I wanted to make just a short note to say that in the subject altruist the defusion of the ego ideal concerns impulses for the restoration of the the dead, injured, or harmed (in ego or object drive) mother. Just as there are different forms of perfection in egoism, death in altruism can be literal death (conceived of as the not-finite) but also death in regards to the other's image or social status. Death is also transcribed to the father, just as perfection is.
Working with groups it's often surprising how many people want to protect the leader and make attacks on his behalf, but who are otherwise self-effacing where their own egoism is concerned.
I believe that 'feminine masochism' or what I believe is better called echoism, captures the defused state of altruism. When altruism is no longer something that vicarious pleasure is gained from (i.e. fusion) but becomes a compulsive act without pleasure but based on fear (phobos) we use terms like self-effacing, people pleasing, (etc.) This should in turn be contrasted to projective identification in the altruist. In projective identification the altruist is herself victimized (near death, injured, about to face social ruin, etc.) and projects anxiety around restorative ego drives into another person.
I've had several patients that come from work in substance abuse who present themselves in a dangerous or near death environment, or who present themselves as overwhelmed by planning or managing their lives. I become aware of the anxiety they put in me and want to cut through the confusion and fear or just to touch ground and hold back the impulse to "life coach" or hold their head still so it stops spinning.
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