Beneath the covers
Lester D. Friedman, Therese Jones in Routledge Handbook of Health and Media, 2022
Sexual deviancy or perversion can be identified as a behavior or desire that departs from conventional standards or is considered abnormal. As suggested by the definition, society establishes models to guide what is or is not acceptable, while the identification of what is or is not deemed “normal” might be best described by medical professionals who are equipped to diagnose and treat abnormal behavior or desire such as Paraphilia Disorder. The most recent Diagnostic and Statistical Manual for Psychiatric Disorders (DSM-5) classifies Paraphilia, previously known as sexual deviation and perversion, under a family of Paraphilic Disorders including Voyeuristic Disorder, Exhibitionistic Disorder, Frotteuristic Disorder, Sexual Masochism Disorder, Sexual Sadism Disorder, Pedophilic Disorder, Fetishistic Disorder, Transvestic Disorder, Unspecified Paraphilic Disorder, and Other Specific Paraphilic Disorder. A paraphilia “denotes any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners” (DSM-5 685). Sometimes the sexual interest focuses on the individual’s erotic activities (spanking, whipping, cutting, binding, or strangulating another person) or on the target of the individual’s sexual interest (children, corpses, or amputees [as a class], as well as intense or preferential interest in nonhuman animals) (685).
The Sexually Addicted Couple
Len Sperry, Katherine Helm, Jon Carlson in The Disordered Couple, 2019
While not true for every person with a sex addiction, the counselor should assess for paraphilic interests and behaviors. Multiple studies have confirmed the presence of paraphilic behavior in sexual addicts (Black et al., 1997; Langstrom & Hanson, 2006; Kafka, 2010). A paraphilia can be defined as non-genital sexual desires and behaviors equal to or exceeding interest in genital-focused sexuality (American Psychological Association, 2013). While Black et al. (1997), found the presence of paraphilic behaviors within their sample, this was true for only 3% of their sample. The behaviors reported within this study included exhibitionism, sadism, transvestic fetishism, fetishism, and telephone sex. Contrary to these findings, Langstrom and Hanson (2006) found a strong correlation between sexually addicted men and exhibitionism, voyeurism, masochism, and sadism.
Psychosexual aspects of men’s
Laura Serrant-Green, John McLuskey, Alan White in The Sexual Health of Men, 2018
In addition the DSM IV scheme also includes the sexual deviations, e.g. paraphilias. Paraphilias are disorders in which an individual experiences recurrent and intense sexual urges and fantasies involving either non-human objects, e.g. fetish, suffering or humiliation of oneself or partner (sadomasochism), or non-consenting partners, e.g. paedophilia, exhibitionism. However, other areas of sexual dysfunctions or sexual distress are not currently addressed by this diagnostic scheme, e.g. possible sexual addiction, hypersexual arousal disorder and sexual orientation issues. What is clear in clinical practice is that these ‘clear-cut’ categories do not truly reflect the complexity of the sexual problems individuals present. It is rarely possible to identify situations with a purely organic or purely psychogenic aetiology. In addition sexual dysfunctions are not all-or-nothing situations, but occur on a continuum in terms of both frequency and severity.
Kink-Oriented People and Exogenous Oppressions: Understanding Mental Health and Related Service Use in a Rural Context
Published in Journal of Homosexuality, 2023
Tamara D. Reynish, Ha Hoang, Heather Bridgman, Bróna Nic Giolla Easpaig
Although kink is becoming more mainstream, the mental health needs of kink-oriented people living in rural areas are insufficiently researched and often missing from traditional mental health training or care provision. Kink-oriented individuals engage in alternate, non-vanilla, non-heteronormative, or non-mononormative sexual interactions as their primary forms of sexual expression. Vanilla is conventional sex that conforms to basic cultural expectations or people who engage in it. Kink can be synonymous with bondage, discipline, domination, submission, sadism, and masochism (BDSM) and can include an array of activities including power or pain exchange, role play, polyamory, or fetishism (Damm, Dentato, & Busch, 2018; Pitagora, 2016). Consensual non-monogamy is associated with kink, but is not an inherent feature of kink (Pitagora, 2016). Researchers have increasingly focused on the nature and prevalence of kink (Damm et al., 2018; Gemberling, Cramer, Wright, & Nobles, 2015; Graham, Butler, McGraw, Cannes, & Smith, 2016; Hughes & Hammack, 2019; Richters, de Visser, Rissel, Grulich, & Smith, 2008; Waldura, Arora, Randall, Farala, & Sprott, 2016). With almost half of their participants interested in kink and roughly one-third having experience with kink, Joyal and Carpentier (2017) concluded that kink was more normophilic than paraphilic in their sample (N = 1,040), or less anomalous and more mainstream than previously thought. Speciale and Khambatta (2020) found that kink had therapeutic benefit and yet all of their participants experienced a lack of affirmative care.
Curative kink: survivors of early abuse transform trauma through BDSM
Published in Sexual and Relationship Therapy, 2023
Cory J. Cascalheira, Ellen E. Ijebor, Yelena Salkowitz, Tracie L. Hitter, Allison Boyce
Kink-aware therapy in conjunction with client-initiated BDSM and kink as a means to process past trauma may facilitate positive outcomes. Kink-aware is a term used to describe therapists who are familiar with and leverage BDSM, fetishism, and paraphilias in their work with kink-identified clients (Shahbaz & Chirinos, 2016). Ortmann and Sprott (2013) present a case study of a heterosexual couple who used skin-breaking spanking to help the male partner, Darren, process traumatic memories of his mother humiliating and beating him throughout adolescence. “The goal was catharsis,” the couple told their therapist, “and a reclamation of power by [Darren’s] consenting to the same physical […] pain from his youth—only this time as an adult […] on his terms” (p. 61). While the kink scene and requisite aftercare were perceived as curative, Darren’s presenting problems were not completely resolved (Ortmann & Sprott, 2013). That is, he needed the support of a kink-aware therapist to achieve clinically significant therapeutic change, suggesting that mental health practitioners who create space in session to process kink in relation to early abuse not only prevent stigma-based harm, but may improve clinical outcomes.
Queer & kinky: what do queer BDSM practitioners need from psychosexual therapy to ensure their experience is relevant and inclusive?
Published in Sexual and Relationship Therapy, 2023
Jody M. Sill
The 3rd edition of the DSM (APA, 1987) introduced fetishism, sadism and masochism as paraphilic disorders and this categorisation heavily influenced the ways that therapists perceived and approached non-normative sexual thoughts and behaviours with clients. Despite a change in nomenclature in the most recent 5th edition of the DSM (APA, 2013) which means that kink behaviours are no longer considered to be a disorder on the condition that they cause no distress to the client, kink behaviours are still categorised as paraphilic. Moser and Kleinplatz (2006) highlight in their research how the pairing of unusual sexual interests with psychiatry is often used as a justification to oppress people belonging to sexual minority communities. Despite their article being published prior to the most recent edition of the DSM, their investigation into the labelling of non-normative sexual behaviours and interests as “paraphilic” is important in highlighting why pathologising BDSM practitioners is problematic. For example, their findings show how both BDSM and paedophilia fall under the same categorisation as “paraphillic,” implying the same level of criminality. Despite the DSM being of American origin, the editions highlighted within this context are key pieces of literature which have influenced the ways in which queer people, as well as people who practice BDSM, have been pathologised through social and therapeutic lenses in the UK.
Related Knowledge Centers
- Pedophilia
- Psychoanalysis
- Sexual Fetishism
- Sexual Arousal
- Sexology
- Love
- Perversion
- Object Sexuality
- Bdsm
- Rape