Sadomasochism Peer-reviewed Research

 

Sadomasochism Peer-reviewed Research

Curated by Oregonleatherboy


https://drive.google.com/drive/folders/178Np9m7MVRfX0t5tznTCwE4KNcjn_NI0

BDSM

Sexual masochism disorder (SMD) 


https://docs.google.com/document/d/18IWQDbuGsd6F0D9FjaDABGHhYgEy2K0XYp2XQrYNY9I/edit?usp=drivesdk

single-case reports rather than empirical investigation and mainly from a psychodynamic perspective was prevalent through much of the 20th century 

Berliner, 1947; 

Blos, 1991;

Blum, 1991; 

Fitzpatrick Hanly, 1995; 

Freud, 1924; 

Kernberg, 1991; 

to Reik, 1941;

 Rothstein, 1991; 

Sack & Miller, 1975; 

Stekel, 1929

 

considered as an erotic/sexual practice (e.g., Barker et al., 2007).

published

scholarly or renowned BDSM-experienced authors/contributors

 Baldwin, 1993; 

Bean, 1994;

 Easton & Hardy, 2004;

 Easton & Liszt, 1994; 

Harrington, 2016; 

Kinsey, 2014; 

Langdridge & Barker, 2007; 

Miller & Devon, 1995;

 Moser & Madeson, 1996;

 Taormino, 2012;

 Thompson, 1991; 

Warren, 1994;

 Weinberg, 1995;

 Wiseman, 1992

foundations of m/s behavior definition is the production of erotic/sensual/sexual pleasure 

(Turley & Butt, 2015).

Doctoral theses dealing with BDSM practitioners also began to be published

 (Baker, 2016; 

Busbee, 2008; 

Cutler, 2003; 

Damon, 2001;

 Levine-Ward, 2016; 

Matthews, 2005;

 Silva, 2015

; Taylor, 1995

; Van der Walt, 2014; 

Yost, 2006


practitioners of Bondage-Discipline/Dominance-Submission/Sadism-Masochism (BDSM) began to publish first-hand accounts

 Mains, 1984; 

Scott, 1985

; Townsend, 1972

ethnographic and/or participatory reports 

Beckmann, 2001; 

Carlström, 2018a, 2019

; Caruso, 2016; Fennell, 2018;

 Kamel, 1980

; Newmahr, 2008, 2011; 

Prior, 2013; 

Weinberg et al., 1984; 

Weiss, 2011

; Zambelli, 2016).

Unbalanced Power between partners is sexually arousing for half of general adult population (Jozifkova, 2018),  


sexual Play (and sexual fetishism)

  anthropologists and sociologists to   exists only in well-developed, complex, symbol-based cultures

 (Gebhard, 1969; Weinberg, 1994).

Sexual power 

 acts of domination


submission


humiliation

 (Gebhard, 1969; Stoller, 1991)

sexual pleasure (masochism) 

 consenting

playful sexual submission 


not  forced submission)  (Baumeister, 1989). 

sexual interests developed through an environmental process 

(Laumann et al., 1994) 


Victorian era saw the pathologization of sexual masochism, based principally on intuitive clinical opinions, moral judgments, and dramatic reports of cases in forensic psychiatry

 (Freud, [1905] 1920; Krafft-Ebing, 1895)

ancient Indian Hindu Kama Sutra (Vatsyayana, 1883, original circa 400),

medieval Indian Koka Shastra 

(Kokkoka, 1965, original ca. 1150), 

classic

Sex

 books

Arabic The Perfumed Garden (Al-Nafzawi, 1886, original ca. 1400)

recommend  painful stimulation 

 biting

 scratching

spanking

 hair pulling 

 enhance sexual arousal





rates of mental illness are not higher in BDSM practitioners compared with the general population 

(Brown et al., 2019; De Neef et al., 2019).

mainstream leisure activity (Blackshaw, 2013).

did not exist in modern preliterate societies 

(Gebhard, 1969; Stoller, 1991)

 or before the early modern period (1500–1800; Bullough, 1976).

19th century and 20th

 ethnologists reported on the practice of inflicting mild pain–but not on plays of submission for sexual pleasure in several preliterate societies

 (Ford & Beach, 1951)..

Spanking and flagellation  popular  in this  puritan period

 (Marcus, 1966)

physical or psychological pain may be involved in erotic power-exchange behaviors, playing with power relationships is more important than inflicting or receiving pain in this context

 (Alison et al., 2001; Langdridge & Butt, 2005)

arrested sexual development


 a response to guilt


 expression of death instinct


 overdevelopment of feminine psychological factors


 an expression of self-destructive violence


a transgression of the Oedipal prohibition


 fear of intimacy


annihilation


 castration  

(Taylor, 1995

Giving, taking, and/or exchanging power between partners is sexually arousing for most practitioners (Prior, 2013; Taylor & Ussher, 2001)



medical doctors in Western Europe prescribed flagellation  cure for erectile dysfunction (Apertus, 1928; Debay, 1862; Doppet, 1788; Meibomius, 1761; 

flagellation to enhance sexual arousal in women).

 Boileau, 1700

mental disorders  dominant view  a century  

(Frías et al., 2017;

 Kurt & Ronel, 2017


unproven, largely 

subjective theories 

(e.g., Holtzman & Kulish, 2012

; Hucker, 2008) 


 studies conducted with samples

 of clinical participants 

(Hopkins et al., 2016;  Blos, 1991; Blum, 1991; 

Hall, 2014; Rothstein, 1991;

 Thomas-Peter & Humphreys, 1997)


 Studies fail to find link 

between m/s practices

 and psychopathology 

(Connolly, 2006; Cross & Matheson, 2006;

 Gemberling et al., 2015; 

Wismeijer & Assen, 2013;  Baumeister & Butler, 1997 

BDSM practitioners, obtained significantly higher levels of education than adults in the general population 

(Bienvenu et al., 2005; Botta et al., 2019; Breslow et al., 1986; Connolly, 2006; Gemberling et al., 2015; Levitt et al., 1994; Moser & Levitt, 1987; Sandnabba et al., 1999; Spengler, 1977; Taylor & Ussher, 2001; Wismeijer & Assen, 2013; Yost & Hunter, 2012)➡️➡️

rates of major mental disorders are lower among adults who have university diplomas than  those who do not

 (ESEMeD/MHEDEA 2000 Investigators et al., 2004)

more signs of psychological difficulties than those who are sexually dominant,   anxiety, worry, and self-esteem 

(Bienvenu et al., 2005; Botta et al., 2019; Connolly, 2006; Damon, 2001; Gemberling et al., 2015; Gosselin & Wilson, 1980; Hébert & Weaver, 2015; Wismeijer & Assen, 2013)

BDSM, and particularly m/s behaviors, have therapeutic effects 

(Easton, 2007; Graham et al., 2016; Lindemann, 2011

interest in m/s was already present,  not erotized, during childhood

 ( Breslow et al., 1986; Carlström, 2019; Scott, 1985; Stiles & Clark, 2011). 

interests  developed further ( became conscious) as sexual fantasies during puberty 

(Gosselin & Wilson, 1980). 

subgroup of m/s practitioners aware of  interests  early during adolescence 

(Bezreh et al., 2012; Breslow et al., 1985, 1986; Sandnabba et al., 1999).

instrumental learning (associating a nonsexual stimulus with sexual gratification), maltreatment in childhood, being introduced to the practices by another person, or chronic illness (Scott, 1985; Yost & Hunter, 2012). 

m/s inclinations represent an adaptative mechanism,  

 to triumph over childhood trauma such as verbal, physical, or sexual abuse

 (Blum, 1991; Holtzman & Kulish, 2012; Stoller, 1975; Van der Kolk, 1989)


 

   


 

propose a basic dichotomy that opposes intrinsic vs. extrinsic influences

 (Yost & Hunter, 2012).

usually within a psychodynamic framework. In fact, rates of childhood physical and sexual abuse are no higher among BDSM practitioners than in the general population 

(Breslow et al., 1986; Gosselin & Wilson, 1980; Moser & Levitt, 1987; Taylor & Ussher, 2001; Yost & Hunter, 2012).

BDSM practitioners do report having been victimized during childhood

 (Nordling et al., 2000; Yost & Hunter, 2012) 

reenacting the traumatic event might help take psychological control over it, making it more positive through erotization and changing the power relationship (Taylor & Ussher, 2001).

theories derive from a psychological approach that is subjective and based on clinical cases

 ( Abrams & Stefan, 2012),l

sexo-erotic proclivities (especially m/s behaviors) are part of a healing process 

(Easton, 2007; Kleinplatz, 2006; Mains, 1991; Ortmann & Sprott, 2013)


during childhood or adolescence to eroticize a chronic and painful condition, rendering it pleasurable 

Sandahl, 2000; Stoller, 1991; Takemoto, 2009). T

Intrinsic origins of m/s interests –  


 essentialist 

dispositional 

trait

 sexual orientation or identity –  deeply rooted individual personal history  

 (Damon, 2001; Jozifkova, 2013; Portillo, 1991; Scott, 1985). 

ethnographical  similarity to the rituals of European religious groups  Flagellants (Mooney, 1896)






subgroup of BDSM practitioners (approximately 30%) alternate between domination and submission 


“switch” practitioners Alison et al., 2001; Breslow et al., 1986; Martinez, 2018; Moser & Levitt, 1987; Sandnabba et al., 2002, 1999).

Inequity in interpersonal erotic power is at the heart of BDSM (Busbee, 2008; Cross & Matheson, 2006; Ernulf & Innala, 1995; Faccio et al., 2014; Hébert & Weaver, 2015; Kaldera, 2011; Langdridge & Butt, 2005; Yost, 2006). 


self-administered flagellation  Christian devotion and penitence,  transcendence, sense of the sacred, and ecstasy  (Glucklich, 2001).

physical restriction does not necessarily involve painful stimulation, which may be valued not as much for itself but as a symbol of power

 (Easton & Hardy, 2004).

3/4 interested in engaging in domination/submission behaviors during sexual intercourse (Apostolou & Khalil, 2018)


Krafft-Ebing5 pioneered in classifying sadism and masochism as pathologies in his Psychopathia Sexualis, 

 19th century sexology. 


 Freud’s 6 theories on sexuality.  

perception of BDSM as being pathologic influenced scientific articles from the 1970s and 1980s, which tended to focus on (non-consensual) sexual sadism from a forensic perspective and incidental SM-related fatalities.7, 8, 9


 

m/s practitioners report 

 they do not enjoy pain per se context (erotic ambiance, scene, and clothing) and preparation (e.g., pre-agreeing, scripting, expectation)  are crucial, both subjectively

 (Alison et al., 2001; Baumeister, 1989; Langdridge & Barker, 2007; Taylor & Ussher, 2001; Weinberg et al., 1984) and objectively (i.e., brain response patterns; Kamping et al., 2016

M/S activities requires concentration and focus on the present 


  force practitioners to pay attention to the present moment

 (Newmahr, 2008). 


  

explain  experience in religious or spiritual terms, 

 

mystic experience,

 transcendent, 

reaching for God,

 a feeling of wholeness 

oneness with  universe,

 sacred kink

magical

 a connection, 

 mind expanding 

(Baker, 2016; Beckmann, 2009; Busbee, 2008; Easton & Hardy, 2004; Graham et al., 2016; Harrington, 2016; Kaldera, 2006; Mains, 1991; Norman, 1991; Sagarin et al., 2015; Taylor & Ussher, 2001; Van der Walt, 2014; Westerfelhaus, 2007; Zussman & Pierce, 1998).  

altered states of consciousness can be reached in non-painful m/s circumstances (e.g., bondage with soft ropes, mummification), their association with intense and prolonged painful erotic stimulations is especially strong (Ambler et al., 2016; A. Beckmann, 2007; Easton & Hardy, 2004; Lee et al., 2016; Mains, 1984; Newmahr, 2008; Sagarin et al., 2015).

m/s practitioners report psychological benefits 

 meditation, hobbies and sports, elevated concentration, less mental activity, absorption in the moment, and relaxation 

(e.g., Easton & Hardy, 2004; Kaldera, 2006; Kleinplatz & Ménard, 2007)

partial opposition  meditation/mindfulness

 Baumeister (1989, 1997) 

proposed that m/s serves instead to provide a way to escape the self. 


studies also failed to find support for Baumeister’s speculations 

(Cross & Matheson, 2006; Hébert & Weaver, 2015). 

m/s behaviors provide an escape from mundane and external stimuli to allow exploration of inner space 

(Baldwin, 1993; Bean, 1994; Easton & Hardy, 2004; Easton & Liszt, 1994; Harrington, 2016; Kinsey, 2014; Langdridge & Barker, 2007; Miller & Devon, 1995; Moser & Madeson, 1996; Taormino, 2012; Thompson, 1991; Warren, 1994; Weinberg, 1995; Wiseman, 1992



BDSM practices might also be viewed as a type of leisure activity, one undertaken either seriously (Newmahr, 2010) 


recreationally (Williams et al., 2016; Wismeijer & Assen, 2013).

individuals were expressing their true feelings, as they were in an anonymous, welcoming, and safe environment ( Ernulf & Innala, 1995; Langdridge & Butt, 2004).  (Dunkley & Brotto, 2019). 


 



 BDSM-related activity on a regular basis is reported by 12.5% of the general population.3Santilla and colleagues28 showed that these interests also seem to evolve over time, from initial milder interactions toward more extreme forms later BDSM-related interests are sexual in nature in most, but not all, BDSM community members


; 70% 

 always or regularly combined BDSM  with sex,  


7%

 never combined the 2


 23% 

 on occasion.. 



BDSM practices require training and behavioral


 cognitive learning  are associated 


 self-exploration


pleasure


 sense of adventure


generating stress reduction 


 positive emotions 

(Williams et al., 2016),  

Discourse analysis confirmed that m/s activity allowed practitioners to escape not from themselves but from mundane matters

 (Taylor & Ussher, 2001). 

practitioners (90.9%) also included sexual arousal 


 sexual arousal is a part of most definitions of m/s (e.g., American Psychiatric Association [APA], 2013),  

modification of mental, psychological, 

 (N = 64 or 28%)


 reach an altered state of consciousness (12%); 


 state of focussed attention or relaxation (9%); 


 humiliated (7%). 


genital sexuality  absent from  m/s activities. 

 m/s practioners  asexual (9%) 

 (Sloan, 2015

persons contributing to Internet forums might not really engage in face-to-face BDSM interaction (Newmahr, 2010) and some websites devoted to the BDSM (or kink) 

Yost 39

  4 categories BDSM stigmatizing attitudes:


 (i) BDSM is socially and morally wrong, 


(ii)  associated with non-consensual violence


 (iii)  general lack of tolerance toward SM practitioners, , 


(iv)  submissive or dominant traits translate to other domains in  life

extrinsic factors


Past Trauma

 22%

Including childhood sexual abuse 


 11%; 

 parental discipline 


9%; 

 spanking, usually with an object;


9%

 positive (enjoyable) operant learning (N  


9%

  introduced to practices by  person

 during adulthood 

 

 1%

 m/s   associated with a chronic illness 

m/s


( 46%) 

  playing with interpersonal power


 exchanging power  28%; “


  physically restrained 

 18%,  being tied up; 


  19%

  specified  importance of trusting  partner

second for engaging in m/s activities – 


(37%) 

 receive physical pain

 importance of the context surrounding painful stimuli  


( 46%) 

 feeling of painful stimuli  including nonsexual context  


 (18%)

  spanking   preferred way to receive pain


 both physical  stimulation


 psychological (submission) qualities.

third  reasons to engage in m/s 

 

  (28%) 

modification of mental, psychological,  inner space 


(12%); 

to reach a state of focussed attention  relaxation 


(9%); 

 be humiliated 


(7%)

 Altered states of consciousness and focused attention 

  use of power

 restraint


 


extrinsic source of m/s 

 learning   associated with fetishism (e.g., Darcangelo, 2008)   among BDSM practitioners. 


 linking childhood chronic illness to m/s practices  Supermasochist”; Dick, 1997; Reynolds, 2007), 


 two participants (1%) associated their interests in m/s activities 


 painful chronic illness. Overall, the origins of m/s interests  (DeLamater & Hyde, 1998)




patriarchal values and a sexist environment (Rogak & Connor, 2018; see also Chancer, 2000; Deckha, 2011


patriarchal society that taught women to act that way 

( Linden et al., 1982).  before  feminism  sex wars 

(Horney, 1935; Kinsey et al., 1953; Maslow, 1942)  

(Califia, 1979; Weinberg et al., 1984) and after that time

 (, Hawley & Hensley, 2009; Wismeijer & Assen, 2013; Yost & Hunter, 2010).

 


Prolonged, intense, contextual, anticipated, and consensual sexualized painful stimulation seems to induce analgesia and ecstasy, just like runner’s rush, cross-fit’s high, orgasmic birth, and other pain-related euphoric phenomena (e.g., Buckley & Dip, 2003; Mayberry & Daniel, 2016; Raichlen et al., 2012). As Mains (1984)



physical pain 

 secretion of endorphins (or “endogenous morphine”)


  both analgesic and euphoric effects. Endorphins are neuropeptides that act on opioid receptors ( mu receptors),  reduce sensitivity to pain. Agonists for these receptors (e.g., opioid drugs) not only induce analgesia  euphoria and, potentially, dependency. Indeed, these physically related euphoric states like effects of drugs might become addictive,  for athletes also  practitioners of m/s

 ( Kurt & Ronel, 2017)


Pain (Pertovaara et al., 1982; Zubieta et al., 2001)

physical effort (Schwarz & Kindermann, 1992)

meditation (Harte et al., 1995)

sexual stimulation (Whipple & Komisaruk, 1988) 


 enhance endorphin secretion and produce a feeling of well-being. 

 Endorphin secretion  promotes interpersonal bonding 

(Machin & Dunbar, 2011),  (Hébert & Weaver, 2015; Sagarin et al., 2009; Van der Walt, 2014

suspending the body on metal hooks (“Bagad”) 


 fire walking  common in southern India  

 20th century, despite repression of and laws against such practices

 (Kosambi, 1967; Powell, 1914; Thurston, 1906).

Sacred” states of mind reached through physical pain are also reported in religious traditions (Glucklich, 2001) 



Traditional Indian religions (.Jainism)  extreme aesthetic behaviors,

 body mortification


 “a technique of altering consciousness or withdrawing consciousness from the world of the senses in order to experience total world transcendence” (Cort, 2002







Bondage-Discipline, Dominance-Submission and Sadomasochism (BDSM) From an Integrative Biopsychosocial Perspective: A Systematic Review


Nele De Neef, MD, Violette Coppens, PhD, [...], and Manuel Morrens, MD, PhD


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525106/?report=reader


Abstract

Introduction

BDSM (bondage and discipline, dominance and submission, and sadism and masochism) increasingly receives attention from the scientific community. Where earlier research efforts mainly focused on epidemiologic characteristics, psychological and biologic factors driving BDSM preferences have recently gained interest as well.

BDSM Disclosure and Stigma Management: Identifying Opportunities for Sex Education


Tanya Bezreh, Thomas S. Weinberg, and Timothy Edgar


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3382736/?report=reader


Abstract

While participation in the activities like bondage, domination, submission/sadism, masochism that fall under the umbrella term BDSM is widespread, stigma surrounding BDSM poses risks to practitioners who wish to disclose their interest. 

1

Bondage-Discipline, Dominance-Submission and Sadomasochism (BDSM) From an Integrative Biopsychosocial Perspective: A Systematic Review


Nele De Neef, MD, Violette Coppens, PhD, [...], and Manuel Morrens, MD, PhD


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6525106/


Abstract

Introduction

BDSM (bondage and discipline, dominance and submission, and sadism and masochism) increasingly receives attention from the scientific community. Where earlier research efforts mainly focused on epidemiologic characteristics, psychological and biologic factors driving BDSM preferences have recently gained interest as well.

Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations



https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701471/?report=reader

J. Whitehead, John Shaver, and Rob Stephenson


Additional article information


Associated Data

Data Availability Statement

Abstract

Background

Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.

2

What Is So Appealing About Being Spanked, Flogged, Dominated, or Restrained? Answers from Practitioners of Sexual Masochism/Submission

Frédérike Labrecque,Audrey Potz,Émilie Larouche &Christian C. JoyalORCID Icon


https://www.tandfonline.com/doi/full/10.1080/00224499.2020.1767025?src=recsys


A growing number of studies have demonstrated that BDSM (Bondage/Discipline-Domination/Submission-Sadism/Masochism) practices are not signs of mental illness. However, the reasons for engaging in such behaviors are not well understood, especially for sexual masochism or submission (m/s). A thorough review of the literature was conducted, as well as a search in Internet forums and an online survey to obtain testimonies that provide information on the origins of interest in m/s and the reasons for engaging in it. A qualitative content analysis was performed on narratives from 227 m/s practitioners. Sixteen themes emerged from this analysis, eight related to the origins of interest in m/s and eight to the reasons for engaging in m/s. 




https://drive.google.com/drive/folders/1TjNrYMJWl9HenthIvvAso1whtIlOW0sE

Masochism

Cloud







Contextual modulation of pain in masochists: involvement of the parietal operculum and insula


Sandra Kamping, Jamila Andoh, [...], and Herta Flor


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795098/?report=reader


Abstract

Pain can be modulated by contextual stimuli, such as emotions, social factors, or specific bodily perceptions. We presented painful laser stimuli together with body-related masochistic visual stimuli to persons with and without preferred masochistic sexual behavior and used neutral, positive, and negative pictures with and without painful stimuli as control.

Sexual Masochism Disorder with Asphyxiophilia: A Deadly yet Underrecognized Disease


Anna Coluccia, Mario Gabbrielli, [...], and Andrea Fagiolini


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5055911/?report=reader


Abstract

DSM-5 distinguishes between paraphilias and paraphilic disorders. Paraphilias are defined as atypical, yet not necessarily disordered, sexual practices. 


Subs give away their power in m/s 

 two main subgroups:

1

professionally (Lammers & Imhoff, 2016),

powerful in everyday life 

⬅️ 


(Brame et al., 1993; Hawley & Hensley, 2009; Stoller, 1991)


➡️

2

simply more sexually aroused by submission




















BDSM ideology in that they frame the male/female dynamic and establish a psychosexual contract


(Wilson, 2005; Palandri & Green, 2000; Brown et al., 2020; Cascalleira et al., 2021).

1

2.2% of men and 1.3% of women between ages 16–59 years had engaged in BDSM activity during the previous year. 


 


 BDSM interest in as much as 46.8% of the general population (n = 1,027), who have engaged in BDSM-themed activities least once, 


  7.6% of the general population self-identified as a BDSM practitioner. 


Holvoet et al3

Studies reporting on individuals having BDSM fantasies reveal higher prevalence rates. Holvoet et al,3 for example, found that 69% of the general population had fantasies about BDSM-related activities


 

1

SM” or “BDSM” without specifying a definition18, 19, 24, 25 systematically yielded lower prevalence rates, compared with studies gauging interest or practices of specific activities and dynamics (eg, “tying up,” “blindfolding,” “whipping”).3, 16, 21, 22

1


 Martinez’s survey study


self-identifying

 41.1% 

submissive

slave

 bottom


28.2% 

as dominant

master

sadist 


 22.3% 

as switch


 52%

 maintaining the same role (dominant or submissive) throughout all interactions


88%  

 identified with 1 BDSM identity



  men  less fluid in their role 


43.4% of the men had at least some level of fluidity, 

 

51.5% of the women).


 


stigma and its effect on working conditions (Benoit et al., 2017a, b), the punitive approach and effect on sex workers (Benoit et al., 2018) and its role in strategies and challenges sex workers face (Bungay & Guta, 2018), 


 highly relevant to sex relations and the work of findommes on digital platforms. How sex workers manage enacted or felt that stigma may impose upon both their psychological and mental health

 (Garcia & Crocker, 2008; Sanders, 2005a, 2008; Van Wesenbeek, 2005


 stigma associated with sex 


work ostracise workers


Impair their human rights


 ability to access legal


 health, and psychological 


support mechanisms 

(Brooks-Gordon, 2006; Scambler & Paoli, 2008; Ward & Day, 2004; Jiaou & Bungay, 2019).


Stigma has also been shown to impair the ability to regulate and control one’s actions (Inzlicht et al., 2006). 


, develop strategies to fight stigma rather than internalising feelings of shame 

(Parker & Aggelton, 2003; Koken, 2012; Koken et al, 2014)

constructing a sexual identity  a complicated process that evolves over time

 (Maguen, Floyd, Bakeman, & Armistead, 2002; Rust, 1993).  (1978)

SM appears early age and  individuals are in teens-20's (Breslow, Evans, & Langley, 1985). Moser and Levitt (1987)


 

 

cases of discrimination against individuals, parents, private parties, and organized SM community events, demonstrating that SM-identified individuals may suffer discrimination, become targets of violence, and lose security clearances, inheritances, jobs, and custody of children. According to Link and Phelan (2001), stigma reduces a person's status in the eyes of society and “marks the boundaries a society creates between ‘normals’ and ‘outsiders’” (p. 377). Goffman (1963) 

BDSM community members to identify with


dominant

master/mistress

top

 sadist

submissive

bottom

masochist 

 switch,34, 35 a


Lines between roles does not always exist. 

exert considerable influence in the willingness to fulfil clients’ desires and maintain their loyalties (Sanders, 2005b). Wilson (2005) advises that, even with the commercial BDSM community and the suggested dominant/slave relationship,

Morris and Feldman’s extended model of emotional labour (1996)

theorizes four dimensions: the prevalence of appropriate emotional display, the diversity of emotions that are displayed, attentiveness to required display rules, and the emotional dissonance experienced by having to display desired emotions that are not genuinely felt.

psychological implications and pressure to extend sexual boundaries (Megan Smith, 2017)



majority of an SM-identified sample had revealed their interests to significant others. Kamel (1983) outlined the stages of emerging sadomasochistic desires and integration into community for leathermen


 gay men who wear leather to indicate interest in BDSM). He described phases of disenchantment, depression, and “a second ‘closet’” 

. Moser and Levitt (1987


 

 

When Someone You Love Is Kinky. (Easton & Liszt, 2000).


 Healthcare Without Shame by Charles Moser is a handbook for people who want to disclose their sexuality to their doctors and gives guidance to caregivers on how to respond 

(Moser, 1999)

SM can appear at an early age and usually appears by the time individuals are in their twenties (Breslow, Evans, & Langley, 1985)


 Moser and Levitt (1987


 10% of an SM support group they studied “came out” between the ages of 11 and 16; 


26% reported a first SM experience by age 16; 


 26%  “came out” into SM before having their first SM experience. A study by Sandnabba, Santtila, and Nordling (1999) surveyed members of SM clubs in Finland and found that 9.3% had awareness of their sadomasochistic inclinations before the age of 10.



10%

“came out” between the ages of 11 and 16; 

Sandnabba, Santtila, and Nordling (1999)

26% 

reported a first SM experience by age 16


SM support group

26% 

 “came out” into SM before having their first SM experience. 

Canadian university students 


 72% of the men 

 59% of the women  

 fantasies of being tied up


 65% of the men 

58% of the women 

 fantasies of tying up a partner


 60% of the men 

 31% of the women 

 thoughts of whipping or spanking

27.0%

 identifying themselves sadistic


22.7% 

both sadistic and masochistic


 50.2% as mainly masochistic.



surveyed members of SM clubs in Finland 


 9.3% 

 awareness of their sadomasochistic inclinations before the age of 10.



National Coalition of Sexual Freedom survey of adult SM group members found that 70% “were at least partially closeted” to

 (Wright, 2006). Breslow (1986) 


positive association between the level of well-being and the degree of integration into SM subcultures. Kolmes et al. (2006) found that disclosing an interest in SM to therapists can be dangerous. 

175 BDSM-inclined therapy patients surveyed experienced 118 incidents of biased care


more extroverted, more open to new experiences, more conscientious, and less agreeable. Moreover, BDSM practitioners differed in their attachment styles because they were less sensitive to rejection, more confident in their relationships, had lower need for approval, and were less anxiously attached compared with the non-BDSM participants. Most of these effects were driven by the female subsample of the BDSM practitioners. Frías et al72 suggested a higher prevalence of sexual masochism in subjects with borderline personality disorder



Frías et al72 suggested a higher prevalence of sexual masochism in subjects with borderline personality disorde


Connolly64 demonstrated higher levels of narcissism among practitioners

self-reported sexual childhood abuse was higher among BDSM practitioners (8% men, 23% women), as compared with the general population (3% men and 8% women). 

self-reported sexual childhood abuse was higher among BDSM practitioners (8% men, 23% women), as compared with the general population (3% men and 8% women). 




cases of discrimination against individuals, parents, private parties, and organized SM community events, demonstrating that SM-identified individuals may suffer discrimination, become targets of violence, and lose security clearances, inheritances, jobs, and custody of children. According to Link and Phelan (2001), stigma reduces a person's status in the eyes of society and “marks the boundaries a society creates between ‘normals’ and ‘outsiders’” (p. 377). Goffman (1963) 


constructing a sexual identity may be a complicated process that evolves over time (Maguen, Floyd, Bakeman, & Armistead, 2002; Rust, 1993). Weinberg (1978)Google search of “BDSM” in 2010 returned 28 million Web pages. Janus and Janus (1993) found that up to 14% of American males and 11% of American females have engaged in some form of SM. A study of Canadian university students found that 65% have fantasies of being tied up, and 62% have fantasies of tying up a partner (Renaud & Byers, 1999).

“power (exchanging it, taking it, and/or giving it up), the mind (psychology), and sensations (using or depriving use of the senses and working with the chemicals released by the body when pain and/or intense sensation are experienced)” (Pawlowski, 2009).1




distinguishes BDSM activity from abuse and/or psychopathology is the presence of mutual informed consent of all those involved

 (Bezleh et al., 2012; Dunkley & Brotto, 2020). Reviewers Dunkley and Brotto (2020)



 examined literature on consent in BDSM


 safety precautions


consent violations


North American laws  BDSM practice


  role of the BDSM community with respect to education and etiquette surrounding consent. 

Suler (2004)  DP work enables  ‘toxic dis inhibition’ 

 characterise findomme postings and  due to the ability to use dis-associative imagination 

 creation of a persona

  not subject to the rules/ demands of the real world

. Griffiths (2016)


  findommes is  wallet rape

 takes advantage of the addictive nature of the BDSM client/submissive— 

suggestion  participants find offensive. Financial domination is, 


 academic research is only beginning to surface 

(Swallow, 2018).

cyber-ethnographic study of findomme culture by Durkin (2007


 observation and content analysis of specific findomme websites, blog pages, and personal profiles. Much of the findomme vernacular identified in that study implied a connection to commercial BDSM identified in other studies (McLintlock, 1993; Cheng, 2013), 



from its S/M component. A descriptive exploratory investigation by 

explored how bondage and discipline, dominance and submission, and sadomasochism act as recreational leisure

Williams et al. (016

Discourses within the BDSM community have also attempted to focus upon the issues of erotic gender power play (Cascalleira, et al., 2021; Williams, 2012) 2) 





explicit approach to consent practiced by those in the BDSM community is proposed as a model for discussions around consent in other areas of sexuality, commercial, or otherwise (Dunkley & Brotto, 2020).


Asphyxiophilia

paraphilias such as bondage and transvestism and a great range of paraphernalia (props and devices involved in paraphilia sexual activities), sexual aids or pain-stimulating agents, intimate feminine garments, bondage, locks, pornographic magazines, and rubber items [11]. The inhalation of anesthetics, inhalants, and solvents sometimes occurs in combination with other appropriate devices like gas masks, anesthetic masks, diving masks, or even anesthetic machines [12]. The individual may inhale the substances or more often soak a rag with a solvent and then insert the rag in the mouth to inhale the fumes. Jones and colleagues [13] described a case of asphyxiophilia characterized by plastic-bag asphyxiation in combination with inhaled glue spray. Similarly, Gowitt and Hanzlick [14]

.  


Canadian study,

 sadomasochistic sexual fantasies during sexual intercourse were reported by 10% of men 


 females (from 31 to 57%) were reported to have rape fantasies [2].


 survey of sexual behavior in the US 

 2026 respondents

 4.8% of males 

 2.1% of females reported sexual pleasure from inflicting pain 


 2.5% of males 

 4.6% of females  receiving pain. 


 [4]  literature on women's rape fantasies 

 31–57% of women had fantasies in which they were forced into sex against their will 


 9–17% these were a frequent or favorite fantasy experience.


 Hunt [3] 






mortality rate of autoerotic asphyxia range from 250 to 1000 deaths per year in the United States [6]. In a review of all published cases of autoerotic deaths from 1954 to 2004, Hucker [7] reported that autoerotic death practitioners were predominantly Caucasian males. Most cases of asphyxia were by hanging, ligature, plastic bags, chemical substances, or a mixture of these. Atypical methods of autoerotic activity leading to death accounted for about 10.3% of cases in the literature and included electrocution (3.7%), overdressing/body wrapping (1.5%), foreign body insertion (1.2%), and atypical asphyxia method (2.9%). Victims were aged from 9 to 77 years and were mainly found in various indoor locations [7].














  1. Krueger, Richard B. (8 December 2009)"The DSM Diagnostic Criteria for Sexual Sadism" (PDF)Archives of Sexual Behavior39 (2): 325–345. doi:10.1007/s10508-009-9586-3ISSN 0004-0002PMID 19997774S2CID 11495623
  2. ^ Krueger, Richard B. (10 March 2010). "The DSM Diagnostic Criteria for Sexual Masochism" (PDF)Archives of Sexual Behavior39 (2): 346–356. doi:10.1007/s10508-010-9613-4ISSN 0004-0002PMID 20221792S2CID 17284505
  3. Moore, Alison (2009). "Rethinking Gendered Perversion and Degeneration in Visions of Sadism and Masochism, 1886-1930"Journal of the History of Sexuality18 (1): 138–157. doi:10.1353/sex.0.0034JSTOR 20542722PMID 19274884S2CID 32855635
  4. Krueger, Richard B.; Kaplan, Meg S. (2001). "The Paraphilic and Hypersexual Disorders:An Overview". Journal of Psychiatric Practice7 (6): 391–403. doi:10.1097/00131746-200111000-00005PMID 15990552S2CID 17478379.
  5. Fedoroff, Paul J. (2008). "Sadism, Sadomasochism, Sex, and Violence"Canadian Journal of Psychiatry53 (10): 637–646. doi:10.1177/070674370805301003PMID 18940032S2CID 19577135.
  6. Gordon, Harvey (2008). "The treatment of paraphilias: An historical perspective"Criminal Behaviour and Mental Health18 (2): 79–87. doi:10.1002/cbm.687PMID 18383202.
  7. Byrne, Romana (2013). Aesthetic Sexuality: A Literary History of Sadomasochism. New York: BloomsburyISBN 9781441183583

  1. Ernulf, Kurt E.; Innala, Sune M. (1995). "Sexual bondage: A review and unobtrusive investigation"Archives of Sexual Behavior24 (6): 631–654. doi:10.1007/BF01542185ISSN 0004-0002PMID 8572912S2CID 6495515

  1. Roffee, James (2015) "When Yes Actually Means Yes". When Yes Actually Means Yes in Rape Justice. pp. 72–91. doi: 10.1057/9781137476159.0009. ISBN 9781137476159.

  1. Reed, Geoffrey M.; Drescher, Jack; Krueger, Richard B.; Atalla, Elham; Cochran, Susan D.; First, Michael B.; Cohen‐Kettenis, Peggy T.; Arango‐de Montis, Iván; Parish, Sharon J. (October 2016). "Disorders related to sexuality and gender identity in the ICD‐11: revising the ICD‐10 classification based on current scientific evidence, best clinical practices, and human rights considerations"World Psychiatry15 (3): 205–221. doi:10.1002/wps.20354ISSN 1723-8617PMC 5032510PMID 27717275.
  2. Jump up to:a b c d e f g h Krueger, Richard B.; Reed, Geoffrey M.; First, Michael B.; Marais, Adele; Kismodi, Eszter; Briken, Peer (2017). "Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)"Archives of Sexual Behavior46 (5): 1529–1545. doi:10.1007/s10508-017-0944-2ISSN 0004-0002PMC 5487931PMID 28210933.
  3. ^ Giami, Alain (2 May 2015). "Between DSM and ICD: Paraphilias and the Transformation of Sexual Norms". Archives of Sexual Behavior44 (5): 1127–1138. doi:10.1007/s10508-015-0549-6ISSN 0004-0002PMID 25933671S2CID 21614140.
  4. ^ Reiersøl, O.; Skeid, S (2006). "The ICD diagnoses of fetishism and sadomasochism". Journal of Homosexuality50 (2–3): 243–62. doi:10.1300/J082v50n02_12PMID 16803767S2CID 7120928.
  5. ^ "ICD Revision White Paper"Revise F65. 24 September 2009. 
  6. ^ "The ICD-11 Revision: Scientific and political support for the Revise F65 reform Second report to the World Health Organization"Revise F65. 11 November 2011. 
  7. ^ "Fetish and SM diagnoses deleted in Sweden". ReviseF65. 17 November 2008
  8. ^ "SM and fetish off the Norwegian sick list". ReviseF65. 6 February 2010. 
  9. ^ "Finland joins Nordic sexual reform". ReviseF65. 13 May 2011. 
  10. ^ "Iceland removes Sadomasochism as a diagnosis"Revise F65. 17 November 2018. .
  11. Jump up to:a b Cochran, Susan D; Drescher, Jack; Kismödi, Eszter; Giami, Alain; García-Moreno, Claudia; Atalla, Elham; Marais, Adele; Vieira, Elisabeth Meloni; Reed, Geoffrey M (17 June 2014). "Proposed declassification of disease categories related to sexual orientation in theInternational Statistical Classification of Diseases and Related Health Problems(ICD-11)"Bulletin of the World Health Organization92 (9): 672–679. doi:10.2471/blt.14.135541ISSN 0042-9686PMC 4208576PMID 25378758

1. American Psychiatric Association: https://www.psychiatry.org/


2. National Institute of Mental Health: https://www.nimh.nih.gov/index.shtm

l

3. Mayo Clinic: https://www.mayoclinic.org/


References:


1. Bivona, J., & Critelli, J. W. (2009). Sadism and Sexual Sadism: A Review of Etiological Theories. Journal of Sex Research, 46(2-3), 242-256. doi: https://doi.org/10.1080/00224490902747229



2. Hucker, S. J., & Langevin, R. (2004). Sexual Sadism. Sexual Deviance: Theory, Assessment, and Treatment, 115-146. doi: https://doi.org/10.1007/978-1-4419-8857-5_5


3. Strassberg, D. S., Eastvold, A., & Kugler, R. (2009). Darker Demons of our Nature: The Need for Clinical Theory and Practice to Incorporate the Dark Side of Human Experience. Journal of Sex Research, 46(2-3), 201-212. doi: https://doi.org/10.1080/00224490902747211

Top 3 Authoritative Reference Publications/URLs:



1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596


2. Millon, T., Davis, R., & Millon, C. (1997). Millon Clinical Multiaxial Inventory-III (MCMI-III) Manual. National Computer Systems.


3. Widiger, T. A., & Trull, T. J. (2007). Plate tectonics in the classification of personality disorder: Shifting to a dimensional model. American Psychologist, 62(2), 71–83. https://doi.org/10.1037/0003-066X.62.2.71





 American Psychiatric Association: https://www.psychiatry.org/patients-families/personality-disorders/sadistic-personality-disorder


Psychology Today: https://www.psychologytoday.com/us/basics/sadism


 National Institute of Mental Health: https://www.nimh.nih.gov/health/topics/personality-disorders/index.shtml


Book: "The Sadistic Personality" by Ania Kielar


Article: "Sadism and Antisocial Behavior: A Review" by Michael C. Seto


Study: "The Dark Triad of Personality: Narcissism, Machiavellianism, and Psychopathy" by Delroy L. Paulhus and Kevin M. Williams


Buckels, E. E., Jones, D. N., & Paulhus, D. L. (2013). Behavioral confirmation of everyday sadism. Psychological Science, 24(11), 2201-2209.


Wilson, D. S., Ireland, M., & Lindsay, R. C. L. (2015). The measurement of everyday sadism: Development and validation of the Short Sadistic Impulse Scale. Personality and Individual Differences, 87, 20-24.


 Chabrol, H., Van Leeuwen, N., Rodgers, R., & Séjourné, N. (2009). Contributions of psychopathic, narcissistic, Machiavellian, and sadistic personality traits to juvenile delinquency. Personality and Individual Differences, 47(7), 734-739.



 Miller, J. D., Maples-Keller, J. L., Lynam, D. R., & Sleep, C. E. (2018). An examination of the Dirty Dozen measure of psychopathy: A cautionary tale about the costs of brief measures. Psychological Assessment, 30(3), 370-378.



Edens, J. F., Marcus, D. K., Lilienfeld, S. O., & Poythress Jr, N. G. (2008). Psychopathic, not sadistic, traits differentiate violent from nonviolent sex offenders among civilly committed sexual offenders. Journal of Personality Disorders, 22(4), 366-382.


Buckels, E. E., Jones, D. N., & Paulhus, D. L. (2013). Behavioral confirmation of everyday sadism. Psychological Science, 24(11), 2201-2209.


Chabrol, H., Van Leeuwen, N., Rodgers, R., & Séjourné, N. (2009). Contributions of psychopathic, narcissistic, Machiavellian, and sadistic personality traits to juvenile delinquency. Personality and Individual Differences, 47(7), 734-739.



Jonason, P. K., Li, N. P., Webster, G. D., & Schmitt, D. P. (2009). The dark triad: Facilitating a short-term mating strategy in men. European Journal of Personality, 23(1), 5-18.


Book, A., Visser, B. A., Blais, J., Hosker-Field, A., Methot-Jones, T., Gauthier, N. Y., & Hershfield, L. E. (2019). Unpacking the Dark Triad: Examining the relationships among sadism, psychopathy, and Machiavellianism. Personality Disorders: Theory, Research, and Treatment, 10(4), 329-337.


Reidy, D. E., Zeichner, A., Seibert, L. A., & Martinez, M. A. (2011). Effects of psychopathy and sadism on aggressive behavior in college students. Journal of Interpersonal Violence, 26(14), 2794-2810

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