Sexual masochism is described as the feeling of intense sexual arousal that results from physical or psychological pain, suffering and humiliation. These acts are not only imagined, but played out either alone or with a partner. A person with this diagnosis may be referred to as a masochist, and may prefer to engage in sexual activities that include the deprivation of oxygen, whipping, beating, rape, mutilation, cutting, burning or psychological humiliation or degradation. People who suffer from this condition generally prefer submission, whether psychological or sexual, and can engage in behaviors that range from mild to extremely dangerous.
Symptoms of Sexual Masochism
Due to the prevalence of mild behaviors included in the span of sexual masochism, this type of behavior can and does occur outside of mental disorder. Especially when involving consenting partners inside a relationship, sexual masochism may not lead to debilitating side-effects that interfere with daily life. However, when the patient becomes the victim of, or even begins to prefer physically dangerous masochistic acts, or is subject to extreme psychological humiliation, a mental disorder may develop. Following are the main symptoms that could indicate sexual masochism as a mental disorder:
- Sexual excitement derived from receiving physical pain or psychological torment at the hands of another person or by oneself
- Disruption of social, occupational or other contexts due to fixation on sexual masochism
- Interference with daily, normal routine due to physical injury or psychological torment
Causes of Sexual Masochism
There is no concrete evidence or universally accepted theory as to the exact cause of sexual masochism. Several theories have been presented and there may be some conflict among professionals as to which one or more is most accurate. As with all mental disorders, brain chemical imbalance and psychological upbringing may play a role. Some other theories to consider are the following:
- Escape – often sexual masochism includes role-playing and fantasy games during sex. Many people may wish to engage in behavior or alternative realities that provide them with something they feel like they do not possess under normal circumstances.
- Domination – if a patient is conflicted about domination vs. submission and cannot reach a healthy balance between the two, he or she may often be subject to and learn to prefer the pain and insult of sexual masochism.
- Suppression of sexual fantasy – if inappropriate sexual fantasies are originally suppressed, either by friends, family members or society, an individual may continue to have the fantasies in secret. The recurring fantasy becomes more and more distraught with confusion and arousal and when finally carried out, is accompanied by this mixture of pain and pleasure. The theory continues that masochistic behavior then becomes associated with sex.
Diagnosis of Sexual Masochism
In order to be diagnosed with sexual masochism, not only must the behavior be present for at least 6 months, but it must also be interfering with a person's social, work or family lifestyle. Significant stress due to the physical or emotional pain endured in sex can indicate this condition as a mental disorder. Sexual masochism must be differentiated from self-mutilation that is performed for reasons other than sexual, and if the desire for or act of domination and to be the person performing the painful acts is present, such as with sexual sadism, sexual masochism may not be the preferred diagnosis. People with this disorder may be subject to additional diagnoses as well.
Treatment for Sexual Masochism
Treatment options for sexual masochism vary depending upon the individual and situation. Medication may be used to reduce fantasy and sexual impulse in those who prefer severely dangerous physical and mental masochism. Aside from this, therapy is usually the treatment of choice. Cognitive-behavioral therapy can help the patient to become aware of arousal patterns and help to restructure thoughts, feelings and behaviors associated with these patterns, therefore preventing symptoms and initiating new and healthier sexual options.