Pain, aggression, fantasy, and concepts of sadomasochism.

Traumatized infants and children may exhibit syndromes of aggressive, pain-seeking, and self-destructive behavior resembling the so-called sadomasochism seen in adults. Three hypotheses are offered to account for the repetition of sadomasochistic phenomena in childhood and later character disorders: 1) pain and painful affects are sources of aggression; 2) the need to control aggression plays an important role in the development of psychic structure; 3) child abuse and trauma impair the ability to use fantasy for the mastery of impulses. Difficulty in expression and control of aggression are central issues in character disorders.