Sexual masochism disorder

This article is about the medical condition where experiencing pain/humiliation is required for sexual arousal. For consenting partners engaging in sexual play behavior, see BDSM.
Sexual masochism disorder
Classification and external resources
ICD-10 F65.5

Sexual masochism disorder is the condition of experiencing recurring and intense sexual arousal in response to enduring extreme pain, suffering, or humiliation.[1] It may occur either with or without asphyxiophilia, the experience of sexual arousal from restricted breathing. The Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association indicates that a person may have a masochistic sexual interest and that the diagnosis of Sexual Masochism Disorder would only apply to individuals also report psychosocial difficulties because of it.

Related terms and conditions

Current terminology

Sexual masochism disorder is the term employed by the current version of the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association.[1] It refers to the “recurrent and intense sexual arousal from the act of being humiliated, beated, bound, or otherwise made to suffer, as manifested by fantasies, urges, or behaviors” (p. 694). It is classified as one of the paraphilias, called an “algolagnic disorder” (p. 685), which is one of the “anomalous activity preferences” (p. 685). The formal diagnosis of Sexual Masochism Disorder would apply only if the individual experiences clinically significant distress to the individual or impairment in social, occupational, or other important areas of functioning.

Sadomasochism appears in current version of the International Classification of Diseases (ICD-10) of the World Health Organization.[2] It refers to the “preference for sexual activity that involves bondage or the infliction of pain or humiliation” (p. 172), and divides sadomasochism into masochism and sadism according to whether the individual prefers to be the recipient or provider of it. The ICD-10 specifies that mild forms of sadomasochism “are commonly used to enhance otherwise normal sexual activity” (p. 172), and that the diagnosis would apply only if the behavior is preferred or required for sexual gratification. The condition is classified as one of the disorders of sexual preference, which includes the paraphilias (p. 170).

BDSM or “bondage/domination sadomasochism” is a colloquial term referring to the subculture of individuals who willingly engage in consenting forms of mild or simulated pain or humiliation.[3] It is not currently a diagnosable condition in either the DSM or ICD system. Alternative terms have included Bondage and Discipline (B&D), Domination and Submission (D&S), and Sadism and Masochism (S&M).

Previous terminology

Sexual masochism was the term employed in the DSM-III,[4] DSM-IV,[5] DSM-IV-TR.[6] Each manual noted that the condition referred to real rather than simulated or fantasized pain or humiliation.

Masochism was the term employed by the DSM-II.[7] In that manual, the condition was classified as a sexual deviation, which was used to describe “individuals whose sexual interests are directed primarily toward…coitus performed under bizarre circumstances” (p. 44). The term “paraphilia” did not exist in the DSM-II, and diagnoses did not have specific criteria until DSM-III.

Although Sexual sadism was mentioned in DSM-I as one of the sexual deviations[8] (p. 39), sexual masochism was not.

Features

The prevalence of Sexual Masochism disorder in the population is unknown, but the DSM-5 estimates 2.2% among males and 1.3% among females.[1] Extensive use of pornography depicting humiliation is sometimes associated with Sexual Masochism Disorder.[1]

Behaviors associated with Sexual Masochism Disorder can be acted out alone (e.g., binding, self-sticking pins, self-administration of electric shock, or self-mutilation) or with a partner (e.g., physical restraint, blindfolding, paddling, spanking, whipping, beating, electric shock, cutting, pinning and piercing , and humiliation such as by being urinated or defecated upon, being forced to crawl and bark like a dog, or being subjected to verbal abuse).[6] Behaviors sometimes include being forced to cross-dress or being treated like an infant.[6]

In extreme cases, accidental deaths can occur, such as from engaging in self-application of electric shock.[9] One of the most extreme cases of masochism was Bernd Brandes, who answered a person ad from Armin Meiwes, who was seeking someone who wanted to be slaughtered and eaten.[10]

See also

Sexual sadism disorder

References

  1. ↑ 1.0 1.1 1.2 1.3 American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. ↑ World Health Organization. (2007). International statistical classification of diseases and related health problems (10th rev., version for 2007). Retrieved from http://apps.who.int/classifications/apps/icd/icd10online/index.htm?gf60.htm
  3. ↑ Aggrawal, A. (2009). Forensic and medico-legal aspects of sexual crimes and unusual sexual practices. New York: Taylor & Francis. p. 145.
  4. ↑ American Psychiatric Association. (1980). Diagnostic and Statistical Manual of Mental Disorders (3rd ed.). Washington, DC: Author.
  5. ↑ American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.
  6. ↑ 6.0 6.1 6.2 American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.
  7. ↑ American Psychiatric Association. (1968). Diagnostic and Statistical Manual of Mental Disorders (2nd ed.). Washington, DC: Author.
  8. ↑ American Psychiatric Association. (1952). Diagnostic and Statistical Manual: Mental Disorders. Washington, DC: Author.
  9. ↑ Cairnes, F. J., & Rainer, S. P. (1981). Death from electrocution during auto-erotic procedures. New Zealand Medical Journal, 94, 259-260.
  10. ↑ Cantor, J. M., & Sutton, K. S. (2014). Paraphilia, gender dysphoria, and hypersexuality. In P. H. Blaney & T. Millon (Eds.), Oxford textbook of psychopathology (3rd ed.) (pp. 589–614). New York: Oxford University Press.