Drawing on recent research, the classifications of DSMR-III-R and DSM-IV and relevant clinical experiences, this practical and engaging seminar will focus on therapeutic interventions for both sides – clients presenting with masochistic, sadistic or echoist personality manifestations who are seeking help as well as those living with or in significant relationships with people who exhibit these personality traits.

Masochism, which has been classified as Self-defeating personality disorder (SDPD) feeds on self-inflicted pain. Freud identified it as: in which the individual relentlessly pursues psychologically painful, humiliating, or self-defeating outcomes and seems to avoid opportunities for pleasure and success. In these instances, sexual satisfaction is usually not a component of the overt behavior patterns. (1993, American Psychiatric Press).

The key characteristic of Sadism is defined as taking pleasure in inflicting physical, emotional and/or psychological pain on others. People with sadistic personality traits intentionally cause personal harm as they derive satisfaction and even pleasure from it. A very recognisable form of sadism is “everyday sadism” which shows up in the behaviour of subclinical sadists who take pleasure in trolling people on the internet or bullying people face-to-face. While persons with sadistic traits may come across as dominating and controlling, their socio-behavioural manifestations in most cases are the result of childhood trauma, bullying, physical or emotional abuse by caregivers and / or internalized humiliation. Thus, while they come across as perpetrators, they can also be classified as ‘victims’ from a psychotherapeutic point of view.

Those with Echoist traits meanwhile are most likely to be found in relationships with narcissists, or even internally manifesting as someone struggling to exist as a person in their own right. Seeking approval from others, a debilitating fear of upsetting others, and defensive or avoidant behaviour often produces traits of servile agreement, people-pleasing, and struggling to express their thoughts and wishes.

Masochists may often present in clinical settings as people who unconsciously set themselves up for failure, to satisfy the implicit need to punish themselves. Self-sabotage can become their defining characteristic. Masochistic individuals often stay in destructive or emotionally abusive relationships and show masochistic submissiveness. This is a reaction in which their submissiveness often masks sadism as a need to control and induce guilt in their partners.

While echoism is presented by clients in a relationship with narcissists, the similarity of characteristics of submissiveness, an inability to leave damaging relationships and experiencing pleasure, comfort, or familiarity in suffering at the hands of a narcissist often overlap those of a masochistic submissive.  

Similarly, clients with sadistic personality traits often camouflage the pain of childhood abuse and/or indignities and their behavioural manifestations can perhaps be viewed and better understood through the lens of masochistic presentations.

The clinical challenge is to be able to understand the meaning of such circular and self-defeating dynamics. Whilst they are lived and enacted, both ‘perpetrators’ and ‘victims’ have little chance to make positive changes. It is essentially very difficult to get out of a sado-masochistic relationship, whether with an external or internal other, and this work presents particular difficulties for clinicians.

This seminar will focus on the meaning of masochistic / sadist and echoist behaviours and attitudes and provide practical therapeutic skills which impart clinical help in seemingly intractable situations. It will be of interest to all clinicians; not only those working specifically with victims of abuse but also with individuals who display masochistic / sadist and echoist traits.

At this webinar, we will:

• Build a cross-modality psychotherapeutic understanding of masochism, sadism and echoism – specifically focussing on their overlapping manifestations
• Comprehend how masochism, sadism and echoism can have manifestations that are mirror images of each other and how we can trace their similar developmental roots
• Understand what makes relationships particularly challenging for both ‘perpetrators’ and ‘victims’ – leading to negative outcomes for both sides
• Learn how we can delineate these manifestations in clinical settings and the psychotherapeutic techniques we can use to help both sides – so we can help our clients break developed behavioural patterns of inflicting / accepting abuse
• Discern the ways in which masochistic, sadist and echoist manifestations can be reflected in the therapeutic process and learn how we can handle these creatively to restore balance in the therapeutic relationship
• Consider the specific clinical pitfalls of working with these manifestations and learn how we can improve therapeutic outcomes

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