Franko B and his contemporaries have been performing similar acts for many years, but it is only recently that they have become part of mainstream culture. Much of the shock value has disappeared, and consequently the meaning of the word "masochism", which is usually applied to much body art and is defined as "a form of perversion in which the sufferer derives pleasure from his own pain or humiliation", seems inadequate, especially considering how fashionable body-piercing has now become.
Where once artists would insist on the importance of a work's political meaning, recent efforts have become more personal. Performance art that looks gory, such as that of Franko B, may say something about the performer's personal state in the world, but the messages that it sends out to audiences have become more complex. "I don't want people to feel sorry for me," says Franko B. "It's not my intention to freak people out. I just want to create beautiful images and survive them, like life - make the bearable unbearable." It is natural for us to respond to the performances' strength in the light of the artists' physical suffering.
Ron Athey, a former Pentecostal preacher, has Aids, and his performances function as a form of cathartic release. Not surprisingly, he uses plenty of religious imagery. For a recent work, he pierced his head with a series of 14-in lumbar needles to create a crown of thorns. He has also been crucified, with meat hooks through his arms. Athey describes himself as "a fatalist with a lust for life", but he does not see his performance as masochism for its own sake.
"Some of the sado-masochistic techniques in my work are used as metaphor, and create a ritual by doing them. When I put an arrow through myself it is a metaphor for Saint Sebastian, and represents HIV-positive people."
"I was brought up to be ashamed of my body," says Franko B. "I use blood, urine and shit as a metaphor because that is what I am." In an era when technology may give the impression that the body is intellectually and physically redundant (as demonstrated by Stelarc's electronic body extensions), performance artists see the body not as an object to experiment on, but as a means of showing how vulnerable we have become. There is nothing new about this. The intention of 17th-century vanitas paintings, with their skulls and other emblems of mortality, was to remind viewers of the omnipresence of death.
Things have changed. In the heyday of performance art in the late Sixties and Seventies, however chaotic or violent, experimentation was almost more of an intellectual enquiry. Take Marina Abramovic's Rhythm (1974). She placed in front of her various instruments of pleasure and pain and invited her audience to do as they pleased over a six-hour period. What began innocently - gropes and prods - turned into an uncontrollable spectacle. Her clothes were ripped off, then her skin was cut with blades. A protective gang surrounded her when a loaded gun was put to her head.
Chris Burden's acts were similarly extreme. He had himself nailed to a VW Beetle, burnt and electrocuted. Most famously, in a piece called Shoot (1971), a friend shot him at point-blank range.
Self-mythologising was important to these artists, though it was often seen as macho posturing. No one did it better than the Viennese actionist Rudolf Schwarzkogler. His sexually provocative and psychologically inflammatory acts were based around mutilation. He presented pictures of a bandaged stump, along with his supposedly dismembered penis. Most saw it as the perfect masochistic act. Which it would have been, had it been true - but his penis was neatly tucked inside his Y-fronts.
Today the most poignant performers deal with confessional subject matter, and use it to their advantage. The late Bob Flanagan, for example, a long-term cystic fibrosis sufferer, re-created a hospital room in which he would lie in bed, tell jokes and write stories for the visitors. It was his way of dealing with his impending death. Here was a sense of optimism that is lacking in, say, Orlan's relentless cosmetic surgery to remodel her face in the image of a variety of female icons. Flanagan had a hedonistic spirit that added greatly to his work.
In the same way, Franko B, Ron Athey and their contemporaries,are confessing their own lives, for their own ends. For Leopold von Sacher Masoch, from whom masochism takes its name, pain was most definitely a pleasurable luxury in which he could indulge, supported by wealth and privilege. But he was living in a dream world. Franko B is not. His actions may look like masochism, but they are instead just one of many types of therapy that are becoming increasingly common in our culture.
`Franko B' is to be published by Black Dog on 11 March, with signings by the artist. For more information, call 0171-485 4996.
The newly created Live Art Development Agency has information on forthcoming events in the UK (0171-247 3339).
Chris Burden's recent (non-body art) work will appear at the Tate Gallery, London SW1 (0171-887 8000) from 18 March