Sexual Masochism Disorder
Sexual masochism is a disorder in which an individual becomes sexually aroused from fantasies, desires, or behaviors related to being degraded, humiliated, or engaging in sexual acts that result in pain.
Overview of SMD:
Sexual Masochism Disorder is a type of paraphilic disorder. Paraphilia is a strong sexual interest in abnormal activities that cause stress, harm, or problems. People with masochistic interests may fantasize or engage in sexual activities that involve humiliation, being tied up, beaten, or suffering. Experiencing pain during sexual play doesn’t mean someone has a Sexual Masochism Disorder, but it’s important to ensure safety measures are taken.
Sexual masochism is part of BDSM, where one partner has all the power and control, and the other partner is submissive and enjoys being hurt or humiliated. BDSM urges are a normal part of sexual arousal.
Asphyxiophilia:
Assessing sexually masochistic interests includes checking if someone gets sexually excited by asphyxiophilia, which is restricting breathing. This is very dangerous and can cause serious harm or death. Protecting the trachea is crucial, and pressure should never be applied to the front of the throat.
Symptoms of Sexual Masochism Disorder:
To be diagnosed with Sexual Masochism Disorder, a person must:
- Feel intense sexual arousal from being beaten, humiliated, tied up, or made to suffer in other ways.
- Have these feelings, fantasies, or behaviors for at least six months.
- Experience significant distress or problems in their daily life because of these feelings.
It’s common for people with this disorder to also be interested in pornography with themes of humiliation, suffering, or being hurt.
Causes & Triggers of (SMD):
Experts believe frequent porn use might be related, but the exact cause is unknown.
- SMD typically starts in young adulthood (around age 19).
- Some people may have had masochistic thoughts since childhood or after puberty.
- Like other similar disorders, SMD may become less prominent as individuals age.
Prevalence:
- There is no link between experiencing childhood sexual abuse and having SMD.
- Studies show more men than women are aroused by masochistic fantasies.
How Is Sexual Masochism Disorder Diagnosed?
Sexual Masochism Disorder is usually diagnosed through self-report of disturbing masochistic fantasies, urges, or behaviors. Diagnosis is based on specific criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):
- The individual has been recurrently and extremely aroused by being disgraced, beaten, bound, or being abused in any other way, arousal is expressed as intense urges, fantasies, or behaviors.
- Their fantasies, intense urges, or behaviors cause noteworthy stress or disturb their functioning at work, in social situations, or in other important areas.
- The condition has been present for at least 6 months.
Treatment of Sexual Masochism Disorder:
Psychotherapy helps people who feel bad about their masochistic desires. It’s best to see a therapist who knows about sexual paraphilias. They can help you understand why you feel this way and how to deal with it.
Medication:
Although there is no medication therapy for this disorder, many times the disorder coincides with other psychological problems, for example, depression. In these cases, medication might be helpful.
Antidepressants:
Fluoxetine (Prozac), a type of SSRI, can help with mood disorders like anxiety or depression. It can also reduce sex drive, which may help with impulsive behaviors and thoughts related to masochism. However, it won’t directly address masochistic urges.
Antiandrogens:
Cyproterone acetate and Medroxyprogesterone acetate are medications that lower testosterone levels, reducing sex drive and improving therapy. They lower testosterone in the blood and may reduce compulsive or impulsive sexual behavior.