Signs of sexual masochism and sadism are not necessarily symptoms of a mental health disorder. It’s time to reduce the stigma.
For some, open conversations about sex continue to be a touchy subject, especially if you engage in practices deemed “unconventional.”
Bondage, discipline, sadism, and masochism (BSDM) lies under the larger kink umbrella, which is considered a sexual activity that does not “follow the straight and narrow.”
If you’re someone less versed in the ins and outs of BDSM, hearing of a person being slapped or tied up during sex may sound scary, but in reality, many feel empowered through their engagement.
Learning the difference between healthy fun and a potential issue is important. While avoiding pain is paramount for some, others find it pleasurable.
What is masochism?
Sexual masochism is defined as taking erotic pleasure in receiving pain.
While this can include being tied up, beaten, or degraded verbally, it can also include more subtle acts, such as biting or rough sexual intercourse.
What is sadism?
Sadism is defined as taking erotic pleasure in inflicting pain on others.
Similarly, this can include using bondage on another individual, impact play, or degradation.
There are two sides to everything — for every masochist, there is a sadist.
Suggested read: Fetishistic disorder symptoms
What is sadomasochism?
Sadomasochism refers to the enjoyment of giving and receiving pain in sexual settings.
Consent is a non-negotiable pillar regarding safety within kink and BDSM. All parties must agree to boundaries around activities that will take place — otherwise, you are involved in an abusive situation.
Misconceptions about masochism and sadism
Because of the stigma that surrounds the kink community in tandem with the lack of accurate media portrayals (no, “Fifty Shades of Grey” does not count — boundaries should never be crossed), there are often misunderstandings about the intricacies of the community and how sexual interactions unfold.
For those outside of the community, it can be assumed that violence or aggression during sex is the only important facet, whereas key elements of safe “play” include:
- informed consent
- safe words
- boundaries and limits
- aftercare
Masochism and sadism as paraphilia
Several researchers have referred to desire around pain as “disordered,” defining it as a paraphilia. Paraphilia is a condition characterized by abnormal sexual desires typically involving extreme or dangerous activities.
While experts may separate masochistic or sadistic behavior from disordered behavior depending on severity, the inclusion of the term as a paraphilia leads to the idea that those desires are “deviant.”
Stewart discusses the stigma around engaging in BDSM, particularly masochism and sadism, because of these preconceived ideas about how it may feel and what it says about an individual.
Studies have suggested those who participate in BDSM-related activities are no more likely to have diagnosed mental health disorders, and may even have better psychological health than those who do not.
When it comes to biology, the pain and pleasure centers within our brains are very close together and research shows that they release similar chemicals when engaged, resulting in a pleasurable response to pain.
Clinical definitions
The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) definition is clear that a recurrence of distressing thoughts and urges around masochism are necessary for it to be considered a disorder.
According to their entry on sexual masochism disorder, diagnostic criteria include:
- The person experiences intense urges or behaviors involving receiving extreme physical pain or humiliation for erotic purposes.
- These urges significantly and negatively impact day-to-day life.
- Symptoms are present for at least six months.
If a professional medical diagnoses sexual masochism disorder, they may specify if additional conditions may be present. For example, the specifier “with asphyxiophilia” means a person diagnosed with sexual masochism disorder and experiences sexual arousal by asphyxiation (restricting breathing). However, a specifier is not a requirement for diagnosing sexual masochism disorder.
The DSM-5 diagnostic criteria for sexual sadism disorder similarly include:
- The person experiences intense urges or behaviors involving inflicting or observing another person’s physical or psychological suffering for erotic purposes.
- The person has acted on these urges with a person without their consent, or the urges significantly and negatively impact day-to-day life.
- Symptoms are present for at least six months.
Both DSM-5 diagnoses require the person to experience significant distress, which is different from BDSM, in which there is consent and no distress. Plus, sexual sadism disorder can involve a nonconsenting partner, which is unacceptable in BDSM.
Some experts suggest that while changes from the fourth to the fifth edition of the DSM have brought some improvements concerning paraphilic disorders, there’s still a high risk of falsely diagnosing people with disorders such as sexual masochistic or sexual sadism disorder based on the updated criteria in DSM-5.
Is it abuse?
Historically, there are ample examples of people gaining pleasure from giving and receiving pain, and if you and your partner(s) fully enjoy yourselves, there is no cause for concern.
If we think about anything in history, we’ve been taught to use pain for punishment rather than actually to enjoy the pain.
However, when consent is incorporated into the process and boundaries are respected, activities are not abusive.
In fact, according to a 2015 study, some who engage in these kink activities have reported that it can be therapeutic, while others report that engaging in BDSM enables folks to reach an alternate state of consciousness or serves as an alternate form of leisure or meditative practice.
Hurt vs. harm
Harm is where we say, ‘harm is where the psychological trauma is,’ but not necessarily the hurt, the pain. We’ve just been taught that when things are painful, they are not good. So it just takes a lot of that unlearning.
One of the main differences between hurt and harm is the role of consent. Pain inflicted and received between two consenting adults can include hurt, but without everyone having consented, it becomes abuse — resulting in harm.
Suggested read: Sexual disorders and dysfunctions: What to know
Examples of masochism and sadism
Potential engagements in masochism or sadism may include:
- biting
- scratching
- rough sexual intercourse
- bondage, including rope play or suspension
- impact play, including slapping, whipping, or spanking
Because these actions typically cause pain and, in some cases, can lead to pleasure, incorporating them during sexual encounters falls under the category of BDSM.
Summary
Masochism and sadism are important parts of BDSM interactions. Despite the continued stigma that folks within the kink community receive, when engaged among consenting adults, it can lead to positive experiences.
The DSM-5 has entries for both sexual masochistic disorder and sexual sadistic disorder, both of which require an extreme desire for pain — either to be given or to inflict — to the point that their regular lives are significantly and negatively impacted and they’re unable to function.
This differs greatly from kink practices, which can be playful, empowering, fun, and sexy — without negatively affecting day-to-day life.
If you engage in practice similar to those listed with partners who fully consent and you’re not feeling any distress around your engagements, then there is a good chance that your sexual interactions are just plain old kinky.
But if you have concerns about your urges and desires, you can always seek a medical professional or sex therapist to discuss them.
