What is sexual masochism? How can erotic desires or behaviors affect someone’s life?

• Individuals with sexual masochism are sexually aroused when they are beaten, bound, or otherwise made to suffer—and they suffer significantly in important areas of life because of these sexual desires/behaviors.
• Those who experience these sexual desires and exhibit these behaviors, but do not suffer as a result, are described simply as having masochistic sexual interests.
• While there isn’t a clear cause for the development of this disorder, the suppression of sexual desires may play a role.
• Fortunately, there is treatment for those with sexual masochism: both psychotherapy and medication prove effective.
• Fifty Shades of Grey features sexual masochism, as the main character Ana experiences distress in her personal relationships as a result of her sexual desires/behaviors.

Everyone has their sexual preferences or fetishes—for some, that involves extremely erotic practices like being tied up, handcuffed, or otherwise made to suffer. That said, there’s a fine line between having a sexual fetish and struggling with sexual fantasies and behaviors that cripple your life. When it reaches this point, you might be dealing with sexual masochism disorder.

Those with sexual masochism disorder experience sexual arousal from the act of being beaten, humiliated, bound, or made to suffer in another manner. These individuals experience great difficulties in their life because of these sexual preferences. If, however, they do not experience distress—which may present itself as anxiety, shame, or guilt related to these interests—the individuals may be described as having masochistic sexual interests. But they would not be diagnosed with the disorder.

Diagnostic Criteria for Sexual Masochism

As with any other disorder, one must meet certain criteria to get diagnosed. According to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5), the individual must experience the following to be diagnosed with sexual masochism:

• Over a period of 6 months or longer, the individual experiences intense sexual arousal when made to suffer (as mentioned earlier, this might involve being humiliated, beaten or bound), as manifested by fantasies and behaviors.
• The fantasies and actions cause significant distress or impairment in important areas of life, like at work or in one’s relationships.

If the individual meets the criteria for sexual masochism, it should also be evaluated and specified if the disorder…

• Involves asphyxiophilia, which is when the individual restricts his or her breathing in order to achieve desired arousal.
• Is in a controlled environment, meaning the individual is living in a setting that specifically restricts opportunities to engage in masochistic sexual behaviors.
• Is in full remission, whereas he or she has not experienced distress or impairment in important areas of life for at least 5 years while in an uncontrolled environment.

Who Experiences Sexual Masochism? Why?

Based on individual reports, the mean age of onset for this disorder is 19 years. That said, earlier ages have also been reported for the onset of these specific sexual interests. Factors like sexual impulsivity and hypersexuality change over time and with age, and can play a significant role in the development of this disorder. Additionally, suppressing sexual fantasies just might lead to the development of paraphilias like sexual masochism.

Is There Treatment for Sexual Masochism?

Fortunately, there are multiple treatment options for sexual masochism. If you are experiencing symptoms and you need help managing these symptoms or overcoming this disorder, the following have proven effective for individuals just like you:

1. Psychotherapy

The purpose and goal of therapy is to uncover and work through underlying causes of unwanted, distressful behaviors. More specifically, cognitive behavioral therapy (CBT) is especially effective in restructuring your thoughts and beliefs that may lead you to engage in harmful behavior. It may also help you learn new skills that will prove important to resisting sexual urges.

2. Medication

Certain medications may be used to decrease testosterone levels and, in turn, reduce the occurrence of erections. Additionally, antidepressant medications may be prescribed to reduce overall sex drive.

Fifty Shades of Grey: Is Sexual Masochism Present?

Fifty Shades of Grey is a popular erotic romance novel written by E.L. James, which was recently adapted for the big screen. It is the first installment of its trilogy, which follows the development of what some would call a strange, yet loving relationship between a recent college grad, Ana Steele, and a young, rich businessman, Christian Grey.

The book gained significant attention and traction for its explicit sex scenes—of which featured bondage and other erotic practices—as well as its plotline surrounding sexual dominance and submission. It sure sounds like masochistic sexual interests are involved, huh? But does that mean the characters are suffering from sexual masochism? Christian clearly is very fond of Ana and begins to develop deep feelings for her; however, his sexual preferences scare her and ultimate drive a wedge between the two. Eventually, she gives in to his pleas and her curiosity and finds that she enjoys engaging in the submission, but it’s something she must keep from her loved ones, which proves to damage her relationships—fulfilling the two criteria for sexual masochism.

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