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You are here: Home / Boston Counseling and Boston Psychotherapy Topics / Sadism and Masochism: Sexual Sadomasochism Facts, Diagnosis and Counseling Treatments

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

August 29, 2018 by Thriveworks Staff Leave a Comment

boston sex therapy, sadism and masochism

Portraits of Sadism and Masochism

Since he was a teenager, Carl has thought about being restrained, humiliated, or abused in a sexual way. 

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 in.

Definitions and Key Thoughts for Sadism and Masochism

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:

  • 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.
  • The person has acted on these urges with a non-consenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.

The official DSM-IV criteria for sexual masochism are:

  • 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.
  • 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.

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. They need replace violent behaviors with caring, less violent behaviors.

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. Being tempted to do something is not doing it. One method for encouraging this is by helping one see that people 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.

For more information on sexual health related issues and to schedule an appointment with a Thrive Boston sex therapist, visit our Boston Sex Therapy page. Appointments scheduled within 24 hours.

[i] Isidor Isaak Sadger: Über den sado-masochistischen Komplex. in: Jahrbuch für psychoanalytische und psychopathologische Forschungen, Bd. 5, 1913, S. 157–232 (German)

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Filed Under: Boston Counseling and Boston Psychotherapy Topics, Sex Therapy and Sexual Disorders Tagged With: counseling, masochism, overcoming masochism, overcoming sadism, paraphilia, sadism, sadistic, sadomasocism, sex problem, sex therapy, therapy, violent sex

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