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When Pain Equals Pleasure: Understanding BDSM

In a world where sexual harassment, trauma, abuse, and violence are all too common, the issue and experience of BDSM raises some obvious red flags. Some argue that BDSM reflects the unbalanced gender dynamics that are so painfully apparent in our current world (#MeToo). Some think that BDSM is nothing more than a justification used to force people to act against their will. Others view BDSM as an unhealthy form of trauma repetition.

For the most part, these arguments are based on a lack of understanding about human sexual arousal, the pain-pleasure continuum, and what BDSM really is. Sadly, this lack of understanding often extends into the clinical space. Even if you’re an experienced family or marital therapist, you may not know much about BDSM, and because of that you might unconsciously place an unhelpful (possibly harmful) value judgment on a client’s perfectly healthy (for that person) arousal template and sexual behaviors. And that is just not good therapy.

Recognizing this, I have created a brief clinical guide to BDSM. If you encounter a client who is interested in or currently engaging in BDSM, this basic understanding will help you counsel your client on his or her issues and concerns. Please note, this article is not a complete guide to the BDSM world. It is simply a starting point that can help you understand the basics of what your client is talking about.

What is BDSM?

BDSM is an acronym for Bondage, Discipline, Submission, Masochism. BDSM involves the creation of intense physical, emotional, and psychological sensations, the consensual exchange of sexual power, and the experience of pleasure through pain. And yes, pain really can create pleasure – via the release of endorphins. We’ve all heard the term runner’s high, used to describe the endorphin rush experienced when runners push themselves to the point of exhaustion. Practitioners of BDSM say they experience the same pain-pleasure sensation.

BDSM Terminology

  • Scene: This refers to the setting where the action takes place – a dungeon, a sex club, a rubber room, etc.
  • Play: This refers to the acts that take place in a scene. There is a wide spectrum of BDSM play, everything from light tickling with feathers to a practice known as Tamakari, which involves men voluntarily getting kicked in the genitals.
  • Safe, Sane, and Consensual: These are the axioms of the BDSM community. Without these three elements, BDSM ceases to be BDSM. If BDSM play is not safe, sane, and consensual, it’s abusive.
    • Safe: BDSM is not a license to inflict injury in whatever way you please. Practitioners of BDSM know what they’re doing. They educate themselves and they avoid unintentional, non-consensual harm. That includes protection against pregnancy and STIs. This does not, however, mean that BDSM play does not at times create welts, bruises, and the like. It sometimes does. But only as a mutually consented to form of play.
    • Sane: BDSM play is controlled, with good communication before, during, and after. There is always a safe word, so participants can clearly and effectively communicate a desire to take it easy or stop the action. BDSM play involves trust and exchanges of power, and those gifts are not to be violated for any reason.
    • Consensual: BDSM play requires the thorough discussion of boundaries and limits before play begins. Again, this discussion always includes setting a safe word. This is especially important if physical restraint, infliction of pain, or fighting back is planned as part of the play.

What Types of Play Are Most Common?

As long as the action is safe, sane, and consensual, pretty much anything goes with BDSM. That said, some scenes and types of play are more common than others.

  • Bondage: Bondage involves one person (or many people) being tied up, handcuffed, suspended, or otherwise restrained.
  • Sensation Play: Sensation play involves the creation of intense physical sensations (usually some form of mild to severe pleasure or pain). This may involve the use of feathers, sex toys, pinching, nipple clamps, suction, hot wax, ice cubes, etc.
  • Role Play: Role play typically involves a power dynamic of some sort – a teacher and student, a master and slave, a nurse and patient, etc.
  • Fetish Play: Fetishes involve the intense sexualization of objects, body parts, or certain actions. Typically this includes things like feet, latex, leather, cigars, dirty talk, infantilism, high heels, masks, costumes, and the like. The variety of fetish play is somewhat endless.

Ideally, BDSM play also includes at least a little bit of aftercare, with participants discussing what happened to make sure everyone is OK. A drink of water, a blanket, a hug, and an empathetic listener may be needed by one or more participants. For scenes that were especially intense, checking in a day or two later at an agreed-upon time may be an integral part of the aftercare process.

Is BDSM a Form of Unhealthy Trauma Repetition?

While it is true that physical abuse can become fetishized (made sexually arousing) during the sexual latency period, adult arousal to that same stimulus is not necessarily a form of re-traumatization. The behavior may simply be something that the individual, as an adult, finds sexually arousing. Even though the trigger for entry into the arousal template is trauma, it is not problematic as part of the adult’s sexual arousal and behavior unless it leads to reduced functioning or psychological distress. Otherwise, what happens between safe, sane, consenting adults is up to them, and clinicians should not judge those behaviors.

Is BDSM a Polite Term for Abuse?

As stated above, to qualify as BDSM, the scene and play must be safe, sane, and consensual. Without those elements, it’s not BDSM. BDSM scenes and play may create the illusion of force and unwanted control, but in reality, everything is consensual. Among consensual players, strict boundaries are in place, with safe words to stop the action at any time with no judgment or reprisal. BDSM always happens in a context of trust, safety, and mutual consent. No act should ever be pressured. Consent is never assumed. It’s as OK for a participant to say no as it is to say yes.

So no, BDSM is not a disguise for abuse. If, however, the “safe, sane, and consensual” boundaries of BDSM are not in place or not strictly followed, BDSM-like behaviors can indeed be abusive.

Need to Learn More?

Check out the following websites, podcasts, and videos.

If you want more information on sex therapy or becoming a sex therapist, check out the International Institute of Clinical Sexology.

When Pain Equals Pleasure: Understanding BDSM


Robert Weiss PhD, LCSW

Robert Weiss PhD, LCSW is Chief Clinical Officer of Seeking Integrity Treatment Centers. He is an expert in the treatment of adult intimacy disorders and related addictions, most notably sex/porn/relationship addictions along with co-occurring drug/sex addiction. A clinical sexologist and practicing psychotherapist, Dr. Rob frequently serves as a subject matter expert for major media outlets including CNN, HLN, MSNBC, OWN, The New York Times, The Los Angeles Times, and NPR, among others.Dr. Rob is the author of Prodependence: Moving Beyond Codependency, Out of the Doghouse, Sex Addiction 101, and Cruise Control, among other books. He blogs regularly for Psychology Today and Psych Central. His podcast, Sex, Love, & Addiction, is rated as a Top 10 Addiction Podcast for 2019. He also hosts a weekly live no-cost Webinar with Q&A on SexandRelationshipHealing.com. A skilled clinical educator, Dr. Rob routinely provides training to therapists, hospitals, psychiatric organizations, and even the US military. Over the years, he has created and overseen nearly a dozen high-end addiction and mental health treatment facilities across the globe. For more information or to reach Dr. Rob, visit SeekingIntegrity.com. You can also follow him on Twitter (@RobWeissMSW), LinkedIn (Robert Weiss LCSW), and Facebook (Rob Weiss MSW).


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APA Reference
Weiss PhD, R. (2019). When Pain Equals Pleasure: Understanding BDSM. Psych Central. Retrieved on January 29, 2020, from https://blogs.psychcentral.com/sex/2019/12/when-pain-equals-pleasure-understanding-bdsm/

 

Last updated: 5 Dec 2019
Statement of review: Psych Central does not review the content that appears in our blog network (blogs.psychcentral.com) prior to publication. All opinions expressed herein are exclusively those of the author alone, and do not reflect the views of the editorial staff or management of Psych Central. Published on PsychCentral.com. All rights reserved.