Sexual Sadism

Sexual sadism is characterized by an intense sexual arousal that is derived from delivering physical and psychological pain, suffering and humiliation to another person during sex. These acts are not just imagined or fantasized, but carried out in reality with another person as the victim. Victims can be consenting, as is the case in a sadomasochistic relationship, but may also be non-consenting and unsuspecting individuals. Acts of sadism may include choking, beating, rape, murder, mutilation, cutting, burning or psychological torture. People who suffer from this condition hold a strong desire to dominate and when coupled with other mental disorders, such as antisocial personality disorder, sadism can lead to extreme violence or death of one or more victims.

Symptoms of Sexual Sadism

Sexual sadism with consenting partners, which may be reflected in a sadomasochistic relationship, is not necessarily uncommon and doesn't always indicate mental disorder. However, if thoughts or acts of sadism begin to interfere with family, work or social activities, or occur with non-consenting individuals, this disorder may require treatment. Following is a brief list of symptoms that may point to sexual sadism as a mental disorder:

  • Sexual excitement derived from administering physical pain or psychological humiliation and embarrassment to another person, whether in a consenting relationship or to an unsuspecting or unfamiliar victim
  • Disruption of social, work, family or other contexts due to fixation on fantasies of sexual sadism

Causes of Sexual Sadism

Research has not discovered an exact cause for sexual sadism, but theories may reveal any of several possibilities. Studies have shown that brain injuries or other mental illnesses, such as schizophrenia or social disorders may be present alongside this condition. Other theories to consider in the case of sexual sadism are as follows:

  • Escape – the feeling of power can be gained from an act of sexual sadism. People who feel powerless during everyday life may seek pleasure in the domination of a partner during sex. 
  • Suppression of sexual fantasy – when sexual fantasies which are inappropriate by the standards of family members or society are initially suppressed, an individual may be required to experiences these fantasies secretly. Once the individual is able to carry out the fantasy, he or she is in a state of considerable confusion and distress, leading to an association between pain and sex. If the desire to dominate accompanies this confusion, sexual sadism may result.
  • Perpetuation of sexual fantasy – study of sexual offenders leads to a theory that people who suffer sexual sadism begin by displaying milder symptoms of the illness, such as sketching ropes or chains on pictures of models or displaying pornographic materials involving sadistic acts. This progression typically leads to more involved behavior and symptoms indicating the disorder.

Diagnosis of Sexual Sadism

Most people who suffer from sexual sadism do not willingly seek treatment. Most often, diagnosis is made after a violent crime has been committed and the patient is required by law to seek professional help. In order to be diagnosed with sexual sadism, a psychologist or psychiatrist will perform an evaluation containing questions developed to measure the presence of distorted thoughts regarding rape and other impulsive or aggressive activity. The condition must be present for at least 6 months and the behavior either must have resulted in an act with a non-consenting person or fantasies and urges must be interfering with normal activities to the point of dysfunction.

Treatment for Sexual Sadism

Treatment options for sexual sadism may vary according to the individual situation. Medication that balances brain chemicals, reduces impulsive behavior or suppresses sexual tendencies may be considered. There are also many options for therapy, which could be of significant benefit. Cognitive-behavioral therapy can lead the patient to an awareness of arousal patterns and provide exercises to learn new and more productive behavioral and sexual responses. Cognitive restructuring may also help to clear up distortions in thought processing.