BDSM is an umbrella term for a wide range of sexual practices that involve physical bondage, the giving or receiving of pain, dominant or submissive roleplay, and/or other related activities. The acronym is a combination of Bondage/Discipline, Dominance/Submission, and Sadism/Masochism. Though BDSM has long been socially stigmatized or thought to be a sign of mental illness, recent research suggests that it has no clear connection to psychiatric disorders and can in fact be a part of healthy, loving relationships.
Depictions of BDSM-type sexual acts—involving dominance, bondage, or the use of pain—have been found in art and literature from around the world dating back hundreds of years. But until the latter part of the 20th century, many people, particularly in the Western world, believed that an interest in BDSM reflected mental illness, sexual deviance, or a history of abuse or sexual trauma. More recent research, however, has suggested that people who engage in BDSM (also sometimes referred to as kink) are no more likely to be mentally unwell than the rest of the population.
Despite decreasing stereotypes, however, many people—including some mental health professionals—still hold negative views about BDSM practices and the people who willingly engage in them. But the rise of the Internet—as well as the explosion of BDSM-related media, including the Fifty Shades books and films—has brought BDSM into the public consciousness, rendered it more socially acceptable, and allowed those interested in it to connect with one another more easily and engage more openly.
Sex that incorporates elements of BDSM is more common than many think. One study, for example, found that 30 percent of people had tried spanking during sex and nearly a quarter had tried dominant/submissive roleplay. Another study found that 47 percent of adults reported experimenting with at least one aspect of BDSM.
While some aspects of kink do come with a risk of bodily harm—and in rare cases, people do become seriously injured—BDSM is not inherently dangerous. The majority of dedicated BDSM practitioners pride themselves on practicing “safe, sane, and consensual” sex—where even if pain is inflicted, caution is exercised so that there is no lasting damage.
Interest in BDSM is not concentrated among a single demographic, but a small body of evidence suggests that those who enjoy BDSM may share some key personality traits. One study, for instance, found that people who enjoyed BDSM were less neurotic, more extraverted, more open, and less sensitive to rejection than those who didn’t.
Not necessarily; some recent studies have found that BDSM practitioners have, on average, lower levels of PTSD than the general population. On the other hand, there are some people who report practicing BDSM as a way of working through their past trauma.
It’s hard to know for sure. Some studies have indicated slightly more men than women report engaging in BDSM, but some researchers caution that social stigma may lead to survey respondents not being entirely truthful.
To many, the idea of voluntarily being hurt, tied up, or called names during sex is unimaginable; as a result, many have long assumed that those who do desire such practices must have something wrong with them. This may be further compounded in cultures in which speaking openly about sex is frowned upon or that mandate a more traditional view of sexuality.
But recent psychological research has tended to conclude that there is nothing inherently mentally unhealthy about mutually consensual BDSM activities. A national survey of Australian adults, for instance, found that those who participated in BDSM were no more likely than others to have experienced sexual abuse or to be unhappy or anxious; a Dutch study found that BDSM practitioners showed greater subjective well-being than a control group.
No. Early psychologists viewed BDSM-related interests as pathological—leading many in the kink community to feel intense shame about their desires. Today, however, many researchers and clinicians acknowledge that BDSM can be part of healthy sexual expression. However, if the interests and behaviors involve non-consenting parties or cause the individual distress, they may indicate a mental health disorder.
While the direction of cause-and-effect is not fully understood, some studies suggest that BDSM is associated with improved mental health for partnered people. Research has found, for instance, that those who engage in BDSM in romantic relationships—and particularly those who take the dominant role—have lower neuroticism, decreased rejection sensitivity, and greater sexual satisfaction than controls.
Paraphilias are sexual interests that are “atypical”; by this definition, certain aspects of BDSM (such as extreme sadism or masochism) could be considered paraphilias. However, the DSM currently defines paraphilic disorders as sexual practices that are “atypical” and cause the individual distress or involve non-consenting others. Thus, BDSM alone is not considered a paraphilic disorder.
Qualified therapists should never be openly judgmental of his or her patients, even if they engage in practices the therapist personally does not understand. Therapy patients who feel as if their therapist is shaming them for consensual, non-dangerous sexual practices—BDSM or otherwise—should feel empowered to end therapy and find a new clinician.
Many therapists who identify as “kink-friendly” or “sex-positive” include that information on their website. Individuals can also search for kink-friendly therapists using the Psychology Today Therapy Directory, which allows them to filter by specialty. Patients are also free to ask their therapist directly if they are kink-friendly, if they are comfortable doing so.
Many who engage in BDSM within the context of romantic relationships report that it brings them closer to their partner(s). Part of that benefit, many report, are increased feelings of trust that result from setting and respecting boundaries, as well as the emotional safety that comes from being able to explore less conventional sexual interests without judgment.
Whether in a long-term relationship or a short-term fling, for the vast majority of those who self-identify as BDSM practitioners, consent from all parties is paramount to the practice. So, too, are open dialogue and clear rules about what is acceptable and what is not. As a result, some people find that relationships that incorporate BDSM have better sexual communication than those that didn’t.
Trust is crucial to BDSM. To build trust, partners should communicate clearly about desires and limits, and decide on a “safeword” or signal to stop. Afterwards, partners should discuss what worked and what didn’t. BDSM aficionados encourage “aftercare”—affectionate, care-taking behavior after sex—which can help both parties decompress and enhance intimacy.
Not at all. Though BDSM typically involves aspects of pain, humiliation, physical restraint, and/or an apparent lack of control, it is not synonymous with abusive relationships or sexual practices. Many people in long-term, loving relationships practice BDSM. In some cases, however, relationships that engage in BDSM can also be abusive.
BDSM practices require ongoing, enthusiastic consent from all parties. Abusive relationships involve physical, emotional, or sexual harm that is non-consensual and do not involve communication or boundaries. Individuals in BDSM relationships who fear their partner, do not trust that their boundaries will be respected, and feel unable to communicate their concerns should seek help immediately.
Ultimately, no one is obligated to engage in sexual behavior they’re uncomfortable with. However, if the couple think compromise is possible, it’s best to start small. In some cases, the reluctant partner is uneasy with extreme aspects of BDSM that are depicted in media. Baby steps—using a blindfold, for instance—may help them determine if they’re interested in trying more.