.

Nancy McWilliams, Psychoanalytic Diagnosis (2nd ed., 2011), p. 283

How It Differs From Look-Alikes

Depressive personality
The two often coexist, and most people tilt one way. The predominantly depressive person needs to learn that the therapist will not judge or abandon and will be especially available during suffering. The predominantly masochistic person needs to learn that self-assertion, not helpless suffering, earns warmth, and that the therapist is not especially interested in the details of current misery. Treating a masochistic person as depressive may reinforce self-destructiveness (McWilliams, 2011, p. 286). Masochistic people also feel more entitled anger and act more, where depressive people tend toward resignation (McWilliams, 2011, pp. 271–272). McWilliams notes Richard Friedman’s similar argument that masochistic depressed patients form a hidden subgroup among the chronically depressed, especially those who respond poorly to treatment (McWilliams, 2011, p. 270).
Dissociative psychology
Some self-harm that was once explained as masochism happens in dissociated states linked to past trauma. If the therapist misses that, interpretations of masochism will be futile; reducing dissociation comes first (McWilliams, 2011, pp. 286–287).
Dependent personality
Dependent people subordinate themselves to keep nurturing relationships and can be content when they have them. The dependent-victimized pattern, and relational masochism, add a draw toward mistreatment and disowned anger expressed indirectly (McWilliams & Shedler, 2026, pp. 671–673).
Paranoid personality
Both are preoccupied with threat. Paranoid people may attribute malevolence to distant forces and live reclusively; masochistic people need others close at hand and attach the badness to someone nearby whose behavior seems to prove it (McWilliams, 2011, pp. 276–278).
Staying in danger
Remaining with an abusive partner is not in itself evidence of a masochistic personality. McWilliams stresses that calling a behavior masochistic never means the person enjoys being hurt, only that staying seems to serve some aim, such as keeping a family together or avoiding abandonment (McWilliams, 2011, p. 269). The proposed DSM-III-R criteria for self-defeating personality disorder excluded behavior occurring only in response to, or in anticipation of, abuse (Huprich, 1994).

History

Freud returned to masochism repeatedly, revising his theory to account for it, and in 1924 coined “moral masochism” for a general pattern of suffering in the service of some deeper aim (McWilliams, 2011, pp. 267–268; Freud, 1924). Reich’s masochistic character (1933) and Reik’s study (1941) carried the concept into character analysis, and mid-century analysts, including Menaker, Berliner, and Brenner, developed relational and clinical accounts (McWilliams, 2011, pp. 268, 274–275).

The diagnosis then became controversial. From June 1984 the American Psychiatric Association considered a “masochistic personality disorder” for DSM-III-R, derived from the psychoanalytic concept. After revisions, three criteria were dropped, others revised or added, and the name was changed to “self-defeating personality disorder,” which was placed in DSM-III-R (1987) as a disorder needing further study (Huprich, 1994). McWilliams recalls that many people in the debate heard the label as accusing victims of enjoying abuse, which psychoanalysts never meant by it (McWilliams, 2011, p. 269). Feminist critics argued the category was poorly supported and dangerous, especially for women (Caplan & Gans, 1991). The APA considered it for DSM-IV (1994) but did not include it (McWilliams, 2011, p. 268; Huprich et al., 2006), and later studies found little support for reviving it (Huprich et al., 2006; Bradley et al., 2006).

The Psychodynamic Diagnostic Manual has gone back and forth. The first edition (2006) listed masochistic personality, with moral and relational forms (Kotan et al., 2018). Robert Gordon’s summary of the PDC-2, the rating form that accompanied the PDM-2, lists twelve personality syndromes and no masochistic one (Gordon, n.d.). The PDM-3 includes it as a style, with relational, moral, and paranoid versions, while openly acknowledging the controversy (McWilliams & Shedler, 2026, pp. 670–672), and the PDC-3 rating form again lists “Masochistic (Self-Defeating)” (Gordon & Bornstein, 2025).

McWilliams has continued to argue for the clinical value of the concept, including in a lecture, “Masochism revisited: Some thoughts on addressing self-defeating dynamics,” which her curriculum vitae lists at several institutions between 2010 and 2013 (McWilliams, n.d.). In a 2016 talk at Adelphi University, a student report quotes her as describing how much depressive and masochistic thinking overlap, with attachment in both “predicated on suffering” (DeRubeis-Byrne, 2016).

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