Boston Counseling and Psychotherapy

Sadism and Masochism: Sexual Sadomasochism, Facts and Diagnosis, Counseling Treatments

August 18, 2008 – 8:14 am

Sadism and Masochism

Portraits

Since he was a teenager, Carl has had reoccurring fantasies about being restrained, humiliated, or abused in a sexual way. His fantasies took root when he found a group of others who routinely participate in these behaviors.

Jenny was reading the personals section of the classifieds when she came across an ad from a person requesting a “sex slave.” She immediately ignored the ad, but then found herself excited by it, and drawn back to it.

“Sex isn’t the same for me as it is for other people,” Ryan explains. “I can’t get aroused with normal sexual touching. I need to dominate another person to feel anything. I want to tie someone up, then blindfold and paddle them.”

Definitions and Key Thoughts

Sexual Sadism and Sexual Masochism are two separate psychological disorders and each are categorized by the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) as a paraphilia, which is a sexual disorder characterized by socially unacceptable preoccupations or behaviors (other paraphilias include voyeurism, exhibitionism, and Fetishism).

Sadism and masochism are characterized by feelings of sexual pleasure or gratification when inflicting suffering on another person, or having it inflicted upon one’s self, respectively.

The official DSM-IV criteria for sexual sadism are:

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.

B. The person has acted on these urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

The official DSM-IV criteria for sexual masochism are:

A. Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving the act (real, not simulated) of being humiliated, beaten, bound, or otherwise made to suffer.

B. The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

A person with a diagnosis of sexual sadism is known as a sadist. The name is derived from Marquis Donatien de Sade (1740-1814), a French aristocrat who became famous for writing novels around the theme of inflicting pain as a source of sexual pleasure.

A person with a diagnosis of sexual masochism is known as a masochist. Like sadism, the term masochist is derived from a proper name; Leopold von Sacher-Masoch (1836-1895), an Austrian novelist who described the disorder in his works.

The term Sadomasochism is used to describe either the co-occurrence of sadism and masochism in one individual, or as a replacement for both terms.

In 1905, Sigmund Freud described “Sadism” and “Masochism” in his Drei Abhandlungen zur Sexualtheorie (”Three papers on Sexual Theory”) as diseases developing from an incorrect development of the child psyche.

The first use of the compound term Sado-Masochism was by the Viennese Psychoanalyst Isidor Isaak Sadger in his work Über den sado-masochistischen Komplex (”Regarding the sadomasochistic complex”) in 1913.[i]

In some extreme cases, sexual sadism can lead to serious injury or death for the target of the sadistic behaviors. According to the DSM-IV these occurrences are often when the paraphilia is diagnosed as severe, and when antisocial personality disorder is also present.

Some acts of sadism are not physically harmful, and are aimed at humiliation. These include:

· Urinating on someone

· Insults

· Restraining a person with handcuffs, chains, ropes, or cages.

Act of physical sadism include:

· paddling

· spanking

· whipping

· burning

· beating

· administering electrical shocks

· biting

· urinating or defecating on the other person

· cutting

· rape

· murder

· physical mutilation.

Action Steps and Treatment Plan for Sadism and Masochism

Treatment of sexual sadism or sexual masochism may be complicated by health problems related to promiscuous sexual behavior. Sexually transmitted diseases (STDs) and other medical problems may be present.

Note: Acts of sexual sadism or sexual masochism tend to grow more violent or bizarre over time. However, as persons with either disorder grow older, their ability or desire to participate in such behaviors begins to decrease. For example, sexual sadism is rarely diagnosed in men over 50 years of age.

1) Replace Violent Behaviors

Sadistic behaviors range in terms of their violent nature. Some sadistic behaviors are focused on humiliation and mild pain, while others are aimed toward severe pain.

Also, a practicing sadist will either find a willing partner to participate in these behaviors, or will find a sexual victim.

Replacing violent behaviors with less violent behaviors, and making a commitment to only participate in rough sexual activities with persons who are willing to participate is a preliminary way to ensure the safety of the sadist, masochist, and other persons involved.

2) Focus on Healthy Sexuality

Identifying and focusing on sexual practices that are gratifying and that do not incorporate sadistic or masochistic behaviors will help one to participate in normal sexual behavior.

Encouraging and expanding normal sexual practices is a way to use the strengths and assets and tendencies toward normal sexual practices that a person already has.

3) Make a Commitment to Change

Even if a person is fantasizing about sadism or masochism, one can make a conscious commitment to not outwardly participate in such behaviors.

One method for encouraging this is by helping one see that other persons are innately valuable and should be treated with respect and even care. This understanding of another person’s value is to supersede any desire to practice violent or humiliating acts against them. Similarly, seeing one’s self in this same way (as valuable) should supersede one’s masochistic desire to have violent or humiliating acts inflicted upon them.